Duration of Oral Antibiotics Administration for Cetuximab-Induced Acneiform Eruption

Dermatology ◽  
2020 ◽  
pp. 1-7
Author(s):  
Ji-Hye Park ◽  
YoungHwan Choi ◽  
Hyun Je Kim ◽  
Se Jin Oh ◽  
Dong-Youn Lee ◽  
...  
Keyword(s):  
Antibiotic Use ◽  
Time Interval ◽  
Antibiotic Administration ◽  
Oral Antibiotic ◽  
Oral Antibiotics ◽  
Younger Age ◽  
Acneiform Eruption ◽  
Cutaneous Adverse Event ◽  
The Mean

<b><i>Background:</i></b> Acneiform eruption is the most common cutaneous adverse event associated with cetuximab. As it can affect quality of life and adversely affect chemotherapy schedule, additional medical care is required. <b><i>Objectives:</i></b> To investigate the adherence to and the duration of antibiotic administration to treat cetuximab-induced acneiform eruption. <b><i>Methods:</i></b> Medical data of patients who were referred to the Department of Dermatology were reviewed from January 2013 to June 2018. Dermatologists assessed the severity of acneiform eruption and prescribed tetracycline-class antibiotics according to the severity every 2 or 4 weeks. We investigated the duration and amount of oral antibiotic administration and analyzed the factors that may affect the control of acneiform eruption statistically. <b><i>Results:</i></b> A total of 207 of 267 patients referred to the Department of Dermatology showed acneiform eruption; 124 patients were treated with minocycline, 34 patients with doxycycline, 27 patients with both, and 22 patients with topical agents. The mean duration of oral antibiotic medication was 82.7 days. A statistical analysis of the factors that prolonged the use of antibiotics for more than 90 days showed that male and younger age were risk factors. Shorter time interval from starting cetuximab to starting antibiotics was associated with longer duration of antibiotic use, statistically. <b><i>Conclusions:</i></b> Cetuximab-induced acneiform eruption can be well controlled with tetracycline-class antibiotics in about 3 months. It can last longer in male and younger patients. The sooner and the more severe it appears, the longer it can last.

scholarly journals Evaluation of antibiotic usage in swine reproduction farms in Umbria region based on the quantitative analysis of antimicrobial consumption

2017 ◽  
Vol 6 (3) ◽  
Author(s):  
Fausto Scoppetta ◽  
Marco Sensi ◽  
Maria Pia Franciosini ◽  
Marinella Capuccella
Keyword(s):  
Antibiotic Resistance ◽  
Antibiotic Use ◽  
Antibiotic Consumption ◽  
Diagnostic Methods ◽  
Antibiotic Administration ◽  
Oral Antibiotic ◽  
Defined Daily Doses ◽  
Umbria Region ◽  
Antimicrobial Susceptibility Tests ◽  
Critical Aspects

Antibiotic use in food-producing animals has considerable impact on public health, especially with respect to the development and spread of antibiotic resistance. Pigs represent one of the main species in which antibiotics are frequently used for different purposes. Surveillance of antibiotic consumption and dose appropriateness, through novel approaches based on defined daily doses, is strongly needed to assess farms’ antibiotic risk, in terms of spread of antibiotic resistance and possibile presence of residues in meat. In this study, antibiotic consumption was monitored in 14 swine reproduction farms, together with managerial, structural, and health aspects. Most of the controlled farms (65%) were classified as at medium antibiotic risk, 21% at high antibiotic risk, and 14% at low antibiotic risk. Critical aspects of antibiotic administration concerned treatments for suckling and weaner piglets, oral antibiotic administration, treatment and diagnosis of gastroenteric infections, and use of critically important antimicrobials for human medicine, especially colistin. These aspects could be considered critical aspects of antibiotic use in from-farrow-to-wean/finish swine farms in the Umbria region and must be controlled to minimize risks. Even though a small number of farms in Umbria region are at high antibiotic risk, the risk of antibiotic resistance should be minimized, and management and biosecurity of the farms should be improved by extending the use of antimicrobial susceptibility tests and optimizing the diagnostic methods for infectious diseases. Furthermore, farmers’ and veterinarians’ knowledge of antibiotic resistance should be improved and the prudent use of antibiotics encouraged to prevent the development and spread of resistant microorganisms.

scholarly journals The effect of maternal antibiotic use in sows on intestinal development in offspring

2020 ◽  
Vol 98 (6) ◽  
Author(s):  
Astrid de Greeff ◽  
Dirkjan Schokker ◽  
Petra Roubos-van den Hil ◽  
Peter Ramaekers ◽  
Stephanie A Vastenhouw ◽  
...  
Keyword(s):  
Early Life ◽  
Antibiotic Use ◽  
Fecal Microbiota ◽  
Antibiotic Administration ◽  
Oral Antibiotic ◽  
Intestinal Development ◽  
Neonatal Piglets ◽  
Tight Junction Formation ◽  
Whole Genome Microarray ◽  
Morphometry Analysis

Abstract The objective of this study is to investigate the effect of a maternal antibiotic administration during the last week of gestation on the early life intestinal development in neonatal piglets. Colonization of the gut with bacteria starts during birth and plays a major role in the intestinal and immunological development of the intestine. We demonstrate that maternal interventions induced changes in the sows (n = 6 to 8 per treatment) fecal microbiota diversity around birth (P &lt; 0.001, day 1). Whole-genome microarray analysis in small intestinal samples of 1-d old piglets (n = 6 to 8 per treatment) showed significantly expressed genes (Padj &lt; 0.05) which were involved in processes of tight junction formation and immunoglobulin production. Furthermore, when performing morphometry analysis, the number of goblet cells in jejunum was significantly (P &lt; 0.001) lower in piglets from amoxicillin administered sows compared with the respective control piglets. Both significantly expressed genes (Padj &lt; 0.05) and significant morphometry data (jejunum P &lt; 0.05 and ileum P &lt; 0.01) indicate that the crypts of piglets from amoxicillin administered sows deepen around weaning (day 26) as an effect of the amoxicillin administration in sows. The latter might imply that the intestinal development of piglets was delayed by maternal antibiotic administration. Taken together, these results show that maternally oral antibiotic administration changes in early life can affect intestinal development of the offspring piglets for a period of at least 5 wk after the maternal antibiotic administration was finished. These results show that modulation of the neonatal intestine is possible by maternal interventions.

scholarly journals Probiotics to reduce antibiotic administration in care home residents aged 65 years and older: the PRINCESS RCT

2021 ◽  
Vol 8 (7) ◽  
pp. 1-128
Author(s):  
Christopher C Butler ◽  
Eleri Owen-Jones ◽  
Mandy Lau ◽  
David Gillespie ◽  
Mark Lown ◽  
...  
Keyword(s):  
Care Home ◽  
Lactobacillus Rhamnosus ◽  
Antibiotic Use ◽  
Antibiotic Administration ◽  
Systemic Antibiotic ◽  
Bifidobacterium Animalis ◽  
Stool Samples ◽  
Future Work ◽  
Antibiotic Associated Diarrhoea

Background Care homes are an increasingly important sector of care. Care home residents are particularly vulnerable to infections and are often prescribed antibiotics, driving antibiotic resistance. Probiotics may be a cheap and safe way to reduce antibiotic use. Efficacy and possible mechanisms of action are yet to be rigorously evaluated in this group. Objective The objective was to evaluate efficacy and explore mechanisms of action of a daily oral probiotic combination in reducing antibiotic use and infections in care home residents. Design This was a multicentre, parallel, individually randomised, placebo-controlled, double-blind trial, with qualitative evaluation and mechanistic studies. Setting A total of 310 care home residents were randomised from 23 UK care homes (from December 2016 to May 2018). Participants The participants were care home residents aged ≥ 65 years who were willing and able to give informed consent or, if they lacked capacity to consent, had a consultee to advise about participation on their behalf. Intervention A daily capsule containing an oral probiotic combination of Lactobacillus rhamnosus GG and Bifidobacterium animalis subsp. lactis BB-12 (n = 155) or matched placebo (n = 155) for up to 1 year. Main outcome measures The primary outcome was cumulative systemic antibiotic administration days for all-cause infections. Secondary outcomes included incidence and duration of infections, antibiotic-associated diarrhoea, quality of life, hospitalisations and the detection of resistant Enterobacterales cultured from stool samples (not exclusively). Methods Participants were randomised (1 : 1) to receive capsules containing probiotic or matched placebo. Minimisation was implemented for recruiting care home and care home resident sex. Care home residents were followed up for 12 months with a review by a research nurse at 3 months and at 6–12 months post randomisation. Care home residents, consultees, care home staff and all members of the trial team, including assessors and statisticians, were blinded to group allocation. Results Care home residents who were randomised to probiotic had a mean 12.9 cumulative systemic antibiotic administration days (standard error 1.49 days) (n = 152) and care home residents randomised to placebo had a mean 12.0 cumulative systemic antibiotic administration days (standard error 1.50 days) (n = 153) (adjusted incidence rate ratio = 1.13, 95% confidence interval 0.79 to 1.63; p = 0.495). There was no evidence of any beneficial effects on incidence and duration of infections, antibiotic-associated diarrhoea, quality of life, hospitalisations, the detection of resistant Enterobacterales cultured from stool samples or other secondary outcomes. There was no evidence that this probiotic combination improved blood immune cell numbers, subtypes or responses to seasonal influenza vaccination. Conclusions Care home residents did not benefit from daily consumption of a combination of the probiotics Lactobacillus rhamnosus GG and Bifidobacterium animalis subsp. lactis BB-12 to reduce antibiotic consumption. Limitations Limitations included the following: truncated follow-up of some participants; higher than expected probiotics in stool samples at baseline; fewer events than expected meant that study power may have been lower than anticipated; standard infection-related definitions were not used; and findings are not necessarily generalisable because effects may be strain specific and could vary according to patient population. Future work Future work could involve further rigorous efficacy, mechanisms and effectiveness trials of other probiotics in other population groups and settings regarding antibiotic use and susceptibility to and recovery from infections, in which potential harms should be carefully studied. Trial registration Current Controlled Trials ISRCTN16392920. Funding This project was funded by the Efficacy and Mechanism Evaluation (EME) programme, a MRC and NIHR partnership. This will be published in full in Efficacy and Mechanism Evaluation; Vol. 8, No. 7. See the NIHR Journals Library website for further project information.

Effect of Antibiotic Therapy and Etiologic Microorganism on the Risk of Bacterial Meningitis in Children with Occult Bacteremia

PEDIATRICS ◽  
1993 ◽  
Vol 92 (1) ◽  
pp. 140-143 ◽  
Author(s):  
Larry J. Baraff ◽  
Scott Oslund ◽  
Mark Prather
Keyword(s):  
Bacterial Meningitis ◽  
Antibiotic Therapy ◽  
Oral Antibiotic ◽  
Oral Antibiotics ◽  
Parenteral Antibiotic ◽  
The Mean ◽  
Occult Bacteremia ◽  
Meningitis In Children ◽  
Meta Analyses ◽  
Culture Positive

Objective. To quantify the effect of antibiotic therapy on the probability of subsequent bacterial meningitis in children with fever without source treated as outpatients. Design. Bayesian meta-analyses. Reports included. All reports of the organism-specific prevalence of occult bacteremia in children with fever without source treated as outpatients, and the organism-specific prevalence of subsequent meningitis in children with occult bacteremia initially treated as outpatients stratified by type of antibiotic therapy. Results. The mean probabilities of subsequent meningitis in children with occult bacteremia were 9.8%, 8.2%, and 0.3% in the no antibiotic, oral antibiotic, and parenteral antibiotic therapy groups, respectively. All cases of bacterial meningitis in children with occult bacteremia treated with oral antibiotics were due to Haemophilus influenzae. There were no cases of culture-positive bacterial meningitis in 139 bacteremic children treated with ceftriaxone (mean probability, 0.3%; 95% confidence interval, 0.0% to 1.5%). The mean probabilities of bacterial meningitis in a child with fever without source treated as an outpatient without antibiotics were: Streptococcus pneumoniae, 0.21%; and H influenzae, 0.06%. Conclusions. Antibiotic therapy is effective in preventing meningitis in children at risk of occult bacteremia.

scholarly journals A nationwide parent survey of antibiotic use in Australian children

2020 ◽  
Vol 75 (5) ◽  
pp. 1347-1351
Author(s):  
Rebecca Anderson ◽  
Anthea Rhodes ◽  
Noel Cranswick ◽  
Marnie Downes ◽  
Jonathan O’Hara ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Binary Logistic Regression ◽  
Parental Knowledge ◽  
Antibiotic Use ◽  
Global Strategy ◽  
Health Interventions ◽  
Antibiotic Administration ◽  
Oral Antibiotics ◽  
Online Questionnaire ◽  
Parent Survey

Abstract Background Antimicrobial resistance is increasing globally, largely due to high rates of antibiotic use and misuse. Factors that influence frequent antibiotic use in children are poorly understood. Objectives This study describes rates of antibiotic use in Australian children and investigates parental factors including knowledge, attitudes and behaviours that influence antibiotic use. Methods An online questionnaire relating to antibiotic use was administered as part of the Royal Children’s Hospital National Child Health Poll to a randomly recruited nationwide sample of parents or guardians of children aged 0–17 years in Australia. Data on antibiotic use in children and parental knowledge of appropriate indications for antibiotics and behaviours were collected. Standard binary logistic regression was used to assess associations between parent demographics and behaviour with antibiotic administration. Results The survey was completed by 2157 parents (64% completion rate), of which 1131 (52%) reported having given oral antibiotics to one or more of their children in the preceding 12 months. Of the 3971 children represented overall, 1719 (43%) had received at least one course of antibiotics. The average number of courses per child was 0.86 overall and 1.96 courses per child among those with reported antibiotic use. Notably, 194/1131 (17%) parents reported giving antibiotics to their child without a prescription. Poor parental knowledge of antibiotic indications was associated with antibiotic use. Conclusions Reducing excessive use of antibiotics in children is necessary in the global strategy for preventing antimicrobial resistance. This study identified areas for public health interventions to educate parents and increase regulation of access to antibiotics.

A Commentary on the “Duration of Oral Antibiotics Administration for Cetuximab-Induced Acneiform Eruption”

Dermatology ◽  
2021 ◽  
pp. 1-4
Author(s):  
Jawaher Tariq A. AlMulhem ◽  
Farah A.O.A. Zuaiter
Keyword(s):  
Oral Antibiotics ◽  
Ongoing Research ◽  
Systemic Corticosteroids ◽  
Prophylactic Drugs ◽  
Acneiform Eruption ◽  
Treatment Measures ◽  
Cutaneous Side Effect ◽  
Prevention Methods ◽  
Dermatological Side Effects

Acneiform eruption is a devastating cutaneous side effect of cetuximab, a monoclonal antibody used to treat a variety of cancers. Despite its effectiveness, many patients avoid or discontinue it after experiencing its dermatological side effects as it negatively impacts their quality of life (QoL). This displays the immense need for multidisciplinary collaboration to prevent and treat cetuximab-induced acneiform eruption (CIAE). Prevention methods include, but are not limited to, education, skin care routines, and prophylactic drugs. The following measures reduce the likelihood of developing CIAE and decrease its severity, making it easier to treat if it were to occur. Ongoing research on the treatment of CIAE continues. Of these treatments, oral tetracyclines and systemic corticosteroids have been shown to be the most effective by far. This commentary aims to evaluate the study by Park et al. [Dermatology. 2021;237(3):457–63], further elaborate on prevention and treatment measures of CIAE, and highlight the implications of CIAE on a patient’s QoL.

scholarly journals Protocol for a double-blind placebo-controlled trial to evaluate the efficacy of probiotics in reducing antibiotics for infection in care home residents: the Probiotics to Reduce Infections iN CarE home reSidentS (PRINCESS) trial

BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e027513 ◽  
Author(s):  
Eleri Owen-Jones ◽  
Rachel Lowe ◽  
Mark Lown ◽  
David Gillespie ◽  
Katy Addison ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Tract Infection ◽  
Controlled Trial ◽  
Care Home ◽  
Antibiotic Use ◽  
Full Blood Count ◽  
Antibiotic Administration ◽  
Double Blind ◽  
Increased Risk

IntroductionCare home residents are at increased risk of infections and antibiotic prescription. Reduced antibiotic use from fewer infections would improve quality of life. TheProbiotics toReduceInfections iN CarEhome reSidentS(PRINCESS) trial aims to determine the efficacy and investigate mechanisms of daily probiotics on antibiotic use and incidence of infections in care home residents.Methods and analysisPRINCESS is a double-blind, individually randomised, placebo-controlled trial that will assess the effect of a daily oral probiotic combination ofLactobacillus rhamnosus,GG (LGG) andBifidobacterium animalissubsp.lactis, BB-12 (BB-12) on cumulative antibiotic administration days (CAADs) (primary outcome) for infection in up to 330 care home residents aged ≥65 years over up to 12 months. Secondary outcomes include:Infection:Total number of days of antibiotic administration for each infection type (respiratory tract infection, urinary tract infection, gastrointestinal infection, unexplained fever and other); number, site, duration of infection; estimation of incidence and duration of diarrhoea and antibiotic-associated diarrhoea;Stool microbiology:Clostridium difficileinfection; Gram-negative Enterobacteriaceae and vancomycin-resistant enterococci; LGG and BB-12.Oral microbiology: Candidaspp.Health and well-being:Self and/or proxy health-related quality of life EQ5D (5 L); self-and/or proxy-reported ICEpop CAPability measure for older people.Hospitalisations:number and duration of all-cause hospital stays.Mortality:deaths.Mechanistic immunology outcomes:influenza vaccine efficacy (haemagglutination inhibition assay and antibody titres); full blood count and immune cell phenotypes, plasma cytokines and chemokines; cytokine and chemokine response in whole blood stimulatedex vivoby toll-like receptor 2 and 4 agonists; monocyte and neutrophil phagocytosis ofEscherichia coli; serum vitamin D.Ethics and disseminationEthics approval is from the Wales Research Ethics Committee 3. Findings will be disseminated through peer-reviewed journals and conferences; results will be of interest to patient and policy stakeholders.Trial registration numberISRCTN16392920; Pre-results.

scholarly journals 576 Audit of Instillation of Intravesical Mitomycin-C Following Transurethral Resection for Bladder Tumour

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
G McCabe ◽  
D S Sahni
Keyword(s):  
Mitomycin C ◽  
Transurethral Resection ◽  
Bladder Tumour ◽  
Time Interval ◽  
Nice Guidelines ◽  
Disease Staging ◽  
Theatre Staff ◽  
The Mean ◽  
Mean Time

Abstract Aim The administration of intravesical chemotherapy (IVCT) following transurethral resection of bladder tumour (TURBT) has been shown to decrease the risk of recurrence and is recommended as standard practice following TURBT for new & recurrent tumours. Our aim was to evaluate the adherence to this guideline in our trust and if needed, to implement changes in order to improve the patient care. Method A retrospective analysis of 25 patients was done and details regarding the time interval between administration, demographic details and disease staging was collected. NICE guidelines were later implemented, and the data was recollected for 24 patients who underwent TURBT Results The analysis showed that the mean time between the end point of TURBT and instillation of Intravesicular Mitomycin-C was 7.66 hours. Thereafter, we tried to implement the guidelines by improving communication between the Theatre staff, Nursing staff and the pharmacy. The data was collected for re-audit for 24 patients and it was observed that the interval between surgery and Mitomycin administration had dropped down to 4.67 hours. The 3rd cycle of the audit revealed the interval dropping down further to 4.24hours.The 24hr administration rate was &gt;90%, which was much higher than previous year audits Conclusions Engagement with theatre team and pharmacy is required, in order to coordinate the delivery of the IVCT to theatre for administration at the time of surgery. If everyone (hospital pharmacy and theatre staff) is supportive, patients’ quality of care can be improved by following the standardised protocol.

scholarly journals Oral Antibiotic Use Following Stented Hypospadias Repair: Does It Play a Role in the Prevention of Urinary Tract Infections?

2020 ◽  
Vol 12 (3) ◽  
Author(s):  
Mohammed Suoub ◽  
Fadi Sawaqed
Keyword(s):  
Urine Culture ◽  
Antibiotic Use ◽  
Oral Antibiotic ◽  
Hypospadias Repair ◽  
Oral Antibiotics ◽  
Positive Urine ◽  
Group A ◽  
Group B ◽  
Tract Infections

Background: There is a lack of consensus regarding the role of oral antibiotics following hypospadias repair. Objectives: The study aimed to evaluate the role of oral antibiotic use following stented Tubularized incised plate urethroplasty (TIPU) in the prevention of bacteriuria and urinary tract infections (UTIs). Methods: A prospective study was conducted on 40 patients undergoing stented TIPU for coronal hypospadias between January 2014 and December 2016. The average age of the subjects was 13.2 months at the time of surgery, ranging from 11 to 16 months. The patients were divided into two groups. Group A consisted of 20 patients receiving oral antibiotics until urethral catheter removal, whereas group B consisted of 20 patients without any oral antibiotics postoperatively. Results: The two groups were followed for three years. The urethral catheter was removed eight days postoperatively in the two groups. In group A, the patients received oral antibiotics as long as the catheter was left in situ. Urine samples were collected from the patients and sent for analysis and culture at the time of stent removal and after three weeks. The results showed that 3/20 (15%) patients from group A had pyuria and bacteriuria, while all of them had negative urine culture results. On the other hand, in group B, 8/20 (40%) patients had pyuria and bacteriuria (P > 0.05), and four (20.0%) patients had positive urine cultures for Escherichia coli (P < 0.05), sensitive to co-trimoxazole. None of the patients in the two groups had febrile UTI. Conclusions: The use of oral antibiotics for patients following stented TIPU reduces pyuria and significantly decreases positive urine culture results and the risk of UTI after surgery.

Antibiotic Use in Developing Countries

2000 ◽  
Vol 21 (6) ◽  
pp. 394-397 ◽  
Author(s):  
Raúl E. Istúriz ◽  
Claude Carbon
Keyword(s):  
Local Level ◽  
Antibiotic Use ◽  
The United States ◽  
Antibiotic Administration ◽  
The Public ◽  
Societal Issues ◽  
Hospital Infection Control ◽  
Gentamicin Resistance ◽  
Emergence Of Resistance

Antimicrobials have been used successfully for over 6 decades, but genes expressing resistance to them have emerged in strains of bacteria and have disseminated through the global ecosystem to reach infecting microorganisms, produce disease, and seriously interfere with therapy, allowing infections to progress and kill despite antibiotic administration. The upsurge in prevalence of such resistance genes in the bacterial population that colonize and infect humans involves two processes, emergence and dissemination, in both of which there have been contributions from the developing world, where resistance is common and increasing. The emergence of pneumococcal isolates noted in Papua New Guinea and later in South Africa that 1 decade later spread to most of the world and the intercontinental spread between the United States and Venezuela of a new gentamicin resistance gene carried on an epidemic plasmid are examples of the ability of bacteria to travel freely, without regard to borders. Complex societal issues such as the misuse of antibiotics by physicians, pharmacists, and the public; the suboptimal quality of the drugs (emergence); and conditions such as crowding, lack of hygiene, poor or nonexistent hospital infection control practices, or insufficient surveillance (dissemination) play a largely unmeasured role that requires study and solutions. In the meantime, we may intervene to delay the emergence of resistance and to limit its spread by promoting the judicious use of antibiotics both at the local level as well as from multinational organized cooperative efforts. Education and improvement of surveillance and socioeconomic conditions are integral parts of any solution strategy.

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