The Common Cold—Principles of Judicious Use of Antimicrobial Agents

PEDIATRICS ◽  
1998 ◽  
Vol 101 (Supplement_1) ◽  
pp. 181-184 ◽  
Author(s):  
Nancy Rosenstein ◽  
William R. Phillips ◽  
Michael A. Gerber ◽  
S. Michael Marcy ◽  
Benjamin Schwartz ◽  
...  
Keyword(s):  
Antimicrobial Therapy ◽  
Common Cold ◽  
Antimicrobial Agents ◽  
Signs And Symptoms ◽  
Antimicrobial Treatment ◽  
Controlled Trials ◽  
Nasal Discharge ◽  
Treatment Changes ◽  
The Common ◽  
Antimicrobial Prescription

Most children will suffer between 3 and 8 colds per year, and over half of patients seen for the common cold are given an antimicrobial prescription. Unnecessary antimicrobial therapy can be avoided by recognizing the signs and symptoms that are part of the usual course of these diseases. Controlled trials of antimicrobial treatment of the common cold are reviewed. These trials consistently fail to show that treatment changes the course or outcome. Furthermore, antimicrobial therapy for patients with viral rhinosinusitis is not an effective way to prevent bacterial complications. Mucopurulent rhinitis (thick, opaque, or discolored nasal discharge) frequently accompanies the common cold and is part of the natural course of viral rhinosinusitis. It is not an indication for antimicrobial treatment unless it persists without improvement for >10 to 14 days.

scholarly journals Real-world effectiveness and tolerability of Zelesse cream® for treating vulvovaginitis in adult women: an observational, prospective study

2021 ◽  
Vol 49 (5) ◽  
pp. 030006052110132
Author(s):  
Ana Rosa Masero ◽  
Luís Manuel San Frutos ◽  
Ernesto Vizcaíno ◽  
María Palma ◽  
Syra Velasco-Ortega ◽  
...  
Keyword(s):  
Antimicrobial Therapy ◽  
Vaginal Discharge ◽  
Signs And Symptoms ◽  
Controlled Trials ◽  
Adult Women ◽  
Global Score ◽  
Point Scale ◽  
Vaginal Cream ◽  
Before And After ◽  
Larger Sample

Objective To assess the efficacy, acceptability, and tolerability of a vaginal cream based on plant extracts for treating signs and symptoms of vulvovaginitis (VV) (Zelesse cream®), either as monotherapy (non-infectious VV) or adjuvant to antimicrobial therapy (infectious VV). Methods This prospective, observational, multicenter study included women who attended outpatient offices for VV. The severity of signs (vaginal discharge, erythema, and edema) and symptoms (pruritus, burning, and dysuria) was assessed before and after 15±5 days of daily treatment with Zelesse cream on a 4-point scale (18-point global score). Results The study included 58 women aged 43.0±13.2 years, including 42 who were treated with Zelesse cream only and 16 who used Zelesse cream as adjuvant to antimicrobial therapy. All participants showed significantly reduced scores and absolute prevalence of individual signs and symptoms in both groups. Similarly, the median signs/symptoms decreased by 4.0 and 8.0 points in women using Zelesse only and those using Zelesse plus antimicrobial therapy, respectively. This product was well tolerated and had high acceptability. Conclusions Zelesse cream relieves signs and symptoms of VV, either as monotherapy in non-infectious VV or as adjuvant to antimicrobial therapy in infectious VV. Future randomized, placebo-controlled trials with larger sample sizes are warranted.

Short Oral Antibiotic Treatment of Osteomyelitis Questioned

1980 ◽  
Vol 2 (1) ◽  
pp. 18-18
Keyword(s):  
Antimicrobial Therapy ◽  
Oral Therapy ◽  
Initial Period ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Oral Route ◽  
Antimicrobial Treatment ◽  
Blood Levels ◽  
Oral Antibiotic ◽  
Cortical Destruction

Dr. Rothman of Haverhill, MA questioned the short duration of antimicrobial treatment and use of oral route for the patient with osteomyelitis presented by Bennett in PIR 1:153, November 1979. He noted that the traditional regimen for osteomyelitis calls for six weeks of intravenous antimicrobial therapy. Dr. Bennett quotes from Telzlaff et al (J Pediatr 92:485, 1978). In this report good results were found when antimicrobial regimens for patients with osteomyelitis and suppurative arthritis consisted of a brief initial period of parenteral therapy of only one to seven days followed by oral antimicrobial therapy begun when there was a definitive decrease in clinical signs of inflammation and continued for three weeks or longer. It is important to note that surgical drainage of pus was carried out, that antimicrobial blood levels were obtained after initiation of oral therapy to ensure adequate levels, that therapy was continued until all signs and symptoms had subsided, that there was no evidence of cortical destruction or sequestrum formation on roentgenogram, and the erythrocyte sedimentation rate was less than 20 mg/hr. When these conditions are met it is clear that oral therapy can be an adequate substitute for prolonged intravenous therapy for osteomyelitis in children.

scholarly journals Antimicrobial Treatment Options for Granulomatous Mastitis Caused by Corynebacterium Species

2015 ◽  
Vol 53 (9) ◽  
pp. 2895-2899 ◽  
Author(s):  
Hazel C. Dobinson ◽  
Trevor P. Anderson ◽  
Stephen T. Chambers ◽  
Matthew P. Doogue ◽  
Lois Seaward ◽  
...  
Keyword(s):  
Antimicrobial Therapy ◽  
Breast Tissue ◽  
Antimicrobial Agents ◽  
Treatment Options ◽  
Antimicrobial Treatment ◽  
Granulomatous Mastitis ◽  
Sensitivity Testing ◽  
Treatment Protocols ◽  
Content Type ◽  
16S Rna

Corynebacteriumspecies are increasingly recognized as important pathogens in granulomatous mastitis. Currently, there are no published treatment protocols forCorynebacteriumbreast infections. This study describes antimicrobial treatment options in the context of other management strategies used for granulomatous mastitis.Corynebacteriumspp. isolated from breast tissue and aspirate samples stored from 2002 to 2013 were identified and determined to the species level using matrix-assisted laser desorption ionization–time of flight mass spectrometry (MALDI-TOF MS), 16S RNA sequencing, andrpoBgene targets. The MICs for 12 antimicrobials were performed using Etest for each isolate. Correlations of these with antimicrobial characteristics, choice of antimicrobial, and disease outcome were evaluated.Corynebacteriumspp. from breast tissue and aspirate samples were confirmed in 17 isolates from 16 patients. Based on EUCAST breakpoints,Corynebacterium kroppenstedtiiisolates (n= 11) were susceptible to seven antibiotic classes but resistant to β-lactam antibiotics.Corynebacterium tuberculostearicumisolates (n= 4) were multidrug resistant. Two nonlipophilic species were isolated,Corynebacterium glucuronolyticumandCorynebacterium freneyi, both of which have various susceptibilities to antimicrobial agents. Short-course antimicrobial therapy was common (median, 6 courses per subject; range, 1 to 9 courses). Patients withC. kroppenstedtiipresented with a hot painful breast mass and underwent multiple surgical procedures (median, 4 procedures; range, 2 to 6 procedures). The management ofCorynebacteriumbreast infections requires a multidisciplinary approach and includes culture and appropriate sensitivity testing to guide antimicrobial therapy. Established infections have a poor outcome, possibly because adequate concentrations of some drugs will be difficult to achieve in lipophilic granulomata. Lipophilic antimicrobial therapy may offer a therapeutic advantage. The role of immunotherapy has not been defined.

scholarly journals Predictors of Mortality in Patients with Bloodstream Infections Caused by Extended-Spectrum-β-Lactamase-Producing Enterobacteriaceae: Importance of Inadequate Initial Antimicrobial Treatment

2007 ◽  
Vol 51 (6) ◽  
pp. 1987-1994 ◽  
Author(s):  
Mario Tumbarello ◽  
Maurizio Sanguinetti ◽  
Eva Montuori ◽  
Enrico M. Trecarichi ◽  
Brunella Posteraro ◽  
...  
Keyword(s):  
Antimicrobial Therapy ◽  
Antimicrobial Agents ◽  
Cohort Analysis ◽  
Bloodstream Infections ◽  
Treated Group ◽  
Antimicrobial Treatment ◽  
Predictors Of Mortality ◽  
Extended Spectrum ◽  
Initial Antimicrobial Therapy ◽  
The Impact

ABSTRACT Bloodstream infections (BSI) caused by extended-spectrum β-lactamase (ESBL)-producing organisms markedly increase the rates of treatment failure and death. We conducted a retrospective cohort analysis to identify risk factors for mortality in adult in-patients with BSI caused by ESBL-producing Enterobacteriaceae (ESBL-BSI). Particular attention was focused on defining the impact on the mortality of inadequate initial antimicrobial therapy (defined as the initiation of treatment with active antimicrobial agents >72 h after collection of the first positive blood culture). A total of 186 patients with ESBL-BSI caused by Escherichia coli (n = 104), Klebsiella pneumoniae (n = 58), or Proteus mirabilis (n = 24) were identified by our microbiology laboratory from 1 January 1999 through 31 December 2004. The overall 21-day mortality rate was 38.2% (71 of 186). In multivariate analysis, significant predictors of mortality were inadequate initial antimicrobial therapy (odds ratio [OR] = 6.28; 95% confidence interval [CI] = 3.18 to 12.42; P < 0.001) and unidentified primary infection site (OR = 2.69; 95% CI = 1.38 to 5.27; P = 0.004). The inadequately treated patients (89 of 186 [47.8%]) had a threefold increase in mortality compared to the adequately treated group (59.5% versus 18.5%; OR = 2.38; 95% CI = 1.76 to 3.22; P < 0.001). The regimens most commonly classified as inadequate were based on oxyimino cephalosporin or fluoroquinolone therapy. Prompt initiation of effective antimicrobial treatment is essential in patients with ESBL-BSI, and empirical decisions must be based on a sound knowledge of the local distribution of pathogens and their susceptibility patterns.

scholarly journals Chronic Rhinosinusitis in Children

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Hassan H. Ramadan
Keyword(s):  
Mortality Rate ◽  
Medical Treatment ◽  
Common Cold ◽  
Surgical Intervention ◽  
Common Disease ◽  
Nasal Discharge ◽  
High Morbidity ◽  
The Us ◽  
The Common ◽  
High Index Of Suspicion

Rhinosinusitis is a very common disease worldwide and specifically in the US population. It is a common disease in children but may be underdiagnosed. Several reasons may account to the disease being missed in children. The symptoms in children are limited and can be very similar to the common cold or allergic symptoms. Cough and nasal discharge may be the only symptoms present in children. A high index of suspicion is necessary to make the diagnosis of rhinosinusitis in these children. The majority of those children are treated medically. Only a few number will require surgical intervention when medical treatment fails. Complications of rhinosinusitis, even though rare, can carry a high morbidity and mortality rate.

scholarly journals Antimicrobial prescription practices for outpatients with acute respiratory tract infections: A retrospective, multicenter, medical record-based study

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0259633
Author(s):  
Tomoharu Ishida ◽  
Hideharu Hagiya ◽  
Hiroyuki Honda ◽  
Yasuhiro Nakano ◽  
Hiroko Ogawa ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Broad Spectrum ◽  
Common Cold ◽  
Medical Records ◽  
Respiratory Tract Infections ◽  
Age Groups ◽  
Prescription Practices ◽  
The Common ◽  
Tract Infections ◽  
Antimicrobial Prescription

Antimicrobial stewardship for outpatients with acute respiratory tract infections (ARTIs) should be urgently promoted in this era of antimicrobial resistance. Previous large-sample studies were based on administrative data and had limited reliability. We aimed to identify current antimicrobial prescription practices for ARTIs by directly basing on medical records. This multicenter retrospective study was performed from January to December in 2018, at five medical institutes in Japan. We targeted outpatients aged ≥18 years whose medical records revealed International Classification of Diseases (ICD-10) codes suggesting ARTIs. We divided the eligible cases into three age groups (18–64 years, 65–74 years, and ≥75 years). We defined broad-spectrum antimicrobials as third-generation cephalosporins, macrolides, fluoroquinolones, and faropenem. Primary and secondary outcomes were defined as the proportion of antimicrobial prescriptions for the common cold and other respiratory tract infections, respectively. Totally, data of 3,940 patients were collected. Of 2,914 patients with the common cold, 369 (12.7%) were prescribed antimicrobials. Overall, compared to patients aged ≥75 years (8.5%), those aged 18–64 years (16.6%) and those aged 65–74 years (12.1%) were frequently prescribed antimicrobials for the common cold (odds ratio [95% confidential interval]; 2.15 [1.64–2.82] and 1.49 [1.06–2.09], respectively). However, when limited to cases with a valid diagnosis of the common cold by incorporating clinical data, no statistical difference was observed among the age groups. Broad-spectrum antimicrobials accounted for 90.2% of the antimicrobials used for the common cold. Of 1,026 patients with other respiratory infections, 1,018 (99.2%) were bronchitis, of which antimicrobials were prescribed in 49.9% of the cases. Broad-spectrum antimicrobials were the main agents prescribed, accounting for nearly 90% of prescriptions in all age groups. Our data suggested a favorable practice of antimicrobial prescription for outpatients with ARTIs in terms of prescribing proportions, or quantitative aspect. However, the prescriptions were biased towards broad-spectrum antimicrobials, highlighting the need for further antimicrobial stewardship in the outpatient setting from a qualitative perspective.

scholarly journals Extra Dose of Vitamin C Based on a Daily Supplementation Shortens the Common Cold: A Meta-Analysis of 9 Randomized Controlled Trials

2018 ◽  
Vol 2018 ◽  
pp. 1-12 ◽  
Author(s):  
Li Ran ◽  
Wenli Zhao ◽  
Jingxia Wang ◽  
Hongwu Wang ◽  
Ye Zhao ◽  
...  
Keyword(s):  
Vitamin C ◽  
Common Cold ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Controlled Trials ◽  
China National Knowledge Infrastructure ◽  
Randomized Controlled ◽  
Knowledge Infrastructure ◽  
The Common ◽  
Therapeutic Doses

Aim. To investigate whether vitamin C is effective in the treatment of the common cold.Method. After systematically searching the National Library of Medicine (PubMed), Cochrane Library, Elsevier, China National Knowledge Infrastructure (CNKI), VIP databases, and WANFANG databases, 9 randomized placebo-controlled trials were included in our meta-analysis in RevMan 5.3 software, all of which were in English.Results. In the evaluation of vitamin C, administration of extra therapeutic doses at the onset of cold despite routine supplementation was found to help reduce its duration (mean difference (MD) = -0.56, 95% confidence interval (CI) [-1.03, -0.10], and P = 0.02), shorten the time of confinement indoors (MD = -0.41, 95% CI [-0.62, -0.19], and P = 0.0002), and relieve the symptoms associated with it, including chest pain (MD = -0.40, 95% CI [-0.77, -0.03], and P = 0.03), fever (MD = -0.45, 95% CI [-0.78, -0.11], and P = 0.009), and chills (MD = -0.36, 95% CI [-0.65, -0.07], and P = 0.01).Conclusions. Extra doses of vitamin C could benefit some patients who contract the common cold despite taking daily vitamin C supplements.

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