scholarly journals Optimization of Therapeutic Measurements in Rotavirus Infection in Infants with Perinatal Exposure to HIV

2016 ◽  
Vol 22 (2) ◽  
pp. 2016213
Author(s):  
Hryhoriy Trotskyy
Keyword(s):  
Serum Level ◽  
Antibiotic Therapy ◽  
Antimicrobial Therapy ◽  
Clinical Course ◽  
Inflammatory Activity ◽  
Perinatal Exposure ◽  
Procalcitonin Level ◽  
Rotavirus Infection ◽  
Basic Treatment

The features of the clinical course of rotavirus infection in infants with perinatal exposure to HIV were studied. Serum level of procalcitonin as a marker of inflammatory activity and the need for antimicrobial therapy was determined. The efficiency of the proposed additions to basic treatment (low-lactose mixture for two months, antibiotic therapy in case of elevated procalcitonin level) was demonstrated.

scholarly journals Colour Me Blue: The History and the Biotechnological Potential of Pyocyanin

Molecules ◽  
2021 ◽  
Vol 26 (4) ◽  
pp. 927
Author(s):  
Thiago Gonçalves ◽  
Ulrich Vasconcelos
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Antibiotic Therapy ◽  
Electric Current ◽  
Antimicrobial Therapy ◽  
Blue Colour ◽  
Current Generation ◽  
Biotechnological Potential ◽  
Avant Garde ◽  
New Horizons ◽  
The Subject

Pyocyanin was the first natural phenazine described. The molecule is synthesized by about 95% of the strains of Pseudomonas aeruginosa. From discovery up to now, pyocyanin has been characterised by a very rich and avant-garde history, which includes its use in antimicrobial therapy, even before the discovery of penicillin opened the era of antibiotic therapy, as well as its use in electric current generation. Exhibiting an exuberant blue colour and being easy to obtain, this pigment is the subject of the present review, aiming to narrate its history as well as to unveil its mechanisms and suggest new horizons for applications in different areas of engineering, biology and biotechnology.

Mathematical Examination of Dual Individualization Principles (III): Development of a Scoring System for Pneumonia Staging and Quantitation of Response to Antibiotics: Results in Cefmenoxime-Treated Patients

1992 ◽  
Vol 26 (11) ◽  
pp. 1358-1365 ◽  
Author(s):  
Aileen Luzier ◽  
Thomas F. Goss ◽  
Thomas J. Cumbo ◽  
Jerome J. Schentag
Keyword(s):  
Clinical Improvement ◽  
Antimicrobial Therapy ◽  
Scoring System ◽  
Time Course ◽  
Clinical Course ◽  
Clinical Status ◽  
Gram Stain ◽  
Retrospective Data Collection ◽  
The Mean ◽  
Important Time

OBJECTIVE: In order to quantitatively express the important, time-related aspects of response to antimicrobial therapy in patients with pneumonia, we required validated measures of the time course of events during the infection. To quantitate the changes in clinical status in relation to changes in cultures, we developed a scoring system to be used for patient assessment during therapy. DESIGN: Retrospective data collection, prospective analysis of factors. SETTING: Intensive care unit, Millard Fillmore Hospital. PATIENTS: Twenty-eight patients with nosocomial pneumonia. MAIN OUTCOME MEASURES: Clinical parameters were assessed daily for the duration of antimicrobial therapy. Using linear regression, the rate of clinical change in each patient treated was quantified. Eradication of the pathogen was determined by serial cultures of the infection site. RESULTS: Seventeen of the patients demonstrated eradication of the organism, and 11 demonstrated persistence of the pathogen (7 were considered colonization). The system described the patients at baseline in that the mean baseline scores were similar in both groups of patients (p=0.79). Patients in whom the pathogen was eradicated showed a rate of clinical improvement significantly different from those who had persistence of the organism (p=0.04). In patients demonstrating eradication, the time to eradication inversely correlated with the rate of clinical improvement (p<0.05). Of the ten parameters descriptive of the disease, those most sensitive to change after eradication of bacteria were body temperature, bacterial Gram stain, white blood cell Gram stain, and volume of sputum. CONCLUSIONS: In this set of pneumonia patients, the scoring system effectively quantified both baseline and time-related changes in clinical status. The system distinguished between the clinical course of the patient with organism eradication versus organism persistence. A shorter time to eradication was associated with a better clinical response. Prospective study of the system will determine its sensitivity.

scholarly journals ETIOLOGICAL SPECTRUM OF CAUSATIVE PATHOGENS AND FEATURES OF THE COURSE OF PYELONEPHRITIS IN CHILDREN FROM DIFFERENT REGIONS OF DAGESTAN

2019 ◽  
Vol 21 (6) ◽  
pp. 357-361
Author(s):  
Magomed I. Izrailov ◽  
A. M. Aliskandiev ◽  
B. M. Makhachev ◽  
M. R. Islamova ◽  
Z. M. Ramazanova ◽  
...  
Keyword(s):  
Antibiotic Therapy ◽  
Inflammatory Activity ◽  
Urinary System ◽  
Optimal Correction ◽  
Etiological Spectrum ◽  
The Republic ◽  
Chronic Course

The data on the analysis of the etiological structure of pyelonephritis pathogens in 303 children, from different regions of the Republic of Dagestan, is presented in dependence on the form of the disease, leading uropathogen, and inflammatory activity. Pyelonephritis with the prevalence of the chronic course was established to take the first place in the structure of urinary system infections in children of the Republic of Dagestan. At the same time, children suffering from secondary pyelonephritis caused by cocci showed more severity of pain and intoxication syndromes, which requires an optimal correction. Knowledge of the modern structure of pyelonephritis pathogens in each of the examined groups allows a timely and differentiated approach to the appointment of timely antibiotic therapy.

scholarly journals Generalized tetanus in an 11-year-old boy: A case report

2021 ◽  
Vol 11 (1) ◽  
pp. 69-75
Author(s):  
Artem A. Kozlov ◽  
Irina V. Shevchuk ◽  
Aleksei E. Zavialov ◽  
Anatoly N. Emelyanov
Keyword(s):  
Case Report ◽  
Respiratory Failure ◽  
Gastrointestinal Tract ◽  
Pain Relief ◽  
Antibiotic Therapy ◽  
Clinical Course ◽  
Treatment Strategies ◽  
Adequate Pain Relief ◽  
Choice Of Treatment ◽  
Severe Tetanus

The study presents a case report of a generalized form of severe tetanus in an unvaccinated 11-year-old child. Pain and convulsive syndromes, respiratory failure, and damage to the gastrointestinal tract prevailed in the acute period. Antibiotic therapy, anti-tetanus serum, adequate pain relief, and anticonvulsant therapy were the leading treatments of the child. Moreover, the paper discusses literature data on the options for the clinical course and choice of treatment strategies. The lack of planned vaccination in children is unsafe.

scholarly journals Association of polymorphic variants of xenobiotic biotransformation genes and glutation metabolizing genes with clinical course of cystic fibrosis, antimicrobial therapy efficacy and adverse reactions

2020 ◽  
pp. 64-65
Author(s):  
О.Г. Новоселова ◽  
Е.И. Кондратьева ◽  
Н.В. Петрова ◽  
В.Д. Шерман ◽  
А.Ю. Воронкова ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cystic Fibrosis ◽  
Treatment Failure ◽  
Antimicrobial Therapy ◽  
Adverse Reactions ◽  
Clinical Course ◽  
Clinical Manifestations ◽  
Therapy Efficacy ◽  
Xenobiotic Biotransformation ◽  
Polymorphic Variants

Тяжесть клинических проявлений муковисцидоза может быть обусловлена действием генов-модификаторов. Выяснение причин неэффективности терапии и нежелательных побочных реакций, определение факторов риска позволит улучшить прогноз для данной категории больных. Исследованы ассоциации 18 полиморфных вариантов 10 генов ферментов первой и второй фазы биотрансформации ксенобиотиков: CYP2C9 (c.430C>T, c.1075A> C), CYP2C19 (c.681G>A), CYP2D6 (1846G>A), CYP3A4 (c-392C>T), GSTT1 (del), GSTM1 (del), GSTP1 (c.313A>C), GCLC (TVR GAG, c.-129C>T), GCLM (c.-588C>T), NAT2 (c.282C>T, c.341T>C, c.434A>C, c.481C>T, c.590G>A, c.845A>C, c.857G>A) с тяжестью клинических проявлений муковисцидоза. CF clinical variability could be associated with interaction of modifier genes. Сlarification of the causes of treatment failure and adverse reactions, prediction of risk factors could improve the outcome of therapy. Association of 18 polymorphic variants of 10 genes of xenobiotic biotransformation: CYP2C9 (c.430C>T, c.1075A> C), CYP2C19 (c.681G>A), CYP2D6 (1846G>A), CYP3A4 (c-392C>T), GSTT1 (del), GSTM1 (del), GSTP1 (c.313A>C), GCLC (TVR GAG, c.-129C>T), GCLM (c.-588C>T), NAT2 (c.282C>T, c.341T>C, c.434A>C, c.481C>T, c.590G>A, c.845A>C, c.857G>A) with severity of clinical manifestations were analyzed in 333 CF patients.

Orbital Complications of Acute Sinusitis: Evaluation, Management, and Outcome

1978 ◽  
Vol 86 (2) ◽  
pp. ORL-221-ORL-230 ◽  
Author(s):  
Victor L. Schramm ◽  
Eugene N. Myers ◽  
John S. Kennerdell
Keyword(s):  
Antibiotic Therapy ◽  
Surgical Intervention ◽  
Clinical Course ◽  
Age Groups ◽  
Orbital Cellulitis ◽  
Acute Sinusitis ◽  
Study Population ◽  
Orbital Complications

Acute orbital cellulitis is most commonly caused by sinusitis. This complication is based on the anatomy of the sinuses, orbit, and their venous connections. A series of 134 patients is reviewed to demonstrate the etiology and clinical course of orbital cellulitis. Antibiotic therapy alone does not prevent permanent complications. Surgical intervention is found necessary in all age groups and is required in 20% of the study population.

Peritoneal dialysis-associated peritonitis caused by Enterococcus avium

2021 ◽  
Vol 14 (3) ◽  
pp. e240272
Author(s):  
Rita Calça ◽  
Francisca Gomes da Silva ◽  
Ana Rita Martins ◽  
Patrícia Quadros Branco
Keyword(s):  
Abdominal Pain ◽  
Peritoneal Dialysis ◽  
Antibiotic Therapy ◽  
Rare Case ◽  
Clinical Course ◽  
Catheter Removal ◽  
Coagulase Negative Staphylococci ◽  
Gram Positive ◽  
Laboratory Findings ◽  
Microbial Agents

Peritonitis remains a common and serious complication of peritoneal dialysis. Peritonitis caused by gram-positive organisms includes coagulase-negative staphylococci, Streptococcus spp and Enterococcus spp. We present a rare case of peritoneal dialysis-associated peritonitis, where persisting abdominal pain and worsening laboratory findings despite antibiotic therapy led to the identification of Enterococcus avium, requiring Tenckoff catheter removal and temporary transfer to haemodialysis. The available literature reports only few cases where peritonitis is caused by this agent, underlining the need to consider atypical microbial agents when heterogeneous clinical course is presented.

Obstetric and Gynecologic Issues Related to Infectious Diseases

2012 ◽  
pp. 464-484
Author(s):  
Kristi L. Boldt
Keyword(s):  
Urinary Tract ◽  
Antibiotic Therapy ◽  
Urinary Tract Infections ◽  
Antimicrobial Therapy ◽  
Placental Transfer ◽  
Serum Levels ◽  
Common Complication ◽  
Excretion In Milk ◽  
Tract Infections ◽  
Preterm Rupture Of Membranes

Infection is the most common complication during pregnancy and the postpartum period. Choices are limited for antibiotic therapy are limited. One must take into account the effect of pregnancy on serum levels, distribution of antibiotics, placental transfer, the fetus, the newborn, excretion in milk, the breast-feeding infant. Antimicrobial therapy is selected on the basis of experience and guidelines. Diagnosis and treatment of urinary tract infections, bacterial vaginosis, preterm labor, preterm rupture of membranes, intra-amniotic infection, and major perinatal and puerperal infections are reviewed.

scholarly journals P64 Implementation of a paediatric outpatient parenteral antibiotic therapy (p-OPAT) service at a specialist children’s hospital

2020 ◽  
Vol 105 (9) ◽  
pp. e39.2-e40
Author(s):  
Hannah Porter ◽  
Kate Stock
Keyword(s):  
Data Collection ◽  
Antibiotic Therapy ◽  
Antimicrobial Stewardship ◽  
Antimicrobial Therapy ◽  
List Type ◽  
Parenteral Antibiotic ◽  
Outpatient Parenteral Antimicrobial Therapy ◽  
Paediatric Outpatient ◽  
Bed Days ◽  
One Year

AimThe aim of this project is to optimise patient care, enhance patient experience, improve antimicrobial stewardship and assist patient flow through the hospital.MethodData collection was conducted one day a week over five consecutive weeks. All eligible wards were visited. Patient medication charts were inspected to see if intravenous antimicrobials were prescribed and a patient - specific data collection form was then completed. All the patients that met the eligibility criteria to be put forward for OPAT referral were then considered from a clinical perspective by a paediatric consultant as to their suitability for OPAT or IVOST and discharge. If the patient was deemed suitable for an OPAT discharge or IVOST and discharge a decision was made as to what antimicrobials they would theoretically have been on when discharged home. The number of potential bed days saved was calculated as the number of days between the patients review by the consultant (ie the day of data collection) and the date of their discharge prescription from that episode of care.The following was examinedpercentage of patients with identified pathogenspercentage of patients that had received input from the ID teampercentage of patients that had received input from microbiologythe prevalence of antimicrobials prescribedthe location of the patient’s home residencepatient/parent willingness to go home on OPAT.The data for patient numbers and bed day savings was then extrapolated to 52 weeks in order to be indicative of one year.ResultsOver the five days, 66 patients were identified that met the exclusion criteria to be referred for OPAT or IVOST. After clinical consideration the consultant deemed 4 patients to be suitable for OPAT and 19 for IVOST and discharge which generated a potential bed day saving of 38 bed days. This was comprised of 17 days through providing IVAs via OPAT and 21 days from timelier IVOST and discharge of patients. Extrapolated to be representative of one year, this would be a bed saving to the Trust of 1, 976 bed days.ConclusionThe potential has been identified for the hospital to make considerable bed day savings through the investment in an extended antimicrobial stewardship programme and establishment of a paediatric OPAT service. A business case has been submitted to the hospital board for consideration, with the hope that the service will be funded for a six month probationary period in order to assess its impact over the winter months, when demand for beds and pressures on PICU and theatres are highest.ReferencesPatel S, et al. 2015. Good practice recommendations for paediatric outpatient parenteral antibiotic therapy (p-OPAT) in the UK: a consensus statement. Journal of Antimicrobial Chemotherapy2015;702:360–373.Carter B, et al. Delivery, setting and outcomes of paediatric outpatient parenteral antimicrobial therapy (OPAT): a scoping review. BMJ Open, 2018;8:e021603.Hodgson KA, et al. The use, appropriateness and outcomes of outpatient parenteral antimicrobial therapy. Archives of Disease in Childhood, 2016:10:886–893.Knackstedt ED, et al. Outpatient parenteral antimicrobial therapy in pediatrics: an opportunity to expand antimicrobial stewardship. Infection Control & Hospital „Epidemiology 2015:36:222–224.

scholarly journals 2082. Evaluation of Outpatient Parenteral Antimicrobial Therapy (OPAT) Processes and Outcomes Among Patients Within an Integrated Health System

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S702-S702
Author(s):  
Brittany Brown ◽  
Thomas J Dilworth ◽  
Margaret Cook ◽  
Charles F Brummitt
Keyword(s):  
Antibiotic Therapy ◽  
Health System ◽  
Antimicrobial Therapy ◽  
High Volume ◽  
Treatment Level ◽  
Once Daily ◽  
Outpatient Parenteral Antimicrobial Therapy ◽  
Patient Demographics ◽  
Level Data ◽  
Access Complications

Abstract Background Successful management of outpatient parenteral antimicrobial therapy (OPAT) optimizes outcomes and reduces cost. We examined (i) local OPAT processes and outcomes, (ii) whether OPAT constraints favoring once daily antibiotics promoted suboptimal therapeutic choices, and (iii) whether these data could drive OPAT improvements. Methods Patients ≥ 18 years of age who received > 48 hours of OPAT at five infusion centers within a single health-system from January 1, 2018 to March 1, 2018 were eligible for review. The following patient- and treatment-level data were collected: age, gender, drug allergies, laboratory studies and frequency, OPAT indication, infection source, pathogen(s), antibiotic sensitivities, antibiotic therapy and duration, electronic order set used, prescriber specialty, evidence of failed prior oral or intravenous (IV) therapy and IV access type. The primary outcome was OPAT success: the clinical resolution of the infection without relapse within 30 days of antibiotic therapy completion. Secondary outcomes included change in antibiotic therapy due to lack of clinical improvement, adverse drug reactions and IV access complications. A sub-analysis of patients who received daptomycin and/or ertapenem was also performed. OPAT practice was compared with 2018 Infectious Diseases Society of America OPAT guidelines (Norris et al. Clin Infect Dis. 2019;68(1):e1-e35). Results A total of 108 patients were evaluated. Patient demographics, treatment and outcomes are shown in Table 1. The most common OPAT indications were bone/joint, bacteremia and skin infection. Third-generation cephalosporins, carbapenems and daptomycin were most commonly prescribed. In 34.3% and 24.2% of daptomycin and ertapenem cases, respectively, β-lactam therapy could have been utilized. Assessment of prior failed antibiotic therapy, patient allergies and pathogen-site pairing found 28.7% of patients were eligible for oral therapy upon OPAT initiation. Conclusion Several components of our local OPAT aligned with current guidelines. Initial OPAT patient selection may benefit from added scrutiny. Given the high volume of once daily antibiotics administered for convenience there is an internal opportunity to facilitate multi-daily infusions. Disclosures All authors: No reported disclosures.

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