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Appropriate Antibiotic Use for Acute Respiratory Tract Infection in Adults

Susanna Esposito, Chiara Rosazza, Calogero Sathya Sciarrabba, Nicola Principi
Upper respiratory tract infections (URTIs), primarily acute rhinopharyngitis, tonsillitis, adenoiditis, and rhinosinusitis (RS), are major causes of morbidity in both children and adults of any age. In addition to the frequent occurrence of related medical problems and the associated socioeconomic costs, URTIs have a significant impact on the quality of life of patients and their families, and have placed an escalating financial burden on the global healthcare system. Most URTIs are caused by viruses and require only symptomatic treatment...
June 23, 2016: Journal of Aerosol Medicine and Pulmonary Drug Delivery
Sompong Khamsarn, Yupin Nampoonsak, Supunnee Busamaro, Teerawit Tangkoskul, Chakkraphong Seenama, Pinyo Rattanaumpawan, Adhiratha Boonyasiri, Visanu Thamlikitkul
OBJECTIVE: To generate epidemiological information regarding antibiotic use and antimicrobial resistance (AMR) in targeted communities for use by the Thailand AMR Containment and Prevention Program. MATERIAL AND METHOD: A survey of antibiotics sold by 215 grocery stores and retail shops located in the target communities was done by the local people who were instructed to purchase specified antibiotics and to present to such stores and shops with symptoms of sore throat, backache, common cold, acute diarrhea, inflamed uterus, and dysuria...
March 2016: Journal of the Medical Association of Thailand, Chotmaihet Thangphaet
Katherine Loens, Margareta Ieven
Mycoplasma pneumoniae (M. pneumoniae) belongs to the class Mollicutes and has been recognized as a common cause of respiratory tract infections (RTIs), including community-acquired pneumonia (CAP), that occur worldwide and in all age groups. In addition, M. pneumoniae can simultaneously or sequentially lead to damage in the nervous system and has been associated with a wide variety of other acute and chronic diseases. During the past 10 years, the proportion of LRTI in children and adults, associated with M...
2016: Frontiers in Microbiology
Aaron M Harris, Lauri A Hicks, Amir Qaseem
BACKGROUND: Acute respiratory tract infection (ARTI) is the most common reason for antibiotic prescription in adults. Antibiotics are often inappropriately prescribed for patients with ARTI. This article presents best practices for antibiotic use in healthy adults (those without chronic lung disease or immunocompromising conditions) presenting with ARTI. METHODS: A narrative literature review of evidence about appropriate antibiotic use for ARTI in adults was conducted...
March 15, 2016: Annals of Internal Medicine
Anita Shet, Suba Sundaresan, Birger C Forsberg
BACKGROUND: Inappropriate antibiotic use for treatment of common self-limiting infections is a major problem worldwide. We conducted this study to determine prevalence of non-prescription sale of antimicrobial drugs by pharmacies in Bangalore, India, and to assess their associated avoidable cost within the Indian private healthcare sector. METHODS: Between 2013 and 2014, two researchers visited 261 pharmacies with simulated clinical scenarios; upper respiratory tract infection in an adult and acute gastroenteritis in a child...
2015: Antimicrobial Resistance and Infection Control
J M Fitzpatrick, J S Biswas, J D Edgeworth, J Islam, N Jenkins, R Judge, A J Lavery, M Melzer, S Morris-Jones, E F Nsutebu, J Peters, D G Pillay, F Pink, J R Price, M Scarborough, G E Thwaites, R Tilley, A S Walker, M J Llewelyn
Increasing antibiotic resistance makes choosing antibiotics for suspected Gram-negative infection challenging. This study set out to identify key determinants of mortality among patients with Gram-negative bacteraemia, focusing particularly on the importance of appropriate empiric antibiotic treatment. We conducted a prospective observational study of 679 unselected adults with Gram-negative bacteraemia at ten acute english hospitals between October 2013 and March 2014. Appropriate empiric antibiotic treatment was defined as intravenous treatment on the day of blood culture collection with an antibiotic to which the cultured organism was sensitive in vitro...
March 2016: Clinical Microbiology and Infection
Cédric Etienne, Céline Pulcini
OBJECTIVES: The aim of our study was to assess the quality of antibiotic prescriptions in a sample of general practitioners (GPs) receiving junior doctors in training, whatever the motive of the prescription. METHODS: We performed a prospective observational study of all antibiotics prescribed in October 2012 by 21 GPs working in southeastern France. Two specialists (general medicine and infectious diseases) independently assessed the compliance with recommendations of antibiotic prescriptions using a validated algorithm...
March 2015: La Presse Médicale
Shaulnie Mohan, Katelin Sisler, Kara Christopher, Joshua Hentzelman, Jastin Antisdel
BACKGROUND: Sinusitis is diagnosed in 31 million individuals annually and has a significant impact on health care expenditures. Otolaryngologists understand that patient expectations, health knowledge, and the use of therapeutic options by patients and primary care physicians (PCPs) vary greatly. The intent of this study was to elucidate differences in the perspectives of patients, PCPs and otolaryngologists regarding the diagnosis and treatment of sinonasal disease. METHODS: Three surveys were developed with questions targeting sinonasal infections: specifically, prevalence, diagnosis, physician prescribing patterns, treatment alternatives, and referral patterns to tertiary level physicians...
November 2014: American Journal of Rhinology & Allergy
F Casas Maldonado, I Alfageme Michavila, V S Barchilón Cohen, J I Peis Redondo, D A Vargas Ortega
Community-acquired pneumonia is an acute respiratory infectious disease which has an incidence of 3-8 cases/1,000 inhabitants, and increases with age and comorbidities. The pneumococcus is the organism most frequently involved in community-acquired pneumonia in the adult (30-35%). Around 40% of patients with community-acquired pneumonia require hospital admission, and around 10% need to be admitted to an intensive care unit. The most serious forms of pneumococcal infection include invasive pneumococcal disease (IPD), which covers cases of bacteremia (associated or not to pneumonia), meningitis, pleuritis, arthritis, primary peritonitis and pericarditis...
September 2014: Semergen
John P Donnelly, John W Baddley, Henry E Wang
Inappropriate use of antibiotics for acute respiratory tract infections (ARTIs) has decreased in many outpatient settings. For patients presenting to U.S. emergency departments (EDs) with ARTIs, antibiotic utilization patterns are unclear. We conducted a retrospective cohort study of ED patients from 2001 to 2010 using data from the National Hospital Ambulatory Medical Care Survey (NHAMCS). We identified patients presenting to U.S. EDs with ARTIs and calculated rates of antibiotic utilization. Diagnoses were classified as antibiotic appropriate (otitis media, sinusitis, pharyngitis, tonsillitis, and nonviral pneumonia) or antibiotic inappropriate (nasopharyngitis, unspecified upper respiratory tract infection, bronchitis or bronchiolitis, viral pneumonia, and influenza)...
2014: Antimicrobial Agents and Chemotherapy
Kathryn M Harmes, R Alexander Blackwood, Heather L Burrows, James M Cooke, R Van Harrison, Peter P Passamani
Acute otitis media is diagnosed in patients with acute onset, presence of middle ear effusion, physical evidence of middle ear inflammation, and symptoms such as pain, irritability, or fever. Acute otitis media is usually a complication of eustachian tube dysfunction that occurs during a viral upper respiratory tract infection. Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis are the most common organisms isolated from middle ear fluid. Management of acute otitis media should begin with adequate analgesia...
October 1, 2013: American Family Physician
Stephen D Persell, Mark W Friedberg, Daniella Meeker, Jeffrey A Linder, Craig R Fox, Noah J Goldstein, Parth D Shah, Tara K Knight, Jason N Doctor
BACKGROUND: Inappropriate antibiotic prescribing for nonbacterial infections leads to increases in the costs of care, antibiotic resistance among bacteria, and adverse drug events. Acute respiratory infections (ARIs) are the most common reason for inappropriate antibiotic use. Most prior efforts to decrease inappropriate antibiotic prescribing for ARIs (e.g., educational or informational interventions) have relied on the implicit assumption that clinicians inappropriately prescribe antibiotics because they are unaware of guideline recommendations for ARIs...
2013: BMC Infectious Diseases
Michael L Grover, Jon T Nordrum, Martina Mookadam, Richard L Engle, Carolyn C Moats, Brie N Noble
The objective of this study was to educate health care providers and patients to reduce overall antibiotic prescription rates for patients with acute respiratory tract infection (ARTI). An interdisciplinary quality improvement team used the Define, Measure, Analyze, Improve, and Control quality improvement process to change patient expectations and provider antibiotic prescribing patterns. Providers received personal and group academic detailing about baseline behaviors, copies of treatment guidelines, and educational materials to use with patients...
November 2013: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
Cara B Litvin, Steven M Ornstein, Andrea M Wessell, Lynne S Nemeth, Paul J Nietert
BACKGROUND: Antibiotics are often inappropriately prescribed for acute respiratory infections (ARIs). OBJECTIVE: To assess the impact of a clinical decision support system (CDSS) on antibiotic prescribing for ARIs. DESIGN: A two-phase, 27-month demonstration project. SETTING: Nine primary care practices in PPRNet, a practice-based research network whose members use a common electronic health record (EHR). PARTICIPANTS: Thirty-nine providers were included in the project...
June 2013: Journal of General Internal Medicine
Kim E Kavanagh, Eamonn O'Shea, Rita Halloran, Peter Cantillon, Andrew W Murphy
BACKGROUND: New approaches are being sought to safely reduce community antibiotic prescribing. A recent study demonstrated that CRP testing resulted in decreased antibiotic prescribing for lower respiratory tract infection in primary care. There is little other published primary care data available evaluating CRP in the treatment of lower respiratory tract infections in routine clinical practice. This pilot study aims to describe the performance of near-patient CRP testing, in a mixed payments health system...
2011: BMC Family Practice
Erika Leemann Price, Thomas D Mackenzie, Joshua P Metlay, Carlos A Camargo, Ralph Gonzales
BACKGROUND: Over-use of antibiotics for acute respiratory infections (ARIs) increases antimicrobial resistance, treatment costs, and side effects. Patient desire for antibiotics contributes to over-use. OBJECTIVE: To explore whether a point-of-care interactive computerized education module increases patient knowledge and decreases desire for antibiotics. METHODS: Bilingual (English/Spanish) interactive kiosks were available in 8 emergency departments as part of a multidimensional intervention to reduce antibiotic prescribing for ARIs...
December 2011: Patient Education and Counseling
Jeffrey A Linder, Jeffrey L Schnipper, Ruslana Tsurikova, Tony Yu, Lynn A Volk, Andrea J Melnikas, Matvey B Palchuk, Maya Olsha-Yehiav, Blackford Middleton
BACKGROUND AND OBJECTIVE: Clinical guidelines discourage antibiotic prescribing for many acute respiratory infections (ARIs), especially for non-antibiotic appropriate diagnoses. Electronic health record (EHR)-based clinical decision support has the potential to improve antibiotic prescribing for ARIs. METHODS: We randomly assigned 27 primary care clinics to receive an EHR-integrated, documentation-based clinical decision support system for the care of patients with ARIs - the ARI Smart Form - or to offer usual care...
2009: Informatics in Primary Care
Alessandro Liberati, Roberto D'Amico, Silvia Pifferi, Valter Torri, Luca Brazzi, Elena Parmelli
BACKGROUND: Pneumonia is an important cause of mortality in intensive care units (ICUs). The incidence of pneumonia in ICU patients ranges between 7% and 40%, and the crude mortality from ventilator-associated pneumonia may exceed 50%. Although not all deaths in patients with this form of pneumonia are directly attributable to pneumonia, it has been shown to contribute to mortality in ICUs independently of other factors that are also strongly associated with such deaths. OBJECTIVES: To assess the effects of prophylactic antibiotic regimens, such as selective decontamination of the digestive tract (SDD) for the prevention of respiratory tract infections (RTIs) and overall mortality in adults receiving intensive care...
2009: Cochrane Database of Systematic Reviews
Hortensia Reyes-Morales, Sergio Flores-Hernández, Patricia Tomé-Sandoval, Ricardo Pérez-Cuevas
BACKGROUND AND OBJECTIVES: The Mexican Institute of Social Security (IMSS) is the largest public health care system in Mexico. IMSS family physicians' management of clinical problems is frequently not consistent with published evidence. This study aimed to evaluate the effects of a multifaceted educational intervention to improve management of acute respiratory infections (ARI) by IMSS family physicians. METHODS: A non-randomized pre-post intervention with comparison group design was conducted in eight IMSS family medicine clinics in which 106 family physicians practiced...
April 2009: Family Medicine
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