scholarly journals Efficacy of Combined Therapy with Nitroimidazole Drugs and Broad-Spectrum Antibiotics on Intra-Abdominal Infection: A 10 Years Real-World Cohort Study

2022 ◽  
Author(s):  
Hongyi Liang ◽  
Gaici Xue ◽  
Jiasheng Ye ◽  
Fangfang Wen ◽  
Leifang Ouyang ◽  
...  
Keyword(s):  
Propensity Score ◽  
Abdominal Surgery ◽  
Clinical Efficacy ◽  
Broad Spectrum ◽  
Combined Therapy ◽  
The Body ◽  
Apache Ii Score ◽  
Abdominal Infection ◽  
Broad Spectrum Antibiotics ◽  
Hospitalization Costs

Abstract Background: Abdominal infection still has a high mortality rate, and whether the combination of nitroimidazoles against obligate anaerobe could improve the outcome of abdominal infection remains controversial. Objective: This study aimed at exploring the clinical efficacy of broad-spectrum antibiotics combined with nitroimidazoles in the treatment of abdominal infection. Methods: Clinical data of patients with abdominal infection who received broad-spectrum antibiotics alone (BSA) or broad-spectrum antibiotics in combination with nitroimidazole (NCBSA) at a single center from June 2010 to May 2020 were retrospectively reviewed. One-to-one propensity score matching (PSM) was performed to adjust the potential differences in age, gender, APACHE II score and SOFA score of the two groups. Clinical effective rate, hospitalization days and total hospitalization costs were compared between the two groups. Meanwhile, subgroup efficacy was analyzed according to disease severity (APACH II score) and whether abdominal surgery was performed. Result: A total of 149 propensity score-matched case pairs were included in this study. There was no statistical difference in clinical effective rates between the two groups (P = 0.236). The patients in BSA group had shorter hospital stays (18d vs 27d, P = 0.001) and lower hospitalization costs (85185.7 yuan vs 187898.3 yuan, P < 0.001). However, the body temperature and PCT in patients in NCBSA group were higher than those in BSA group (P = 0.007 and P = 0.045, respectively), and CRP and WBC values in NCBSA group also were higher, but there were no significant differences between the two groups (P = 0.105 and P = 0.170, respectively). And more patients (92 vs 38) in NCBSA group underwent abdominal surgery, which indicated the infection and clinical conditons in NCBSA group were probably more severe. Subgroup analysis showed that the severity of the disease and whether the patient suffered postoperative co-infection did not affect the therapeutic effect of the two groups (P > 0.05). Conclusion: The clinical efficacy of broad-spectrum antibiotics combined with nitroimidazoles for abdominal infection was similar to that of broad-spectrum antibiotics alone, and whether the combination of nitroimidazoles in these conditions still needs more lcinical evidence.

scholarly journals Efficacy of Combined Therapy With Nitroimidazole Drugs and Broad-spectrum Antibiotics on Intra-abdominal Infection: a 10 Years Real-world Cohort Study

2021 ◽  
Author(s):  
Zhifeng Liu ◽  
Hongyi Liang ◽  
Gaici Xue ◽  
Jiasheng Ye ◽  
Fangfang Wen ◽  
...  
Keyword(s):  
Propensity Score ◽  
Abdominal Surgery ◽  
Clinical Efficacy ◽  
Broad Spectrum ◽  
Combined Therapy ◽  
The Body ◽  
Apache Ii Score ◽  
Abdominal Infection ◽  
Broad Spectrum Antibiotics ◽  
Hospitalization Costs

Abstract Background: Abdominal infection still has a high mortality rate, and whether the combination of nitroimidazoles against obligate anaerobe could improve the outcome of abdominal infection remains controversial. Objective: This study aimed at exploring the clinical efficacy of broad-spectrum antibiotics combined with nitroimidazoles in the treatment of abdominal infection. Methods: Clinical data of patients with abdominal infection who received broad-spectrum antibiotics alone (BSA) or broad-spectrum antibiotics in combination with nitroimidazole (NCBSA) at a single center from June 2010 to May 2020 were retrospectively reviewed. One-to-one propensity score matching (PSM) was performed to adjust the potential differences in age, gender, APACHE II score and SOFA score of the two groups. Clinical effective rate, hospitalization days and total hospitalization costs were compared between the two groups. Meanwhile, subgroup efficacy was analyzed according to disease severity (APACH II score) and whether abdominal surgery was performed. Result: A total of 149 propensity score-matched case pairs were included in this study. There was no statistical difference in clinical effective rates between the two groups (P = 0.236). The patients in BSA group had shorter hospital stays (18d vs 27d, P = 0.001) and lower hospitalization costs (85185.7 yuan vs 187898.3 yuan, P < 0.001). However, the body temperature and PCT in patients in NCBSA group were higher than those in BSA group (P = 0.007 and P = 0.045, respectively), and CRP and WBC values in NCBSA group also were higher, but there were no significant differences between the two groups (P = 0.105 and P = 0.170, respectively). And more patients (92 vs 38) in NCBSA group underwent abdominal surgery, which indicated the infection and clinical conditons in NCBSA group were probably more severe. Subgroup analysis showed that the severity of the disease and whether the patient suffered postoperative co-infection did not affect the therapeutic effect of the two groups (P > 0.05). Conclusion: The clinical efficacy of broad-spectrum antibiotics combined with nitroimidazoles for abdominal infection was similar to that of broad-spectrum antibiotics alone, and whether the combination of nitroimidazoles in these conditions still needs more lcinical evidence.

scholarly journals 1045. A Multicenter Propensity Score-Adjusted Retrospective Study for Comparison of the Outcome of Treatment With Third-Generation Cephalosporin vs. Broad-Spectrum Antibiotics for Enterobacter Bacteremia

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S312-S312
Author(s):  
Satoshi Hayano ◽  
Shungo Yamamoto ◽  
Ryota Hase ◽  
Akihiro Toguchi ◽  
Yoshihito Otsuka ◽  
...  
Keyword(s):  
Propensity Score ◽  
Broad Spectrum ◽  
Antimicrobial Therapy ◽  
Resistant Strain ◽  
Propensity Score Analysis ◽  
Risk Difference ◽  
Third Generation ◽  
Broad Spectrum Antibiotics ◽  
Score Analysis ◽  
Definitive Therapy

Abstract Background Enterobacter spp. can develop resistance during prolonged therapy with third-generation cephalosporins (3GC: ceftriaxone, cefotaxime, or ceftazidime) because of derepression of AmpC β-lactamase. However, the clinical significance of this phenomena remains undetermined. This study aims to assess the outcome of patients with 3GC-susceptible Enterobacter bacteremia (EB) who received definite therapy with 3GC or broad-spectrum antibiotics (BSA) using propensity score analysis. Methods In this retrospective, cohort study conducted at two tertiary care hospitals in Japan, we determined consecutive patients with EB identified from the laboratory databases between January 2010 and December 2017. We enrolled patients with 3GC-susceptible EB treated with 3GC or BSA (defined as fourth-generation cephalosporins, carbapenems, and piperacillin/tazobactam) as definitive therapy. The primary outcome was 28-day mortality. The secondary outcome was the emergence of antimicrobial-resistant strain during antimicrobial therapy. We compared outcomes using the propensity scores and inverse-probability-weighting (IPW) adjustment to decrease the confounding by indication. Results We identified 320 patients with EB; of these, 191 cases were eligible (86 treated with 3GC and 105 treated with BSA). All the measured covariates were well balanced after the IPW adjustment. We observed no significant differences in the unadjusted mortality [5.8% in the 3GC group vs. 13.3% in the BSA group; risk difference, −7.5%; 95% confidence interval (CI): −15.7–0.6; P = 0.09], and the IPW-adjusted mortality (5.1% vs. 9.4%; risk difference −4.3%; 95% CI: −12.2–3.5; P = 0.3) between the groups. The results of the propensity score-matched analysis and sensitivity analysis were similar. Furthermore, we did not observe the emergence of antimicrobial resistance during antimicrobial therapy in both groups. Conclusion Definitive therapy with 3GC for susceptible EB was not associated with an increased risk of the 28-day mortality after adjustment for potential confounders with the propensity score analysis or with the emergence of antimicrobial-resistant strain. Disclosures All authors: No reported disclosures.

Evaluation of clinical efficacy of Derinat® in form of spray in practice of district therapist

2019 ◽  
Vol 1 (9) ◽  
pp. 38-46
Author(s):  
A. P. Babkin ◽  
A. A. Zuikova ◽  
O. N. Krasnorutskaya ◽  
Yu. A. Kotova ◽  
D. Yu. Bugrimov ◽  
...  
Keyword(s):  
Clinical Efficacy ◽  
Respiratory Diseases ◽  
Viral Infections ◽  
Pharmacological Action ◽  
The Body ◽  
Natural Resistance ◽  
Acute Respiratory Diseases ◽  
T Helpers ◽  
T Killers ◽  
Stimulation Of

The widespread worldwide spread of acute respiratory diseases is an urgent problem in health care. Expressed polyetiology of respiratory diseases does not allow to limit the use of specific vaccine preparations and dictates the need to use to combat them a variety of non-specific means that stimulate the natural resistance of the human body. The main pharmacological action of sodium deoxyribonucleate is the stimulation of phagocytic activity of T-helpers and T-killers, increasing the functional activity of neutrophils and monocytes/ macrophages, providing regeneration and repair processes in the epithelial component of antiviral protection of the body. Based on the above, the study of the clinical efficacy of Derinat® in the form of spray in the treatment of acute respiratory viral infections is relevant.

scholarly journals Trends in Antibiotic Prescribing in Out-of-Hours Primary Care in England from January 2016 to June 2020 to Understand Behaviours during the First Wave of COVID-19

Antibiotics ◽  
2021 ◽  
Vol 10 (1) ◽  
pp. 32
Author(s):  
Nina J. Zhu ◽  
Monsey McLeod ◽  
Cliodna A. M. McNulty ◽  
Donna M. Lecky ◽  
Alison H. Holmes ◽  
...  
Keyword(s):  
Primary Care ◽  
Time Series ◽  
Patient Outcomes ◽  
Broad Spectrum ◽  
Antibiotic Prescribing ◽  
Broad Spectrum Antibiotic ◽  
Out Of Hours ◽  
Broad Spectrum Antibiotics ◽  
National Quality ◽  
General Practices

We describe the trend of antibiotic prescribing in out-of-hours (OOH) general practices (GP) before and during England’s first wave of the COVID-19 pandemic. We analysed practice-level prescribing records between January 2016 to June 2020 to report the trends for the total prescribing volume, prescribing of broad-spectrum antibiotics and key agents included in the national Quality Premium. We performed a time-series analysis to detect measurable changes in the prescribing volume associated with COVID-19. Before COVID-19, the total prescribing volume and the percentage of broad-spectrum antibiotics continued to decrease in-hours (IH). The prescribing of broad-spectrum antibiotics was higher in OOH (OOH: 10.1%, IH: 8.7%), but a consistent decrease in the trimethoprim-to-nitrofurantoin ratio was observed OOH. The OOH antibiotic prescribing volume diverged from the historical trend in March 2020 and started to decrease by 5088 items per month. Broad-spectrum antibiotic prescribing started to increase in OOH and IH. In OOH, co-amoxiclav and doxycycline peaked in March to May in 2020, which was out of sync with seasonality peaks (Winter) in previous years. While this increase might be explained by the implementation of the national guideline to use co-amoxiclav and doxycycline to manage pneumonia in the community during COVID-19, further investigation is required to see whether the observed reduction in OOH antibiotic prescribing persists and how this reduction might influence antimicrobial resistance and patient outcomes.

scholarly journals Oral Antibiotic for Empirical Management of Acute Dentoalveolar Infections—A Systematic Review

Antibiotics ◽  
2021 ◽  
Vol 10 (3) ◽  
pp. 240
Author(s):  
Leanne Teoh ◽  
Monique C Cheung ◽  
Stuart Dashper ◽  
Rodney James ◽  
Michael J McCullough
Keyword(s):  
Systematic Review ◽  
Clinical Outcomes ◽  
Broad Spectrum ◽  
Dental Treatment ◽  
Clinical Success ◽  
Empirical Therapy ◽  
Oral Antibiotic ◽  
Dose Frequency ◽  
Odontogenic Infections ◽  
Broad Spectrum Antibiotics

Concerns regarding increasing antibiotic resistance raise the question of the most appropriate oral antibiotic for empirical therapy in dentistry. The aim of this systematic review was to investigate the antibiotic choices and regimens used to manage acute dentoalveolar infections and their clinical outcomes. A systematic review was undertaken across three databases. Two authors independently screened and quality-assessed the included studies and extracted the antibiotic regimens used and the clinical outcomes. Searches identified 2994 studies, and after screening and quality assessment, 8 studies were included. In addition to incision and drainage, the antibiotics used to manage dentoalveolar infections included amoxicillin, amoxicillin/clavulanic acid, cefalexin, clindamycin, erythromycin, metronidazole, moxifloxacin, ornidazole and phenoxymethylpenicillin. Regimens varied in dose, frequency and duration. The vast majority of regimens showed clinical success. One study showed that patients who did not receive any antibiotics had the same clinical outcomes as patients who received broad-spectrum antibiotics. The ideal choice, regimen and spectrum of empirical oral antibiotics as adjunctive management of acute dentoalveolar infections are unclear. Given that all regimens showed clinical success, broad-spectrum antibiotics as first-line empirical therapy are unnecessary. Narrow-spectrum agents appear to be as effective in an otherwise healthy individual. This review highlights the effectiveness of dental treatment to address the source of infection as being the primary factor in the successful management of dentoalveolar abscesses. Furthermore, the role of antibiotics is questioned in primary space odontogenic infections, if drainage can be established.

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