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Antibiotic course

Damien Subtil, Gilles Brabant, Emma Tilloy, Patrick Devos, Frédérique Canis, Annie Fruchart, Marie-Christine Bissinger, Jean-Charles Dugimont, Catherine Nolf, Christophe Hacot, Sophie Gautier, Jérôme Chantrel, Marielle Jousse, David Desseauve, Jean Louis Plennevaux, Christine Delaeter, Sylvie Deghilage, Anne Personne, Emmanuelle Joyez, Elisabeth Guinard, Eric Kipnis, Karine Faure, Bruno Grandbastien, Pierre-Yves Ancel, François Goffinet, Rodrigue Dessein
BACKGROUND: Preterm delivery during pregnancy (<37 weeks' gestation) is a leading cause of perinatal mortality and morbidity. Treating bacterial vaginosis during pregnancy can reduce poor outcomes, such as preterm birth. We aimed to investigate whether treatment of bacterial vaginosis decreases late miscarriages or spontaneous very preterm birth. METHODS: PREMEVA was a double-blind randomised controlled trial done in 40 French centres. Women aged 18 years or older with bacterial vaginosis and low-risk pregnancy were eligible for inclusion and were randomly assigned (2:1) to three parallel groups: single-course or triple-course 300 mg clindamycin twice-daily for 4 days, or placebo...
October 12, 2018: Lancet
Michelle Herberts, Bradley Hicks, Muhammad Rizwan Sohail, Anil Jagtiani
A 70-year-old man with a history of hepatic cirrhosis presented with abdominal discomfort and distention. Physical examination revealed abdominal distention, positive fluid wave and abdominal tenderness. Due to concerns for spontaneous bacterial peritonitis (SBP), paracentesis was performed. Fluid analysis revealed 5371 total nucleated cells with 48% neutrophils. Ceftriaxone was then initiated for the treatment of SBP. Bacterial cultures of the fluid, however, grew Cl ostridium difficile Therefore, metronidazole was added...
October 12, 2018: BMJ Case Reports
Eric R Coon, Raj Srivastava, Greg Stoddard, Jacob Wilkes, Andrew T Pavia, Samir S Shah
: media-1vid110.1542/5804909691001PEDS-VA_2018-0345 Video Abstract BACKGROUND: Guidelines recommend a prolonged course (10 days) of intravenous (IV) antibiotic therapy for infants with uncomplicated, late-onset group B Streptococcus (GBS) bacteremia. Our objective was to determine the frequency with which shorter IV antibiotic courses are used and to compare rates of GBS disease recurrence between prolonged and shortened IV antibiotic courses. METHODS: We performed a multicenter retrospective cohort study of infants aged 7 days to 4 months who were admitted to children's hospitals in the Pediatric Health Information System database from 2000 to 2015 with GBS bacteremia...
October 11, 2018: Pediatrics
Sten Saar, Vladislav Mihnovitš, Thomas Lustenberger, Mariliis Rauk, Erast-Henri Noor, Edgar Lipping, Karl-Gunnar Isand, Jaak Lepp, Andrus Lomp, Urmas Lepner, Peep Talving
BACKGROUND: Recent investigations noted noninferiority in short-course antimicrobial treatments following source control in abdominal infections. We set out to investigate noninferiority of a short and fixed (24-hour) antibiotic administration compared to extended treatment after source control in complicated appendicitis in a prospective single-center open-label randomized controlled trial. METHODS: After IRB approval, all consecutive adult patients (age ≥18 years) with complicated appendicitis including gangrenous appendicitis, perforated appendicitis, and appendicitis with periappendicular abscess between 5/2016 and 2/2018 were randomly allocated to antibacterial therapy limited to 24 hours (short) vs...
October 11, 2018: Journal of Trauma and Acute Care Surgery
Vinay P Rao, Jianhua Wu, Richard Gillott, M Wazir Baig, Pankaj Kaul, Jonathan A T Sandoe
OBJECTIVES: Surgery is often required for acute infective endocarditis (IE) to repair or replace damaged heart valves. Traditionally, long courses of antibiotic treatment have been prescribed after surgery for active IE for fear of infecting newly implanted/repaired valves, but the need for this, in the present era of enhanced antimicrobial stewardship, has been questioned. In our institution, the choice and duration of antimicrobial therapy is tailored to individual patients by a multidisciplinary team with an interest in IE...
October 10, 2018: European Journal of Cardio-thoracic Surgery
Sarah Asch, Diana L Vork, Josiane Joseph, Brittny Major-Elechi, Megha M Tollefson
BACKGROUND/OBJECTIVES: Skin infection is common in atopic dermatitis (AD), often necessitating treatment with systemic antibiotics. Topical adjunctive therapies such as dilute bleach baths are increasingly recommended, and topical dilute acetic acid (AA) has not been widely studied. The objective of this study was to evaluate whether various topical anti-infective bathing recommendations were associated with decreased systemic antibiotic exposure in pediatric AD, as well as evaluate topical anti-infective recommendations over time within our institution...
October 10, 2018: Pediatric Dermatology
T Echtermann, C R Müntener, P R Torgerson, X Sidler, D Kümmerlen
A significant Antibiotic-Monitoring-System is essential to analyse the use of antibiotics and to a better understanding of trends in resistance development. In human and veterinary medicine, for example, a system based on defined daily and treatment doses (Defined Daily Dose: DDD and Defined Course Dose: DCD) is applied. These definitions can be used to estimate the number of treatment days and treatments with antimicrobial agents in a population. For veterinary medicine, the European Medicines Agency (EMA) has published the European values DDDvet and DCDvet in the farm animal sector...
October 2018: Schweizer Archiv Für Tierheilkunde
Manjit K Cartlidge, Maeve P Smith, Pallavi Bedi, Samantha Donaldson, Andrea Clarke, Leandro C Mantoani, Roberto A Rabinovich, Adriano G Rossi, Adam T Hill
RATIONALE: There is a need for a validated clinical endpoint to assess response to therapies in bronchiectasis. OBJECTIVE: To assess the reliability, validity and responsiveness of the incremental shuttle walk test (ISWT) as a clinical endpoint in bronchiectasis. METHODS: and measurements: Reliability: In clinically stable patients (n=30) the ISWT was performed twice; 6months apart. VALIDITY: Correlation between the St George's Respiratory Questionnaire (SGRQ) and ISWT (n=94) was performed...
October 6, 2018: Chest
Ludovico Furlan, Luca Erba, Lucia Trombetta, Roberto Sacco, Giorgio Colombo, Giovanni Casazza, Monica Solbiati, Nicola Montano, Chiara Marta, Rodolfo Sbrojavacca, Francesco Perticone, Gino Roberto Corazza, Giorgio Costantino
Reduction of the inappropriate use of antibiotics in clinical practice is one of the main goals of the Società Italiana di Medicina Interna (SIMI) choosing wisely campaign. We conducted a systematic review of secondary studies (systematic reviews and guidelines) to verify what evidence is available on the duration of antibiotic treatment in Pneumonia. A literature systematic search was performed to identify all systematic reviews and the three most cited and recent guidelines that address the duration of antibiotic therapy in pneumonia...
October 8, 2018: Internal and Emergency Medicine
Young Bae Choi, Dae Yong Yi
RATIONALE: Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening disease characterized by an excessive systemic inflammatory response. HLH is classified as primary or secondary, where the latter may occur in association with many infections. However, no case of HLH has been previously associated with group b streptococcus (GBS) sepsis. PATIENT CONCERNS: We present a fatal case of HLH in a 5-year-old girl with GBS sepsis. DIAGNOSIS: The present patient met 5 of the HLH criteria: fever, splenomegaly, bicytopenia, hypertriglyceridemia and/or hypofibrinogenemia, and hyperferritinemia...
October 2018: Medicine (Baltimore)
Carolyne Ghobrial, Engy Adel Mogahed, Hanaa El-Karaksy
Ascitic fluid infection is a major cause of morbidity and mortality in cirrhotic patients, requiring early diagnosis and therapy. We aimed to determine predictors of ascitic fluid infection in children with chronic liver disease. The study included 45 children with chronic liver disease and ascites who underwent 66 paracentesis procedures. Full history taking and clinical examination of all patients were obtained including fever, abdominal pain and tenderness and respiratory distress. Investigations included: complete blood count, C-reactive protein, full liver function tests, ascitic fluid biochemical analysis, cell count and culture...
2018: PloS One
David Steybe, Pit Jacob Voss, Michael Andreas Ermer, Marc Anton Fuessinger, Rainer Schmelzeisen, Philipp Poxleitner
BACKGROUND: Necrotizing fasciitis has been reported as a complication secondary to bisphosphonate-related osteonecrosis of the jaw (BRONJ) in a low number of patients. The only report of such a case in an osteoporosis patient found in current literature was related to short-term bisphosphonate but long time corticosteroid and methotrexate treatment. CASE PRESENTATION: In this article, we report a case of necrotizing fasciitis secondary to osteonecrosis of the jaw related to long-term oral bisphosphonate treatment in an osteoporosis patient additionally suffering from poorly controlled type 2 diabetes...
October 5, 2018: Oral and Maxillofacial Surgery
Christopher Chang
Irritable bowel syndrome (IBS) is a common gastrointestinal (GI) disorder characterized by abdominal pain that occurs with defecation or alterations in bowel habits. Further classification is based on the predominant bowel habit: constipation-predominant IBS, diarrhea-predominant IBS (IBS-D), or mixed IBS. The pathogenesis of IBS is unclear and is considered multifactorial in nature. GI dysbiosis, thought to play a role in IBS pathophysiology, has been observed in patients with IBS. Alterations in the gut microbiota are observed in patients with small intestinal bacterial overgrowth, and overgrowth may occur in a subset of patients with IBS...
2018: Clinical and Experimental Gastroenterology
Felix Aurnhammer, Gesche Först, Winfried V Kern
The adequate duration of antibiotic therapy in the treatment of bacterial infections is often unclear. For many indications guidelines recommend intervals with ranges of several days instead of fixed courses of treatment, and physicians tend to choose longer rather than shorter durations. The emergence of infections due to multidrug-resistant bacteria and the valuation of avoidable side effects from antibiotic agents raised the question whether a shortened duration of therapy is appropriate in specific indications...
October 2018: Deutsche Medizinische Wochenschrift
J Albrecht, P A Baine, B Ladizinski, G B Jemec, Michael Bigby
CLINICAL QUESTION: Can therapy with clindamycin and rifampicin be safely continued long term beyond the recommended 10 week course?. BACKGROUND: Clindamycin and rifampicin are used in combination to treat hidradenitis suppurativa (HS). There is no data on the efficacy and safety of clindamycin/rifampicin combination therapy for HS beyond 10 weeks. METHODS: We identified the following major concerns that still lack a proper evidenced based analysis: For rifampicin: drug induced liver injury, interstitial nephritis, drug interaction and hepatic p450 3A4 enzyme induction; for clindamycin the concern was community acquired clostridium difficile infection (CA-CDI); and experience with long-term treatment...
October 3, 2018: British Journal of Dermatology
Ashwin K Thiagaraj, Richard Bloomingdale, Tesfaye Telila, Luis C Afonso
The HELEX septal occluder (W.L. Gore & Associates, Newark, DE, USA) is a popular closure device for patent foramen ovale (PFO) and secundum atrial septal defect (ASD). Composed of a versatile polymer and a wire frame, it has been used for nearly a decade. A 50-year-old African American man with a PFO repaired 5 years previously with the HELEX was admitted to our hospital with methicillin-resistant Staphylococcus aureus bacteremia. A transesophageal echocardiogram demonstrated large mobile vegetations on the left and right atrial aspects of the occluder...
December 2017: Journal of Cardiology Cases
Krishn Khanna, Abhinav Janghala, David Sing, Brennan Vail, Grigoriy Arutyunyan, Bobby Tay, Vedat Deviren
Background: It is unclear whether patients can be taken off suppressive antibiotics with infected retained instrumentation. This study aimed to retrospectively analyze the perioperative course and antibiotic regimen that led to the clinical intervention of patients with infected spinal instrumentation. Methods: Consecutive adult patients with spine instrumentation who suffered surgical site infections (SSI) requiring debridement were retrospectively analyzed. The patients were grouped into 4 cohorts based on their clinical intervention: removal of instrumentation, reinstrumentation, retention of instrumentation with continued antibiotic suppression, and retention of instrumentation with no antibiotic suppression...
August 2018: International Journal of Spine Surgery
Paul Ríos, Claudio Rocha, William Castro, Maria Vidal, Enrique Canal, Manuela Bernal, Nathanael D Reynolds, Drake H Tilley, Mark P Simons
Introduction: Pseudomonas aeruginosa has the ability to acquire plasmids and other mobile genetic elements that confer resistance to antibiotics. Bacterial genes encoding different β-lactamases (bla), such as metallo-β-lactamases (MBLs) and extended-spectrum β-lactamases (ESBL), can confer resistance to multiple classes of β-lactam antibiotics. Case presentation: An 83 year old female was admitted in 2012 to the Peruvian Naval Hospital, Centro Médico Naval 'Cirujano Mayor Santiago Távara' (CEMENA), in Lima, Peru...
July 2018: JMM Case Reports
Anthony D Vinson, Reinaldo Rampolla-Selles, E Shannon Cooper, Caroline R Alquist
Background: Acute rejection of lung allografts is an important contributor to morbidity and mortality in the transplant patient population, resulting in the dysfunction and destruction of the graft by the host's immune system via cellular or antibody-mediated mechanisms. Acute cellular rejection (ACR) is more common and better characterized than antibody-mediated rejection, which to date lacks any widely agreed upon, standardized set of diagnostic criteria. We present a case of AMR attributable to a rare phenomenon, non-human leukocyte antigen (HLA) antibodies...
2018: Ochsner Journal
Batuk Diyora, Sachin Ashok Giri, Bhagyashri Bhende, Deepali Giri, Sanjay Kukreja, Alok Sharma
We report a case of orbital tuberculosis (OTB) with intracranial extension without active tuberculosis in the rest of the body organs or a history of tuberculosis infection. A 29-year-male patient presented with left-sided painful periorbital swelling with pus discharging sinus and visual impairment. Orbital computed tomography revealed contrast enhancing cystic mass lesion in the left orbit with erosion of the lateral and superior orbital wall with intracranial extension. After the failure of 3 weeks' course of oral antibiotics, the patient underwent left lateral orbitotomy, pus was drained out, and granulation tissues were excised...
October 2018: Journal of Neurosciences in Rural Practice
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