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Antibiotics and prescribing

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https://www.readbyqxmd.com/read/28430992/identifying-practice-related-factors-for-high-volume-prescribers-of-antibiotics-in-danish-general-practice
#1
Rune Aabenhus, Volkert Siersma, Håkon Sandholdt, Rasmus Køster-Rasmussen, Malene Plejdrup Hansen, Lars Bjerrum
Objectives: In Denmark, general practice is responsible for 75% of antibiotic prescribing in the primary care sector. We aimed to identify practice-related factors associated with high prescribers, including prescribers of critically important antibiotics as defined by WHO, after accounting for case mix by practice. Methods: We performed a nationwide register-based survey of antibiotic prescribing in Danish general practice from 2012 to 2013. The unit of analysis was the individual practice...
April 19, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28428532/ceftriaxone-induced-hemolytic-anemia-in-a-jehovah-s-witness
#2
James Tasch, Pedro Gonzalez-Zayaz
BACKGROUND Drug-induced immune hemolytic anemia (DIIHA) is a rare condition that may result from the administration of an antibiotic, most notably the cephalosporin class, commonly used in both the adult and pediatric populations. A delay in recognition by a provider may lead to continuation of the offending agent and possibly result in fatal outcomes. CASE REPORT We report the case of a 65-year-old woman on ceftriaxone infusions after being diagnosed with acute mitral valve endocarditis 3 weeks prior, which presented with severe anemia and bilateral transient vision loss...
April 21, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28428160/simulated-conversations-with-virtual-humans-to-improve-patient-provider-communication-and-reduce-unnecessary-prescriptions-for-antibiotics-a-repeated-measure-pilot-study
#3
Antoinette Schoenthaler, Glenn Albright, Judith Hibbard, Ron Goldman
BACKGROUND: Despite clear evidence that antibiotics do not cure viral infections, the problem of unnecessary prescribing of antibiotics in ambulatory care persists, and in some cases, prescribing patterns have increased. The overuse of antibiotics for treating viral infections has created numerous economic and clinical consequences including increased medical costs due to unnecessary hospitalizations, antibiotic resistance, disruption of gut bacteria, and obesity. Recent research has underscored the importance of collaborative patient-provider communication as a means to reduce the high rates of unnecessary prescriptions for antibiotics...
April 19, 2017: JMIR Medical Education
https://www.readbyqxmd.com/read/28425828/compliance-to-guidelines-for-the-prescribing-of-antibiotics-in-acute-infections-at-namibia-s-national-referral-hospital-a-pilot-study-and-the-implications
#4
S Nakwatumbah, D Kibuule, B Godman, V Haakuria, F Kalemeera, A Baker, M Mwangana
BACKGROUND: Sub-optimal antibiotic prescribing remains a public health concern in Namibia. The objective is to determine the level and predictors of compliance to guidelines in the prescribing of antibiotics in acute infections at a national referral hospital in Namibia to improve future prescribing. METHODS: Descriptive observational cross-sectional study. The clinical records of patients receiving care were reviewed. Prescribing practices were assessed using a self- administered questionnaire with reference to Namibia Standard Treatment Guidelines (NSTG)...
April 20, 2017: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/28421576/-confusion-caused-by-dietary-supplement-lithium-orotate
#5
G van Weringh, E B Uitvlugt, G H M Ponjee, G M Jalink
A 38-year-old woman was referred to our hospital with pelvic inflammatory disease. She had been diagnosed as having a tubo-ovarian abscess, for which antibiotic therapy with metronidazole and levofloxacin was indicated. Because the patient was already taking lithium she was prescribed clindamycin instead of metronidazole, a drug that interacts with lithium. For the same reason, naproxen could not be prescribed to reduce pain. However, the lithium taken by the patient turned out to be a dietary supplement containing lithium orotate which she had obtained via the Internet...
2017: Tijdschrift Voor Psychiatrie
https://www.readbyqxmd.com/read/28421551/macrolides-digoxin-toxicity-and-the-risk-of-sudden-death-a-population-based-study
#6
Kieran L Quinn, Erin M Macdonald, Tara Gomes, Muhammad M Mamdani, Anjie Huang, David N Juurlink
INTRODUCTION: Digoxin is commonly prescribed to elderly patients with heart failure and atrial fibrillation, and macrolide antibiotics markedly increase the risk of digoxin toxicity. OBJECTIVE: The aim was to determine whether, in older patients receiving digoxin, macrolide antibiotics are associated with sudden death. METHODS: We used a population-based, nested, case-control design from January 1, 1994 to December 31, 2012 in a cohort of Ontario residents aged 66 years or older prescribed digoxin...
April 18, 2017: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
https://www.readbyqxmd.com/read/28419786/toward-the-rational-design-of-macrolide-antibiotics-to-combat-resistance
#7
Anna Pavlova, Jerry M Parks, Adegboyega K Oyelere, James C Gumbart
Macrolides, one of the most prescribed classes of antibiotics, bind in the bacterial ribosome's polypeptide exit tunnel and inhibit translation. However, mutations and other ribosomal modifications, especially to the base A2058 of the 23S rRNA, have led to a growing resistance problem. Here, we have used molecular dynamics simulations to study the macrolides erythromycin and azithromycin in wild-type, A2058G-mutated, and singly or doubly A2058-methylated E. coli ribosomes. We find that the ribosomal modifications result in less favorable interactions between the base 2058 and the desosamine sugar of the macrolides, as well as greater displacement of the macrolides from their crystal structure position, illuminating the causes of resistance...
April 17, 2017: Chemical Biology & Drug Design
https://www.readbyqxmd.com/read/28418482/effect-of-oral-dexamethasone-without-immediate-antibiotics-vs-placebo-on-acute-sore-throat-in-adults-a-randomized-clinical-trial
#8
Gail Nicola Hayward, Alastair D Hay, Michael V Moore, Sena Jawad, Nicola Williams, Merryn Voysey, Johanna Cook, Julie Allen, Matthew Thompson, Paul Little, Rafael Perera, Jane Wolstenholme, Kim Harman, Carl Heneghan
Importance: Acute sore throat poses a significant burden on primary care and is a source of inappropriate antibiotic prescribing. Corticosteroids could be an alternative symptomatic treatment. Objective: To assess the clinical effectiveness of oral corticosteroids for acute sore throat in the absence of antibiotics. Design, Setting, and Participants: Double-blind, placebo-controlled randomized trial (April 2013-February 2015; 28-day follow-up completed April 2015) conducted in 42 family practices in South and West England, enrolled 576 adults recruited on the day of presentation to primary care with acute sore throat not requiring immediate antibiotic therapy...
April 18, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28417452/worldwide-pattern-of-antibiotic-prescription-in-endodontic-infections
#9
REVIEW
Juan José Segura-Egea, Jenifer Martín-González, María Del Carmen Jiménez-Sánchez, Isabel Crespo-Gallardo, Juan José Saúco-Márquez, Eugenio Velasco-Ortega
BACKGROUND: Odontogenic infections, and especially endodontic infections, are polymicrobial, involving a combination of Gram-positive and Gram-negative facultative anaerobes and strictly anaerobic bacteria. Therefore, antibiotics can be used as an adjunct to endodontic treatment. However, most chronic and even acute endodontic infections can be successfully managed by disinfection of the root-canal system, which eliminates the source of infection, followed by abscess drainage or tooth extraction, without the need for antibiotics...
April 17, 2017: International Dental Journal
https://www.readbyqxmd.com/read/28417451/prophylactic-anti-staphylococcal-antibiotics-for-cystic-fibrosis
#10
REVIEW
Alan R Smyth, Margaret Rosenfeld
BACKGROUND: Staphylococcus aureus causes pulmonary infection in young children with cystic fibrosis. Prophylactic antibiotics are prescribed hoping to prevent such infection and lung damage. Antibiotics have adverse effects and long-term use might lead to infection with Pseudomonas aeruginosa. This is an update of a previously published review. OBJECTIVES: To assess continuous oral antibiotic prophylaxis to prevent the acquisition of Staphylococcus aureus versus no prophylaxis in people with cystic fibrosis, we tested these hypotheses...
April 18, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28413520/prognosis-of-patients-with-acinetobacter-baumannii-infection-in-the-intensive-care-unit-a-retrospective-analysis
#11
Dong Xiao, Lu Wang, Daquan Zhang, Dongming Xiang, Qi Liu, Xuezhong Xing
The present retrospective study aimed to investigate the prognostic factors for critically ill patients with an Acinetobacter baumannii (A. baumannii) infection. A total of 37 patients from the intensive care unit (ICU) were enrolled in the study. Data was collected from patients, including age, gender, ethnicity, A. baumannii infection status, concurrent infection status, prescribed antibiotics, Acute Physiology and Chronic Health Evaluation II (APACHE II) and sepsis-related organ failure assessment (SOFA) scores, procalcitonin level, site of infection, shock, sepsis and renal replacement therapy status...
April 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28413207/rate-of-active-helicobacter-pylori-infection-among-symptomatic-patients-of-pakistan
#12
F Rasheed, A Yameen, T Ahmad, R Bilal
Only few epidemiological studies have examined the rate of active H. pylori infection in the symptomatic population in Pakistan. This retrospective study presents the laboratory data collected during the past 13 years (2002 to 2015) from 2315 symptomatic patients referred to the BreathMAT Lab, Nuclear Medicine, Oncology and Radiotherapy Institute, Islamabad for the diagnosis of active H. pylori infection using the (13)C Urea Breath Test. Rate of infection and its association with gender and age were evaluated...
April 2017: Malaysian Journal of Pathology
https://www.readbyqxmd.com/read/28411959/implementation-and-outcomes-of-an-antimicrobial-stewardship-program-effectiveness-of-education
#13
Yea-Yuan Chang, Hsin-Pai Chen, Chia-Wei Lin, Jen-Jen Tang, Ti-Ying Hsu, Yueh-Chun Weng, Yuan-Ming Lee, Wei-Shu Wang, Su-Shun Lo
BACKGROUND: Unnecessary use of antibiotics is a common occurrence in hospitals. Implementation of antibiotic stewardship programs (ASPs) has been shown to reduce both unnecessary antibiotic use and drug-resistant bacteria. Education is a fundamental component of an ASP. However, the effectiveness of proper uses of antibiotics education has not been clearly analyzed. METHODS: In a 520-bed university hospital located in northeastern Taiwan, a significantly increasing prescription of carbapenems, specifically imipenem and meropenem, was observed...
April 12, 2017: Journal of the Chinese Medical Association: JCMA
https://www.readbyqxmd.com/read/28410572/incidence-of-infection-following-internal-fixation-of-open-and-closed-tibia-fractures-in-india-infiniti-a-multi-centre-observational-cohort-study
#14
Prakash Doshi, Hitesh Gopalan, Sheila Sprague, Chetan Pradhan, Sunil Kulkarni, Mohit Bhandari
BACKGROUND: Trauma is a major public health problem, particularly in India due to the country's rapid urbanization. Tibia fractures are a common and often complicated injury that is at risk of infection following surgical fixation. The primary objectives of this cohort study were to determine the incidence of infection within one year of surgery and to describe the distribution of infections by location and time of diagnosis for tibia fractures in India. METHODS: We conducted a multi-center, prospective cohort study...
April 14, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28410366/brief-educational-interventions-to-improve-performance-on-novel-quality-metrics-in-ambulatory-settings-in-kenya-a-multi-site-pre-post-effectiveness-trial
#15
Robert Ryan Korom, Stephanie Onguka, Peter Halestrap, Maureen McAlhaney, Mary Adam
BACKGROUND: The quality of primary care delivered in resource-limited settings is low. While some progress has been made using educational interventions, it is not yet clear how to sustainably improve care for common acute illnesses in the outpatient setting. Management of urinary tract infection is particularly important in resource-limited settings, where it is commonly diagnosed and associated with high levels of antimicrobial resistance. We describe an educational programme targeting non-physician health care providers and its effects on various clinical quality metrics for urinary tract infection...
2017: PloS One
https://www.readbyqxmd.com/read/28408806/patient-knowledge-and-pulmonary-medication-adherence-in-adult-patients-with-cystic-fibrosis
#16
Ann Hsu-An Lin, Jennifer G Kendrick, Pearce G Wilcox, Bradley S Quon
BACKGROUND AND OBJECTIVES: Patient knowledge of lung function (ie, forced expiratory volume in 1 s [FEV1]% predicted) and the intended benefits of their prescribed pulmonary medications might play an important role in medication adherence, but this relationship has not been examined previously in patients with cystic fibrosis (CF). METHODS: All patients diagnosed with CF and without prior lung transplantation were invited to complete knowledge and self-reported medication adherence questionnaires during routine outpatient visits to the Adult CF Clinic, St Paul's Hospital, Vancouver, Canada from June 2013 to August 2014...
2017: Patient Preference and Adherence
https://www.readbyqxmd.com/read/28403649/a-survey-of-probiotic-use-practices-among-patients-at-a-tertiary-medical-centre
#17
K Draper, C Ley, J Parsonnet
Probiotic use has skyrocketed in recent years. Little is known, however, about patient knowledge and practices regarding probiotic use, especially in the context of antibiotic use. An invitation to complete a short, anonymous, electronic survey was sent by email to 965 patients at a tertiary medical centre in California who had agreed to be contacted for participation in research studies. Questions were asked about both probiotic and antibiotic use in the prior three months. Of 333 survey respondents, 55% had recently used probiotics, including food products and/or supplements (90 and 60% of probiotic users, respectively)...
April 13, 2017: Beneficial Microbes
https://www.readbyqxmd.com/read/28403114/prevalence-of-inappropriate-antibiotic-prescriptions-after-the-great-east-japan-earthquake-2011
#18
Kentaro Iwata, Takahiko Fukuchi, Midori Hirai, Kenichi Yoshimura, Yasuhiro Kanatani
Few studies have investigated the appropriateness of antibiotic use in postdisaster settings. We retrospectively evaluated clinical databases on health care delivered at clinics near shelters set up after the Great East Japan Earthquake, 2011. We defined appropriate, acceptable, and inappropriate antibiotic use for each diagnostic category, by applying and adopting precedent studies and clinical guidelines. From March to July, 2011, a total of 23,704 clinic visits occurred at 98 shelters with 7934 residents...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28400887/antibiotic-prophylaxis-in-orbital-fractures
#19
Benjamin Reiss, Lamise Rajjoub, Tamer Mansour, Tony Chen, Aisha Mumtaz
PURPOSE: To determine whether prophylactic antibiotic use in patients with orbital fracture prevent orbital infection. DESIGN: Retrospective cohort study. PARTICIPANTS: All patients diagnosed with orbital fracture between January 1, 2008 and March 1, 2014 at The George Washington University Hospital and Clinics. MAIN OUTCOME MEASURES: Development of orbital infection. RESULTS: One hundred seventy-two patients with orbital fracture met our inclusion and exclusion criteria...
2017: Open Ophthalmology Journal
https://www.readbyqxmd.com/read/28397622/identifying-opportunities-to-improve-guideline-concordant-antibiotic-prescribing-in-veterans-with-acute-respiratory-infections-or-cystitis
#20
Hayley E Meyer, Brian C Lund, Brett H Heintz, Bruce Alexander, Jason A Egge, Daniel J Livorsi
We investigated the frequency and determinants of guideline-discordant antibiotic prescribing in outpatients with respiratory infections or cystitis. Antibiotic prescribing was guideline discordant in 60% of patients. The most common reason for discordance was prescribing an antibiotic when not indicated. In a multivariate analysis, physicians in training had the highest likelihood of guideline-concordant antibiotic prescribing. Infect Control Hosp Epidemiol 2017;1-5.
April 11, 2017: Infection Control and Hospital Epidemiology
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