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pneumonia antibiotic adult

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Respiratory tract infections (RTI) are among the most common acute conditions leading to GP consultations and to antibiotic prescribing in primary care, even though 70% are viral, and many others are minor self-limiting bacterial infections.(1-4) Between 0.5% and 1.1% of adults have community-acquired pneumonia every year in the UK, most of whom are managed in primary care.(4,5) The decision to prescribe antibiotics for an acute RTI in primary care is often based on clinical symptoms, which have low sensitivity and specificity, and high inter-observer variability...
October 2016: Drug and Therapeutics Bulletin
J M Prins, T van der Poll
Better use of current antibiotics is warranted to curb increasing antimicrobial resistance rates. Procalcitonin guidance can safely reduce antibiotic usage when used to initiate or discontinue antibiotics in adult patients with a respiratory tract infection. However, the claimed reductions in antibiotic usage are mainly achieved in patients with acute bronchitis and exacerbations of COPD, conditions for which guidelines already discourage antibiotic treatment. Sequential procalcitonin measurements can also reduce the treatment duration of community-acquired pneumonia from 10-12 to 5-7 days, which is, however, already the recommended treatment duration for in- and outpatients under the current Dutch guidelines...
2016: Nederlands Tijdschrift Voor Geneeskunde
A-F Dureau, G Duclos, F Antonini, D Boumaza, N Cassir, J Alingrin, C Vigne, E Hammad, L Zieleskiewicz, M Leone
Ventilator-associated pneumonia (VAP) due to methicillin-resistant Staphylococcus aureus (MRSA) is associated with excess mortality and costs. Molecular biology test allows rapid identification of MRSA in sputum with high negative predictive value. We hypothesized that use of a rapid diagnostic test in patients with suspected VAP was associated with reduced use of antibiotics directed against MRSA. This retrospective, observational study was conducted in a polyvalent intensive care unit (ICU) of a university hospital...
October 7, 2016: European Journal of Clinical Microbiology & Infectious Diseases
Charles Feldman, Ronald Anderson
Pneumococcal infections continue to cause significant morbidity and mortality in patients throughout the world. This microorganism remains the most common bacterial cause of community-acquired pneumonia and is associated with a considerable burden of disease and health-care costs in both developed and developing countries. Emerging antibiotic resistance has been a concern because of its potential negative impact on the outcome of patients who receive standard antibiotic therapy. However, there have been substantial changes in the epidemiology of this pathogen in recent years, not least of which has been due to the use of pneumococcal conjugate vaccines in children, with subsequent herd protection in unvaccinated adults and children...
2016: F1000Research
Whitney R Buckel, Edward Stenehjem, Jeff Sorensen, Nathan Dean, Brandon Webb
RATIONALE: Guidelines recommend a switch from intravenous to oral antibiotics once patients who are hospitalized with pneumonia achieve clinical stability. However, little evidence guides the selection of an oral antibiotic for patients with healthcare-associated pneumonia, especially where no microbiological diagnosis is made. OBJECTIVES: To compare outcomes between patients who were transitioned to broad vs narrow spectrum oral antibiotics after initially receiving broad-spectrum intravenous antibiotic coverage...
October 3, 2016: Annals of the American Thoracic Society
J Rello, E Diaz, R Mañez, J Sole-Violan, J Valles, L Vidaur, R Zaragoza, S Gattarello
A retrospective analysis from prospectively collected data was conducted in intensive care units (ICUs) at 33 hospitals in Europe comparing the trend in ICU survival among adults with severe community-acquired pneumonia (CAP) due to unknown organisms from 2000 to 2015. The secondary objective was to establish whether changes in antibiotic policies were associated with different outcomes. ICU mortality decreased (p = 0.02) from 26.9 % in the first study period (2000-2002) to 15.7 % in the second period (2008-2015)...
September 21, 2016: European Journal of Clinical Microbiology & Infectious Diseases
Jer-Hwa Chang, Wen-Yueh Hung, Kuan-Jen Bai, Shun-Fa Yang, Ming-Hsien Chien
Osteopontin (OPN) is an essential cytokine involved in immune cell recruitment and an important regulator of inflammation. The purpose of this study was to examine differences in OPN plasma levels between before and after antibiotic treatment in hospitalized adult patients with community-acquired pneumonia (CAP). OPN levels were measured in 93 patients with CAP and 54 healthy controls using a commercial enzyme-linked immunosorbent assay (ELISA). The CURB-65, Pneumonia Severity Index (PSI), and Acute Physiology and Chronic Health Evaluation II (APACHE II) scores were used to determine the CAP severity in patients upon initial hospitalization...
2016: International Journal of Medical Sciences
Dwight J Hardy, David Vicino, Prabhavathi Fernandes
There has been an increase in the number of pertussis cases reported since the introduction of the acellular pertussis vaccine. While children that present with pertussis have a characteristic whooping cough, adults can simply have a persistent, non-specific cough and remain undiagnosed. Macrolide antibiotics, such as azithromycin, are the currently recommended treatment for pertussis. Solithromycin is a new macrolide and the first fluoroketolide, with broad activity against a wide spectrum of bacterial pathogens and has completed clinical development for community-acquired bacterial pneumonia (CABP)...
September 12, 2016: Antimicrobial Agents and Chemotherapy
Michael O Iroezindu, Godsent C Isiguzo, Emmanuel I Chima, Godwin C Mbata, Kenneth I Onyedibe, Cajetan C Onyedum, Obiageli J John-Maduagwu, Leo E Okoli, Ekenechukwu E Young
BACKGROUND: We investigated predictors of in-hospital mortality and length of hospital stay among adults with community-acquired pneumonia (CAP) in Nigeria in order to provide recommendations to improve CAP outcomes in developing countries. METHODS: This was a multi-centre case control study of patients ≥18 years who were admitted with CAP between 2008 and 2012. Case notes of 100 consecutive patients who died (cases) and random sample of 300 patients discharged (controls) were selected...
August 2016: Transactions of the Royal Society of Tropical Medicine and Hygiene
Behrooz Heydari, Hossein Khalili, Iman Karimzadeh, Hamid Emadi-Kochak
In this study demographic, clinical, paraclinical, microbiological, and therapeutic features of patients with community-acquired acute bacterial meningitis admitted to a referral center for infectious diseases in Iran, have been evaluated. Medical records of adult (> 18 years) individuals with confirmed diagnosis of community-acquired bacterial meningitis during a 4-year period were retrospectively reviewed. All required data were obtained from patients' medical charts. Available findings about antimicrobial susceptibility of isolated bacteria from CSF and/or blood were also collected...
2016: Iranian Journal of Pharmaceutical Research: IJPR
Stefano Aliberti, Luis F Reyes, Paola Faverio, Giovanni Sotgiu, Simone Dore, Alejandro H Rodriguez, Nilam J Soni, Marcos I Restrepo
BACKGROUND: Antibiotic resistance is a major global health problem and pathogens such as meticillin-resistant Staphylococcus aureus (MRSA) have become of particular concern in the management of lower respiratory tract infections. However, few data are available on the worldwide prevalence and risk factors for MRSA pneumonia. We aimed to determine the point prevalence of MRSA pneumonia and identify specific MRSA risk factors in community-dwelling patients hospitalised with pneumonia. METHODS: We did an international, multicentre study of community-dwelling, adult patients admitted to hospital with pneumonia who had microbiological tests taken within 24 h of presentation...
September 1, 2016: Lancet Infectious Diseases
Stephanie E Giancola, Ai Thi Nguyen, Binh Le, Omar Ahmed, Catherine Higgins, James A Sizemore, Kara W Orwig
This retrospective study aimed to validate the concordance between nasal swab methicillin-resistant Staphylococcus aureus (MRSA) polymerase chain reaction (PCR) test and respiratory culture and to determine the number of potentially preventable days of anti-MRSA therapy in patients with pneumonia. Two hundred adult inpatients in the intensive and intermediate care units were included. The nasal swab MRSA PCR test was positive in 55 (27.5%) patients. MRSA was isolated from respiratory culture in 21 (10.5%) patients...
November 2016: Diagnostic Microbiology and Infectious Disease
Kassu Desta, Yimtubezinash Woldeamanuel, Aklilu Azazh, Halima Mohammod, Dawit Desalegn, Damte Shimelis, Dereje Gulilat, Biruk Lamisso, Eyasu Makonnen, Alemayehu Worku, Kerstin Mannerqvist, Johan Struwe, Olov Aspevall, Eleni Aklillu
We investigated the gastrointestinal colonization rate and antibiotic resistance patterns of Extended-Spectrum Beta-Lactamase (ESBL)- producing Escherichia coli and Klebsiella pneumoniae in hospitalized patients admitted at Ethiopia's largest tertiary hospital. Fecal samples/swabs from 267 patients were cultured on chrome agar. ESBL. Bacterial species identification, verification of ESBL production and antibiotic susceptibility testing were done using Vitek 2 system (bioMérieux, France). Phenotype characterization of ESBL-E...
2016: PloS One
Julio César Cambray-Gutiérrez, Ulises Noel García-Ramírez, Leonel Gerardo Del Rivero-Hernández, Patricia López-Pérez, Aurora Chávez-García
BACKGROUND: Common variable immunodeficiency is the most commonly-diagnosed primary immunodeficiency in adults; it is characterized by recurrent sinopulmonary and gastrointestinal infections, and increased incidence of malignancy and autoimmune processes. Many patients begin to have clinical manifestations during reproductive age. CASE REPORT: A 34-year-old woman with 12 weeks of gestation who was diagnosed with common variable immunodeficiency after recurrent episodes of rhinosinusitis, pharyngoamygdalitis, and pneumonia...
July 2016: Revista Alergia Mexico: Organo Oficial de la Sociedad Mexicana de Alergia e Inmunología, A.C
Miyuki Morozumi, Takeaki Wajima, Misako Takata, Satoshi Iwata, Kimiko Ubukata
Streptococcus agalactiae (group B streptococcus) isolates (n=443) obtained from Japanese adults with invasive infections between April 2010 and March 2013 were analyzed for capsular serotype, multilocus sequence typing, antibiotic susceptibility, and resistance genes. Among these cases, bacteremia without primary focus was the most common variety of infection (49.9%), followed by cellulitis (12.9%) and pneumonia (9.0%). Concerning patient age (18 to 59 years, the 60s, 70s, and 80s, and the 90s or older), the incidence of pneumonia increased in the 70s and 80s (P<0...
August 24, 2016: Journal of Clinical Microbiology
Constantinos Tsioutis, Evangelos I Kritsotakis, Spyridon A Karageorgos, Soultana Stratakou, Charalambos Psarologakis, Sofia Kokkini, Achilleas Gikas
Limited data exist regarding prognostic factors and optimal antimicrobial treatment of infections caused by extensively drug-resistant Acinetobacter baumannii (XDR-AB). This retrospective cohort study included 93 adult patients who developed ventilator-associated pneumonia (VAP) due to XDR-AB in the ICU of the University Hospital of Heraklion, Greece, from October 2012 to April 2015. XDR-AB isolates were mainly susceptible to colistin (93.5%) and tigecycline (25.8%), whereas 6 (6.5%) were pandrug-resistant...
August 12, 2016: International Journal of Antimicrobial Agents
Priya Daniel, Mark Woodhead, Sally Welham, Tricia M Mckeever, Wei Shen Lim
Community-acquired pneumonia (CAP) is a leading cause of death in the UK. In this analysis of 23 315 cases from the British Thoracic Society national CAP audit, an overall reduction in 30-day inpatient mortality over 6 years was observed-2014 compared with 2009 adjusted OR 0.86 (95% CI 0.68 to 1.08, p for trend 0.004). Significant increases in the proportions of patients who had (a) a chest X-ray and (b) the first antibiotic dose within 4 hours of admission were also observed (3.7% and 11.5% increases respectively)...
November 2016: Thorax
L K Wilson, A Phiri, D Soko, M Mbvwinji, A L Walsh, M E Molyneux
This is a report of blood CSF isolates from the adults medical and paediatric of wards QECH, Blantyre, cultured and identified at the Welcome Trust Research Laboratories during 1996-2002. The commonest causes of adults and children bacteraemia were non-typhoidal Salmonella (35% of all blood isolates for adults and children) and Streptococcus pneumoniae (14% and 13% respectively). Cryptococcus neoformans was the commonest isolates from CSF of adults with meningitis(67%) but was very rare in children. S.pneumoniae was the commonest cause of bacterial meningitis in children and adults (38% and 28% of all CSF isolates respectively)...
June 2003: Malawi Medical Journal: the Journal of Medical Association of Malawi
S M Graham
Respiratory disease is the commonest cause of morbidity and mortality in HIV-infected children. While the pattern of HIV-related pneumonia in African adults is well documented and is recognised as quite different from that which occurs among HIV-infected adults in high-income regions, less is known of the situation in children. Most children are infected by mother-to-child transmission and presentation of HIV-related pneumonia is often in infancy or early childhood, an age group in which confirmation of the cause of pneumonia is difficult...
September 2002: Malawi Medical Journal: the Journal of Medical Association of Malawi
Sevinç Baba, Mustafa Derya Aydın
Streptococcus agalactiae (Group B streptococcus, GBS), a member of normal flora of human gastrointestinal and genitourinary systems, is a leading cause of sepsis, meningitis, and pneumonia particularly in newborn. GBS can also cause severe infections in pregnant women and adults with underlying disease, as well as mild diseases, such as urinary tract infections (UTIs). GBS strains exhibit 10 different serotypes, and the identification of serotype distribution is important epidemiologically. The role of biofilm production is one of the virulence factors that has been discussed in the pathogenesis of GBS infections...
July 2016: Mikrobiyoloji Bülteni
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