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antibiotic escalation

Jong Hoo Lee, Yee Hyung Kim
Although blood cultures (BCs) are an important component of diagnostic practice for antibiotic management in patients with pneumonia, several studies have questioned whether they should be performed. The objective of this study was to evaluate the predictive factors of bacteremia and the role of BCs in patients with community-onset pneumonia (community-acquired pneumonia and healthcare-associated pneumonia).This study was retrospectively conducted in patients with community-onset pneumonia who were hospitalized at Jeju National University Hospital between January 2012 and December 2014...
October 2016: Medicine (Baltimore)
Alison Vogel, Diana Lennon, Emma Best, Alison Leversha
Admissions for skin and soft-tissue infections have been increasing steadily in children and in the general population. Concerns have been raised recently about the increasing widespread use of topical fusidic acid and concurrent increase of fusidic acid-resistant Staphylococcus aureus. Fusidic acid resistance and methicillin resistant Staphylococcus aureus (MRSA) are both more prevalent in youngest age group (<5 year-olds) and particularly in the North island. In New Zealand, fusidic acid is recommended for treatment of minor impetigo and is the only fully-funded topical antibiotic...
October 14, 2016: New Zealand Medical Journal
George Denny, Milan J Anadkat
BACKGROUND: Treatment for hidradenitis suppurativa is often empiric and inadequate, and determining which patients will respond is difficult. OBJECTIVE: We sought to determine which patient factors are associated with a positive response to first-line medical therapy. METHODS: A single-center retrospective cohort study of all patients with hidradenitis suppurativa seen between January 1, 1992, and October 1, 2014, was conducted. Response to first-line medical therapy (oral/topical antibiotics, intralesional corticosteroids, and topical washes) was examined at follow-up within 6 months of initiating therapy...
September 28, 2016: Journal of the American Academy of Dermatology
U Ni Riain, M Tierney, C Doyle, A Vellinga, C Fleming, M Cormican
OBJECTIVE: Use of meropenem in our hospital has doubled in recent years. An audit in 2013 showed that although initiation of therapy with meropenem was generally appropriate, therapy was rarely subsequently reviewed and de-escalated where appropriate. Therefore, a structured stewardship initiative focussed on meropenem de-escalation was developed. METHODS: A local guideline for review and de-escalation of meropenem was developed and approved by the Antimicrobial Stewardship Team...
September 29, 2016: Irish Journal of Medical Science
Paula Rodríguez-Escales, Xavier Sanchez-Vila
Degradation of emerging organic compounds in saturated porous media is usually postulated as following simple low-order models. This is a strongly oversimplified, and in some cases plainly incorrect model, that does not consider the fate of the different metabolites. Furthermore, it does not account for the reversibility in the reaction observed in a few emerging organic compounds, where the parent is recovered from the metabolite. One such compound is the antibiotic sulfamethoxazole (SMX). In this paper, we first compile existing experimental data to formulate a complete model for the degradation of SMX in aquifers subject to varying redox conditions, ranging from aerobic to iron reducing...
November 15, 2016: Water Research
J M Ageitos, A Sánchez-Pérez, P Calo-Mata, T G Villa
Antimicrobial peptides (AMPs) are short peptidic molecules produced by most living creatures. They help unicellular organisms to successfully compete for nutrients with other organisms sharing their biological niche, while AMPs form part of the immune system of multicellular creatures. Thus, these molecules represent biological weapons that have evolved over millions of years as a result of an escalating arms race for survival among living organisms. All AMPs share common features, such as a small size, with cationic and hydrophobic sequences within a linear or cyclic structure...
September 20, 2016: Biochemical Pharmacology
Aparna Goel, Mollie Biewald, Shirish Huprikar, Thomas Schiano, Gene Y Im
BACKGROUND: Spontaneous bacterial peritonitis (SBP) is a common infection in cirrhosis associated with high mortality. More than 20% of patients with SBP do not respond to initial antibiotics. Guidelines differ in recommendations to repeat paracentesis (retap) to confirm antibiotic efficacy. We aim to evaluate the effect of retap-guided management of SBP on antibiotic escalation and 30-day transplant-free survival. MATERIALS AND METHODS: Retrospective cohort study of cirrhotic patients with SBP admitted to a single transplant center from 2010 to 2014...
September 22, 2016: Journal of Clinical Gastroenterology
Rafael Barberena Moraes, Julián Alberto Viteri Guillén, William Javier Castillo Zabaleta, Flavia Kessler Borges
OBJECTIVE: To evaluate the prevalence of antibiotic de-escalation in patients diagnosed with severe sepsis or septic shock at a public academic tertiary hospital and to evaluate antibiotic adequacy and culture positivity. METHODS: The prevalence of antibiotic de-escalation, the adequacy of antibiotic treatment and the rates of culture positivity were analyzed in patients with severe sepsis and septic shock between April and December 2013 at an intensive care unit in a tertiary university hospital...
September 2016: Revista Brasileira de Terapia Intensiva
Christopher J Graber, Makoto M Jones, Peter A Glassman, Charlene Weir, Jorie Butler, Kevin Nechodom, Chad L Kay, Amy E Furman, Thuong T Tran, Christopher Foltz, Lori A Pollack, Matthew H Samore, Matthew Bidwell Goetz
BACKGROUND: Antibiotic time-outs can promote critical thinking and greater attention to reviewing indications for continuation. OBJECTIVE: We pilot tested an antibiotic time-out program at a tertiary care teaching hospital where vancomycin and piperacillin-tazobactam continuation past day 3 had previously required infectious diseases service approval. METHODS: The time-out program consisted of 3 components: (1) an electronic antimicrobial dashboard that aggregated infection-relevant clinical data; (2) a templated note in the electronic medical record that included a structured review of antibiotic indications and that provided automatic approval of continuation of therapy when indicated; and (3) an educational and social marketing campaign...
November 2015: Hospital Pharmacy
Joseph Paul Weiner, Andrew Thomas Wong, David Schwartz, Manuel Martinez, Ayse Aytaman, David Schreiber
Pelvic radiation is a commonly utilized treatment for malignancy of the genitourinary and lower gastrointestinal tract. Radiation proctitis and the resultant clinical picture varies from asymptomatic to potentially life threatening. Similarly, treatment options also vary greatly, from medical therapy to surgical intervention. Commonly utilized medical therapy includes sucralfate enemas, antibiotics, 5-aminosalicylic acid derivatives, probiotics, antioxidants, short-chain fatty acids, formalin instillation and fractionated hyperbaric oxygen...
August 21, 2016: World Journal of Gastroenterology: WJG
Kevan Akrami, Daniel A Sweeney, Atul Malhotra
No abstract text is available yet for this article.
July 2016: Journal of Thoracic Disease
Mary Lou Manning, Jeanne Pfeiffer, Elaine L Larson
Antibiotic resistance is one of the top infectious disease threats facing the world today. The escalating resistance to antibiotics has been named by the Centers for Disease Control and Prevention as one of the top 5 threats to health in the United States and has led to the development of the National Action Plan for Combating Antibiotic-Resistant Bacteria. The plan, released by the White House in March 2015, calls for the establishment of antibiotic stewardship programs in all acute care hospitals by 2020...
August 31, 2016: American Journal of Infection Control
Jonathan M Fura, Sourav Sarkar, Sean E Pidgeon, Marcos M Pires
The discovery of antibiotics is one of the most significant milestones in modern medicine. Upon the advent of the antibiotic era, invasive surgical procedures, which were previously deemed too risky because of the possibility of bacterial infection, became a reality. In the process, medicine as a whole made great strides that led to the rise of the average human life span by almost three decades. Unfortunately, over the course of time bacteria have started to evolve resistance to antibiotic agents being administered, thus rendering many of these drugs ineffective (or on the verge of being ineffective)...
August 29, 2016: Current Topics in Medicinal Chemistry
Nina M Clark, George G Zhanel, Joseph P Lynch
PURPOSE OF REVIEW: Bacteria within the genus Acinetobacter [principally Acinetobacter baumannii-calcoaceticus complex (ABC)] are Gram-negative coccobacilli that may cause serious nosocomial infections (particularly ventilator-associated pneumonia and infections of the bloodstream, urinary tract, and wounds) as well as community-acquired infections (often skin/soft tissue infections in the context of trauma). Within the past two decades, Acinetobacter spp. have been responsible for an increasing number of infections in intensive care units (ICUs) globally...
October 2016: Current Opinion in Critical Care
Javier Fernández, Frédéric Bert, Marie-Hélène Nicolas-Chanoine
Antimicrobial resistance has become a major global public health security problem that needs coordinated approaches at regional, national and international levels. Antibiotic overuse and the failure of control measures to prevent the spread of resistant bacteria in the healthcare environment have led to an alarming increase in the number of infections caused by resistant bacteria, organisms that resist many (multi-drug and extensively drug-resistant strains), if not all (pan-drug-resistant bacteria) currently available antibiotics...
November 2016: Journal of Hepatology
Gabriel Levy Hara, Souha S Kanj, Leonardo Pagani, Lilian Abbo, Andrea Endimiani, Heiman F L Wertheim, Carlos Amábile-Cuevas, Pierre Tattevin, Shaheen Mehtar, Fernando Lopes Cardoso, Serhat Unal, Ian Gould
The Antibiotic Stewardship and Resistance Working Groups of the International Society for Chemotherapy propose ten key points for the appropriate use of antibiotics in hospital settings. (i) Get appropriate microbiological samples before antibiotic administration and carefully interpret the results: in the absence of clinical signs of infection, colonisation rarely requires antimicrobial treatment. (ii) Avoid the use of antibiotics to 'treat' fever: use them to treat infections, and investigate the root cause of fever prior to starting treatment...
September 2016: International Journal of Antimicrobial Agents
J Gozdowska, M Czerwińska, Ł Chabros, G Młynarczyk, A Kwiatkowski, A Chmura, M Durlik
INTRODUCTION: The aim of this study was to investigate risk factors for urinary tract infections (UTI), the causative organisms of UTI and also their management and treatment. In addition, we evaluated the effects of UTI on renal graft function. METHODS: This analysis included 107 kidney transplant recipients (64% women) with a diagnosis of UTIs confirmed by positive results on urine culture. Type of pathogens, sensitivity to drugs, risk factors for infection, incidence of urosepsis, hospitalization period, treatment methods, and recurrence rates were analyzed...
June 2016: Transplantation Proceedings
Nawal Salahuddin, Lama Amer, Mini Joseph, Alya El Hazmi, Hassan Hawa, Khalid Maghrabi
Introduction. Deescalation refers to either discontinuation or a step-down of antimicrobials. Despite strong recommendations in the Surviving Sepsis Guidelines (2012) to deescalate, actual practices can vary. Our objective was to identify variables that are associated with deescalation failure. Methods. In this prospective study of patients with sepsis/septic shock, patients were categorized into 4 groups based on antibiotic administration: no change in antibiotics, deescalation, escalation (where antibiotics were changed to those with a broader spectrum of antimicrobial coverage), or mixed changes (where both escalation to a broader spectrum of coverage and discontinuation of antibiotics were carried out)...
2016: Critical Care Research and Practice
L S El-Hosseiny, N N Alqurashy, S A Sheweita
Clinical studies have shown that several classes of antibiotics are evidenced in drug induced liver injury. The combination of amoxicillin with clavulanic acid is commonly cited in such cases. Accordingly, the present study investigated the potential hepatoprotective and in vivo antioxidant efficacy of sage essential oil in Co-amoxiclav induced hepatotoxicity in rats. Sage essential oil was hydrodistilled from the aerial parts of Salvia officinalis L. and its compositional analysis was characterized by Gas chromatography-Mass spectroscopy...
June 2016: International Journal of Biomedical Science: IJBS
Liesbet De Bus, Pieter O Depuydt
No abstract text is available yet for this article.
October 2016: Intensive Care Medicine
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