scholarly journals Antibiotic Prescribing by Pediatricians for Respiratory Tract Illness in Children † 507

1998 ◽  
Vol 43 ◽  
pp. 89-89
Author(s):  
Sandra R Arnold ◽  
Upton D Allen ◽  
Mohamed al-Zahrani ◽  
Darrell Tan ◽  
Elaine E L Wang
Keyword(s):  
Respiratory Tract ◽  
Antibiotic Prescribing ◽  
Respiratory Tract Illness

scholarly journals Parent and Clinician Views of Managing Children with Symptoms of a Lower Respiratory Tract Infection and Their Influence upon Decisions to Take Part in a Placebo-Controlled Randomised Control Trial

Antibiotics ◽  
2021 ◽  
Vol 10 (4) ◽  
pp. 356
Author(s):  
Catherine J. Woods ◽  
Zoe Morrice ◽  
Nick A. Francis ◽  
Paul Little ◽  
Theo Verheij ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Lower Respiratory Tract ◽  
Controlled Trial ◽  
Randomised Control Trial ◽  
Antibiotic Prescribing ◽  
Parent Attitudes ◽  
Telephone Interviews ◽  
Tract Infections ◽  
Interview Studies ◽  
Safety Netting

Children presenting with uncomplicated lower respiratory tract infections (LRTIs) commonly receive antibiotics despite public campaigns on antibiotic resistance. Qualitative interview studies were nested in a placebo-controlled trial of amoxicillin for LRTI in children. Thirty semi-structured telephone interviews were conducted with sixteen parents and fourteen clinicians to explore views of management and decisions to participate in the trial. All interviews were audio-recorded, transcribed and analysed using thematic analysis. Parents found it difficult to interpret symptoms and signs, and commonly used the type of cough (based on sound) to judge severity, highlighting the importance of better information to support parents. Provision of a clinical examination and reassurance regarding illness severity were key motivations for consulting. Many parents now acknowledge that antibiotics should only be used when ‘necessary’, and clinicians reported noticing a shift in parent attitudes with less demand for antibiotics and greater satisfaction with clinical assessment, reassurance and advice. Decisions to take part in the trial were influenced by the perceived risks associated with allocation to a placebo, and concerns about unnecessary use of antibiotics. Clear communication about self-management and safety-netting were identified as important when implementing ‘no antibiotic’ prescribing strategies to reassure parents and to support prescribing decisions.

scholarly journals In SilicoApproach towards Designing Virtual Oligopeptides for HRSV

2014 ◽  
Vol 2014 ◽  
pp. 1-12 ◽  
Author(s):  
Ruchi Jain ◽  
Shanmughavel Piramanayagam
Keyword(s):  
Respiratory Syncytial Virus ◽  
Respiratory Tract ◽  
Virus Replication ◽  
Lower Respiratory Tract ◽  
Specific Interaction ◽  
Infection Process ◽  
Rational Choices ◽  
Respiratory Tract Illness ◽  
Syncytial Virus ◽  
Infants And Young Children

HRSV (human respiratory syncytial virus) is a serious cause of lower respiratory tract illness in infants and young children. Designing inhibitors from the proteins involved in virus replication and infection process provides target for new therapeutic treatments. In the present study,in silicodocking was performed using motavizumab as a template to design motavizumab derived oligopeptides for developing novel anti-HRSV agents. Additional simulations were conducted to study the conformational propensities of the oligopeptides and confirmed the hypothesis that the designed oligopeptide is highly flexible and capable of assuming stable confirmation. Our study demonstrated the best specific interaction of GEKKLVEAPKS oligopeptide for glycoprotein strain A among various screened oligopeptides. Encouraged by the results, we expect that the proposed scheme will provide rational choices for antibody reengineering which is useful for systematically identifying the possible ways to improve efficacy of existing antibody drugs.

Day-Care Center Attendance and Hospitalization for Lower Respiratory Tract Illness

PEDIATRICS ◽  
1988 ◽  
Vol 82 (3) ◽  
pp. 300-308
Author(s):  
Larry J. Anderson ◽  
Robert A. Parker ◽  
Raymond A. Strikas ◽  
Jeffrey A. Farrar ◽  
Eugene J. Gangarosa ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Day Care ◽  
Lower Respiratory Tract ◽  
Care Center ◽  
Demographic Data ◽  
Care Home ◽  
Univariate Analysis ◽  
Day Care Center ◽  
Respiratory Tract Illness ◽  
Syncytial Virus

To identify risk factors associated with hospitalization for acute lower respiratory tract illness, 102 children <2 years of age admitted to four Atlanta metropolitan area hospitals between December 1984 and June 1985 with the diagnosis of lower respiratory tract illness were studied. The most common causative agent associated with illness was respiratory syncytial virus, followed by other respiratory viruses, Haemophilus influenzae, and Streptococcus pneumoniae. The 102 case-patients were compared with 199 age- and sex-matched controls. A parent or guardian for each patient and control was interviewed by telephone regarding demographic data, care outside the home, breast-feeding, previous medical history, allergies, and smoking and illness in household members. Five factors were associated with lower respiratory tract illness in both a univariate analysis and a multiple logistic regression model (P < .05). These factors were the number of people sleeping in the same room with the child, a lack of immunization the month before the patient was hospitalized, prematurity, a history of allergy, and regular attendance in a day-care center (more than six children in attendance). Care received outside of the home in a day-care home (less than or equal to six children in attendance) was not associated with lower respiratory tract illness. The suggestion made by our study and other studies was that for children <2 years of age, care outside of the home is an important risk factor for acquiring lower respiratory tract illness, as well as other infectious diseases, and that this risk can be reduced by using a day-care home instead of a day-care center.

scholarly journals Diagnostic Stewardship in Lower Respiratory Tract Infections Using Procalcitonin

2021 ◽  
Vol 1 (S1) ◽  
pp. s31-s32
Author(s):  
Amanda Gusovsky ◽  
David Burgess ◽  
Donna Burgess ◽  
Emily Slade ◽  
Chris Delcher ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Infectious Diseases ◽  
Respiratory Tract ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Length Of Hospital Stay ◽  
Prescribing Patterns ◽  
Antibiotic Prescribing ◽  
Lower Respiratory Tract Infections ◽  
Tract Infections

Background: A team of infectious diseases physicians, infectious diseases pharmacists, clinical laboratorians, and researchers collaborated to assess the management of lower respiratory tract infections (LRTIs). In 1 sample from our institution, 96.1% of pneumonia cases were prescribed antibiotics, compared to 85.0% in a comparison group. A collaborative effort led to the development of a protocol for procalcitonin (PCT)-guided antibiotic prescribing that was approved by several hospital committees, including the Antimicrobial Stewardship Committee and the Healthcare Pharmacy & Therapeutics Committee in December 2020. The aim of this analysis was to develop baseline information on PCT ordering and antibiotic prescribing patterns in LRTIs. Methods: We evaluated all adult inpatients (March–September 2019 and 2020) with a primary diagnosis of LRTI who received at least 1 antibiotic. Two cohorts were established to observe any potential differences in the 2 most recent years prior to adoption of the PCT protocol. Data (eg, demographics, specific diagnosis, length of stay, antimicrobial therapy and duration, PCT labs, etc) were obtained from the UK Center for Clinical and Translational Science, and the study was approved by the local IRB. The primary outcome of interest was antibiotic duration; secondary outcomes of interest were PCT orders, discharge antibiotic prescription, and inpatient length of stay. Results: In total, 432 patients (277 in 2019 and 155 in 2020) were included in this analysis. The average patient age was 61.2 years (SD, ±13.7); 47.7% were female; and 86.1% were white. Most patients were primarily diagnosed with pneumonia (58.8%), followed by COPD with complication (40.5%). In-hospital mortality was 3.5%. The minority of patients had any orders for PCT (29.2%); among them, most had only 1 PCT level measured (84.1%). The median length of hospital stay was 4 days (IQR, 2–6), and the median duration of antibiotic therapy was 4 days (IQR, 3–6). Conclusions: The utilization of PCT in LRTIs occurs in the minority of patient cases at our institution and mostly as a single measurement. The development and implementation of a PCT-guided therapy could help optimize antibiotic usage in patients with LRTIs.Funding: NoDisclosures: None

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