Footrot control, farm assurance and antimicrobial stewardship — making use of opportunities to engage sheep farmers

Livestock ◽  
2019 ◽  
Vol 24 (6) ◽  
pp. 299-304
Author(s):  
Liz Nabb
Keyword(s):  
Best Practice ◽  
Health Assessment ◽  
Antibiotic Use ◽  
Antimicrobial Use ◽  
First Line ◽  
Topical Antibiotics ◽  
Treatment Practices ◽  
Prompt Treatment ◽  
Veterinary Surgeon ◽  
First Line Treatment

Prompt treatment of individually lame sheep with parenteral and topical antibiotics without foot trimming remains the recommended best practice for footrot control, and is considered appropriate and justified antimicrobial use. Several antibiotic groups are licensed for footrot in sheep; all are effective but it would be prudent to use certain classes as a first-line treatment. Culling sheep with repeated lameness, separating at time of treatment and preserving the flock lameness status through quarantine procedures can also have a significant impact on lameness prevalence. Farm assurance visits and antibiotic use reviews facilitate farmer–veterinary surgeon interactions and provide an opportunity to improve flock productivity and welfare. A flock health assessment should include observation of groups of ewes to estimate lameness prevalence, examination of lame sheep to determine aetiology and a review of records to determine treatment practices.

scholarly journals Increasing use of linezolid in a tertiary NICU during a 10-year period: reasons and concerns for the future

2020 ◽  
Author(s):  
Lucie Matrat ◽  
Frank Plaisant ◽  
Christine Barreto ◽  
Olivier Claris ◽  
Marine Butin
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort ◽  
Bacterial Resistance ◽  
Antibiotic Use ◽  
Line Treatment ◽  
First Line ◽  
Coagulase Negative Staphylococci ◽  
Persistent Bacteremia ◽  
Therapeutic Alternatives ◽  
First Line Treatment

Abstract Background Linezolid has been increasingly used in tertiary NICUs. The objectives of this study were to explore the indications of these linezolid prescriptions, to analyze a possible misuse and to provide solutions to avoid such misuse. Methods A monocentric retrospective cohort study included all neonates hospitalized in one tertiary NICU between January 1st, 2010 and December 31st, 2019 and who received at least one administration of linezolid. These data were confronted to epidemiological and antibiotic use data from the same NICU. Two independent pediatricians secondarily classified linezolid uses as adequate or not. Results During the study period, 66 infections in 57 patients led to linezolid use. Most patients were pre-term and 21 patients (37%) died. Infections were mainly related to methicillin-resistant coagulase negative staphylococci and were frequently either pneumoniae (35%) or isolated bacteremia (48%), including 25 persistent bacteremia (64% of the 39 bacteremia). Need for a better tissue distribution or first-line treatment failure were the main reasons to initiate linezolid. Linezolid was administered for a median duration of 7 [3;10] days. No side effects were reported. Twenty-two (33%) of the 66 linezolid prescriptions were retrospectively classified as inadequate. Conclusions A rapid increase in linezolid prescriptions has been observed in our tertiary NICU, from 2014 to 2019, with 33% inadequate uses. This worrisome trend should lead to search for therapeutic alternatives and to work on antibiotic stewardship to prevent the emergence of new antimicrobial bacterial resistance.

scholarly journals Antibiotic Use and Treatment Outcomes among Children with Community-Acquired Pneumonia Admitted to a Tertiary Care Public Hospital in Nepal

2021 ◽  
Vol 6 (2) ◽  
pp. 55
Author(s):  
Bhishma Pokhrel ◽  
Tapendra Koirala ◽  
Dipendra Gautam ◽  
Ajay Kumar ◽  
Bienvenu Salim Camara ◽  
...  
Keyword(s):  
Treatment Outcomes ◽  
Public Hospital ◽  
Tertiary Care ◽  
Antibiotic Use ◽  
Community Acquired Pneumonia ◽  
Line Treatment ◽  
Hospital Data ◽  
First Line ◽  
Cross Sectional ◽  
First Line Treatment

In the era of growing antimicrobial resistance, there is a concern about the effectiveness of first-line antibiotics such as ampicillin in children hospitalized with community-acquired pneumonia. In this study, we describe antibiotic use and treatment outcomes among under-five children with community-acquired pneumonia admitted to a tertiary care public hospital in Nepal from 2017 to 2019. In this cross-sectional study involving secondary analysis of hospital data, there were 659 patients and 30% of them had a history of prehospital antibiotic use. Irrespective of prehospital antibiotic use, ampicillin monotherapy (70%) was the most common first-line treatment provided during hospitalization followed by ceftriaxone monotherapy (12%). The remaining children (18%) were treated with various other antibiotics alone or in combination as first-line treatment. Broad-spectrum antibiotics such as linezolid, vancomycin, and meropenem were used in less than 1% of patients. Overall, 66 (10%) children were required to switch to second-line treatment and only 7 (1%) children were required to switch to third-line treatment. Almost all (99%) children recovered without any sequelae. This study highlights the effectiveness of ampicillin monotherapy in the treatment of community-acquired pneumonia in hospitalized children in a non-intensive care unit setting.

scholarly journals Increasing use of linezolid in a tertiary NICU during a 10-year period: reasons and concerns for the future

2020 ◽  
Author(s):  
Lucie Matrat ◽  
Frank Plaisant ◽  
Christine Barreto ◽  
Olivier Claris ◽  
Marine Butin
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort ◽  
Bacterial Resistance ◽  
Antibiotic Use ◽  
Line Treatment ◽  
First Line ◽  
Coagulase Negative Staphylococci ◽  
Persistent Bacteremia ◽  
Therapeutic Alternatives ◽  
First Line Treatment

Abstract Background: Linezolid has been increasingly used in tertiary NICUs. The objectives of this study were to explore the indications of these linezolid prescriptions, to analyze a possible misuse and to provide solutions to avoid such misuse.Methods: A monocentric retrospective cohort study included all neonates hospitalized in one tertiary NICU between January 1st, 2010 and December 31st, 2019 and who received at least one administration of linezolid. These data were confronted to epidemiological and antibiotic use data from the same NICU. Two independent pediatricians secondarily classified linezolid uses as adequate or not.Results: During the study period, 66 infections in 57 patients led to linezolid use. Most patients were pre-term and 21 patients (37%) died. Infections were mainly related to methicillin-resistant coagulase negative staphylococci and were frequently either pneumoniae (35%) or isolated bacteremia (48%), including 25 persistent bacteremia (64% of the 39 bacteremia). Need for a better tissue distribution or first-line treatment failure were the main reasons to initiate linezolid. Linezolid was administered for a median duration of 7 [3;10] days. No side effects were reported. Twenty-two (33%) of the 66 linezolid prescriptions were retrospectively classified as inadequate. Conclusions: A rapid increase in linezolid prescriptions has been observed in our tertiary NICU, from 2014 to 2019, with 33% inadequate uses. This worrisome trend should lead to search for therapeutic alternatives and to work on antibiotic stewardship to prevent the emergence of new antimicrobial bacterial resistance.

A Retrospective Study of Poisoning due to Snake Venom in Zimbabwe

1993 ◽  
Vol 12 (1) ◽  
pp. 15-18 ◽  
Author(s):  
O.M.J. Kasilo ◽  
C.F.B. Nhachi
Keyword(s):  
Snake Venom ◽  
Age Groups ◽  
First Line ◽  
Total Cost ◽  
Prompt Treatment ◽  
Snake Envenomation ◽  
Referral Hospitals ◽  
The Mean ◽  
The Cost ◽  
First Line Treatment

1 Hospital records at the six major referral hospitals in urban Zimbabwe were reviewed for the years 1980-1989 in order to determine the types of snake, incidence, morbidity and mortality associated with snake venom poisoning. 2 A total of 1087 cases of animal toxin poisoning were retrieved retrospectively, 91.5% (995) of which were due to snake venom poisoning. Of the 995 cases, 50.9% (506) were females and 49.1% (489) males. The majority of patients were aged from 21 to 30 years (22%), followed by the 6-15 (16%) and the 16-20 year age groups (11 %), respectively. 3 The mean period of hospitalization of a snake venom-poisoned patient was found to be 2 d (the range was 1 d - 9 weeks). The mean total cost of keeping (excluding treatment) a poisoned patient during that period was calculated at Zimbabwean dollars (Zw$) 450.00 (US$ 225.00) per day. The total number of hospitalization days was 344 and the cost of keeping the patients in hospital was therefore Zw$ 154800 (i.e. US$ 77400). 4 The first-line treatment most used was a combination of antibiotics (44.6%), alone or with an antivenom tropical snake polyvalent (ATT) (21.2%), and analgesics (19.9%). 5 Mortality was recorded at 1.8% (18 patients) and the few records of the types of snakes associated with envenomation in order of frequency were the cobra, adders (puff and night), mamba and boomslang. The prevention and prompt treatment of snake envenomation is of priority in the reduction of incidence of poisoning.

Topical antibiotic ototoxicity: does it influence our practice?

2006 ◽  
Vol 121 (4) ◽  
pp. 333-337 ◽  
Author(s):  
E C Ho ◽  
A Alaani ◽  
R Irving
Keyword(s):  
Tympanic Membrane ◽  
General Practitioners ◽  
Neck Surgery ◽  
Line Treatment ◽  
First Line ◽  
Topical Antibiotic ◽  
Topical Antibiotics ◽  
Proven Efficacy ◽  
Perforated Tympanic Membrane ◽  
First Line Treatment

Introduction: We hypothesised that general practitioners and ENT specialists manage discharging ears differently. This study was designed to investigate this further.Methods and materials: Postal questionnaires were sent to all general practitioners in the Birmingham area and all UK consultants on the British Association of Otolaryngology–Head and Neck Surgery address list.Results and discussion: In the presence of an intact tympanic membrane, 99 per cent of consultants and 90 per cent of general practitioners would use topical antibiotics. In the presence of a perforated tympanic membrane, 97 per cent of consultants would continue to use topical antibiotics, compared with only 43 per cent of general practitioners. This was attributed to a fear of ototoxicity. If a topical non-ototoxic antibiotic of proven efficacy could be made available, 93 per cent of consultants and 88 per cent of general practitioners in this study would seriously consider using it as first line treatment.Conclusion: The majority of general practitioners would not use topical antibiotics in the presence of a perforated tympanic membrane. Most doctors would consider using a non-ototoxic topical antibiotic as first line treatment should one be made available.

Impetigo incidence and treatment: a retrospective study of Dutch routine primary care data

2018 ◽  
Vol 36 (4) ◽  
pp. 410-416
Author(s):  
Madelyn E N Loadsman ◽  
Theo J M Verheij ◽  
Alike W van der Velden
Keyword(s):  
Primary Care ◽  
Fusidic Acid ◽  
Treatment Guidelines ◽  
Antibiotic Use ◽  
Prescribing Patterns ◽  
Published Data ◽  
Oral Antibiotic ◽  
Topical Antibiotics ◽  
Treatment Practices ◽  
Patient Demographics

Abstract Background There is a lack of recently published data on impetigo presentation incidence and treatment practices in the routine Western European primary care setting. Objectives To investigate impetigo incidence, treatments and recurrence in primary care in the Netherlands. Methods A retrospective, observational study. Electronic records of patients treated for impetigo in 2015 at 29 general practices in Utrecht and surrounds were reviewed. An episode of impetigo was defined as one or more patient–doctor contacts within 8 weeks of the index consultation. Within an episode, patient demographics and prescribing patterns were analysed including number of treatments, and the category and sequence of individual medicines. Results A total of 1761 impetigo episodes were managed, with an incidence rate of 13.6 per 1000 person years. Impetigo peaked in summer. Most patients, the majority children, experienced a single episode (93%), and 25% had eczema as comorbidity. Topical antibiotics (primarily fusidic acid) were the most prescribed initial treatments (85%), followed by oral antibiotics (14%). Topical antibiotics were progressively used less over subsequent treatments, while there was an inverse increase in oral antibiotic use. Topical fusidic acid as the most common first line treatment seemed satisfactory as only 12% of initial treatments with this drug received further therapy. Repeat treatments generally occurred within 7 days. Conclusion This study of impetigo prescribing patterns in primary care highlighted that Dutch general practitioners were generally adherent to national treatment guidelines. Topical treatment, and if needed systemic small-spectrum antibiotic treatment, appeared satisfactory; these findings aid in antimicrobial stewardship.

scholarly journals Increasing use of linezolid in a tertiary NICU during a 10-year period: reasons and concerns for the future

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Lucie Matrat ◽  
Frank Plaisant ◽  
Christine Barreto ◽  
Olivier Claris ◽  
Marine Butin
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort ◽  
Bacterial Resistance ◽  
Antibiotic Use ◽  
Line Treatment ◽  
First Line ◽  
Coagulase Negative Staphylococci ◽  
Persistent Bacteremia ◽  
Therapeutic Alternatives ◽  
First Line Treatment

Abstract Background Linezolid has been increasingly used in tertiary NICUs. The objectives of this study were to explore the indications of these linezolid prescriptions, to analyze a possible misuse and to provide solutions to avoid such misuse. Methods A monocentric retrospective cohort study included all neonates hospitalized in one tertiary NICU between January 1st, 2010 and December 31st, 2019 and who received at least one administration of linezolid. These data were confronted to epidemiological and antibiotic use data from the same NICU. Two independent pediatricians secondarily classified linezolid uses as adequate or not. Results During the study period, 66 infections in 57 patients led to linezolid use. Most patients were pre-term and 21 patients (37%) died. Infections were mainly related to methicillin-resistant coagulase negative staphylococci and were frequently either pneumoniae (35%) or isolated bacteremia (48%), including 25 persistent bacteremia (64% of the 39 bacteremia). Need for a better tissue distribution or first-line treatment failure were the main reasons to initiate linezolid. Linezolid was administered for a median duration of 7 [3;10] days. No side effects were reported. Twenty-two (33%) of the 66 linezolid prescriptions were retrospectively classified as inadequate. Conclusions A rapid increase in linezolid prescriptions has been observed in our tertiary NICU, from 2014 to 2019, with 33% inadequate uses. This worrisome trend should lead to search for therapeutic alternatives and to work on antibiotic stewardship to prevent the emergence of new antimicrobial bacterial resistance.

scholarly journals Surgical treatment of ingrown toenails in children: what is best practice?

2011 ◽  
Vol 93 (2) ◽  
pp. 99-102 ◽  
Author(s):  
S Mitchell ◽  
CR Jackson ◽  
D Wilson-Storey
Keyword(s):  
Best Practice ◽  
Wedge Resection ◽  
Optimal Management ◽  
Line Treatment ◽  
First Line ◽  
Nail Bed ◽  
Operation Rate ◽  
The Individual ◽  
Ingrown Toenails ◽  
First Line Treatment

INTRODUCTION Surgery for ingrowing toenails carries a significant re-operation rate. We reviewed our departmental figures to assess the optimal management of these patients. PATIENTS AND METHODS We performed a 10-year retrospective review of all patients undergoing surgery for ingrown toenails (IGTN) in order to determine the operations most commonly used and the re-operation rate of each of these procedures. RESULTS A total of 880 procedures were performed on 414 patients. The median age at operation was 8.5 years. About half (48%) of children underwent two or more procedures with wedge excision and phenol application being the most common initial and repeat procedure. Recurrent surgery was most likely following plain avulsion or wedge avulsion without phenol application. Excision of the nailbed with phenol application had the lowest recurrence rate at 18.4%. CONCLUSIONS We recommend wedge resection with phenol application as first-line treatment with simple avulsion reserved for severely infected toes. Total nail bed excisions should be reserved for patients with significant on-going morbidity associated with IGTN. Families must be made aware of the likely outcome of IGTN surgery and the choice of operation must be tailored to the individual.

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