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Antibiotics and prescribing

Lisa E Dumkow, Katie L Axford, K J Suda, Heather M Draper, Kasey L Brandt
A culture follow-up program with an emphasis on symptom assessment may limit antibiotic exposure in patients with Group A Streptococcus on throat culture. A quasi-experimental study of such patients was conducted in our Emergency Department and Urgent Care centers. During the prestewardship initiative phase (March 2011-June 2012), the standard of care for culture follow-up did not include symptom assessment prior to prescribing antibiotics. During the stewardship initiative phase (March 2015-June 2016), culture follow-up was completed with a focus on symptom assessment and antibiotic avoidance...
May 28, 2018: Diagnostic Microbiology and Infectious Disease
Usman Abubakar, Syed Azhar Syed Sulaiman
BACKGROUND: Evidence to demonstrate the prevalence and trend of Methicillin Resistant Staphylococcus aureus (MRSA) infection in Nigeria is scarce. This review evaluates the prevalence, trend and antimicrobial susceptibility of clinical MRSA isolates reported in published studies. METHOD: Electronic search (PubMed, Scopus and Google scholar) was conducted using the following search terms: "MRSA OR Methicillin Resistant Staphylococcus aureus AND Nigeria." Reference list of selected studies was scanned to identify more studies...
June 19, 2018: Journal of Infection and Public Health
Traci D Yates, Marion E Davis, Yhenneko J Taylor, Lisa Davidson, Crystal D Connor, Katherine Buehler, Melanie D Spencer
BACKGROUND: Inappropriate prescribing of antibiotics poses an urgent public health threat. Limited research has examined factors associated with antibiotic prescribing practices in outpatient settings. The goals of this study were to explore elements influencing provider decisions to prescribe antibiotics, identify provider recommendations for interventions to reduce inappropriate antibiotic use, and inform the clinical management of patients in the outpatient environment for infections that do not require antibiotics...
June 23, 2018: BMC Family Practice
Ashley Suchomel, Helen Goeden, Julia Dady
Americans fill upward of four billion prescriptions for pharmaceuticals each year, and many of those pharmaceuticals eventually make their way into the environment. Hundreds of different active pharmaceutical ingredients (APIs) are detected in ambient waters and source water used for drinking water in the U.S. Very few of these drugs have health-based guidance values that suggest a safe level for individuals exposed in the ambient environment through drinking water. The Minnesota Department of Health (MDH) has developed a novel method to derive screening-level human health guidance values for APIs...
June 22, 2018: International Journal of Environmental Research and Public Health
Laura Koppen, Katie J Suda, Susan Rowan, Jessina McGregor, Charlesnika T Evans
BACKGROUND: Gaining a better understanding of dental prescribing can help identify opportunities for intervention regarding optimal medication use. The purpose of this study is to characterize opioid and antibiotic prescribing patterns of dentists in the United States for Medicare Part D beneficiaries. METHODS: The authors conducted a retrospective cross-sectional analysis of national 2014 Medicare Part D Prescriber Public Use File data. Providers in the data set with dental-related disciplines were included (n = 99,797)...
June 18, 2018: Journal of the American Dental Association
Fanny Desbiolles, Laure Malleret, Christophe Tiliacos, Pascal Wong-Wah-Chung, Isabelle Laffont-Schwob
Due to their pseudo-persistence and their biological activity, pharmaceuticals are emerging contaminants of major concern for the environment. The aim of this review is to provide an updated inventory of the contamination of aquatic environments by 43 drugs representing different classes of pharmaceuticals, such as antibiotics, anti-inflammatory drugs, anti-depressants, sex hormones, lipid regulators and beta-blockers. The data collected is focused on contamination levels reported in marine coastal waters and in waste and river waters flowing into the Mediterranean Sea...
October 15, 2018: Science of the Total Environment
Heather L Young, Katherine C Shihadeh, Alisha A Skinner, Bryan C Knepper, Jeffrey Sankoff, Jeremy Voros, Timothy C Jenkins
Smartphones are increasingly used to access clinical decision support, and many medical applications provide antimicrobial prescribing guidance. However, these applications do not account for local antibiotic resistance patterns and formularies. We implemented an institution-specific antimicrobial stewardship smartphone application and studied patterns of use over a 1-year period.
June 21, 2018: Infection Control and Hospital Epidemiology
Janni Katharina Stuhr, Jesper Lykkegaard, Jette Kolding Kristensen, Jette Brommann Kornum, Malene Plejdrup Hansen
Background: Sore throat is a frequent presentation of acute respiratory tract infections in general practice. Though these infections are often harmless and self-limiting, antibiotics are frequently prescribed. In Denmark, practice nurses manage an increasing part of patients with acute minor illnesses. Objectives: We aimed (i) to investigate Danish practice nurses' and GPs' management of patients presenting with a sore throat and (ii) to explore to what extent management is according to current Danish guidelines...
June 19, 2018: Family Practice
Sartaj Hussain, Suraj Singh Yadav, Kamal Kumar Sawlani, Sanjay Khattri
This cross-sectional study was carried out to assess drug prescribing pattern at a tertiary care teaching medical institute. One thousand prescriptions were randomly collected and analyzed using the world health organization prescribing indicators. The average number of drugs per prescription was 2.91. The percentage of drugs prescribed by generic name, from the essential drug list (National) and as fixed dose combinations (FDCs) was 10.05%, 22.57%, and 49.22%, respectively. The total percentage of encounters with antibiotics, injectables, and FDCs was 19...
April 2018: Indian Journal of Public Health
Shaik Mohamed Shamsudeen, R Shanmuga Priya, Govindarajan Sujatha, J Muruganandhan, K Manikandan
INTRODUCTION: Antibiotics are considered the most commonly sold drugs in developing countries. In India, these drugs are very much accessible without a prescription. This irrational and misuse of antibiotics results not only in the emergence of resistance of bacterial strains but also leads to adverse reactions. AIM: The aim of this study was to investigate the level of knowledge, attitude, and practice of antibiotics usage among dental patients. MATERIALS AND METHODS: Study design: This study was a cross-sectional design; a prevalidated structured questionnaire comprising 24 questions was used...
2018: Journal of Education and Health Promotion
Jordana E Hoppe, Brandie D Wagner, Frank J Accurso, Edith T Zemanick, Scott D Sagel
BACKGROUND: Pulmonary exacerbations (PEx) in children with cystic fibrosis (CF) are frequently treated in the outpatient setting with oral antibiotics. However, little is known about the characteristics of PEx managed on an outpatient basis and the effectiveness of oral antibiotic therapy. We sought to prospectively evaluate clinical and laboratory changes associated with oral antibiotic treatment for PEx. METHODS: Children with CF between 8 and 18 years of age prescribed two weeks of oral antibiotics for a PEx were eligible to enroll...
June 16, 2018: Journal of Cystic Fibrosis: Official Journal of the European Cystic Fibrosis Society
Ahmad A Madarati
BACKGROUND: This study aimed at investigating dental clinicians' preferences on management of necrotic pulp with acute apical abscess (NPAAA) cases. METHODS: Following an ethical approval and two pilot studies, an electronic survey was emailed to 400 general dental practitioners (GDPs) and 56 endodontists. The email explained the study's methods and assured that participants' identities and information given would remain anonymous and confidential. A reminder email was sent after eight weeks...
June 19, 2018: BMC Oral Health
Lara Barroso Brito, Luane Ferreira Garcia, Marcos Pereira Caetano, Germán Sanz Lobón, Mayk Teles de Oliveira, Rhaul de Oliveira, Ieda Maria Sapateiro Torres, Alfonso Yepez, Boniek Gontijo Vaz, Rafael Luque, Cesar Koppe Grisolia, Marize Campos Valadares, Eric de Souza Gil, Gisele Augusto Rodrigues de Oliveira
Amoxicillin (AMX) is one of the most commonly prescribed antibiotics around the world to treat and prevent several diseases in both human and veterinary medicine. Incomplete removal of AMX during wastewater treatment contributes to its presence in water bodies and drinking water. AMX is an emerging contaminant since its impact on the environment and human health remains uncertain. This contribution was aimed to evaluate the electrochemical oxidation (EO) of AMX using different anodes in tap water, NaCl or Na2 SO4 solutions and to evaluate the potential toxicity of remaining AMX and its by-products on zebrafish early-life stages...
June 16, 2018: Chemico-biological Interactions
Mohsin Hamid, Bilal Lashari, Irfan Ahsan, Ida Micaily, Usman Sarwar, Joseph Crocetti
Methotrexate (MTX) is a chemotherapeutic synthetic(s) phase cell cycle inhibitor, and its role has evolved as an immunological agent in autoimmune diseases like rheumatoid arthritis, psoriasis, and systemic lupus erythematosus, etc. Trimethoprim-sulfamethoxazole (TS) is one of the most widely prescribed antibiotics commonly used for urinary tract infections, exacerbations of chronic bronchitis, traveler's diarrhea, and pneumocystis pneumonia. Both MTX and TS can have significantly overlapping side effects involving dermatologic, renal, and hematological systems, and the combination of these can be deadly...
2018: Journal of Community Hospital Internal Medicine Perspectives
Evi Germeni, Julia Frost, Ruth Garside, Morwenna Rogers, Jose M Valderas, Nicky Britten
BACKGROUND: Reducing unnecessary prescribing remains a key priority for tackling the global rise of antibiotic-resistant infections. AIM: The authors sought to update a 2011 qualitative synthesis of GPs' experiences of antibiotic prescribing for acute respiratory tract infections (ARTIs), including their views of interventions aimed at more prudent prescribing. They expanded the original scope to encompass all primary care professionals (PCPs) who can prescribe or dispense antibiotics for ARTIs (for example, nurses and pharmacists)...
June 18, 2018: British Journal of General Practice: the Journal of the Royal College of General Practitioners
Xiangjun Liu, Yang Wang, Lanqing Cui, Yun Li, Feng Xue, Jian Liu, Liyuan Wang, Yingbo Shen, Yuan Lv
Objectives: To evaluate the prevalence of clinical mcr-1-positive Escherichia coli and Klebsiella pneumoniae and characterize the antimicrobial resistance profiles of mcr-1-positive E. coli and mcr-1-negative E. coli in China. Methods: A total of 6264 clinical E. coli (n = 3854) and K. pneumoniae (n = 2410) were collected from hospitalized patients from 18 to 20 hospitals as part of the China Antimicrobial Resistance Surveillance Trial (CARST) between January 2007 and June 2016...
April 17, 2018: Journal of Antimicrobial Chemotherapy
Slawomir Chlabicz, Dorota Rogowska-Szadkowska, Barbara Pytel-Krolczuk, Ludmila Marcinowicz, Anna Justyna Milewska, Julia Strumilo
Background: Requests by patients for antibiotics are known to strongly affect doctors' decisions to prescribe them. Objective. The aim of this study was to establish how frequently patients presenting with respiratory tract infections (RTIs) express their expectation not to be treated with antibiotics, which symptoms and physical findings are related to their perception of antibiotics not being helpful, and to what degree their expectations influence doctors' decisions. Methods: This was a direct observational study set in primary care practices in Bialystok, Poland...
June 15, 2018: Family Practice
Denise Cooper, Marilyn McFarland, Francesca Petrilli, Cherrell Shells
BACKGROUND: Nursing home providers face challenges in urinary tract infection assessment and treatment, often prescribing unnecessary antibiotics for asymptomatic bacteriuria, a practice that can result in adverse drug reactions, drug resistance, and an increase in antibiotic-associated diarrhea. PURPOSE: The purpose of this project was to replicate the Cooper Urinary Tract Infection Program in another facility and measure its effectiveness. METHODS: Using a pre-post design, this project was implemented at a 120-bed, long-term care and rehabilitation facility located in the Midwest United States...
June 14, 2018: Journal of Nursing Care Quality
Laura W van Buul, Hilde L Vreeken, Suzanne F Bradley, Christopher J Crnich, Paul J Drinka, Suzanne E Geerlings, Robin L P Jump, Lona Mody, Joseph J Mylotte, Mark Loeb, David A Nace, Lindsay E Nicolle, Philip D Sloane, Rhonda L Stuart, Pär-Daniel Sundvall, Peter Ulleryd, Ruth B Veenhuizen, Cees M P M Hertogh
OBJECTIVES: Nonspecific signs and symptoms combined with positive urinalysis results frequently trigger antibiotic therapy in frail older adults. However, there is limited evidence about which signs and symptoms indicate urinary tract infection (UTI) in this population. We aimed to find consensus among an international expert panel on which signs and symptoms, commonly attributed to UTI, should and should not lead to antibiotic prescribing in frail older adults, and to integrate these findings into a decision tool for the empiric treatment of suspected UTI in this population...
June 14, 2018: Journal of the American Medical Directors Association
Ljubica Bojanić, Vanda Marković-Peković, Ranko Škrbić, Nataša Stojaković, Mirjana Ðermanović, Janja Bojanić, Jurij Fürst, Amanj B Kurdi, Brian Godman
Introduction: There are increasing concerns world-wide with growing rates of antibiotic resistance necessitating urgent action. There have been a number of initiatives in the Republic of Srpska in recent years to address this and improve rational antibiotic prescribing and dispensing despite limited resources to fund multiple initiatives. Objective: Analyse antibiotic utilization patterns in the Republic of Srpska following these multiple initiatives as a basis for developing future programmes in the Republic if needed...
2018: Frontiers in Pharmacology
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