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overuse of antibiotics

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https://www.readbyqxmd.com/read/28728423/changing-antibiotic-prescribing-in-a-primary-care-network-the-role-of-readiness-to-change-and-group-dynamics-in-success
#1
Suratha Elango, Julia E Szymczak, Ian M Bennett, Rinad S Beidas, Rachel M Werner
Overuse of broad-spectrum antibiotics in outpatient pediatrics remains a significant issue and there is limited evidence on how to effectively implement outpatient stewardship interventions. This study examines the relationship between readiness to change and modifiable factors affecting success of a primary care network antibiotic stewardship intervention. A survey designed to measure readiness to accept a health care innovation was administered to 209 clinicians. Practices were split in half into "high" versus "low" readiness to change...
July 1, 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/28727328/-how-to-use-microbiological-diagnostic-tests-in-a-hospital-setting
#2
Romain Martischang, Mohamed Abbas, Stephan Harbarth, Benedikt Huttner, Jacques Schrenzel
Microbiological cultures provide essential information to guide the antibiotic therapy. However, their results might be misleading for physicians and drive useless treatment, sometimes harmful for patients. Recommendations highlight the importance of clinical signs in order to take into account the pre-test probability when interpreting the results. This combination will improve the predictive value of microbiological tests. The sampling strategy is also important to avoid an overuse of these tests but also misleading results through a reduction of contaminants...
April 12, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28710229/pirate-project-point-of-care-informatics-based-randomised-controlled-trial-for-decreasing-overuse-of-antibiotic-therapy-in-gram-negative-bacteraemia
#3
Angela Huttner, Werner C Albrich, Pierre-Yves Bochud, Angèle Gayet-Ageron, Anne Rossel, Elodie von Dach, Stephan Harbarth, Laurent Kaiser
INTRODUCTION: Antibiotic overuse drives antibiotic resistance. The optimal duration of antibiotic therapy for Gram-negative bacteraemia (GNB), a common community and hospital-associated infection, remains unknown and unstudied via randomised controlled trials (RCTs). METHODS AND ANALYSIS: This investigator-initiated, multicentre, non-inferiority, informatics-based point-of-care RCT will randomly assign adult hospitalised patients receiving microbiologically efficacious antibiotic(s) for GNB to (1) 14 days of antibiotic therapy, (2) 7 days of therapy or (3) an individualised duration determined by clinical response and 75% reduction in peak C reactive protein (CRP) values...
July 13, 2017: BMJ Open
https://www.readbyqxmd.com/read/28700964/clinical-and-laboratory-predictors-of-infectious-complications-in-patients-after-out-of-hospital-cardiac-arrest
#4
Josef Kroupa, Jiri Knot, Jaroslav Ulman, Frantisek Bednar, Alena Dohnalova, Zuzana Motovska
PURPOSE: Identification of clinical and laboratory predictors related to Infectious Complications (ICs) in patients after Out-of-Hospital Cardiac Arrest (OHCA). METHODS: Patients, aged >18, after an OHCA between 9/2013 and 11/2015, surviving >24h, were studied. RESULTS: Study group consisted of 42 patients (mean age 63.4years, 88.1% men). Forty percent of patients had IC; lower respiratory tract infections were most common (87.5% of cases)...
July 4, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28694251/advances-in-the-causes-and-management-of-community-acquired-pneumonia-in-adults
#5
REVIEW
Richard G Wunderink, Grant Waterer
Community acquired pneumonia remains a common cause of morbidity and mortality. Usually, the causal organism is not identified and treatment remains empiric. Recent computed tomography and magnetic resonance imaging studies have challenged the accuracy of the clinical diagnosis of pneumonia, and epidemiologic studies are changing our perspective of what causes community acquired pneumonia, especially the role of viral pathogens and the frequent finding of multiple pathogens. The past decade has seen increasing overuse of empiric coverage of meticillin resistant Staphylococcus aureus and antibiotic resistant Gram negative pathogens owing to inappropriate application of guidelines for healthcare associated pneumonia...
July 10, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28684060/top-10-myths-regarding-the-diagnosis-and-treatment-of-cellulitis
#6
Erin K McCreary, Melissa E Heim, Lucas T Schulz, Robert Hoffman, Jeffrey Pothof, Barry Fox
BACKGROUND: Cellulitis is commonly treated in the emergency department (ED). Patients who present with cellulitis incur significant health care costs and may be overtreated with antibiotics. The accurate diagnosis and treatment of cellulitis plays an important role in cost-effective, high-quality medical care, as well as appropriate antibiotic utilization. OBJECTIVE: We aim to describe common fallacies regarding cellulitis. We present 10 myths that result in misdiagnosis, overtreatment, or inappropriate empiric management of cellulitis...
July 3, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28683750/use-of-malaria-rapid-diagnostic-tests-by-community-health-workers-in-afghanistan-cluster-randomised-trial
#7
Toby Leslie, Mark Rowland, Amy Mikhail, Bonnie Cundill, Barbara Willey, Asif Alokozai, Ismail Mayan, Anwar Hasanzai, Sayed Habibullah Baktash, Nader Mohammed, Molly Wood, Habib-U-Rahman Rahimi, Baptiste Laurent, Cyril Buhler, Christopher J M Whitty
BACKGROUND: The World Health Organisation (WHO) recommends parasitological diagnosis of malaria before treatment, but use of malaria rapid diagnostic tests (mRDTs) by community health workers (CHWs) has not been fully tested within health services in south and central Asia. mRDTs could allow CHWs to diagnose malaria accurately, improving treatment of febrile illness. METHODS: A cluster randomised trial in community health services was undertaken in Afghanistan. The primary outcome was the proportion of suspected malaria cases correctly treated for polymerase chain reaction (PCR)-confirmed malaria and PCR negative cases receiving no antimalarial drugs measured at the level of the patient...
July 7, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28668240/influence-of-antibiotic-use-in-early-childhood-on-asthma-and-allergic-diseases-at-age-5
#8
Kiwako Yamamoto-Hanada, Limin Yang, Masami Narita, Hirohisa Saito, Yukihiro Ohya
BACKGROUND: In the past few decades, the prevalence of allergic diseases has increased rapidly worldwide. At the same time, the overuse of antibiotics has been observed, especially in Japan. OBJECTIVE: To elucidate the association of early childhood antibiotic use with allergic diseases in later childhood at 5 years of age. METHODS: Relevant data were extracted from the hospital-based birth cohort study, the Tokyo Children's Health, Illness and Development Study...
July 2017: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/28666918/urinary-tract-infection-after-retrograde-urethrogram-in-children-a-multicenter-study
#9
Neha R Malhotra, Jared R Green, Cynthia K Rigsby, Jane L Holl, Earl Y Cheng, Emilie K Johnson
INTRODUCTION: The risk of post-procedural urinary tract infection (ppUTI) after retrograde urethrogram (RUG) has not been well quantified. Prophylactic antibiotics may reduce the risk, but must be weighed against the risks of antibiotic resistance. Prior research has shown that this risk is variable after voiding cystourethrogram (0-42% reported ppUTI rate) and appears to be low after urodynamics (0-4.8%) but this risk has not been well documented for patients undergoing RUG. OBJECTIVE: We aimed to (1) describe the rate of ppUTI after RUG, and (2) examine factors associated with use of antibiotics at the time of RUG...
June 17, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28653945/microbiological-outcomes-and-antibiotic-overuse-in-emergency-department-patients-with-suspected-sepsis
#10
T C Minderhoud, C Spruyt, S Huisman, E Oskam, S C E Schuit, M D Levin
OBJECTIVE: To study the presence of bacterial disease and antibiotic use in patients in the emergency department (ED) included in the local sepsis protocol. METHODS: An observational retrospective cohort study. Adults aged > 18 years, presenting to the ED of a large teaching hospital, from 1 January to 1 June 2011, with more than two SIRS criteria and a clinical suspicion of sepsis were included. RESULTS: Bacterial disease was suspected or confirmed in only 71% of all the patients with suspected sepsis (2008 definition) and consequently treated with antibiotics...
June 2017: Netherlands Journal of Medicine
https://www.readbyqxmd.com/read/28647364/crystal-structures-of-the-isochorismatase-domains-from-vibrio-anguillarum
#11
Jiansen Du, Tian Deng, Qingjun Ma
Antibiotic resistance is becoming a global threat and overuse of antibiotics in aquaculture disease control worsens the situation. To reduce the risk of drug resistance developed in aquaculture, safer biocontrol programs are needed. Antivirulence therapy, with less chance for developing drug resistance, is a promising approach. To facilitate antivirulence inhibitor design against Vibrio anguillarum, a serious aquaculture pathogen, we present crystal structures for isochorismatase domains of AngB and VabB, which are required to synthesize siderophore, a critical virulence factor...
June 21, 2017: Biochemical and Biophysical Research Communications
https://www.readbyqxmd.com/read/28625839/surveillance-of-upper-respiratory-infections-using-a-new-multiplex-pcr-assay-compared-to-conventional-methods-during-the-influenza-season-in-taiwan
#12
Shu-Chun Chiu, Yung-Cheng Lin, Hsiao-Chi Wang, Jen-Jen Hsu, Ting-Kai Yeh, Hsin-Fu Liu, Jih-Hui Lin
OBJECTIVES: To improve diagnosis as part of laboratory surveillance in Taiwan, influenza-like illness (ILI) surveillance was conducted using a new multiplex PCR assay (FilmArray) and the results compared to those of conventional methods The study was performed during the winter months. METHODS: Throat swabs from patients with an ILI presenting to physicians in sentinel practices were collected during the 2016-2017 influenza season. RESULTS: A total of 52 samples tested positive by FilmArray Respiratory Panel...
June 15, 2017: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/28621106/a-rapid-and-efficient-screening-method-for-antibacterial-compound-producing-bacteria
#13
Sachithra Amarin Hettiarachchi, Su-Jin Lee, Youngdeuk Lee, Young-Kyung Kwon, Mahanama De Zoysa, Song Moon, Eunyoung Jo, Taeho Kim, Do-Hyung Kang, Soo-Jin Heo, Chulhong Oh
Antibacterial compounds are widely used in the treatment of human and animal diseases. The overuse of antibiotics has led to a rapid rise in the prevalence of drug-resistant bacteria, making the development of new antibacterial compounds essential. This study is focused on developing a fast and easy method for identifying marine bacteria that produce antibiotic compounds. Eight randomly selected marine target bacteria species (Agrococcus terreus, Bacillus algicola, Mesoflavibacter zeaxanthinifaciens, Pseudoalteromonas flavipulchra, P...
June 16, 2017: Journal of Microbiology and Biotechnology
https://www.readbyqxmd.com/read/28614101/clinical-characteristics-of-allergy-to-hymenoptera-stings
#14
Nualanong Visitsunthorn, Teera Kijmassuwan, Kittipos Visitsunthorn, Panchama Pacharn, Orathai Jirapongsananuruk
OBJECTIVE: The purpose of this study was to evaluate the clinical characteristics of allergy to stings from the Hymenoptera order of insects in a hospital in Thailand. METHODS: A descriptive retrospective analytical study was carried out in inpatients and outpatients suffering from Hymenoptera stings from 2009 to 2013 in Siriraj Hospital. RESULTS: Medical records of 386 patients with an allergy to Hymenoptera stings were evaluated. Anaphylaxis was more common in patients younger than 15 years, who comprised 22...
June 13, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28603278/transmission-of-the-gut-microbiota-spreading-of-health
#15
REVIEW
Hilary P Browne, B Anne Neville, Samuel C Forster, Trevor D Lawley
Transmission of commensal intestinal bacteria between humans could promote health by establishing, maintaining and replenishing microbial diversity in the microbiota of an individual. Unlike pathogens, the routes of transmission for commensal bacteria remain unappreciated and poorly understood, despite the likely commonalities between both. Consequently, broad infection control measures that are designed to prevent pathogen transmission and infection, such as oversanitation and the overuse of antibiotics, may inadvertently affect human health by altering normal commensal transmission...
June 12, 2017: Nature Reviews. Microbiology
https://www.readbyqxmd.com/read/28602521/gut-microbiota-dysbiosis-in-postweaning-piglets-understanding-the-keys-to-health
#16
REVIEW
Raphaële Gresse, Frédérique Chaucheyras-Durand, Mickaël Alain Fleury, Tom Van de Wiele, Evelyne Forano, Stéphanie Blanquet-Diot
Weaning is a critical event in the pig's life cycle, frequently associated with severe enteric infections and overuse of antibiotics; this raises serious economic and public health concerns. In this review, we explain why gut microbiota dysbiosis, induced by abrupt changes in the diet and environment of piglets, emerges as a leading cause of post-weaning diarrhea, even if the exact underlying mechanisms remain unclear. Then, we focus on nonantimicrobial alternatives, such as zinc oxide, essential oils, and prebiotics or probiotics, which are currently evaluated to restore intestinal balance and allow a better management of the crucial weaning transition...
June 8, 2017: Trends in Microbiology
https://www.readbyqxmd.com/read/28595925/jinggangmycin-suppressed-reproduction-in-the-small-brown-planthopper-sbph-laodelphax-striatellus-fallen-is-mediated-by-glucose-dehydrogenase-gdh
#17
Jun Ding, You Wu, Lin-Lin You, Bin Xu, Lin-Quan Ge, Guo-Qing Yang, Jin-Cai Wu
The small brown planthopper (SBPH), Laodelphax striatellus (Fallen), is a serious pest insect of rice, wheat, and maize in China. SBPH not only sucks plant sap but also transmits plant disease viruses, causing serious damage. These viruses include rice striped virus disease (RSV disease), black streaked dwarf, and maize rough disease virus. SBPH outbreaks are related to the overuse of pesticides in China. Some pesticides, such as triazophos, stimulate the reproduction of SBPH, but an antibiotic fungicide jinggangmycin (JGM) suppresses its reproduction...
June 2017: Pesticide Biochemistry and Physiology
https://www.readbyqxmd.com/read/28587974/a-randomized-controlled-trial-of-sitafloxacin-vs-ertapenem-as-a-switch%C3%A2-therapy-after-treatment-for-acute-pyelonephritis-caused-by-extended-spectrum-%C3%AE-lactamase-producing-escherichia-coli-a-pilot-study
#18
Chitprasong Malaisri, Angsana Phuphuakrat, Arrug Wibulpolprasert, Pitak Santanirand, Sasisopin Kiertiburanakul
BACKGROUND: The overuse and misuse of carbapenems have contributed to the antibiotic resistance crisis. The role of oral fluoroquinolones as a switch therapy for the treatment of urinary tract infection from Escherichia coli (ESBL-EC) is limited. OBJECTIVE: To compare the clinical and bacteriological efficacy of sitafloxacin and ertapenem for non-bacteremic acute pyelonephritis caused by ESBL-EC. METHODS: A prospective randomized controlled trial of patients with acute pyelonephritis caused by ESBL-EC was performed as a pilot study...
August 2017: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://www.readbyqxmd.com/read/28587172/the-rising-tide-of-antimicrobial-resistance-in-aquaculture-sources-sinks-and-solutions
#19
REVIEW
Joy E M Watts, Harold J Schreier, Lauma Lanska, Michelle S Hale
As the human population increases there is an increasing reliance on aquaculture to supply a safe, reliable, and economic supply of food. Although food production is essential for a healthy population, an increasing threat to global human health is antimicrobial resistance. Extensive antibiotic resistant strains are now being detected; the spread of these strains could greatly reduce medical treatment options available and increase deaths from previously curable infections. Antibiotic resistance is widespread due in part to clinical overuse and misuse; however, the natural processes of horizontal gene transfer and mutation events that allow genetic exchange within microbial populations have been ongoing since ancient times...
June 1, 2017: Marine Drugs
https://www.readbyqxmd.com/read/28583227/differential-diagnosis-and-proper-treatment-of-acute-rhinosinusitis-guidance-based-on-historical-data-analysis
#20
Gregor Cevc
BACKGROUND: The time course of rhinovirus positive and negative rhinosinusitis has not been quantified yet, which aggravates proper selection and justification of the optimum treatment for this illness. Such quantitative information would facilitate an early and proper identification of the disease and its differentiation from acute bacterial rhinosinusitis, and could diminish harmful overuse of antibiotics, arguably driven by patients' want for attention and the treating physicians' inability to offer an adequate verbal comfort in its stead...
June 1, 2017: Allergy & Rhinology
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