Narrow-spectrum antibiotics are as effective as broad-spectrum antibiotics in the treatment of community-acquired pneumonia

2015 ◽  
Vol 100 (4) ◽  
pp. 223-223 ◽  
Author(s):  
Anna Selby ◽  
Katrina Pettit ◽  
Nick Brown
Keyword(s):  
Broad Spectrum ◽  
Community Acquired Pneumonia ◽  
Narrow Spectrum ◽  
Broad Spectrum Antibiotics

scholarly journals Evidence Update for Parents: Narrow- versus Broad-Spectrum Antibiotics for Common Infections in Children

2018 ◽  
Author(s):  
Keyword(s):  
Broad Spectrum ◽  
The Other ◽  
Narrow Spectrum ◽  
Broad Spectrum Antibiotics ◽  
Throat Infection ◽  
Research Findings ◽  
New Research ◽  
Common Infections

Choosing an Antibiotic for Your Child's Ear, Nose, or Throat Infection. New research findings can help you and your child’s clinician figure out the best option for treating your child’s infection. When bacteria cause your child’s ear, nose, or throat infection, your clinician will suggest one of two kinds of antibiotics. One kind is narrow-spectrum antibiotics. These medicines fight just the bacteria that are most likely causing your child’s ear, nose, or throat infection. Examples are amoxicillin or Amoxil®. The other kind is broad-spectrum antibiotics. These medicines fight many kinds of bacteria at the same time. Examples are azithromycin or Z-Pak®.

scholarly journals Comparative analysis of the effectiveness of narrow-spectrum versus broad-spectrum antibiotics for the treatment of childhood pneumonia

2021 ◽  
Vol 9 ◽  
pp. 205031212110443
Author(s):  
Chilot Abiyu Demeke ◽  
Getnet Mequanent Adinew ◽  
Tamrat Befekadu Abebe ◽  
Abebech Tewabe Gelaye ◽  
Sisay G/Hana Gemeda ◽  
...  
Keyword(s):  
Broad Spectrum ◽  
Statistical Significance ◽  
Community Acquired Pneumonia ◽  
Referral Hospital ◽  
P Value ◽  
Data Set ◽  
Treatment Regimens ◽  
Narrow Spectrum ◽  
Significant Difference ◽  
The University

Objectives: The main objective of this study was to compare the effectiveness of empiric treatment with narrow-spectrum therapy versus broad-spectrum therapy for children hospitalized with community-acquired pneumonia (CAP) at the University of Gondar Referral Hospital, Gondar, Ethiopia. Methods: Institutional-based retrospective chart review was conducted at the University of Gondar Referral Hospital (GURH) pediatrics ward from 1 February 2016 to 30 April 2016. The collected data were entered and analyzed using Statistical Package for Social Sciences (SPSS) version 20. Descriptive statistics were done to present the basic features and summary of the data set. In addition, binary logistics and multivariable logistic regression analysis were conducted to test for an association between the dependent and independent variables. A P value of <0.05 was taken to declare statistical significance at a 95% confidence interval. Result: A total of 147 patients with CAP were included in the study. Seven different treatment regimens were employed for the 147 children hospitalized. About 63 (42.9%) of the study participants received a narrow-spectrum antibiotic and 84 (57.1%) received a broad-spectrum antibiotic. There was no significant difference between the broad and narrow spectrum treatment groups in main treatment outcomes. The median length of stay (LOS) for the study population was 3 days. The median LOS was shorter among those receiving narrow-spectrum therapy compared with those receiving broad-spectrum therapy. Treatment dose and duration of therapy were significantly associated with treatment outcome (P < 0.0001 and P = 0.003), respectively. Conclusion: The effectiveness of narrow-spectrum therapy is similar to that of broad-spectrum therapy for children hospitalized with CAP. Treatment regimens for children with community-acquired pneumonia should be selected based on their safety profile and their tendency for antibiotic resistance.

scholarly journals Supramolecular antibiotics: a strategy for conversion of broad-spectrum to narrow-spectrum antibiotics for Staphylococcus aureus

Nanoscale ◽  
2020 ◽  
Vol 12 (40) ◽  
pp. 20693-20698
Author(s):  
Thameez M. Koyasseril-Yehiya ◽  
Alam García-Heredia ◽  
Francesca Anson ◽  
Poornima Rangadurai ◽  
M. Sloan Siegrist ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Broad Spectrum ◽  
Bacterial Population ◽  
Narrow Spectrum ◽  
Broad Spectrum Antibiotics

Supramolecular antibiotics: a reactive supramolecular disassembly approach ensures the narrow delivery of broad-spectrum antibiotics to selectively target pathogenic bacterial population.

scholarly journals 921. Antibiotic Prescribing for Children in Family Medicine Clinics Within a Practice Research Network

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S27-S27
Author(s):  
Nicole Poole ◽  
Matthew Kronman ◽  
Jeffrey S Gerber ◽  
Laura-Mae Baldwin ◽  
Danielle Zerr
Keyword(s):  
Family Medicine ◽  
Broad Spectrum ◽  
Acute Otitis Media ◽  
Community Acquired Pneumonia ◽  
Research Network ◽  
Practice Research ◽  
Antibiotic Prescribing ◽  
First Line ◽  
Broad Spectrum Antibiotics ◽  
Tract Infections

Abstract Background Family medicine clinics provide care for one-third of US children, yet comprehensive data about antibiotic prescribing in this patient population are lacking. We aimed to characterize antibiotic prescribing for children in family medicine clinics. Methods A retrospective cohort of patients aged 0–17 years with a visit to a family medicine clinic within the Washington, Wyoming, Alaska, Montana, and Idaho (WWAMI) Region Practice and Research Network (WPRN) from January 1, 2014 to April 30, 2017 was studied. Patients with complex chronic conditions were excluded. We defined narrow-spectrum antibiotics as penicillin, amoxicillin, first-generation cephalosporins, sulfonamides, and nitrofurantoin; and broad-spectrum antibiotics otherwise. On the basis of national guideline recommendations and a previously published hierarchical classification system, we assigned diagnoses to one of the 3 tiers: diagnoses for which antibiotics were (1) almost always indicated (e.g., bacterial pneumonia), (2) may be indicated (e.g., pharyngitis), and (3) generally not indicated (e.g., bronchiolitis/bronchitis). Results We studied 20,779 pediatric patients with 97,228 clinic visits. Oral antibiotics were prescribed in 10,922 (11%) of all encounters. The median rate of antibiotic prescribing among providers was 14% (interquartile range: 4.9%–18.5%). Of all antibiotics prescribed, 51% were broad-spectrum agents. Acute respiratory tract infections (ARTIs) accounted for 67% of all antibiotics prescribed. Of the antibiotics prescribed for ARTI, 25% were for diagnoses where antibiotics are generally not indicated. First-line guideline-recommended antibiotics were prescribed in 80% of acute otitis media, 80% of sinusitis, 68% of pharyngitis, and 31% of community acquired pneumonia diagnoses. Azithromycin monotherapy was prescribed in 52% of community acquired pneumonia diagnoses. Conclusion Specific targets for improving antimicrobial prescribing within a family medicine practice research network include prescribing of broad-spectrum antibiotics (particularly azithromycin), prescribing for conditions where antibiotics are not indicated, and first-line guideline-recommended prescribing for pharyngitis and community acquired pneumonia. Disclosures All authors: No reported disclosures.

scholarly journals Multistep antimicrobial stewardship intervention on antibiotic prescriptions and treatment duration in children with pneumonia

PLoS ONE ◽  
2021 ◽  
Vol 16 (10) ◽  
pp. e0257993
Author(s):  
Sara Rossin ◽  
Elisa Barbieri ◽  
Anna Cantarutti ◽  
Francesco Martinolli ◽  
Carlo Giaquinto ◽  
...  
Keyword(s):  
Antibiotic Therapy ◽  
Broad Spectrum ◽  
Antibiotic Stewardship ◽  
Clinical Pathways ◽  
Community Acquired Pneumonia ◽  
Broad Spectrum Antibiotics ◽  
Outpatient Group ◽  
Before And After ◽  
Tract Infections ◽  
The Impact

Introduction The Italian antimicrobial prescription rate is one of the highest in Europe, and antibiotic resistance has become a serious problem with high costs and severe consequences, including prolonged illnesses, the increased period of hospitalization and mortality. Inadequate antibiotic prescriptions have been frequently reported, especially for lower respiratory tract infections (LRTI); many patients receive antibiotics for viral pneumonia or bronchiolitis or broad-spectrum antibiotics for not complicated community-acquired pneumonia. For this reason, healthcare organizations need to implement strategies to raise physicians’ awareness about this kind of drug and their overall effect on the population. The implementation of antibiotic stewardship programs and the use of Clinical Pathways (CPs) are excellent solutions because they have proven to be effective tools at diagnostic and therapeutic levels. Aims This study evaluates the impact of CPs implementation in a Pediatric Emergency Department (PED), analyzing antibiotic prescriptions before and after the publication in 2015 and 2019. The CP developed in 2019 represents an update of the previous one with the introduction of serum procalcitonin. The study aims to evaluate the antibiotic prescriptions in patients with community-acquired pneumonia (CAP) before and after both CPs (2015 and 2019). Methods The periods analyzed are seven semesters (one before CP-2015 called PRE period, five post CP-2015 called POST 1–5 and 1 post CP-2019 called POST6). The patients have been split into two groups: (i) children admitted to the Pediatric Acute Care Unit (INPATIENTS), and (ii) patients evaluated in the PED and sent back home (OUTPATIENTS). We have analyzed all descriptive diagnosis of CAP (the assessment of episodes with a descriptive diagnosis were conducted independently by two pediatricians) and CAP with ICD9 classification. All antibiotic prescriptions for pediatric patients with CAP were analyzed. Results A drastic reduction of broad-spectrum antibiotics prescription for inpatients has been noticed; from 100.0% in the PRE-period to 66.7% in POST1, and up to 38.5% in POST6. Simultaneously, an increase in amoxicillin use from 33.3% in the PRE-period to 76.1% in POST1 (p-value 0.078 and 0.018) has been seen. The outpatients’ group’s broad-spectrum antibiotics prescriptions decreased from 54.6% PRE to 17.4% in POST6. Both for outpatients and inpatients, there was a decrease of macrolides. The inpatient group’s antibiotic therapy duration decreased from 13.5 days (PRE-period) to 7.0 days in the POST6. Antibiotic therapy duration in the outpatient group decreased from 9.0 days (PRE) to 7.0 days (POST1), maintaining the same value in subsequent periods. Overlapping results were seen in the ICD9 group for both inpatients and outpatients. Conclusions This study shows that CPs are effective tools for an antibiotic stewardship program. Indeed, broad-spectrum antibiotics usage has dropped and amoxicillin prescriptions have increased after implementing the CAP CP-2015 and the 2019 update.

scholarly journals 1446. The Impact of Enterobacteriaceae Isolate Breakpoints on Prescriber Treatment Choices for Discordant Pattern Urinary Tract Infections

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S528-S528
Author(s):  
Philip Lee ◽  
Yi Guo ◽  
Wendy Szymczak ◽  
Vijaya L Soma ◽  
Priya Nori
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Broad Spectrum ◽  
White Blood Cells ◽  
Narrow Spectrum ◽  
Broad Spectrum Antibiotics ◽  
Group A ◽  
Group B ◽  
Tract Infections ◽  
The Impact

Abstract Background Our institution revealed Enterobacteriaceae with discordant cefazolin (CEF)-resistant / ampicillin-sulbactam (SAM) susceptible patterns (CRASS-P). This discordance could be from the multiple MIC cephalosporin breakpoint adjustments from CLSI. SAM has higher resistance for gram-negative bacteria compared with cephalosporins such as CEF which is confirmed by our antibiogram. We sought to understand if narrow-spectrum antibiotic choices for CRASS-P urinary tract infections (UTIs) led to clinical cure (CC). Methods We conducted a retrospective review from January 2018 to February 2019 of all CRASS-P Escherichia coli, Proteus mirabilis, and Klebsiella pneumoniae isolates from urine cultures. Patients with any symptom related to a UTI, urinalysis with >10 white blood cells/high-powered field, urine culture with >10,000 colony-forming units/mL, and receipt of an antibiotic were included. CC was defined as symptom resolution within 48 hours with no return to care within 28 days of the positive urinary culture. “Group A” included patients prescribed narrow-spectrum antibiotics such SAM, CEF, or an oral cephalosporin (OC) vs. broad-spectrum antibiotics such as ceftriaxone, quinolones or sulfa-medications (“Group B”). Results There were 960/1356 (70.8%) CRASS-P urinary isolates and 244 patients met inclusion criteria. Of 244 patients, 72 were in Group A and 172 were in Group B. There was no difference in the diversity of the 3 uropathogens, P = 0.34 (Table 1). Median age was 69±20.3 and 67.5±23.9 years for Group A and Group B, respectively, P = 0.23. Females accounted for 73.6% and 77.9% in Group A and B, respectively, P = 0.51. Overall, patients reached CC in 98.6% (71/72) of Group A patients, compared with 92.4% (159/172) of Group B patients, P = 0.07. Antibiotics used in treatment are outlined in Figure 1. UTI was associated with bacteremia for 2 patients in Group A and 4 patients in Group B (P = 0.84). Both patients in Group A reached CC and used AMC for treatment. However, 1 out of 4 patients did not achieve CC in Group B. Conclusion The use of SAM or OC can spare the broad-spectrum antibiotics use for CRASS-P UTIs as there was no statistical difference in CC between the two groups. The use of SAM with CRASS-P bacteremia secondary to UTI is possible; however, future studies are needed. Disclosures All authors: No reported disclosures.

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