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Antibiotic course

Kerri A Thom, Pranita D Tamma, Anthony D Harris, Kathryn Dzintars, Daniel J Morgan, Shanshan Li, Lisa Pineles, Arjun Srinivasan, Edina Avdic, Sara E Cosgrove
A multicenter quasi-experimental study of a provider-driven antibiotic "time-out" in 3470 antibiotic courses showed no difference in antibiotic use before and after implementation, but did show a decrease in inappropriate therapy (45% vs 31%, P < .05). Single time-outs without input from antibiotic stewardship teams are insufficient to optimize prescribing.
December 4, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Catherine E Oldenburg, Ali Sié, Boubacar Coulibaly, Lucienne Ouermi, Clarisse Dah, Charlemagne Tapsoba, Till Bärnighausen, Kathryn J Ray, Lina Zhong, Susie Cummings, Elodie Lebas, Thomas M Lietman, Jeremy D Keenan, Thuy Doan
Background: Exposure to antibiotics may result in alterations to the composition of intestinal microbiota. However, few trials have been conducted, and observational studies are subject to confounding by indication. We conducted a randomized controlled trial to determine the effect of 3 commonly used pediatric antibiotics on the intestinal microbiome in healthy preschool children. Methods: Children aged 6-59 months were randomized (1:1:1:1) to a 5-day course of 1 of 3 antibiotics, including amoxicillin (25 mg/kg/d twice-daily doses), azithromycin (10 mg/kg dose on day 1 and then 5 mg/kg once daily for 4 days), cotrimoxazole (240 mg once daily), or placebo...
November 2018: Open Forum Infectious Diseases
H O Akhiwu, E S Yiltok, A O Ebonyi, S Gomerep, N Y Shehu, E P Amaechi, A E Onukak, P Iduh, A A Oyagbemi, G Omame, P M Ashir, D Z Egah, S Oguche
Background: Lassa fever (LF) is a viral haemorrhagic fever endemic to West Africa. The clinical presentation and course is variable, making diagnosis difficult. Aim: To report the outbreak and identify the common clinical presentations of LF in paediatric patients in Jos, Plateau State, North Central, Nigeria. Methods: This was a retrospective review of patients managed for LF during the June-August 2017 outbreak. LF was suspected in cases with: fever of less than 3 weeks' duration that had not responded to antimalarials or antibiotics, myalgia, abdominal pain, prostration and history of contact with any person diagnosed with LF...
October 1, 2018: Journal of Virus Eradication
Katarina Boršič, Rok Blagus, Tjaša Cerar, Franc Strle, Daša Stupica
Infected elderly people often present with signs and symptoms that differ from those in younger adults, but data on the association between patient age and presentation of early Lyme borreliosis (LB) are limited. In this study, the association between patient age (18⁻44 years, young vs. 45⁻64 years, middle-aged vs. ≥ 65 years, elderly) and disease course, microbiologic characteristics, and the long-term outcome of treatment was investigated prospectively in 1220 adult patients with early LB manifesting as erythema migrans (EM) at a single-center university hospital...
December 2, 2018: Journal of Clinical Medicine
Andreas Älgå, Karin Karlow Herzog, Murad Alrawashdeh, Sidney Wong, Hamidreza Khankeh, Cecilia Stålsby Lundborg
Healthcare-associated infections (HAIs) constitute a major contributor to morbidity and mortality worldwide, with a greater burden on low- and middle-income countries. War-related injuries generally lead to large tissue defects, with a high risk of infection. The aim of this study was to explore how physicians in a middle-income country in an emergency setting perceive HAI and antibiotic resistance (ABR). Ten physicians at a Jordanian hospital supported by Médecins Sans Frontières were interviewed face-to-face...
December 1, 2018: International Journal of Environmental Research and Public Health
Ciaran Skerry, William E Goldman, Nicholas H Carbonetti
Incidence of whooping cough (pertussis), a bacterial infection of the respiratory tract caused by the bacterium Bordetella pertussis , has reached levels not seen since the 1950s. Antibiotics fail to improve the course of disease unless administered early in infection. Therefore, there is an urgent need for the development of anti-pertussis therapeutics. Sphingosine-1-phosphate receptor (S1PR) agonists have been shown to reduce pulmonary inflammation during Bordetella pertussis infection in mouse models. However, the mechanisms by which S1PR agonists attenuate pertussis disease are unknown...
December 3, 2018: Infection and Immunity
Yi-Hsueh Liu, Wen-Hsien Lee, Chun-Yuan Chu, Ho-Ming Su, Tsung-Hsien Lin, Hsueh-Yei Yen, Wen-Chol Voon, Wen-Ter Lai, Sheng-Hsiung Sheu, Po-Chao Hsu
RATIONALE: Infective endocarditis (IE) complicated with obstructive ST elevation myocardial infarction (STEMI) has been reported in the literature and which were mostly related to coronary artery embolism, obstruction, or compression. However, there has been no reported case discussing about IE complicated with nonobstructive STEMI. PATIENT CONCERNS: In this report, we report a 38-year-old female suffering from intermittent fever and was later diagnosed as IE. Initially antibiotic was given and mitral valve surgery was also arranged due to large vegetation with severe mitral regurgitation...
November 2018: Medicine (Baltimore)
Valerie D Nolt, Kyle D Pijut, Elizabeth B Autry, Whitney C Williams, David S Burgess, Donna R Burgess, Vaneet Arora, Robert J Kuhn
AIM: Pseudomonas aeruginosa (PsA) is a common pathogen in cystic fibrosis (CF). Management of an acute pulmonary exacerbation (APE) caused by PsA is dual anti-pseudomonal antibiotics, a beta-lactam plus aminoglycoside. Aminoglycoside dosing in CF differs from the general population due to altered pharmacokinetics. The primary objective of this study was to utilize pharmacokinetic data from adult CF patients that received amikacin to determine the probability of target attainment for APEs caused by PsA...
December 3, 2018: Pediatric Pulmonology
Joseph A Sujka, Katrina L Weaver, Justin A Sobrino, Ashwini Poola, Katherine W Gonzalez, Shawn D St Peter
BACKGROUND: Post-operative intra-abdominal abscess (PIAA) is the most common complication after appendectomy for perforated appendicitis (PA). Typically, intravenous antibiotics by a peripherally inserted venous catheter are utilized to treat the abscess. We sought to evaluate the role of oral antibiotics in this population. METHODS: This is a retrospective review conducted of children between January 2005 and September 2015 with a PIAA. Demographics, clinical course, complications, and follow-up were analyzed using descriptive statistics...
December 3, 2018: Pediatric Surgery International
E Forbat, M J Rouhani, C Pavitt, S Patel, R Handslip, S Ledot
Background: Leptospirosis is a rare infectious illness caused by the Spirochaete Leptospira. It has a wide-varying spectrum of presentation. We present a rare case of severe cardiogenic shock secondary to leptospirosis, in the absence of its common clinical features. Case presentation: A 36-year-old woman presented to our unit with severe cardiogenic shock and subsequent multi-organ failure. Her clinical course was characterised by ongoing pyrexia of unknown origin with concurrent cardiac failure...
November 2018: Journal of the Intensive Care Society
Ev Christin Heide, Laura Bindila, Julia Maria Post, Dörthe Malzahn, Beat Lutz, Jana Seele, Roland Nau, Sandra Ribes
Easy-to-achieve interventions to promote healthy longevity are desired to diminish the incidence and severity of infections, as well as associated disability upon recovery. The dietary supplement palmitoylethanolamide (PEA) exerts anti-inflammatory and neuroprotective properties. Here, we investigated the effect of prophylactic PEA on the early immune response, clinical course, and survival of old mice after intracerebral E. coli K1 infection. Nineteen-month-old wild type mice were treated intraperitoneally with two doses of either 0...
2018: Frontiers in Immunology
Colin G Buss, Jaideep S Dudani, Reid T K Akana, Heather E Fleming, Sangeeta N Bhatia
BACKGROUND: Respiratory tract infections represent a significant public health risk, and timely and accurate detection of bacterial infections facilitates rapid therapeutic intervention. Furthermore, monitoring the progression of infections after intervention enables 'course correction' in cases where initial treatments are ineffective, avoiding unnecessary drug dosing that can contribute to antibiotic resistance. However, current diagnostic and monitoring techniques rely on non-specific or slow readouts, such as radiographic imaging and sputum cultures, which fail to specifically identify bacterial infections and take several days to identify optimal antibiotic treatments...
November 26, 2018: EBioMedicine
Chandni N Patel, Michael D Swartz, Jeffrey S Tomasek, Laura E Vincent, Wallace E Hallum, John B Holcomb
BACKGROUND: Missing doses of antibiotics in hospitalized patients is a well-described but inadequately recognized issue. We hypothesized that missing doses of antibiotics decreases quality of care. METHODS: Retrospective study on patients admitted to the Shock Trauma ICU from February to June 2015. Patients prescribed a multidose course of antibiotics were evaluated. A missed antibiotic dose was one ordered but never given (a completely missed dose) or a dose that was not given within an hour before or after the planned time (an off-schedule missed dose)...
January 2019: Journal of Surgical Research
Lieke J M Kursten, Anniek Visser, Marloes Emous, Heleen Lameijer
A 66-year-old patient was seen at the emergency department with a skin infection of the left leg, probably erysipelas, which worsened despite the use of antibiotics. The symptoms had started 5 days earlier. The patient was respiratory and haemodynamically stable, he was not clinically ill and had relatively little pain. Lab tests revealed leucocytosis, significantly elevated CRP values and signs of renal and hepatic impairment. The patient was admitted because of suspected necrotising soft tissue infection (NSTI)...
November 19, 2018: Nederlands Tijdschrift Voor Geneeskunde
E V Askhadulin, T V Konchugova, S V Moskvin
AIM: The objective of the present study was the evaluation of the effectiveness of the combined treatment of the patients presenting with trophic ulcers associated with chronic venous insufficiency of the lower extremities of venous etiology with the application of low-intensity laser therapy (LILT) at different wavelengths. MATERIAL AND METHODS: The study included the patients presenting with chronic venous insufficiency (CVI) (class C6 in accordance with the CEAP clinical classification)...
2018: Voprosy Kurortologii, Fizioterapii, i Lechebnoĭ Fizicheskoĭ Kultury
Ryohei Kokado, Hideharu Hagiya, Toshihiro Koyama, Eiko Matsui, Hideo Okuno, Daiichi Morii, Shigeto Hamaguchi, Hisao Yoshida, Yoshihiro Miwa, Kazunori Tomono
INTRODUCTION: To promote antimicrobial stewardship activity, an understanding of the incidence of antibiotic-associated adverse drug events (ADEs) is essential. In this study, we aimed to describe the occurrence of antibiotic-associated ADEs at our hospital. METHODS: We retrospectively searched the ADE registration system in Osaka University Hospital between 2010 and 2017. Registrations of ADEs were dependent on the patients' drug history and clinical course after hospitalization...
November 26, 2018: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
(no author information available yet)
OBJECTIVETemporary CSF diversion through an external ventricular drain (EVD) comes with the risk of EVD-related infections (ERIs). The incidence of ERIs varies from 0.8% to 22%. ERIs increase mortality, morbidity, length of stay, and costs; require prolonged courses of antibiotics; and increase the need for subsequent permanent CSF diversion. The authors report the results of a quality improvement project designed to improve infection rates and EVD placement using simulation training in addition to a standardized perioperative care bundle...
October 1, 2018: Journal of Neurosurgery
Pimjai Ananta, Irin Kham-Ngam, Ploenchan Chetchotisakd, Prajuab Chaimanee, Wipa Reechaipichitkul, Wises Namwat, Viraphong Lulitanond, Kiatichai Faksri
Mycobacterium abscessus is an important infectious agent highly associated with drug resistance and treatment failure. We investigated the drug resistance situation of M. abscessus in Northeast Thailand and the possible genetic basis for this. Sixty-eight M. abscessus clinical isolates were obtained from 26 patients at Srinagarind Hospital during 2012-2016. Drug susceptibility tests and sequencing of erm(41), rrl and rrs genes were performed. Mycobacterium abscessus was resistant to 11/15 antibiotics (nearly 100% resistance in each case)...
2018: PloS One
Gillian Campbell, Ruth M Bland, Scott J Hendry
AIM: To document the clinical features and management of infants presenting with fever after their first meningococcal B vaccination and develop guidance for clinicians. METHODS: A prospective case series over 12 months was conducted in a tertiary paediatric hospital. Infants ≤3 months of age with fever who had received their first set of immunisations within the preceding 72 h were included. RESULTS: A total of 92 infants met the inclusion criteria, accounting for 0...
November 28, 2018: Journal of Paediatrics and Child Health
S Ahmed, T Biswas, S P Paul
Staphylococcus aureus is a global bacterial pathogen. It is an uncommon pathogen causing central nervous system infections, accounting for <1% cases of bacterial meningitis. Sinusitis, trauma and presence of an intracranial device have been reported as risk factors for developing meningitis and brain abscesses. A previously healthy 5-month-old female infant presented to a hospital in North-Eastern India in February 2018 with Staphylococcus aureus sepsis and meningitis and was subsequently detected to have developed bilateral subdural empyema on computed tomography scan of the brain...
October 2018: Mymensingh Medical Journal: MMJ
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