Antimicrobial Treatment Guidelines for Acute Bacterial Rhinosinusitis

2001 ◽  
Vol 40 (6) ◽  
pp. 359-360
Author(s):  
Christine Knoll
Keyword(s):  
Treatment Guidelines ◽  
Antimicrobial Treatment ◽  
Acute Bacterial Rhinosinusitis

scholarly journals Antimicrobial resistance in Neisseria gonorrhoeae isolates and gonorrhoea treatment in the Republic of Belarus, Eastern Europe, 2009–2019

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Aliaksandra Aniskevich ◽  
Iryna Shimanskaya ◽  
Iryna Boiko ◽  
Tatyana Golubovskaya ◽  
Daniel Golparian ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Neisseria Gonorrhoeae ◽  
Eastern Europe ◽  
Treatment Guidelines ◽  
Statistical Significance ◽  
Antimicrobial Treatment ◽  
National Guidelines ◽  
First Line ◽  
Exact Test ◽  
The Republic

Abstract Background Limited antimicrobial resistance (AMR) data for Neisseria gonorrhoeae are available in Eastern Europe. We investigated AMR in N. gonorrhoeae isolates in the Republic of Belarus from 2009 to 2019, antimicrobial treatment recommended nationally, and treatment given to patients with gonorrhoea. Methods N. gonorrhoeae isolates (n = 522) cultured in three regions of Belarus in 2009–2019 were examined. Determination of minimum inhibitory concentrations (MICs) of eight antimicrobials was performed using Etest. Resistance breakpoints from the European Committee on Antimicrobial Susceptibility Testing were applied where available. A Nitrocefin test identified β-lactamase production. Gonorrhoea treatment for 1652 patients was also analysed. Statistical significance was determined by the Z-test, Fisher’s exact test, or Mann-Whitney U test with p-values of < 0.05 indicating significance. Results In total, 27.8% of the N. gonorrhoeae isolates were resistant to tetracycline, 24.7% to ciprofloxacin, 7.0% to benzylpenicillin, 2.7% to cefixime, and 0.8% to azithromycin. No isolates were resistant to ceftriaxone, spectinomycin, or gentamicin. However, 14 (2.7%) isolates had a ceftriaxone MIC of 0.125 mg/L, exactly at the resistance breakpoint (MIC > 0.125 mg/L). Only one (0.2%) isolate, from 2013, produced β-lactamase. From 2009 to 2019, the levels of resistance to ciprofloxacin and tetracycline were relatively high and stable. Resistance to cefixime was not identified before 2013 but peaked at 22.2% in 2017. Only sporadic isolates with resistance to azithromycin were found in 2009 (n = 1), 2012 (n = 1), and 2018–2019 (n = 2). Overall, 862 (52.2%) patients received first-line treatment according to national guidelines (ceftriaxone 1 g). However, 154 (9.3%) patients received a nationally recommended alternative treatment (cefixime 400 mg or ofloxacin 400 mg), and 636 (38.5%) were given non-recommended treatment. Conclusions The gonococcal resistance to ciprofloxacin and tetracycline was high, however, the resistance to azithromycin was low and no resistance to ceftriaxone was identified. Ceftriaxone 1 g can continuously be recommended as empiric first-line gonorrhoea therapy in Belarus. Fluoroquinolones should not be prescribed for treatment if susceptibility has not been confirmed by testing. Timely updating and high compliance with national evidence-based gonorrhoea treatment guidelines based on quality-assured AMR data are imperative. The need for continued, improved and enhanced surveillance of gonococcal AMR in Belarus is evident.

High-dose steroid and heparin: a novel therapy for cerebral vasculitis associated with presumed group A Streptococcus meningitis

2021 ◽  
Vol 14 (2) ◽  
pp. e239618
Author(s):  
Brian Alexander Hummel ◽  
Julie Blackburn ◽  
Anne Pham-Huy ◽  
Katherine Muir
Keyword(s):  
Treatment Guidelines ◽  
Group A Streptococcus ◽  
Oral Prednisone ◽  
Acute Otitis Media ◽  
Antimicrobial Treatment ◽  
Cerebral Vasculitis ◽  
High Dose ◽  
Novel Therapy ◽  
Intravenous Heparin ◽  
Group A

Cerebral vasculitis is a serious complication of bacterial meningitis that can cause significant morbidity and mortality due to stroke. Currently, there are no treatment guidelines or safety and efficacy studies on the management of cerebral vasculitis in this context. Herein, we report a case of a previously well 11-year-old girl who presented with acute otitis media that progressed to mastoiditis and fulminant meningitis. Group A Streptococcus was found in blood and ear-fluid cultures (lumbar puncture was unsuccessful). Her decreased level of consciousness persisted despite appropriate antimicrobial treatment, and repeat MRI revealed extensive large vessel cerebral vasculitis. Based on expert opinion and a presumed inflammatory mechanism, her cerebral vasculitis was treated with 7 days of pulse intravenous methylprednisolone followed by oral prednisone taper. She was also treated with intravenous heparin. Following these therapies, she improved clinically and radiographically with no adverse events. She continues to undergo rehabilitation with improvement.

scholarly journals Non-adherence to antimicrobial treatment guidelines results in more broad-spectrum but not more appropriate therapy

2011 ◽  
Vol 31 (7) ◽  
pp. 1561-1568 ◽  
Author(s):  
L. B. J. van der Velden ◽  
M. Tromp ◽  
C. P. Bleeker-Rovers ◽  
M. Hulscher ◽  
B. J. Kullberg ◽  
...  
Keyword(s):  
Broad Spectrum ◽  
Treatment Guidelines ◽  
Antimicrobial Treatment ◽  
Appropriate Therapy

Antimicrobial prescribing behaviour in dogs and cats by Belgian veterinarians

2017 ◽  
Vol 182 (11) ◽  
pp. 324-324 ◽  
Author(s):  
Alexia Van Cleven ◽  
Steven Sarrazin ◽  
Hilde de Rooster ◽  
Dominique Paepe ◽  
Sofie Van der Meeren ◽  
...  
Keyword(s):  
Primary Care ◽  
Online Survey ◽  
Treatment Guidelines ◽  
Current Treatment ◽  
Antimicrobial Treatment ◽  
Fourth Generation ◽  
National Guidelines ◽  
First Line ◽  
Clinical Scenarios ◽  
Prescribing Behaviour

The objective of this study is to survey general prescribing behaviour by Belgian companion animal veterinarians and to assess agreement of these practices with current treatment guidelines. Therefore an online survey was administered with five realistic and frequently occurring first-line cases to primary-care veterinary practitioners. For each case a predefined pattern of questions were asked about whether or not they would prescribe antimicrobials, if they would prescribe a non-antimicrobial treatment and if they would perform additional diagnostic steps. The responses were compared with recommendations in national guidelines and recent literature. The overall most prescribed antimicrobials were potentiated amoxicillin (43.0 per cent), fluoroquinolones (14.7 per cent), third-generation and fourth-generation cephalosporins (10.9 per cent) and tetracyclines (10.9 per cent). Only 48.3 per cent of the veterinarians complied with the guidelines in nearly all of the clinical scenarios (ie, prescribing antimicrobials when indicated, not prescribing antimicrobials when it is not indicated). Moreover, when prescribing highest priority critically important antimicrobials, susceptibility testing on bacterial cultures was performed in only 12.4 per cent of the prescriptions. The results showed that the prescribing behaviour of antimicrobial compounds by primary-care veterinary practitioners in dogs and cats is often not in agreement with national guidelines. Focus in improvement of this prescribing behaviour should be on performing the appropriate diagnostic steps and decreasing the use of highest priority critically important antimicrobials.

scholarly journals Detection of Extended-Spectrum ß-Lactamases among Acinetobacter Baumannii Isolated from Hospitals of Qazvin, Iran

2021 ◽  
Vol 31 (2) ◽  
Author(s):  
Mina Zarabadi-Pour ◽  
Amir Peymani ◽  
Narges Habibollah-Pourzereshki ◽  
Mohammad Reza Sarookhani ◽  
Ali Akbar Karami ◽  
...  
Keyword(s):  
Acinetobacter Baumannii ◽  
Treatment Guidelines ◽  
Laboratory Data ◽  
Cross Sectional Study ◽  
Antimicrobial Treatment ◽  
Cross Sectional ◽  
Extended Spectrum ◽  
Repetitive Extragenic Palindromic Pcr ◽  
Encoding Genes ◽  
Disk Method

BACKGROUND፡ Acinetobacter baumannii is a major contributor to nosocomial infections. Extended-spectrum ßlactamase (ESBL)-producing A. baumannii is spreading worldwide. We aimed to determine the frequency of ESBLencoding genes in clinical isolates of A. baumannii and to access their clonal relationship by repetitive extragenic palindromic-PCR (rep-PCR).METHODS: In this descriptive cross-sectional study, 203 isolates of A. baumannii were collected from Qazvin hospitals. The Identification of isolates was performed by standard laboratory methods. To verify ESBL production, all isolates were screened by disk agar diffusion and confirmed by the combined disk method. Subsequently, ESBL-encoding genes were detected by PCR and sequencing. Possible clonal association of ESBL-producing isolates was evaluated using rep-PCR.RESULTS: Two hundred (98.5%) isolates showed reduced susceptibility to one of the antibiotics used in the ESBL screening test, of which 127 isolates (62.6%) produced ESBL. PCR results showed blaOXA-1 (20.5%) was the most prevalent gene followed by blaTEM-1 (20%), blaGES-1 (15.7%), blaCTX-M-15 (7.9%), and blaPER-1(1.6%). Rep-PCR results revealed that ESBL-producing isolates belonged to clones A (85%), B (13.4%), and C (1.6%).CONCLUSION: Our study showed the significant presence of blaOXA-1, blaTEM-1, blaGES-1, blaCTX-M-15, and blaPER-1 genes in ESBLproducing A. baumannii isolates in the studied hospitals. This is the first report on the emergence of blaOXA-1 gene in these isolates in Iran. The use of comprehensive antimicrobial treatment guidelines based on laboratory data and appropriate infection control interventions are essential.

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