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Antibiotics guidelines

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https://www.readbyqxmd.com/read/29784837/the-inoculum-effect-in-the-era-of-multidrug-resistance-minor-differences-in-inoculum-have-dramatic-effect-on-minimal-inhibitory-concentration-determination
#1
Kenneth P Smith, James E Kirby
The observed MIC may depend on the number of bacteria initially inoculated into the assay. This phenomenon is termed the inoculum effect (IE) and is often most pronounced for β-lactams in strains expressing β-lactamase enzymes. The Clinical and Laboratory Standards Institute (CLSI) recommended inoculum is 5 x 105 CFU mL-1 with an acceptable range of 2-8 x 105 CFU mL-1 IE testing is typically performed using an inoculum 100-fold greater than the CLSI recommended inoculum. Therefore, it remains unknown whether the IE influences MICs during testing performed according to CLSI guidelines...
May 21, 2018: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/29784453/executive-summary-of-outpatient-parenteral-antimicrobial-therapy-guidelines-of-the-spanish-society-of-clinical-microbiology-and-infectious-diseases-and-the-spanish-domiciliary-hospitalisation-society
#2
Luis Eduardo López Cortés, Abel Mujal Martínez, Magdalena Fernández Martínez de Mandojana, Natalia Martín, Mercè Gil Bermejo, Joan Solà Aznar, Eulalia Villegas Bruguera, Maria José Peláez Cantero, Pilar Retamar Gentil, Miriam Delgado Vicente, Víctor José González-Ramallo, Miguel Ángel Ponce González, Manuel Mirón Rubio, M Montserrat Gómez Rodríguez de Mendarozqueta, Miguel Ángel Goenaga Sánchez, Pedro Sanroma Mendizábal, Elena Delgado Mejía, Marcos Pajarón Guerrero
Outpatient parenteral antimicrobial therapy (OPAT) programmes make it possible to start or complete intravenous antimicrobial therapy for practically any type of infection at home, provided that patient selection is appropriate for the type of OPAT programme available. Although the clinical management of infections in the home setting is comparable in many respects to that offered in conventional hospitalization (selection of antibiotics, duration of treatment, etc.), there are many aspects that are specific to this care modality...
May 18, 2018: Enfermedades Infecciosas y Microbiología Clínica
https://www.readbyqxmd.com/read/29782414/osteomyelitis-a-context-for-wound-management
#3
Mary E Groll, Timothy Woods, Richard Salcido
GENERAL PURPOSE: To provide an overview of osteomyelitis. TARGET AUDIENCE: This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. LEARNING OBJECTIVES/OUTCOMES: After completing this continuing education activity, you should be able to:1. Distinguish the pathogenesis of osteomyelitis in children and adults.2. Identify practical considerations for diagnosis and evidence-based treatment of osteomyelitis...
June 2018: Advances in Skin & Wound Care
https://www.readbyqxmd.com/read/29782295/diagnostic-and-treatment-strategies-of-dermatologists-for-treating-morphea-in-hungary
#4
Gábor Bali, Bernadett Hidvégi
Localized scleroderma is an uncommon disease, only infrequently encountered by dermatologists in private practices or even in larger academic centers. Because of its rarity, current treatment guidelines are mostly based on low-level clinical evidence and expert opinions. The aim of this study was to evaluate treatment strategies to treat localized scleroderma. A questionnaire was developed and sent to dermatologists in Hungary. 101 returned questionnaires were eligible for evaluation. 87.12% of clinicians employed local steroids...
April 2018: Acta Dermatovenerologica Croatica: ADC
https://www.readbyqxmd.com/read/29781385/procalcitonin-guided-use-of-antibiotics-for-lower-respiratory-tract-infection
#5
David T Huang, Donald M Yealy, Michael R Filbin, Aaron M Brown, Chung-Chou H Chang, Yohei Doi, Michael W Donnino, Jonathan Fine, Michael J Fine, Michelle A Fischer, John M Holst, Peter C Hou, John A Kellum, Feras Khan, Michael C Kurz, Shahram Lotfipour, Frank LoVecchio, Octavia M Peck-Palmer, Francis Pike, Heather Prunty, Robert L Sherwin, Lauren Southerland, Thomas Terndrup, Lisa A Weissfeld, Jonathan Yabes, Derek C Angus
Background The effect of procalcitonin-guided use of antibiotics on treatment for suspected lower respiratory tract infection is unclear. Methods In 14 U.S. hospitals with high adherence to quality measures for the treatment of pneumonia, we provided guidance for clinicians about national clinical practice recommendations for the treatment of lower respiratory tract infections and the interpretation of procalcitonin assays. We then randomly assigned patients who presented to the emergency department with a suspected lower respiratory tract infection and for whom the treating physician was uncertain whether antibiotic therapy was indicated to one of two groups: the procalcitonin group, in which the treating clinicians were provided with real-time initial (and serial, if the patient was hospitalized) procalcitonin assay results and an antibiotic use guideline with graded recommendations based on four tiers of procalcitonin levels, or the usual-care group...
May 20, 2018: New England Journal of Medicine
https://www.readbyqxmd.com/read/29780851/top-questions-in-uncomplicated-non-staphylococcus-aureus-bacteremia
#6
Jesse D Sutton, Sena Sayood, Emily S Spivak
The Infectious Diseases Society of America infection-specific guidelines provide limited guidance on the management of focal infections complicated by secondary bacteremias. We address the following 3 commonly encountered questions and management considerations regarding uncomplicated bacteremia not due to Staphylococcus aureus : the role and choice of oral antibiotics focusing on oral beta-lactams, the shortest effective duration of therapy, and the role of repeat blood cultures.
May 2018: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/29778036/polymeric-nanoparticles-as-a-platform-for-permeability-enhancement-of-class-iii-drug-amikacin
#7
Saman Fatima, Zeenat Iqbal, A K Panda, M Samim, Sushama Talegaonkar, Farhan Jalees Ahmad
Amikacin (A), a water soluble aminoglycoside antibiotic is commercially available for intravenous administration only. Present investigation is aimed at the development of poly-lactic-co-glycolic acid (PLGA) nanoparticles (A-NPs).1 for oral permeability enhancement of amikacin. The pharmaceutical attributes of the A-NPs revealed particle size, 260.3 ± 2.05 nm, zeta potential, -12.9 ± 1.12 mV and drug content, 40.10 ± 1.87 μg/mg with spherical shape and smooth surface. In vitro antibacterial studies showed that the A-NPs were active against P...
May 16, 2018: Colloids and Surfaces. B, Biointerfaces
https://www.readbyqxmd.com/read/29776758/using-preference-learning-for-detecting-inconsistencies-in-clinical-practice-guidelines-methods-and-application-to-antibiotherapy
#8
Rosy Tsopra, Jean-Baptiste Lamy, Karima Sedki
Clinical practice guidelines provide evidence-based recommendations. However, many problems are reported, such as contradictions and inconsistencies. For example, guidelines recommend sulfamethoxazole/trimethoprim in child sinusitis, but they also state that there is a high bacteria resistance in this context. In this paper, we propose a method for the semi-automatic detection of inconsistencies in guidelines using preference learning, and we apply this method to antibiotherapy in primary care. The preference model was learned from the recommendations and from a knowledge base describing the domain...
May 15, 2018: Artificial Intelligence in Medicine
https://www.readbyqxmd.com/read/29771360/patient-and-treatment-characteristics-by-infecting-organism-in-cerebrospinal-fluid-shunt-infection
#9
Tamara D Simon, Matthew P Kronman, Kathryn B Whitlock, Samuel R Browd, Richard Holubkov, John R W Kestle, Abhaya V Kulkarni, Marcie Langley, David D Limbrick, Thomas G Luerssen, Jerry Oakes, Jay Riva-Cambrin, Curtis Rozzelle, Chevis N Shannon, Mandeep Tamber, John C Wellons Iii, William E Whitehead, Nicole Mayer-Hamblett
Background: Previous studies of cerebrospinal fluid (CSF) shunt infection treatment have been limited in size and unable to compare patient and treatment characteristics by infecting organism. Our objective was to describe variation in patient and treatment characteristics for children with first CSF shunt infection, stratified by infecting organism subgroups outlined in the 2017 Infectious Disease Society of America's (IDSA) guidelines. Methods: We studied a prospective cohort of children <18 years of age undergoing treatment for first CSF shunt infection at one of 7 Hydrocephalus Clinical Research Network hospitals from April 2008 to December 2012...
May 15, 2018: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/29771104/-appropriateness-of-antimicrobial-prescriptions-in-the-emergency-department-of-a-tertiary-hospital
#10
L Yunquera-Romero, I Márquez-Gómez, A Henares-López, M J Morales-Lara, C Gallego Fernández, R Asensi-Díez
OBJECTIVE: Antibiotics are widely prescribed in the Emergency Department (ED), representing 26-62% of outpatient antibiotic prescriptions. Around 40% of antibiotic prescriptions in hospitalized patients are inappropriate or unnecessary. The aim of the study was to assess the appropriateness of antibiotic prescriptions according to local empirical antibiotic treatment guidelines, in the ED of a tertiary hospital. METHODS: Observational, retrospective study including patients attending the ED in November 2016, with an antibiotic prescription, excluding those from residents...
May 16, 2018: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
https://www.readbyqxmd.com/read/29769028/-careful-goodbye-at-the-door-is-there-role-for-antimicrobial-stewardship-interventions-for-antimicrobial-therapy-prescribed-on-hospital-discharge
#11
R Chavada, J Davey, L O'Connor, D Tong
BACKGROUND: Antimicrobial stewardship (AMS) interventions largely target inpatient antimicrobial prescribing. Literature on appropriateness of antimicrobials prescribed at the interface between hospital and the community is minimal. This study was designed to assess the appropriateness of antimicrobials prescribed on hospital discharge and evaluate the impact of AMS interventions. METHODS: Patients with discharge medications processed by the pharmacy were identified using a computerized pharmacy medication tracker over a four week period...
May 16, 2018: BMC Infectious Diseases
https://www.readbyqxmd.com/read/29769010/evaluation-of-fosfomycin-activity-against-esbl-producing-enterobacteriaceae-isolated-from-iran
#12
Hossein Kazemian
BACKGROUND: Rising rates of antimicrobial resistance among Enterobacteriaceae limit the use of reliably active forms of available drugs. The aim of this study was to investigate the prevalence of fosfomycin (US6794490B2) resistance gene among ESBL producing isolates in Iran. METHOD: We tested 355 isolates of Enterobacteriacea collected from various clinical samples including urine, wounds, blood and other sources during June 2016 to July 2017. Antibiotic sensitivity and extended spectrum beta lactamase (ESBL) production were tested using agar dilution method according to the Clinical and Laboratory Standards Institute (CLSI) guidelines...
May 16, 2018: Recent Patents on Anti-infective Drug Discovery
https://www.readbyqxmd.com/read/29766208/-adequate-anti-infective-treatment-importance-of-individual-dosing-and-application
#13
A Brinkmann, A C Röhr, A Köberer, T Fuchs, W A Krüger, C König, D Richter, M A Weigand, O R Frey
Sepsis-induced changes in pharmacokinetic parameters are a well-known problem in intensive care medicine. Dosing of antibiotics in this setting is therefore challenging. Alterations to the substance-specific kinetics of anti-infective substances have an effect on the distribution and excretion processes in the body. Increased clearance and an increased distribution volume (Vd ) and particularly compromized organ function with reduced antibiotic elimination are often encountered in patients with sepsis. Renal replacement treatment, which is frequently used in intensive care medicine, represents a substantial intervention in this system...
May 15, 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/29761071/long-term-conventionally-dosed-vancomycin-therapy-in-patients-with-orthopaedic-implant-related-infections-seems-as-effective-and-safe-as-long-term-penicillin-or-clindamycin-therapy-a-retrospective-cohort-study-of-103-patients
#14
Jacomien Aleman, Dirk Jan F Moojen, Marc L van Ogtrop, Rudolf W Poolman, Eric J F Franssen
Objectives : Antimicrobial therapy is one of the cornerstones of orthopaedic implant-related infections (OIRI) treatment. Infections with Gram-positive bacteria are often treated with vancomycin, penicillin or clindamycin. A recent IDSA guideline suggests increasing the dose of vancomycin to increase the trough vancomycin target serum concentrations. This is deemed necessary because of an observed decrease in vancomycin susceptibility among Gram-positive bacteria. However, elevated vancomycin concentrations are correlated with the risk of nephrotoxicity, especially with prolonged therapy...
2018: Journal of Bone and Joint Infection
https://www.readbyqxmd.com/read/29757781/misconceptions-surrounding-penicillin-allergy-implications-for-anesthesiologists
#15
Leon Vorobeichik, Elizabeth A Weber, Jordan Tarshis
Administration of preoperative antimicrobial prophylaxis, often with a cephalosporin, is the mainstay of surgical site infection prevention guidelines. Unfortunately, due to prevalent misconceptions, patients labeled as having a penicillin allergy often receive alternate and less-effective antibiotics, placing them at risk of a variety of adverse effects including increased morbidity and higher risk of surgical site infection. The perioperative physician should ascertain the nature of previous reactions to aid in determining the probability of the prevalence of a true allergy...
May 10, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29757408/comparison-of-antibiotic-prescribing-and-antimicrobial-resistance-in-urinary-tract-infections-at-the-municipal-level-among-women-in-two-nordic-regions
#16
Jette Nygaard Jensen, Eva Melander, Katarina Hedin, Lars Bjerrum, Helena Kornfält Isberg, Anne Holm, Helle Neel Jacobsen, Annette Skovby, Gloria Cristina Córdoba Currea, Lena Hyllebusk, Emma Brogaard, Magnus Arpi
Objectives: To describe and compare the prescribing of antibiotics used for urinary tract infections and its correlation with resistance in Escherichia coli in urinary samples across two adjacent regions-the Capital Region and the Skaane Region-and their municipalities in Denmark and Sweden. Methods: The Capital Region consists of 29 municipalities and 725 960 female inhabitants aged ≥18 years and the Skaane Region consists of 33 municipalities and 515 668 female inhabitants aged ≥18 years...
May 10, 2018: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/29757036/determinants-of-antibiotics-prescribing-among-doctors-in-a-nigerian-urban-tertiary-hospital
#17
Olayinka O Ogunleye, Joseph O Fadare, Adesola F Yinka-Ogunleye, Bene D Anand Paramadhas, Brian Godman
BACKGROUND AND OBJECTIVE: The problem of antimicrobial resistance (AMR) has assumed pandemic dimensions especially among low and middle-income countries such as Nigeria. Irrational use of currently available antimicrobial agents is a major contributory factor. There remains a paucity of documented information on the determinants of antibiotics prescribing among physicians in Nigeria to guide future strategies to reduce AMR. This study therefore aimed to investigate the patterns and determinants of antibiotics prescription among doctors in a tertiary hospital in Nigeria as the first step to improve future antibiotic use in hospitals...
May 14, 2018: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/29756174/phenotypic-detection-of-clinical-isolates-of-haemophilus-influenzae-with-altered-penicillin-binding-protein-3
#18
A Aguirre-Quiñonero, I C Pérez Del Molino, C García de la Fuente, M C Sanjuán, J Agüero, L Martínez-Martínez
The aims of this study were to determine the correlation of mutations in the ftsI gene (coding for PBP3) of Haemophilus influenzae with aminopenicillin resistance and to evaluate the 2017 European Committee for Antibiotic Susceptibility Testing (EUCAST) guidelines for clinical categorization of ampicillin, amoxicillin, and amoxicillin-clavulanate for strains with mutated PBP3 conferring resistance (rPBP3). A panel of 91 H. influenzae isolates was genetically characterized by sequencing of the fstI gene. For all the studied isolates, a screening with benzylpenicillin 1U (BP1) was carried out and minimum inhibitory concentrations (MICs) of ampicillin, amoxicillin, and amoxicillin-clavulanate were tested and interpreted according to EUCAST recommendations...
May 13, 2018: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/29755606/chronic-osteomyelitis-bacterial-flora-antibiotic-sensitivity-and-treatment-challenges
#19
Kuzma Jerzy, Hombhanje Francis
Background: Chronic osteomyelitis is a catastrophic sequel of delayed diagnosis of acute osteomyelitis. Objectives: The objectives of the study were to determine bacterial flora and antibiotic sensitivity, and to evaluate the outcome of an aggressive surgical approach to chronic osteomyelitis. Methods: This is a single surgeon, prospective cohort study on 30 consecutive patients with clinically and radiologically diagnosed chronic osteomyelitis presented to a hospital...
2018: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/29754452/part-1-current-prescribing-trends-of-antibiotics-by-dentists-in-australia-from-2013-to-2016
#20
L Teoh, K Stewart, R J Marino, M J McCullough
BACKGROUND: Literature has shown dentists tend to overprescribe antibiotics and do not always prescribe in accordance with recommended guidelines. Unnecessary prescribing is one major factor that contributes to the development of antibiotic resistance. The aim of the present study was to assess the antibacterial prescribing patterns of dentists in Australia from 2013 to 2016. METHODS: Data on dental antibacterial prescriptions dispensed under the Pharmaceutical Benefits Scheme (PBS) from 2013 to 2016 was accessed and prescribing trends analysed...
May 13, 2018: Australian Dental Journal
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