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Optimal duration of antibiotic

Maki Jitsumura, Andrew Laurence Cunningham, Matthew David Hitchings, Saiful Islam, Angharad P Davies, Paula E Row, Andrew D Riddell, James Kinross, Tom S Wilkinson, G J Jenkins, John G Williams, Dean Anthony Harris
BACKGROUND: The interaction of the gut microbiota with the human host is implicated in the pathogenesis of inflammatory and immunological diseases including ulcerative colitis (UC). Faecal microbiota transplantation (FMT) as a method of restoring gut microbial diversity is of increasing interest as a therapeutic approach in the management of UC. The current literature lacks consensus about the dose of FMT, route of administration and duration of response. METHODS AND ANALYSIS: This single-blinded randomised trial will explore the feasibility of FMT in 30 treatment-naïve patients with histologically confirmed distal UC limited to the recto-sigmoid region (up to 40 cm from the anal verge)...
October 18, 2018: BMJ Open
En-Pei Lee, Meng-Kung Yu, Shu-Chun Lee, Feng-Xia Gao, Han-Ping Wu
The aim of this study was to identify the clinical parameters indicative of serious etiology of neonatal hyperthermia and to determine the appropriate cutoff value of body temperature (BT) for predicting the need to transfer the newborn to the special care (SC) nursery.The nursery records of newborns diagnosed with hyperthermia between 2007 and 2013 were retrospectively reviewed. The clinical characteristics of newborns with hyperthermia remained in the nursery were compared with those transferred to the SC nursery...
October 2018: Medicine (Baltimore)
Muhammad Yasin, Shaista Zafar, Hazir Rahman, Taj Ali Khan, Shabnum Nazir, Salman Shah, Muhammad Dawood, Shahbaz Ahmad, Abdul Basit, Shahid Niaz Khan, Shamim Saleha
OBJECTIVE: Studies on diabetic foot ulcers (DFU) involving a representative sample of patients in Pakistan are scarce. This study aimed to determine baseline characteristics of infected DFUs in patients hospitalised at the Pakistan Institute of Medical Sciences Islamabad. METHOD: In this cross-sectional study, carried out during May 2015 and June 2016, foot ulcer characteristics of patients with DFUs were investigated and documented. From infected DFUs, aerobic bacterial pathogens were isolated, identified and evaluated for antimicrobial susceptibility...
October 1, 2018: Journal of Wound Care
Ernesto Crisafulli, Enric Barbeta, Antonella Ielpo, Antoni Torres
Background: Patients with chronic obstructive pulmonary disease (COPD) may experience an acute worsening of respiratory symptoms that results in additional therapy; this event is defined as a COPD exacerbation (AECOPD). Hospitalization for AECOPD is accompanied by a rapid decline in health status with a high risk of mortality or other negative outcomes such as need for endotracheal intubation or intensive care unit (ICU) admission. Treatments for AECOPD aim to minimize the negative impact of the current exacerbation and to prevent subsequent events, such as relapse or readmission to hospital...
2018: Multidisciplinary Respiratory Medicine
Erica L Ditkoff, Marissa Theofanides, Carrie Mlynarczyk Aisen, Casey G Kowalik, Joshua A Cohn, Wilson Sui, Matthew Rutman, Rony A Adam, Roger R Dmochowski, Kimberly L Cooper
INTRODUCTION: Evidence-based screening and treatment for bacteriuria is crucial to prevent increasing antibiotic resistance. The Infectious Disease Society of America (IDSA) previously released guidelines on the management of asymptomatic bacteriuria (ASB) and uncomplicated urinary tract infections (UTIs) in women. The study's objective was to assess physicians' practices in managing women with bacteriuria relative to these guideline recommendations. MATERIALS AND METHODS: Cross-sectional data from physicians were collected using an anonymous questionnaire...
October 2018: Canadian Journal of Urology
Vanina Meyssonnier, Valérie Zeller, Stéphanie Malbos, Beate Heym, Luc Lhotellier, Nicole Desplaces, Simon Marmor, Jean-Marc Ziza
OBJECTIVE: Tuberculous prosthetic joint infection (PJI) is uncommon and often diagnosed late. The objective here is to describe the management of tuberculous PJI at an osteoarticular infection referral center. METHODS: A single-center retrospective study of patients managed between 1987 and 2016 was performed. RESULTS: We identified 9 patients with a median age of 80 years. The hip was involved in all 9 patients. A known history of tuberculosis was noted in 2 patients and tuberculosis was present at other sites in 4 patients (lung, n = 3; urinary tract and scrotum, n = 1; and spine, n = 1)...
September 26, 2018: Joint, Bone, Spine: Revue du Rhumatisme
Yutaka Ito, Satoru Iwashima, Satoshi Hayano, Tomohiro Nishio, Ryosuke Shiozawa, Soichiro Yata, Toshiko Kubota, Akira Kubota, Keiichi Uemura
BACKGROUND AND OBJECTIVES: Macrolide-resistant Mycoplasma pneumoniae (MR-MP) have been reported worldwide. Strategies for the treatment of MR-MP are a key focus of research. The GENECUBE® is a novel, fully automated rapid genetic analyzer. The goals of this study were to assess the macrolide sensitivity of M. pneumoniae (MP) isolates by analyzing 23S ribosomal RNA (rRNA) gene sequences using a GENECUBE® -based system and to determine the validity of this system in determining clinical treatment options for MP pneumonia...
September 26, 2018: Molecular Diagnosis & Therapy
Arnold Louie, Brandon Duncanson, Jenny Myrick, Michael Maynard, Jocelyn Nole, David Brown, Stephan Schmidt, Michael Neely, C A Scanga, Charles Peloquin, G L Drusano
A major goal for improving tuberculosis therapy is to identify drug regimens with improved efficacy and shorter treatment durations. Shorter therapies improve patient adherence to the antibiotic regimens that, in turn, decreases resistance emergence. M. tuberculosis exists in multiple metabolic states. At the initiation of therapy, the bulk of the population is in Log-Phase growth. Consequently, it is logical to focus initial therapy on these organisms. Moxifloxacin has good early bactericidal activity against Log-Phase growth bacteria and is a logical component of initial therapy...
September 24, 2018: Antimicrobial Agents and Chemotherapy
Lifen Pan, Shufang Tan, Linlan Cao, Xiaoling Feng
Background: To investigate and analyze the risk factors of operating room-related infections after coronary artery bypass grafting (CABG), to propose corresponding infection control management strategies, and to verify and evaluate the effectiveness of the strategy implementation. Methods: Patients with coronary heart disease who underwent CABG in a hospital from January 2015 to December 2016 were selected for inclusion in this study. The following patient variables were documented: demographics, history of underlying diseases (hypertension and diabetes), preoperative American Society of Anesthesiologists (ASA) score, skin preparation method, perioperative use of antibiotics, operation duration, intraoperative hypothermia, intraoperative blood loss, intraoperative blood transfusion, presence of visitors in the operating room, consecutive use of the same operating room, qualification of the surgeon, and surgical site infection...
August 2018: Journal of Thoracic Disease
Roberto W Dal Negro, Luca Bonadiman, Paola Turco
BACKGROUND: Fluticasone furoate/vilanterol (FF/V) is an effective long-acting β2 agonist/inhaled corticosteroid combination for managing persistent bronchial asthma. The aim of the study was to assess the outcomes achievable in patients with mild to moderate asthma receiving FF/V 92/22 µg once daily for 12 months. METHODS: Data were automatically and anonymously obtained from the institutional database: forced expiratory volume in 1 s predicted values; the exacerbation and hospitalization rates; days of hospitalization; general practitioner (GP) or specialist visits; days of inactivity; courses of systemic steroids or antibiotics were recorded at baseline and after 3, 6 and 12 months of treatment...
January 2018: Therapeutic Advances in Respiratory Disease
Rosemary Hill, Monique Y Rennie, Joshua Douglas
The urgent need to eliminate unnecessary use of antibiotics in wound patients has been hampered by diagnostic uncertainty and the time required to obtain culture results. The authors evaluated bedside use of a handheld bacterial fluorescence imaging device for real-time visualization of bacteria within and around wounds, used in addition to monitoring of clinical signs and symptoms of infection, in a series of 7 patients (5 women, 2 men; age range 57-93 years) with varying comorbidities who were referred to the wound ostomy continence clinician for wound assessment...
August 2018: Ostomy/wound Management
Jesús López-Alcalde, Ricardo Rodriguez-Barrientos, Jesús Redondo-Sánchez, Javier Muñoz-Gutiérrez, José María Molero García, Carmen Rodríguez-Fernández, Julio Heras-Mosteiro, Jaime Marin-Cañada, Jose Casanova-Colominas, Amaya Azcoaga-Lorenzo, Virginia Hernandez Santiago, Manuel Gómez-García
BACKGROUND: Community-acquired pneumonia (CAP) is a lung infection that can be acquired during day-to-day activities in the community (not while receiving care in a hospital). Community-acquired pneumonia poses a significant public health burden in terms of mortality, morbidity, and costs. Shorter antibiotic courses for CAP may limit treatment costs and adverse effects, but the optimal duration of antibiotic treatment is uncertain. OBJECTIVES: To evaluate the efficacy and safety of short-course versus longer-course treatment with the same antibiotic at the same daily dosage for CAP in non-hospitalised adolescents and adults (outpatients)...
September 6, 2018: Cochrane Database of Systematic Reviews
Lily Whitehurst, Patrick Jones, Bhaskar K Somani
INTRODUCTION: Current trends show a rising incidence of kidney stone disease (KSD) globally, with a lifetime risk of 10% and increasing hospital admissions. However, it is not perceived as a life-threatening condition and there are no publications examining its mortality rate. The aim of this review was to report on the number of KSD mortalities in the literature from the past two decades, identify risk factors, and to summarize their key learning points. METHODS: A search was conducted for full-text English language articles that reported on KSD associated mortality, following intervention or conservative treatment, published between 1999 and 2017, using PubMed, MEDLINE, EMBASE, Scopus, CINAHL, Clinicaltrials...
August 27, 2018: World Journal of Urology
T Ten Doesschate, C H van Werkhoven, S C Meijvis, J E Stalenhoef, A D van Zuilen, A P J de Vries, M J M Bonten
BACKGROUND: The treatment of urinary tract infections (UTI's) in kidney transplant recipients (KTRs) with oral antibiotics is complicated by increasing resistance to trimethoprim-sulfamethoxazole, amoxicillin/clavulanic acid and ciprofloxacin. Fosfomycin-trometamol (FT) could be an alternative, but evidence on clinical effectiveness is scarce. We evaluated the use, effectiveness and safety of FT for UTI in KTRs. METHODS: Data were retrospectively collected in 2 Dutch transplant hospitals from adult KTRs that were treated with FT as initial treatment for lower-UTI or asymptomatic bacteriuria or as stepdown treatment for upper-UTI after initial intravenous antibiotics...
August 20, 2018: Transplantation
Worku Abebe
The growing global availability of the stimulant shrub, khat, has aroused widespread concern. This paper is a review of possible adverse interactions between khat and conventional drugs. Khat chewing has been shown to reduce the bioavailabilities of orally co-administered antibiotics, ampicillin, amoxicillin, cephradine and tetracyclineHCl, and the antimalarial drug, chloroquine. The cardiovascular and central nervous system (CNS) stimulant effects of monoamine oxidase inhibitors (MAOI) and amphetamine-like drugs have been described to be enhanced by khat chewing...
May 3, 2018: Journal of the National Medical Association
Karim Gariani, Dan Lebowitz, Elodie von Dach, Benjamin Kressmann, Benjamin A Lipsky, Ilker Uçkay
AIM: To determine the most appropriate duration of antibiotic therapy for diabetic foot infections (DFIs). METHODS: Using a clinical pathway for adult patients with DFIs (retrospective cohort analysis), we created a cluster-controlled Cox regression model to assess factors related to remission of infection, emphasizing antibiotic-related variables. We excluded total amputations as a result of DFI and DFI episodes with a follow-up time of <2 months. RESULTS: Among 1018 DFI episodes in 482 patients, we identified 392 episodes of osteomyelitis, 626 soft tissue infections, 246 large abscesses, 322 episodes of cellulitis and 335 episodes of necrosis; 313 cases involved revascularization...
August 21, 2018: Diabetes, Obesity & Metabolism
Cheston B Cunha, Steven M Opal
Empiric therapy of the septic patient in the hospital is challenging. Antibiotic stewardship is concerned with optimizing antibiotic use and minimizing resistance. Clinicians should avoid overcovering and overtreating colonizing organisms in respiratory secretions and urinary catheters. Empiric therapy should take into account the prevalence of multidrug-resistant organisms in the hospital setting. The most effective resistance prevention strategies is to preferentially select a low resistance potential antibiotic, which should be administered in the highest possible dose without toxicity for the shortest duration to eliminate the infection...
September 2018: Medical Clinics of North America
Sylvia Szentpetery, Patrick A Flume
PURPOSE OF REVIEW: Pulmonary exacerbations are described as worsening of the daily symptoms of cystic fibrosis airways disease, typically with increased cough and sputum production. There are often associated signs such as weight loss and reduced lung function. These events occur frequently and are associated with considerable cost and morbidity. Although approved maintenance therapies are shown to reduce exacerbations, they still occur and are associated with poor outcomes despite treatment...
November 2018: Current Opinion in Pulmonary Medicine
Samaneh Kameli, Ali Mehrizad
Recent improvements based on heterojunction nanocomposites have opened new possibilities in photocatalysis. In this research, an ultrasound assisted co-precipitation method was used to fabricate silver, zinc sulfide, and reduced graphene oxide (Ag-ZnS/rGO) nanocomposite, and characterization results indicated that 3% Ag-ZnS spherical nanoparticles are successfully embedded in rGO matrix. The potential of the Ag-ZnS/rGO, as a visible light active photocatalyst, was assessed through optimizing degradation of Tetracycline (TC) by response surface methodology...
August 14, 2018: Photochemistry and Photobiology
David Y Graham, Maria Pina Dore, Hong Lu
Recent Helicobacter pylori treatment guidelines recommend the 4-drug combinations bismuth quadruple therapy and concomitant therapy. Areas covered: We review antimicrobial therapy for H. pylori in the context of antimicrobial therapy in general and specifically in relation to good antimicrobial stewardship (defined as optimal selection, dose, and duration of an antimicrobial that results in the best clinical outcome for the treatment of infection, with minimal toxicity to the patient and minimal impact on subsequent resistance)...
September 2018: Expert Review of Anti-infective Therapy
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