scholarly journals The prophylactic effect of bovine colostrum on respiratory infection and diarrhea in formula-fed infants: a randomized trial

2020 ◽  
Author(s):  
Ke Chen ◽  
Haixia Chen ◽  
Jinwen Luo ◽  
Chenggui Zeng ◽  
Xiaobing Dong ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Respiratory Infection ◽  
Respiratory Tract Infections ◽  
Intervention Group ◽  
Protective Role ◽  
Bovine Colostrum ◽  
Control Group ◽  
Prophylactic Effect ◽  
Term Infants ◽  
Tract Infections

Abstract Background It has been reported that regular consumption of bovine colostrum has a protective role for the gastrointestinal immunity of infants. However, not enough investigation has explored the prophylactic effect of bovine colostrum on the morbidity of diarrhea and respiratory tract infections in formula-fed infants. The purpose of the study is to explore the prophylactic effect of BC on morbidity of diarrhea and respiratory tract infections in formula-fed infants.Methods A total of 192 term infants aged 6 to 9 months, who were previously fully formula-fed after birth, were randomly recruited into this multi-centric, randomized, blank-controlled, opened, and post-marketing intervention study. Infants in the intervention group (IG) were given a commercially available bovine colostrum sachet once a day for 3 months while infants in the control group (CG) were not given the bovine colostrum sachet. The morbidity and duration of diarrhea and respiratory tract infections and the fecal IgA, calprotectin, and total fatty acid were monitored during the intervention.Result There was a lower incidence of loose stool [IG/CG rate ratio: 0.22, 95%CI: 0.09-0.67], increased stool frequency (0.30, 0.17-0.78), loss of appetite (0.28, 0.11-0.47), sneezing (0.22,0.07-0.69), upper respiratory infection (0.55, 0.32-0.88), and diarrhea (0.25, 0.09-0.61) and shorter duration of diarrhea for infants in IG than those in CG.Conclusion Bovine colostrum intervention for 3 months showed a potential prophylactic effect on respiratory infection and diarrhea in formula-fed infants. The present data may be applicable to other infants of similar socioeconomic status.

scholarly journals Use of Mustard Seed Footbaths for Respiratory Tract Infections: A Pilot Study

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Katja Goetz ◽  
Aune Hinz ◽  
Jost Steinhäuser ◽  
Ulrich von Rath
Keyword(s):  
Pilot Study ◽  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Intervention Group ◽  
Repeated Measurements ◽  
Mustard Seed ◽  
Control Group ◽  
Subjective Perception ◽  
Tract Infections ◽  
And Control

Objective. Respiratory tract infections (RTIs) are the most commonly treated acute problems in general practice. Instead of treatment with antibiotics, therapies from the field of integrative medicine play an increasingly important role within the society. The aim of the study was to evaluate whether mustard footbaths improve the symptoms of patients with RTIs. Methods. The study was designed as a pilot study and was carried out as an interventional trial with two points of measurement. Between November and December 2017, six practices were invited to participate. Two of them participated in the study. Patients were included who presented with an RTI at one of the involved primary care practices during February and April 2018. Participants in the intervention group used self-administered mustard seed powder footbaths at home once a day, to be repeated for six consecutive days. The improvement of symptoms was measured using the “Herdecke Warmth Perception Questionnaire” (HeWEF). A variance analysis for repeated measurements was performed to analyse differences between the intervention and control groups. Results. In this pilot study, 103 patients were included in the intervention group and 36 patients were included in the control group. A comparison of the intervention and control group before the intervention started showed nearly no difference in their subjective perception of warmth measured by the HeWEF questionnaire. Participants of the intervention group who used mustard seed footbaths for six consecutive days showed an improvement in four of the five subscales of the HeWEF questionnaire. Conclusions. This study could provide a first insight into a possible strategy to improve symptoms regarding RTI by using mustard seed footbaths.

scholarly journals Improving antibiotic prescribing for pediatric acute respiratory tract infections: A cluster randomized trial to evaluate individual versus clinic feedback

2021 ◽  
Vol 1 (1) ◽  
Author(s):  
Herbert W. Clegg ◽  
Stephen J. Ezzo ◽  
Kelly B. Flett ◽  
William E. Anderson
Keyword(s):  
Family Medicine ◽  
Respiratory Tract ◽  
Odds Ratio ◽  
Respiratory Tract Infections ◽  
Pediatric Patients ◽  
Intervention Group ◽  
Control Group ◽  
Antibiotic Prescribing ◽  
Cluster Randomized ◽  
Tract Infections

Abstract Objective: To assess the effect of individual compared to clinic-level feedback on guideline-concordant care for 3 acute respiratory tract infections (ARTIs) among family medicine clinicians caring for pediatric patients. Design: Cluster randomized controlled trial with a 22-month baseline, 26-month intervention period, and 12-month postintervention period. Setting and participants: In total, 26 family medicine practices (39 clinics) caring for pediatric patients in Virginia, North Carolina, and South Carolina were selected based upon performance on guideline-concordance for 3 ARTIs, stratified by practice size. These were randomly allocated to a control group (17 clinics in 13 practices) or to an intervention group (22 clinics in 13 practices). Interventions: All clinicians received an education session and baseline then monthly clinic-level rates for guideline-concordant antibiotic prescribing for ARTIs: upper respiratory tract infection (URI), acute bacterial sinusitis (ABS), and acute otitis media (AOM). For the intervention group only, individual clinician performance was provided. Results: Both intervention and control groups demonstrated improvement from baseline, but the intervention group had significantly greater improvement compared with the control group: URI (odds ratio [OR], 1.62; 95% confidence interval [CI], 1.37–1.92; P < 0.01); ABS (OR, 1.45; 95% CI, 1.11–1.88; P < 0.01); and AOM (OR, 1.59; 95% CI, 1.24–2.03; P < 0.01). The intervention group also showed significantly greater reduction in broad-spectrum antibiotic prescribing percentage (BSAP%): odds ratio 0.80, 95% CI 0.74-0.87, P < 0.01. During the postintervention year, gains were maintained in the intervention group for each ARTI and for URI and AOM in the control group. Conclusions: Monthly individual peer feedback is superior to clinic-level only feedback in family medicine clinics for 3 pediatric ARTIs and for BSAP% reduction. Trial registration: ClinicalTrials.gov identifier: NCT04588376, Improving Antibiotic Prescribing for Pediatric Respiratory Infection by Family Physicians with Peer Comparison.

scholarly journals Effect of C reactive protein point-of-care testing on antibiotic prescribing for lower respiratory tract infections in nursing home residents: cluster randomised controlled trial

BMJ ◽  
2021 ◽  
pp. n2198 ◽  
Author(s):  
Tjarda M Boere ◽  
Laura W van Buul ◽  
Rogier M Hopstaken ◽  
Maurits W van Tulder ◽  
Jos W M R Twisk ◽  
...  
Keyword(s):  
Nursing Home ◽  
Respiratory Tract ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Intervention Group ◽  
Nursing Home Residents ◽  
Control Group ◽  
Antibiotic Prescribing ◽  
Lower Respiratory Tract Infections ◽  
Tract Infections

Abstract Objective To evaluate whether C reactive protein point-of-care testing (CRP POCT) safely reduces antibiotic prescribing for lower respiratory tract infections in nursing home residents. Design Pragmatic, cluster randomised controlled trial. Setting The UPCARE study included 11 nursing home organisations in the Netherlands. Participants 84 physicians from 11 nursing home organisations included 241 participants with suspected lower respiratory tract infections from September 2018 to the end of March 2020. Interventions Nursing homes allocated to the intervention group had access to CRP POCT. The control group provided usual care without CRP POCT for patients with suspected lower respiratory tract infections. Main outcome measures The primary outcome measure was antibiotic prescribing at initial consultation. Secondary outcome measures were full recovery at three weeks, changes in antibiotic management and additional diagnostics during follow-up at one week and three weeks, and hospital admission and all cause mortality at any point (initial consultation, one week, or three weeks). Results Antibiotics were prescribed at initial consultation for 84 (53.5%) patients in the intervention group and 65 (82.3%) in the control group. Patients in the intervention group had 4.93 higher odds (95% confidence interval 1.91 to 12.73) of not being prescribed antibiotics at initial consultation compared with the control group, irrespective of treating physician and baseline characteristics. The between group difference in antibiotic prescribing at any point from initial consultation to follow-up was 23.6%. Differences in secondary outcomes between the intervention and control groups were 4.4% in full recovery rates at three weeks (86.4% v 90.8%), 2.2% in all cause mortality rates (3.5% v 1.3%), and 0.7% in hospital admission rates (7.2% v 6.5%). The odds of full recovery at three weeks, and the odds of mortality and hospital admission at any point did not significantly differ between groups. Conclusions CRP POCT for suspected lower respiratory tract infection safely reduced antibiotic prescribing compared with usual care in nursing home residents. The findings suggest that implementing CRP POCT in nursing homes might contribute to reduced antibiotic use in this setting and help to combat antibiotic resistance. Trial registration Netherlands Trial Register NL5054

scholarly journals A role of oropharyngeal microbiota in developing acute and chronic diseases of the upper respiratory tract

2020 ◽  
Vol 10 (2) ◽  
pp. 359-367
Author(s):  
I. I. Ababii ◽  
L. A. Danilov ◽  
M. K. Maniuc ◽  
P. I. Ababii ◽  
S. S. Ghinda ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Chronic Tonsillitis ◽  
Upper Respiratory Tract Infections ◽  
Control Group ◽  
Healthy Children ◽  
Upper Respiratory Tract ◽  
Upper Respiratory ◽  
Tract Infections

Currently, a rise in incidence of polyethological inflammation of the upper respiratory tract mucosa paralleled by altered resident and transient microbiota displaying in many cases increased antibiotic resistance has been noted. Opportunistic microbes play a major role in developing inflammatory process in Pirogov–Waldeyer’s ring. An inflammatory process occurring in the tonsillar lymphatic tissue results in host systemic complications. Fighting against acute and chronic infections of the upper respiratory tract holds the main task in pediatric otorhinolaryngology, as they can consequently elicit the cardiovascular, genitourinary and musculoskeletal complications. The results of studies examining this issue remain very contradictory, which accounted for a need to conduct our study on the territory of Moldova featured with mixed climatic conditions. Here, we wanted to study a role of microbial factor in etiopathogenesis of chronic tonsillitis in children. Bacteriological microbiota data for superficial palatine tonsils were obtained form 608 children subdivided into 5 groups: group I — 333 children with compensated chronic tonsillitis; group II — 87 children with decompensated chronic tonsillitis; group III — 91 children with acute upper respiratory tract infections (comparison group); group IV — 48 children with acute upper respiratory tract infections treated with antibiotic therapy; group V — 49 apparently healthy children (control group). It was found that β-hemolytic streptococcus exerting high sensitivity to virtually all antibiotics groups was detected in 17.4% of children with acute tonsilar inflammatory processes and decompensated defense in the lymphatic pharyngeal ring compared to 3.5% in control group. Streptococcus pneumoniae was isolated in all study groups ranging within 4.8–21.7%, including 14% in apparently healthy children characterized by reduced antibiotics sensitivity. The data obtained suggest that sickly children with acute and chronic upper respiratory tract infections constitute a risk group for developing somatic diseases. The high incidence of Streptococcus pneumoniae indicates a need for performing immunoprophylaxis, use of therapeutic vaccination as a up-to-date, combined approach in treatment of such pediatric cohort.

scholarly journals The influence of a dietary advice on recurrent upper respiratory tract infections in children: a randomized controlled trial.

2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Ellen van der Gaag ◽  
Ruben Brandsema ◽  
Job van der Palen ◽  
Thalia Hummel
Keyword(s):  
Supportive Care ◽  
Respiratory Tract Infections ◽  
Controlled Trial ◽  
Intervention Group ◽  
Dietary Advice ◽  
Control Group ◽  
Upper Respiratory Tract ◽  
Randomized Controlled ◽  
Upper Respiratory ◽  
Tract Infections

AbstractIntroductionSince there is no treatment for children suffering from upper respiratory tract infections (URTI) without immunological disorders, we searched for a possible tool to improve the health of these children.We evaluated whether a dietary advice including standard supportive care, can decrease the number and duration of URTI compared to standard supportive care in children aged 1–4 years with recurrent URTI.Material and MethodsDesign: A multicenter randomized controlled trial, with an intervention group receiving the dietary advice plus standard supportive care and a control group receiving standard supportive care alone.Setting: 3 Outpatient clinics in The Netherlands (urban and rural).Patients: 118 Children aged 1–4 years with recurrent URTIs.Intervention: A dietary advice consisting of five times per week green vegetables, 3 times per week beef, 300 mL whole milk per day, whole dairy butter on bread every day. Portion sizes are age appropriate. The intervention lasted for 6 months.ResultsChildren in the intervention group had 4.8 (1.6–9.5) days per month with symptoms of an URTI in the last three months of the study, compared to 7.7 (4.0–12.3) in the control group (p = 0.03). The total number of URTIs during the study period of 6 months was 5,7 (± 0,55) versus 6.8 (± 0,49) respectively (p = 0.068). Total use of antibiotics was markedly reduced in the intervention group (p = 0.034), as well as the visits to the general practitioner (p = 0.031), therefore possibly reducing healthcare costs.No adverse effects were observed in the lipid profiles, nor in growth parameters (weight, height, BMI).Discussion and conclusionsThis study shows a reduced number of days with symptoms of an URTI following a dietary advice consisting of green vegetables, beef and whole diary products. It did not significantly lower the number of infections. No adverse effects were observed.RegistrationThis trial is registered in the Dutch Trial Register, NTR4898, www.trialregister.nl.

Clinical efficacy and safety of silver nanoparticlebased disinfectant combined with piperacillin sodium and sulbactam sodium in the treatment of lower respiratory tract infection

2020 ◽  
Vol 10 (5) ◽  
pp. 756-761
Author(s):  
Xiaofei Li ◽  
Lina Sheng ◽  
Juncai Tu ◽  
Lianqing Lou
Keyword(s):  
Tract Infection ◽  
Respiratory Tract ◽  
Silver Nanoparticle ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Control Group ◽  
Efficacy And Safety ◽  
Lower Respiratory Tract Infections ◽  
Tract Infections ◽  
Experimental Group

This study evaluated the clinical efficacy and safety of piperacillin sulbactam in the treatment of lower respiratory tract infections, as well as the efficacy of silver nanoparticle-based disinfectant in equipment disinfection to reduce exogenous infection. From May 2018 to November 2018, 100 patients that had been diagnosed with a lower respiratory tract infection and hospitalized were divided into an experimental group and a control group. The experimental group was given piperacillin/sulbactam, and the control group was given mezlocillin/sulbactam, where 5.0 g was added to 100 mL of normal saline and administered via intravenous drip twice a day over a treatment course of 14 days. The cure rate of the experimental and control groups were 65.22% and 56.52% respectively. The efficacy rate was 91.30% and 91.30% respectively, with no significant difference between the two groups (P > 0.05). The results indicated that piperacillin/sulbactam is a safe, effective treatment for lower respiratory tract infections in elderly patients, the equipment was sterilized with silver nanoparticle-based disinfectant to reduce the incidence of adverse reactions and exogenous infections.

scholarly journals Multifactorial aetiology of recurrent respiratory tract infections in children

2021 ◽  
Vol 17 (3) ◽  
pp. 227-233
Author(s):  
Magdalena Kleszyk ◽  
◽  
Elżbieta Mizgała-Izworska ◽  
Anna Góra ◽  
Maciej Przybył ◽  
...  
Keyword(s):  
Risk Factors ◽  
Vitamin D ◽  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Control Group ◽  
Study Group ◽  
Tract Infections ◽  
Recurrent Respiratory Tract Infections

Recurrent respiratory tract infections in children are a common health problem. Exposure to harmful environmental agents and coexistence of chronic diseases affect the severity and rate of infections. Ineffective outpatient treatment is an indication for a more comprehensive diagnostic workup. The aim of the study was to determine the cause of recurrent respiratory tract infections in children. The study group included 130 children aged 3–17 years who were referred for diagnostic investigation to determine the cause of recurrent respiratory tract infections. The eligibility criterion for the study group was the occurrence of 8 or more respiratory tract infections a year in children aged up to 6 years and 5 or more infections a year in children aged 7–17 years. The study group was subdivided into the following age groups: 3–5 years (n = 60), 6–9 years (n = 35), 10–13 years (n = 11) and 14–17 years (n = 24). The presence of potential risk factors for recurrent infection was analysed on the basis of questionnaires. Tests and examinations were also performed in order to exclude allergies, ear, nose and throat disorders and gastroesophageal reflux disease. Selected laboratory values (complete blood count, vitamin D concentration, immunoglobulin levels) were compared with those obtained from 86 healthy children from the control group. The majority of children had risk factors for recurrent respiratory tract infections. Adenoid hypertrophy was diagnosed in 44.6% of children, asthma in 36.9%, vitamin D deficiency in 30.7%, gastroesophageal reflux disease in 16.2% and immunodeficiency in 9.2% of children. Multimorbidity was found in 34.6% of the subjects. In the study group, there were higher vitamin D levels [study group: 25.6 ng/mL (25th percentile = 17; 75th percentile = 33.3), control group: 22.84 ng/mL (25th percentile = 16.3; 75th percentile = 28.7); p < 0.044] and higher leukocyte levels [study group: 7.5 × 103/μL (25th percentile = 5.9; 75th percentile = 9.1), control group: 6.4 × 103/μL (25th percentile = 5.3; 75th percentile = 7.7); p < 0.02]. The results indicate that children with recurrent respiratory tract infections are a heterogeneous group of patients. The youngest children were the largest group (n = 60). In the majority of children, the onset of symptoms was associated with the beginning of nursery/preschool or school attendance. In 1 in 3 children, a combined presence of a few diseases was found which increase susceptibility to recurrent respiratory tract infections.

scholarly journals Assessment of weight and height of patients with primary immunodeficiency disorders and group of children with recurrent respiratory tract infections.

2019 ◽  
Author(s):  
Karolina Pieniawska-Śmiech ◽  
Kamil Bar ◽  
Mateusz Babicki ◽  
Karol Śmiech ◽  
Aleksandra Lewandowicz-Uszyńska
Keyword(s):  
Birth Weight ◽  
Respiratory Tract ◽  
Primary Immunodeficiency ◽  
Respiratory Tract Infections ◽  
Physical Growth ◽  
Control Group ◽  
Healthy Children ◽  
Significant Difference ◽  
Tract Infections ◽  
Recurrent Respiratory Tract Infections

Abstract Background Primary immunodeficiences (PIDs) are a group of chronic, serious disorders in which the immune response is insufficient. In consequence, it leads to an increased susceptibility to infections. Up to date, there are about 300 different disorders classified in that group. There are also patients suffering from recurrent respiratory tract infections (RRTI), however that group doesn't present any abnormalities in terms of conducted immunological tests. Many factors, including medical, can have an impact on physical development of a child. Data such as birth weight and length, also weight, height, BMI during admission to the hospital were collected from 207 patients' medical histories from their hospitalization at Clinical Immunology and Paediatrics ward of J.Gromkowski Hospital in Wrocław. Investigated groups included patients with PIDs, RRTI and a control group of healthy children. Our purpose was to evaluate the physical growth of children with primary immunodeficiency (PID) and children with recurrent respiratory tract infections (RRTI) by assessment of their height and weight. All of parameters were evaluated using centile charts suitable best for the Polish population. Results The lowest mean birth weight and height was found among the PIDs patients group. Children with PIDs during hospitalization had statistically relevant lower mean weight than the control group and almost 20% of them had their height situated below 3rd percentile. No statistically relevant differences have been found between them and RRTI group. The statistically significant difference was between the nutritional status of PID patients and the control group. Conclusions There is a higher percentage of PID patients with physical growth abnormalities in comparison to healthy children. Our findings indicate a need for further investigation of immune system irregularities and their influence on physical growth of children.

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