Analysis of the Microorganism’s Sensitivity in Patients with Chronic Adenoiditis to Pharmacotherapy with Antibacterial Drugs

2020 ◽  
Vol 17 (9) ◽  
pp. 4741-4745
Author(s):  
Leontiy V. Druzhikin ◽  
Elena S. Druzhikina ◽  
Sergey A. Alekhin ◽  
Elena B. Artyushkova ◽  
Alexander A. Dolzhikov ◽  
...  
Keyword(s):  
Antibiotic Therapy ◽  
Upper Respiratory Tract ◽  
Negative Consequences ◽  
Antibacterial Drugs ◽  
Pharmacological Agents ◽  
Microbial Association ◽  
Hospital Units ◽  
Gram Staining ◽  
Number Of Patients ◽  
Chronic Adenoiditis

Introduction: The prevalence of chronic pathology of the pharyngeal lymphatic system in preschool children reaches 45% and is mainly manifested by hypertrophy of adenoid vegetations, which in half of cases are combined with chronic inflammation, which, with repeated periods of exacerbation, leads to the development of severe chronic pathology of the upper respiratory tract. The role of microorganisms toleranceto pharmacological agents is widely proven in formation of chronic inflammatory disorders and demand correction of therapeutic schemes. Research tasks: The aim of this research was to study the microbial landscape of oropharynx in children who received surgical for adenoiditis and determine the sensitivity of the identified microorganisms to the pharmacotherapy with antibiotics. Material and Methods: We conducted a study of 1577 children aged from 1 year to 17 years and 11 months who received inpatient treatment at the otorhinolaryngological Department of the OO “Scientific and clinical multidisciplinary center named after Z. I. Kruglaya” in the city of Oryol in the period from 2015 to 2017 for hypertrophy of adenoid vegetations. The patients were divided into three groups based on the years of the study. The study of the oropharyngeal microbial association was performed by preparing a smear followed by Gram staining and bacterioscopy. Determination of the sensitivity of microorganisms to antibacterial drugs was performed by discdiffusion method. Results: We found in patients oropharynx microbial landscape with hypertrophy of chronic vegetation in dynamics over the period from 2015 to 2017, an increase in the number of opportunistic saprophytic flora was detected, which was observed against the background of a clear increase in the number of patients with this pathology an increase in the number of cases associated with saprophytic MRCA flora, represented mainly by Staphylococcus aureus, leads to a decrease in the effectiveness of conservative treatment of chronic adenoiditis, which is expressed in an increase in the number of adenotomies. Conclusion: The study revealed negative consequences of uncontrolled use of antibiotic therapy at the pre-hospital stage and irrational schemes of chemotherapy in hospital units, which is manifested in the growing resistance of microorganisms to both “old” antibacterial drugs and a decrease in sensitivity to pharmacotherapy with the latest generation of antibiotics and requires active revision of the schemes of antibiotic therapy and prevention.

Effects of procalcitonin testing on antibiotic use and clinical outcomes in patients with upper respiratory tract infections. An individual patient data meta-analysis

2017 ◽  
Vol 56 (1) ◽  
Author(s):  
Jonas Odermatt ◽  
Natalie Friedli ◽  
Alexander Kutz ◽  
Matthias Briel ◽  
Heiner C. Bucher ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Antibiotic Therapy ◽  
Respiratory Tract Infections ◽  
Meta Analysis ◽  
Antibiotic Exposure ◽  
Upper Respiratory Tract ◽  
Upper Respiratory ◽  
Restricted Activity ◽  
Tract Infections

AbstractBackground:Several trials found procalcitonin (PCT) helpful for guiding antibiotic treatment in patients with lower respiratory tract infections and sepsis. We aimed to perform an individual patient data meta-analysis on the effects of PCT guided antibiotic therapy in upper respiratory tract infections (URTI).Methods:A comprehensive search of the literature was conducted using PubMed (MEDLINE) and Cochrane Library to identify relevant studies published until September 2016. We reanalysed individual data of adult URTI patients with a clinical diagnosis of URTI. Data of two trials were used based on PRISMA-IPD guidelines. Safety outcomes were (1) treatment failure defined as death, hospitalization, ARI-specific complications, recurrent or worsening infection at 28 days follow-up; and (2) restricted activity within a 14-day follow-up. Secondary endpoints were initiation of antibiotic therapy, and total days of antibiotic exposure.Results:In total, 644 patients with a follow up of 28 days had a final diagnosis of URTI and were thus included in this analysis. There was no difference in treatment failure (33.1% vs. 34.0%, OR 1.0, 95% CI 0.7–1.4; p=0.896) and days with restricted activity between groups (8.0 vs. 8.0 days, regression coefficient 0.2 (95% CI –0.4 to 0.9), p=0.465). However, PCT guided antibiotic therapy resulted in lower antibiotic prescription (17.8% vs. 51.0%, OR 0.2, 95% CI 0.1–0.3; p<0.001) and in a 2.4 day (95% CI –2.9 to –1.9; p<0.001) shorter antibiotic exposure compared to control patients.Conclusions:PCT guided antibiotic therapy in the primary care setting was associated with reduced antibiotic exposure in URTI patients without compromising outcomes.

scholarly journals Analysis of antimicrobials' consumption profile in a University Hospital of Western Paraná, Brazil

2009 ◽  
Vol 45 (2) ◽  
pp. 295-302
Author(s):  
Luciane de Fátima Caldeira ◽  
Marcelo Nascimento Burattini
Keyword(s):  
Direct Costs ◽  
University Hospital ◽  
Antimicrobial Consumption ◽  
Significance Level ◽  
Hospital Units ◽  
Number Of Patients ◽  
Annual Consumption ◽  
Financial Expenditure ◽  
Regression Techniques ◽  
Consumption Profile

The objective of this study was to analyze the variation in antimicrobials' consumption and the costs related to their use at a University Hospital between 1999 and 2004. The annual consumption of nine antimicrobials, expressed in DDD/100 patients-day, and the direct costs with their acquisition were evaluated. Analysis of variance and regression techniques were used to compare data, considering a significance level of 5%. The most consumed antimicrobials were amikacin and ceftriaxone. In general, antimicrobials consumption, expressed in DDD/100 patients-day, increased from 9.21 in 1999 to 25.08 in 2004 (p<0.0001). When analyzing antimicrobial consumption as related to specific hospital units, the ICU showed the highest consumption followed by Chemotherapy and Medical Clinical units, respectively. In addition, the number of patients-day increased from 2671/month in 1999 to 3502/month in 2004, p<0.0001. As a consequence, total expenditure with antimicrobials increased from R$ 98.89 per 100 patients-day in 1999 to R$ 731.26 in 2004, p<0.0001. Between 1999 and 2004 significant increases in both consumption and financial expenditure with antimicrobials were observed.

scholarly journals Study on Guillain-Barré Syndrome in A Tertiary Level Military Hospital

2021 ◽  
Vol 16 (2) ◽  
pp. 44-46
Author(s):  
Md Helal Uddin ◽  
ATM Humayun Kabir ◽  
Md Ismail Chowdhury ◽  
Farzana Zafreen
Keyword(s):  
Mechanical Ventilation ◽  
Electrophysiological Study ◽  
Laboratory Data ◽  
Guillain Barre Syndrome ◽  
Military Hospital ◽  
Upper Respiratory Tract ◽  
Intravenous Immunoglobulin Therapy ◽  
Number Of Patients ◽  
Guillain Barré Syndrome ◽  
Guillain Barré

Introduction: Guillain-Barre Syndrome (GBS) is an acute, frequently severe and fulminant polyradiculopathy that is autoimmune in nature and that causes acute neuromascular failure. The condition is quite common in Bangladesh. GBS is an autoimmune and post-infectious immune disease. Objectives: To see the different presentation and outcome of GBS in combined military hospital (CMH) Dhaka. Materials and Methods: This was a retrospective observational study conducted on all the GBS patients admitted in the Neurology Ward of CMH Dhaka from January 2005 to July 2010. Total 25 patients clinical and laboratory data including CSF analysis, electrophysiological study data were collected from patients’ case sheet. Results: Among the 25 GBS patients male was 22 (88%) and female 03(12%) and most common age group affected was 31-40 years comprising of 09(36%) patients. The most common types of GBS patients were acute inflammatory demyelinating polyneuropathy (AIDP) 17(68%) patients and 10(40%) patients were found to have history of upper respiratory tract infection (URTI). Albuminocytological dissociation was found in 20(80%) patients in CSF study. Intravenous immunoglobulin therapy was given to 13(52%) patients, of them 09(36%) patient needed mechanical ventilation; rest 12(48%) patients were treated conservatively. The final outcome was full recovery 22(88%) patients, 02(8%) patients had residual disability and only one patient died after 2 years of GBS. Conclusion: GBS is an important cause of peripheral neuropathy. Patient should be monitored carefully because a significant number of patients ultimately require mechanical ventilation for respiratory failure which may be of sudden onset. JAFMC Bangladesh. Vol 16, No 2 (December) 2020: 44-46

scholarly journals Inhaled antibiotics to improve efficacy and safety in the treatment of upper airway and lung inflammatory diseases

2021 ◽  
pp. 84-92
Author(s):  
Vladimir N. Drozdov ◽  
Konstantin I. Arefev ◽  
Svetlana Y. Serebrova ◽  
Irina A. Komissarenko ◽  
Evgenia V. Shikh ◽  
...  
Keyword(s):  
Antibiotic Therapy ◽  
Targeted Delivery ◽  
Whooping Cough ◽  
Inflammatory Diseases ◽  
Wide Spectrum ◽  
Chronic Obstructive ◽  
Combination Drug ◽  
Antibacterial Drugs ◽  
Systemic Antibiotic Therapy ◽  
Inhaled Antibiotics

Inhaled antibacterial drugs have been used since the 1940s with greater or lesser effectiveness, due to the possibility of targeted delivery of drugs directly to the infection site at concentrations higher than MICs. High local concentrations of antibacterial agents expand the possibilities of treating infections caused by multiresistant strains and reduces antibiotic resistance in the population. The inhaled delivery method is characterized by a high level of safety due to the absence of systemic toxic effects, which reduces the risk of pseudomembranous colitis and other complications of antibiotic therapy. Thiamphenicol glycinate acetylcysteinate is a combined drug that includes thiamphenicol and N-acetylcysteine, which causes its antibacterial and mucolytic activity. The results of clinical studies have demonstrated the effectiveness of TGA in the treatment of acute and chronic bronchitis, chronic obstructive pulmonary disease, community-acquired pneumonia, laryngotracheitis, rhinosinusitis and other infections of the upper and lower respiratory tract. In pediatrics, the drug is used to treat bronchitis and pneumonia, especially those that cannot be treated with other antibacterial drugs, bronchiolitis, whooping cough, and cystic fibrosis. The article presents data on the effectiveness and safety of containing TGA. A wide spectrum of antibacterial actions, the ability to form high local concentrations of antibacterial and mucolytic components in the focus of infection, a low risk of serious side effects in both adults and children are noted. The topical use of the combination drug has proven to be effective not only in bringing about a pronounced clinical improvement, but also in reducing the frequency of use of systemic antibiotic therapy. The efficacy of thiamphenicol glycinate acetylcysteinate is not inferior to macrolide antibiotics.

P–345 Reproductive outcome after treatment of chronic endometritis in patients with recurrent implantation failure

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
A Vega. Carrill. d. Albornoz ◽  
E Carrill. D. Alborno. Riaza ◽  
Á Martíne. Acera ◽  
I Lópe. Carrasco ◽  
N Monter. Pastor ◽  
...  
Keyword(s):  
Antibiotic Therapy ◽  
Case Series ◽  
Pregnancy Rates ◽  
Diagnostic Methods ◽  
Microbiological Analysis ◽  
Implantation Failure ◽  
Reproductive Outcome ◽  
Recurrent Implantation Failure ◽  
Chronic Endometritis ◽  
Number Of Patients

Abstract Study question Does the treatment of chronic endometritis (CE) improve reproductive outcome in patients with recurrent implantation failure (RIF)? Summary answer Treatment and resolution of CE seem to improve pregnancy rates in patients with implantation failure and CE. What is known already Over the last 10 years, the interest in the study of CE has increased given its important association with reproductive failure. The main cause of CE is an infection of the endometrial cavity caused by common microorganisms. Therefore, the recommended treatment is antibiotic therapy. Numerous studies demonstrate an improvement in reproductive outcome in patients with treated and resolved CE. The objectives of this study are to evaluate the resolution rate of CE after antibiotic treatment in patients with implantation failure diagnosed with CE and to analyse their reproductive outcome after treatment. Study design, size, duration In this prospective case series, all patients with RIF who underwent diagnostic hysteroscopy, IHC analysis with CD138 of an endometrial biopsy and microbiological analysis of an endometrial sample between October 2018 and February 2019 were included. Participants/materials, setting, methods Hysteroscopic findings suggestive of CE were collected and endometrial biopsies were taken for pathological study with CD138 and microbiological assessment. Likewise, treated endometrial samples and the results of hysteroscopy or control biopsies after treatment were collected. The data of embryo transfers post-treatment were also included in our study. Main results and the role of chance 30 patients with implantation failure were included. 15 patients (50%) were diagnosed with CE using any of the aforementioned diagnostic methods. All diagnosed patients were treated with antibiotic therapy: positive microbiological samples (9) were treated according to our antibiogram whereas those samples who were negative but were confirmed to have CE by hysteroscopy or pathological assessment (6) were treated with doxycycline. In all cases, CE resolved after treatment, except only one patient who required a second course of antibiotics to acquire a negative result. Ten patients underwent an embryo transfer after resolution of CE, resulting in 60% of ongoing pregnancies. Limitations, reasons for caution Although our results are encouraging and in accordance with other studies, we are aware that this is an observational non-randomised study with a limited number of patients. Wider implications of the findings: It seems that the treatment of CE, following its diagnosis using the aforementioned methods, can improve pregnancy rates in patients with RIF and CE. Therefore, it is likely recommendable to study CE using these three tests. Trial registration number Not applicable

Comparison of antibiotic prescriptions in adults and children with upper respiratory tract infections in Bangka Tengah primary health care centers

2020 ◽  
Vol 30 (6) ◽  
Author(s):  
Pratama Novan Y. I. ◽  
Avianto Primadi ◽  
◽  
Keyword(s):  
Antibiotic Therapy ◽  
Respiratory Tract Infections ◽  
Upper Respiratory Tract Infections ◽  
Upper Respiratory Tract ◽  
Primary Health ◽  
Adults And Children ◽  
Upper Respiratory ◽  
Primary Health Care Centers ◽  
Tract Infections ◽  
Health Care Centers

AbstractBackgroundInappropriate antibiotic therapy is accelerating the development of antimicrobial resistance (AMR). Upper respiratory tract infections (URTIs) are predominantly caused by viruses, resulting in the prescription of antibiotics to a few selected patients. Previous studies in primary health care centers (PHCCs) in Indonesia have shown a high percentage of antibiotic therapy for URTIs. This study tries to analyze the difference in profiles of antibiotic prescription in the treatment of children and adults with URTI in Bangka Tengah, Indonesia.MethodsRandom prescriptions from patients diagnosed with URTIs (sinusitis, bronchitis, common cold, and pharyngitis) from all PHCCs in Bangka Tengah were collected from January to February 2018. Prescriptions from patients with overlapping diagnoses, such as URTI with diarrhea or typhoid, were excluded.ResultsDuring the two months of data collection, 1348 prescriptions for adults and children with URTIs were studied. Children were 1.30 (95% CI, 1.03–1.58) times more likely to be treated with antibiotics compared to adults. Amoxicillin was the most commonly prescribed antibiotic both in children (92.3%) and adults (78.6%). Ciprofloxacin was commonly prescribed in adults (14.6%) but not in children (0.3%).ConclusionsThis study confirms the major antibiotic overuse in patients with URTI, especially in children. Owing to the fact that children are more likely to get URTI of viral origin, they receive high percentage of antibiotic therapy. These findings support the need for collaborated intervention to decrease unnecessary prescription of antibiotics in Bangka Tengah.

Cryotherapy for the prevention of chemotherapy-induced peripheral neuropathy: A systematic review

2020 ◽  
pp. 107815522095943
Author(s):  
Andrea G Bailey ◽  
Jamie N Brown ◽  
Julia M Hammond
Keyword(s):  
Systematic Review ◽  
Peripheral Neuropathy ◽  
Adverse Effects ◽  
Antineoplastic Agent ◽  
Standard Of Care ◽  
Peripheral Nervous System Diseases ◽  
Pharmacological Agents ◽  
Search Terms ◽  
Number Of Patients ◽  
Chemotherapy Agents

Objective Chemotherapy induced peripheral neuropathy (CIPN) is an adverse effect of certain chemotherapy agents that can result in dose reductions, permanent nerve damage, and chronic pain. Although pharmacological agents have been studied in this setting, there is no standard of care for the prevention of CIPN. Thus, the objective of this systematic review is to assess the efficacy and safety of cryotherapy for the prevention of CIPN. Data sources PubMed (1946 to February 2020) and Embase (1947 to February 2020) were utilized to conduct a literature search using the following search terms: antineoplastic agent(s), taxoid(s), or chemotherapy and neuralgia, peripheral nervous system diseases, peripheral neuropathy, or paclitaxel-induced peripheral neuropathy and cryotherapy, cryotherapy device, hypothermia, low temperature procedures, or ice. Data summary A total of 11 studies were included in the final assessment. Results of this systematic review indicate that the efficacy of cryotherapy in preventing CIPN is conflicting. This may be due to studies utilizing differing cryotherapy administration methods, study design, and including only a small number of patients. All included studies utilized cryotherapy with taxane-based chemotherapy treatments and cooling gloves and socks was the most common method of administration. Overall, cryotherapy was well-tolerated and no serious adverse effects were noted. Conclusions Due to the absence of serious adverse effects, cryotherapy is a reasonable option to consider to prevent CIPN in patients receiving taxane-based chemotherapy. However, additional research is needed, including larger, better designed studies, to fully delineate the role of cryotherapy for CIPN.

Antibiotic therapy of acute upper respiratory tract infections and otitis media in adults

2018 ◽  
Vol 7 (1) ◽  
pp. 1-7
Author(s):  
Aleksandra Paź ◽  
Magdalena Arimowicz
Keyword(s):  
Respiratory Tract ◽  
Antibiotic Therapy ◽  
Respiratory Tract Infections ◽  
Viral Infections ◽  
Respiratory Infections ◽  
Symptomatic Treatment ◽  
Upper Respiratory Tract Infections ◽  
Upper Respiratory Tract ◽  
Upper Respiratory ◽  
Tract Infections

An estimated 50% of antibiotic prescriptions may be unjustified in the outpatient setting. Viruses are responsible for most acute respiratory tract infections. The viral infections are often self-limiting and only symptomatic treatment remains effective. Bacteria are involved in a small percentage of infections etiology in this area. In the case of a justified or documented suspicion of a bacterial infection, antibiotic therapy may be indicated. Based on the Polish „Recommendations for the management of non-hospital respiratory infections 2016”, the indications, the rules of choice, the appropriate dosing schedules and the therapy duration, in the most frequent upper respiratory tract infections in adults, have been presented. Implementation of the presented recommendations regarding our Polish epidemiological situation, will significantly reduce the tendency to abuse antibiotics, and thus will limit the spread of drug-resistant microorganisms.

Estimation of efficiency of empirical antibiotic therapy of catheter-associated infection in a urological hospital

2020 ◽  
Vol 10 (2) ◽  
pp. 157-162
Author(s):  
Andrey V. Kuzmenko ◽  
Timur A. Gyaurgiev ◽  
Alexander E. Halchenko ◽  
Yaroslav M. Vorkel
Keyword(s):  
Antibiotic Therapy ◽  
High Frequency ◽  
Empirical Therapy ◽  
Empirical Antibiotic Therapy ◽  
Bacteriological Examination ◽  
Case Histories ◽  
Antibacterial Drugs ◽  
Tract Infections ◽  
Klebsiella Spp ◽  
Clinical Emergency

An analysis of case histories of 119 patients who underwent treatment in the urology department of the Voronezh City Clinical Emergency Hospital No. 10 was performed. All patients were drained with a urethral catheter, a bacteriological examination of the urine was performed, and empirical antibiotic therapy was prescribed. Microflora growth was detected in the urine of 30 (25.2%) patients, most often revealed Klebsiella spp. and Enterococcus faecalis. A high frequency of resistance of uropathogens to antibacterial drugs prescribed as empirical therapy was noted. 66% were resistant to ceftriaxone, and 70% of the isolated microorganism strains to ciprofloxacin. Significantly lower resistance was noted for amikacin and doxycycline. To increase the effectiveness of empirical antibiotic therapy in patients with catheter-associated urinary tract infections, it is necessary to select antibacterial drugs based on the results of monitoring the sensitivity of hospital strains, followed by treatment correction in accordance with the results of urine bacteriological studies.

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