scholarly journals 1454. Cephalosporins and Quinolones Account for 95 Percent of Oral Antibiotic Treatment for Uncomplicated Cystitis in Japan

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S531-S531
Author(s):  
Yoshiki Kusama ◽  
Masahiro Ishikane ◽  
Tomomi Kihara ◽  
Norio Ohmagari
Keyword(s):  
Treatment Failure ◽  
Antibiotic Treatment ◽  
High Morbidity ◽  
Oral Antibiotic ◽  
Acute Cystitis ◽  
New Antibiotics ◽  
Antibiotics Use ◽  
Fosfomycin Trometamol ◽  
Almost All ◽  
Uncomplicated Cystitis

Abstract Background Uncomplicated cystitis (UC) imposes a large burden on antimicrobial use due to its high morbidity. IDSA/ESCMID guidelines recommend nitrofurantoin, sulfamethoxazole/trimethoprim (SMX/TMP), fosfomycin trometamol, and pivmecillinam for treating UC, but only SMX/TMP and fosfomycin calcium (FOM-C) are available in Japan. Therefore, we examined the antibiotics use to treat UC in Japan. Methods We obtained data from the JMDC Inc. claims database, which includes data of corporate employees and their family members. We extracted all records of oral antibiotic prescriptions for the treatment of acute cystitis (ICD-10 code: N300) between 2013 and 2016, and excluded prescriptions for male individuals and inpatients because they were considered to have complicated cystitis. Prescriptions for durations >7 days were also excluded because they were potentially prophylactic. Furthermore, we defined treatment failure as cases that required re-prescription within 13 days after the first prescription and estimated the treatment failure rate (TFR) of each antibiotic. Results Cephalosporins and quinolones accounted for 41.5% and 53.2% of the total number of antibiotic prescriptions (48,678). SMX/TMP and FOM-C only accounted for 0.7% and 0.8%. Third-generation cephalosporins accounted for 93.8% of total cephalosporins. TFR was less than 10% across almost all antibiotic categories, with the only exception being FOM-C. Conclusion Cephalosporins and quinolones accounted for 94.7% of oral antibiotic treatment for UC in Japan between 2013 and 2016. To avoid spreading antimicrobial resistance, approval of new antibiotics with good efficacy or an official recommendation for the use of narrower-spectrum antibiotics for treating UC may be required. Disclosures All authors: No reported disclosures.

scholarly journals LO52: Predictors of oral antibiotic treatment failure for non-purulent skin and soft tissue infections in the emergency department

CJEM ◽  
2018 ◽  
Vol 20 (S1) ◽  
pp. S24-S25 ◽  
Author(s):  
K. Yadav ◽  
K. Suh ◽  
D. Eagles ◽  
J. MacIsaac ◽  
D. Ritchie ◽  
...  
Keyword(s):  
Treatment Failure ◽  
Antibiotic Treatment ◽  
Oral Antibiotic ◽  
Soft Tissue Infections ◽  
Emergency Physicians ◽  
Intravenous Antibiotic ◽  
The Past ◽  
History Of ◽  
Chronic Ulcers ◽  
Mrsa Colonization

Introduction: Current guideline recommendations for optimal management of non-purulent skin and soft tissue infections (SSTIs) are based on expert consensus. There is currently a lack of evidence to guide emergency physicians on when to select oral versus intravenous antibiotic therapy. The primary objective was to identify risk factors associated with oral antibiotic treatment failure. A secondary objective was to describe the epidemiology of adult emergency department (ED) patients with non-purulent SSTIs. Methods: We performed a health records review of adults (age 18 years) with non-purulent SSTIs treated at two tertiary care EDs. Patients were excluded if they had a purulent infection or infected ulcers without surrounding cellulitis. Treatment failure was defined any of the following after a minimum of 48 hours of oral therapy: (i) hospitalization for SSTI; (ii) change in class of oral antibiotic owing to infection progression; or (iii) change to intravenous therapy owing to infection progression. Multivariable logistic regression was used to identify predictors independently associated with the primary outcome of oral antibiotic treatment failure after a minimum of 48 hours of oral therapy. Results: We enrolled 500 patients (mean age 64 years, 279 male (55.8%) and 126 (25.2%) with diabetes) and the hospital admission rate was 29.6%. The majority of patients (70.8%) received at least one intravenous antibiotic dose in the ED. Of 288 patients who had received a minimum of 48 hours of oral antibiotics, there were 85 oral antibiotic treatment failures (29.5%). Tachypnea at triage (odds ratio [OR]=6.31, 95% CI=1.80 to 22.08), chronic ulcers (OR=4.90, 95% CI=1.68 to 14.27), history of MRSA colonization or infection (OR=4.83, 95% CI=1.51 to 15.44), and cellulitis in the past 12 months (OR=2.23, 95% CI=1.01 to 4.96) were independently associated with oral antibiotic treatment failure. Conclusion: This is the first study to evaluate potential predictors of oral antibiotic treatment failure for non-purulent SSTIs in the ED. We observed a high rate of treatment failure and hospitalization. Tachypnea at triage, chronic ulcers, history of MRSA colonization or infection and cellulitis within the past year were independently associated with oral antibiotic treatment failure. Emergency physicians should consider these risk factors when deciding on oral versus intravenous antimicrobial therapy for non-purulent SSTIs being managed as outpatients.

scholarly journals General principles of uncomplicated cystitis therapy during pregnancy

2021 ◽  
pp. 121-126
Author(s):  
V. L. Tyutyunnik ◽  
N. E. Kan ◽  
L. V. Khachatryan
Keyword(s):  
Pregnant Women ◽  
Clinical Symptoms ◽  
Acute Cystitis ◽  
Microbiological Test ◽  
Fosfomycin Trometamol ◽  
Acute Uncomplicated Cystitis ◽  
Tract Infections ◽  
Uncomplicated Cystitis ◽  
Total Elimination

Urinary tract infections during pregnancy are associated with severe complications. Earlier initiation of antibiotic treatment for acute uncomplicated cystitis, reduces the various complications.Objective. To assess the effectiveness of fosfomycin in the treatment of acute uncomplicated cystitis during II and III trimester of pregnancy.Material and methods. The study included 74 pregnant women who had acute uncomplicated cystitis in II or III trimesters. All patients received fosfomycin trometamol 3.754 g (equivalent to 3 g fosfomycin) as antimicrobial therapy for acute uncomplicated cystitis. The drug was prescribed to 24 pregnant women in the II, and 50 in the III trimester of pregnancy.Results. After treatment with fosfomycin signs of acute cystitis gone in all patients. At the same time, regression of clinical symptoms was noted during the next days after therapy in 95.9% (n = 71) of cases. Repeated microbiological test of the middle portion of urine was performed 7 days after the end of antibiotic therapy. In 94.6% (n = 70) cases, total elimination of the pathogen was achieved. In 5.4% (n = 4) cases, there was a significant decrease of colonization Follow-up for three months showed the absence of recurrence of acute cystitis in all pregnant women who were included in the study.Conclusion. Fosfomycin is a highly effective drug in the treatment of uncomplicated cystitis during pregnancy.

scholarly journals Is there an association between long-term antibiotics for acne and subsequent infection sequelae and antimicrobial resistance? A systematic review protocol

BMJ Open ◽  
2020 ◽  
Vol 10 (7) ◽  
pp. e033662 ◽  
Author(s):  
Ketaki Bhate ◽  
Liang-Yu Lin ◽  
John Barbieri ◽  
Clémence Leyrat ◽  
Susan Hopkins ◽  
...  
Keyword(s):  
Systematic Review ◽  
Antimicrobial Resistance ◽  
Treatment Failure ◽  
Antibiotic Treatment ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Oral Antibiotic ◽  
Oral Antibiotics ◽  
The Impact

IntroductionAntimicrobial resistance (AMR) is a global health emergency. Acne vulgaris is a highly prevalent condition and the dominant role antibiotics play in its treatment is a major concern. Antibiotics are widely used in the treatment of acne predominantly for their anti-inflammatory effect, hence their use in acne may not be optimal. Tetracyclines and macrolides are the two most common oral antibiotic classes prescribed, and their average use can extend from a few months to several years of intermittent or continuous use. The overall aim of this systematic review is to elucidate what is known about oral antibiotics for acne contributing to antibiotic treatment failure and AMR.Methods and analysisA systematic review will be conducted to address the question: What is the existing evidence that long-term oral antibiotics used to treat acne in those over 8 years of age contribute towards antibiotic treatment failure or other outcomes suggestive of the impact of AMR? We will search the following databases: Embase, MEDLINE, the Cochrane Library and Web of Science. Search terms will be developed in collaboration with a librarian by identifying keywords from relevant articles and by undertaking pilot searches. Randomised controlled trials, cohort and case-controlled studies conducted in any healthcare setting and published in any language will be included. The searches will be re-run prior to final analyses to capture the recent literature. The Cochrane tool for bias assessment in randomised trials and ROBINS-I for the assessment of bias in non-randomised studies will be used to assess the risk of bias of included studies. GRADE will be used to make an overall assessment of the quality of evidence. A meta-analysis will be undertaken of the outcome measures if the individual studies are sufficiently homogeneous. If a meta-analysis is not possible, a qualitative assessment will be presented as a narrative review.Ethics and disseminationEthical approval is not required for this systematic-review. The results will be published in a peer-reviewed journal and any deviations from the protocol will be clearly documented in the published manuscript of the full systematic-review.PROSPERO registration numberCRD42019121738.

scholarly journals Prevalence and predictors of initial oral antibiotic treatment failure in adult emergency department patients with cellulitis: a pilot study

BMJ Open ◽  
2015 ◽  
Vol 5 (6) ◽  
pp. e008150 ◽  
Author(s):  
Michael Quirke ◽  
Fiona Boland ◽  
Tom Fahey ◽  
Ronan O'Sullivan ◽  
Arnold Hill ◽  
...  
Keyword(s):  
Emergency Department ◽  
Pilot Study ◽  
Treatment Failure ◽  
Antibiotic Treatment ◽  
Oral Antibiotic ◽  
Emergency Department Patients

scholarly journals Can We Predict Oral Antibiotic Treatment Failure in Children with Fast-Breathing Pneumonia Managed at the Community Level? A Prospective Cohort Study in Malawi

PLoS ONE ◽  
2015 ◽  
Vol 10 (8) ◽  
pp. e0136839 ◽  
Author(s):  
Carina King ◽  
Eric D. McCollum ◽  
Limangeni Mankhambo ◽  
Tim Colbourn ◽  
James Beard ◽  
...  
Keyword(s):  
Cohort Study ◽  
Treatment Failure ◽  
Antibiotic Treatment ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Community Level ◽  
Oral Antibiotic

Catheterization Does Not Improve Course of Disease in Female Patients with Acute Cystitis or Pyelonephritis: Retrospective Analysis of >300 In-Hospital Treated Patients

2021 ◽  
pp. 1-9
Author(s):  
Mike Wenzel ◽  
Benedikt Hoeh ◽  
Konstatin Goeldner ◽  
Felix Preisser ◽  
Christoph Würnschimmel ◽  
...  
Keyword(s):  
Antibiotic Treatment ◽  
University Hospital ◽  
White Blood Count ◽  
Hospital Treatment ◽  
Acute Cystitis ◽  
Logistic Regression Models ◽  
Female Patients ◽  
Reactive Protein ◽  
Catheter Group ◽  
Multivariable Analyses

<b><i>Purpose:</i></b> Females with in-hospital treatment for acute cystitis (AC) or pyelonephritis may benefit from catheterization at admission. <b><i>Methods:</i></b> All female patients with AC or pyelonephritis requiring in-hospital treatment at University Hospital Frankfurt (2004–2019) were retrospectively analyzed. Logistic regression models were used to predict the catheter value. <b><i>Results:</i></b> Of 310 female patients, 40% harbored AC versus 60% pyelonephritis, of whom 62% and 74% received a catheter at admission: C-reactive protein (CRP) and white blood count (WBC) were significantly elevated in AC and pyelonephritis catheter versus no catheter patients (both <i>p</i> &#x3c; 0.05). Time to CRP and WBC nadir did not differ between the AC catheter versus no catheter group (both <i>p</i> &#x3e; 0.05). Conversely, time to CRP nadir was prolonged in pyelonephritis catheter patients. AC and pyelonephritis catheter patients exhibited a prolonged antibiotic treatment and length of stay (LOS, both <i>p</i> &#x3c; 0.05). In multivariable analyses, CRP &#x3e;5 ng/mL was a predictor for receiving a catheter in all patients. In AC, a positive urine culture and fever predicted, respectively, prolonged LOS or antibiotic treatment (all <i>p</i> &#x3c; 0.05). <b><i>Conclusion:</i></b> Risk factors exist with regard to receiving a catheter and prolonged antibiotic treatment or LOS in females with AC or pyelonephritis. A catheter may not accelerate recovery or WBC nadir.

Future directions for the discovery of antibiotics from actinomycete bacteria

2017 ◽  
Vol 1 (1) ◽  
pp. 1-12 ◽  
Author(s):  
Rebecca Devine ◽  
Matthew I. Hutchings ◽  
Neil A. Holmes
Keyword(s):  
New Technologies ◽  
Gene Clusters ◽  
Biosynthetic Gene Clusters ◽  
Future Directions ◽  
Streptomyces Species ◽  
Genus Streptomyces ◽  
New Antibiotics ◽  
The Uk ◽  
Almost All ◽  
New Generation

Antimicrobial resistance (AMR) is a growing societal problem, and without new anti-infective drugs, the UK government-commissioned O'Neil report has predicted that infectious disease will claim the lives of an additional 10 million people a year worldwide by 2050. Almost all the antibiotics currently in clinical use are derived from the secondary metabolites of a group of filamentous soil bacteria called actinomycetes, most notably in the genus Streptomyces. Unfortunately, the discovery of these strains and their natural products (NPs) peaked in the 1950s and was then largely abandoned, partly due to the repeated rediscovery of known strains and compounds. Attention turned instead to rational target-based drug design, but this was largely unsuccessful and few new antibiotics have made it to clinic in the last 60 years. In the early 2000s, however, genome sequencing of the first Streptomyces species reinvigorated interest in NP discovery because it revealed the presence of numerous cryptic NP biosynthetic gene clusters that are not expressed in the laboratory. Here, we describe how the use of new technologies, including improved culture-dependent and -independent techniques, combined with searching underexplored environments, promises to identify a new generation of NP antibiotics from actinomycete bacteria.

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