scholarly journals Incidence and Diversity of Antimicrobial Multidrug Resistance Profiles of Uropathogenic Bacteria

2015 ◽  
Vol 2015 ◽  
pp. 1-11 ◽  
Author(s):  
Inês Linhares ◽  
Teresa Raposo ◽  
António Rodrigues ◽  
Adelaide Almeida
Keyword(s):  
Standard Treatment ◽  
Treatment Guidelines ◽  
Empirical Therapy ◽  
Multidrug Resistant ◽  
Antibiotic Resistant ◽  
Resistance Determinants ◽  
Standard Treatment Guidelines ◽  
Tract Infections ◽  
Uropathogenic Bacteria ◽  
High Diversity

The aim of this study was to assess the most frequent multidrug resistant (MDR) profiles of the main bacteria implicated in community-acquired urinary tract infections (UTI). Only the MDR profiles observed in, at least, 5% of the MDR isolates were considered. A quarter of the bacteria were MDR and the most common MDR profile, including resistance to penicillins, quinolones, and sulfonamides (antibiotics with different mechanisms of action, all mainly recommended by the European Association of Urology for empirical therapy of uncomplicated UTI), was observed, alone or in association with resistance to other antimicrobial classes, in the main bacteria implicated in UTI. The penicillin class was included in all the frequent MDR profiles observed in the ten main bacteria and was the antibiotic with the highest prescription during the study period. The sulfonamides class, included in five of the six more frequent MDR profiles, was avoided between 2000 and 2009. The results suggest that the high MDR percentage and the high diversity of MDR profiles result from a high prescription of antibiotics but also from antibiotic-resistant genes transmitted with other resistance determinants on mobile genetic elements and that the UTI standard treatment guidelines must be adjusted for the community of Aveiro District.

scholarly journals Adherence to standard treatment guidelines among prescribers in primary healthcare facilities in the Dodoma region of Tanzania

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Karin Wiedenmayer ◽  
Eva Ombaka ◽  
Baraka Kabudi ◽  
Robert Canavan ◽  
Sarah Rajkumar ◽  
...  
Keyword(s):  
Primary Healthcare ◽  
Standard Treatment ◽  
Treatment Guidelines ◽  
Cross Sectional Study ◽  
Upper Respiratory Tract ◽  
Cross Sectional ◽  
Quality Healthcare ◽  
Healthcare Facilities ◽  
Standard Treatment Guidelines ◽  
Tract Infections

Abstract Background Tanzania’s primary healthcare system suffers from a scarcity of financial and human resources that impedes its effectiveness to deliver dependable and uniform quality healthcare. Adherence to standard treatment guidelines (STG) can help provide more consistent and correct diagnoses and treatments and limit the irrational use of medicines and the negative health consequences that can occur as a result. The purpose of this study was to investigate prescribers’ adherence of their diagnoses and respective treatments to national STG and to identify potential areas for planning interventions. Methods A cross-sectional study on prescribers’ adherence to diagnosis and treatment, according to national STG, was conducted in 2012 in public primary healthcare facilities (HCF) in the Dodoma region of Tanzania. Information on 2886 patients was collected, prospectively and retrospectively, from 120 HCF across the Dodoma region using a structured questionnaire. Twenty-five broadly defined main illness groups were recorded and the nine most prevalent and relevant conditions were statistically analysed in detail. Results Diagnoses and related treatments were recorded and analysed in 2872 cases. The nine most prevalent conditions were upper respiratory tract infections (25%), malaria (18%), diarrhoea (9.9%), pneumonia (6.1%), skin problems (5.8%), gastrointestinal diagnoses (5%), urinary tract infections (4%), worm infestations (3.6%) and eye problems (2.1%). Only 1.8% of all diagnoses were non-communicable diseases. The proportion of prescribers’ primary diagnoses that completely adhered to national STG was 599 (29.9%), those that partially adhered totalled 775 (38.7%), wrong medication was given in 621 cases (30.9%) and no diagnosis or medication was given in nine cases (0.5%). Sixty-one percent of all patients received an antibiotic regardless of the diagnoses. Complete adherence was highest when worms were diagnosed and lowest for diarrhoea. The proportion of cases that did not adhere to STG was highest with patients with skin problems and lowest for malaria. Conclusion Prescribers’ general adherence to national STG in primary HCF in the public sector in Dodoma region is sub-optimal. The reasons are multifaceted and focused attention, directed at improving prescribing and pharmacotherapy, is required with a view of improving patient care and health outcomes.

scholarly journals Adherence to Standard Treatment Guidelines Among Prescribers in Primary Healthcare Facilities in the Dodoma Region of Tanzania

2021 ◽  
Author(s):  
Karin Anne Wiedenmayer ◽  
Eva Ombaka ◽  
Baraka Kabudi ◽  
Robert Canavan ◽  
Sarah Rajkumar ◽  
...  
Keyword(s):  
Primary Healthcare ◽  
Standard Treatment ◽  
Treatment Guidelines ◽  
Cross Sectional Study ◽  
Upper Respiratory Tract ◽  
Cross Sectional ◽  
Quality Healthcare ◽  
Healthcare Facilities ◽  
Standard Treatment Guidelines ◽  
Tract Infections

Abstract Background: Tanzania’s primary healthcare system suffers from a scarcity of financial and human resources which impedes its effectiveness to deliver dependable and uniform quality healthcare. Adherence to standard treatment guidelines (STG) can help provide more consistent and correct diagnoses and treatments and limit the irrational use of medicines and the negative health consequences that can occur as a result. The purpose of this study was to investigate prescribers’ adherence of their diagnoses and respective treatments to national STG and to identify potential areas for planning interventions.Methods: A cross sectional study on prescribers’ adherence to diagnosis and treatment, according to national STG, was conducted in 2012 in public, primary healthcare facilities (HCF) in the Dodoma region of Tanzania. Information on 2886 patients was collected, prospectively and retrospectively, from 120 HCF across the Dodoma region using a structured questionnaire. Twenty-five, broadly defined, main illness groups were recorded and the nine most prevalent and relevant conditions were statistically analysed in detail. Results: Diagnoses and related treatments were recorded and analysed in 2872 cases. The nine most prevalent conditions were upper respiratory tract infections (25%), malaria (18%), diarrhoea (9.9%), pneumonia (6.1%), skin problems (5.8%), gastrointestinal diagnoses (5%), urinary tract infections (4%), worm infestations (3.6%) and eye problems (2.1%). Only 1.8% of all diagnoses were non-communicable diseases. The proportion of prescribers’ primary diagnoses that completely adhered to national STG was 599 (29.9%), those that partially adhered totalled 775 (38.7%), wrong medication was given in 621 (30.9%) cases and no diagnosis or medication was given in nine cases (0.5%). Sixty-one percent of all patients received an antibiotic regardless of the diagnoses. Complete adherence was highest when worms were diagnosed and lowest for diarrhoea. The proportion of cases that did not adhere to STG was highest with patients with skin problems and lowest for malaria.Conclusion: Prescribers’ general adherence to national STG in primary HCF in the public sector in Dodoma region is sub-optimal. The reasons are multifaceted, and focused attention directed at improving prescribing and pharmacotherapy is required with a view of improving patient care and health outcomes.

scholarly journals Changes to the ART guidelines – an overview

2010 ◽  
Vol 11 (1) ◽  
Author(s):  
Celicia Serenata
Keyword(s):  
Antiretroviral Therapy ◽  
South African ◽  
Standard Treatment ◽  
Treatment Guidelines ◽  
Dual Therapy ◽  
National Standard ◽  
Child Transmission ◽  
Task Team ◽  
Standard Treatment Guidelines ◽  
Mother To Child

In 2009 the South African National AIDS Council (SANAC) Treatment Technical Task Team (TTT) finalised recommendations for changes to the national standard treatment guidelines for adult and paediatric management and treatment, as well as changes in the prevention of mother-to-child transmission of HIV (PMTCT) guidelines, moving away from monotherapy to dual therapy. President Zuma announced changes in the national antiretroviral therapy (ART) programme on World AIDS Day 2009. Subsequently additional changes were made to the treatment guidelines to be in line with these new Presidential mandates, which came into effect on 1 April 2010.

scholarly journals Bacterial infections in cirrhosis: a narrative review and key points for clinical practice

2020 ◽  
Vol 14 (3) ◽  
pp. 126-135
Author(s):  
Mario Mitra ◽  
Andrea Mancuso ◽  
Flavia Politi ◽  
Alberto Maringhini
Keyword(s):  
Antibiotic Resistance ◽  
Bacterial Infections ◽  
Empirical Therapy ◽  
Multidrug Resistant ◽  
High Rate ◽  
First Episode ◽  
Bacterial Peritonitis ◽  
Prophylactic Measures ◽  
Tract Infections ◽  
Healthcare Associated

Bacterial infections are frequent complications of liver cirrhosis, accounting for severe clinical courses, and increased mortality. The reduction of the negative clinical impact of infections may be achieved by a combination of prophylactic measures to reduce the occurrence, early identification, and management. Spontaneous bacterial peritonitis (SBP), urinary tract infections, pneumonia, cellulitis, and spontaneous bacteremia are frequent in cirrhosis. The choice of initial empirical antimicrobial therapy should be based on both site, severity, and origin of infection (community-acquired, nosocomial, or healthcare-associated) and on antibiotic resistance patterns. 3rd generation cephalosporins are generally indicated as empirical therapy in most community-acquired cases. However, for nosocomial and healthcare-associated infections, due to a high rate of multidrug-resistant (MDR) pathogens, a broader spectrum treatment is appropriate. In order to prevent antibiotic resistance emergence, microbiological cultures should be collected, and a de-escalation applied when antimicrobial susceptibility tests are available. Standard measures to prevent infections and the identification of carriers of MDR bacteria are essential strategies to prevent infections in cirrhosis. Antibiotic prophylaxis should be applied only to gastrointestinal bleeding, SBP recurrence prevention, and cirrhotics at high risk of a first episode of SBP.

scholarly journals Anti-Bacterial Effects of Essential Oils against Uropathogenic Bacteria

Antibiotics ◽  
2020 ◽  
Vol 9 (6) ◽  
pp. 358
Author(s):  
Maria Loose ◽  
Emmelie Pilger ◽  
Florian Wagenlehner
Keyword(s):  
Essential Oils ◽  
Additional Treatment ◽  
Cross Resistance ◽  
Synergistic Activity ◽  
Antibiotic Resistant ◽  
Tea Tree ◽  
Artificial Urine ◽  
Tract Infections ◽  
Uropathogenic Bacteria

Given the increasing antimicrobial resistance in urinary tract infections (UTI), alternative strategies need to be investigated. Determination of minimal inhibitory and bactericidal concentrations of essential oils from cajeput, lemongrass, tea tree, and thyme in artificial urine, revealed bactericidal activity of all four tested essential oils against seven uropathogenic species with values ranging between 0.78–50 mg/mL. Tea tree and thyme essential oils were more efficient than lemongrass and cajeput. In addition, antibiotic-resistant strains showed similar susceptibility as antibiotic-sensitive strains, suggesting no cross-resistance between antibiotics and these essential oils. Checkerboard assays revealed a synergistic activity of the combination of thyme and tea tree. Furthermore, the combination with thyme and tea tree essential oils increased the activity of fosfomycin and pivmecillinam, but not nitrofurantoin, against Escherichia coli. This study provides a basis for further investigation of the potential of thyme and tea tree oil as an alternative or additional treatment of UTI.

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