Procalcitonin Uptake and Effect on Antibiotics Stewardship: A Single Institution Experience

Background: In the face of antibiotics resistance and adverse effects, emerging evidence suggests that procalcitonin guided therapy can help enhance appropriate use of antibiotics especially in patients with respiratory infections and sepsis. We seek to assess the uptake of procalcitonin among clinicians in a US hospital and assess its correlation with amount and duration of antibiotics use. We also seek to identify factors significantly associated with antibiotic use. Methodology: Retrospective cross-sectional study of patients with sepsis and COPD at a Medical Center in Texas USA. A total 48 COPD and 62 Sepsis patients were assessed. We collected demographic data such as age, weight, height, gender, and race/ethnicity. We also collected data on procalcitonin, number of antibiotics used, duration of antibiotics, and WBC levels at admission. We conducted bivariate analyses and logistic regression analyses to assess factor associated with procalcitonin, number of antibiotics used and duration of antibiotics. Results: We had 48 COPD patients and 62 sepsis patients in this study. Overall physicians ordered Procalcitonin on only 11.8% of patients. Procalcitonin was not significantly associated with antibiotics use. However, patients who had procalcitonin ordered had significantly lower WBC count than those without procalcitonin (10.1 vs. 12.9, p:0.026). Number of antibiotics was significantly associated with type of diagnosis (Sepsis 66.7% vs. COPD 50.7%, p = 0.001). In the logistic regression analysis, after adjusting for other variables patients with sepsis were significantly more likely to be on higher number antibiotics (OR 6.08, p <0.001) and longer duration of antibiotics (OR 7.44, p < 0.001). Conclusion: Inappropriate use of antibiotics is a public health problem. Procalcitonin has been touted as a biomarker that is effective in reducing use of antibiotics. Our study showed a low utilization of Procalcitonin by physicians and that patients with lower WBC counts were more likely to have procalcitonin ordered. However, our study did not find any association between procalcitonin and the number and duration of antibiotics use.

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The Correlation Between Knowledge With Community Behavior In Antibiotic Use In Kelurahan Petukangan Utara With Home Pharmacy Care

SANITAS : Jurnal Teknologi dan Seni Kesehatan ◽

10.36525/sanitas.2019.14 ◽

2020 ◽

Vol 10 (2) ◽

pp. 136-147

Author(s):

Adin Hakim Kurniawan ◽

Wardiyah Wardiyah ◽

Yuri Tadashi

Keyword(s):

Antibiotic Use ◽

Cross Sectional Study ◽

Antibiotics Resistance ◽

P Value ◽

Sectional Study ◽

Chi Square ◽

Cross Sectional ◽

Community Behavior ◽

Antibiotics Use ◽

Cluster Random Sampling

Uncontrolled antibiotics use can induce antibiotics resistance cases. The community believe that antibiotics can cure all disease. Because of that Pharmacist is needed home pharmacy care related by antibiotics use knowledge to justify people's misconceptions. The main purpose of this research to analysis relationship between knowledge of behavior using antibiotics in Kelurahan Petukangan Utara with home pharmacy care. This research is non-experimental with a cross sectional study design. The sample used in this research was the community of Kelurahan Petukangan Utara with cluster random sampling metode is 101 responden by questionnaires. The data analysis used chi-square statistic test. The results showed that there were categories of antibiotic knowledge (55.4%) and antibiotic Behavior (53.5%). There is a significant relationship between knowledge with community behavior antibiotics use with p-value=0.015; OR: 4.979 in Kelurahan Petukangan Utara

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Characteristics and risk factors associated with stroke subtypes among adult patients admitted to stroke unit of JUMC

Current Hypertension Reviews ◽

10.2174/1573402115666191121120228 ◽

2019 ◽

Vol 15 ◽

Author(s):

Bekalu Getachew Gebreegziabher ◽

Tesema Etefa Birhanu ◽

Diriba Dereje Olana ◽

Behailu Terefe Tesfaye

Keyword(s):

Risk Factors ◽

Stroke Unit ◽

Medical Center ◽

Data Entry ◽

Public Health Problem ◽

Cross Sectional Study ◽

Chi Square ◽

Cross Sectional ◽

Factors Associated ◽

Stroke Subtypes

Background: Stroke is a great public health problem in Ethiopia. According to reports, in-hospital stroke mortality was estimated to be 14.7% in Ethiopia. Despite this, in this country researches done on factors associated with stroke sub-types were inadequate. Objective: To assess the Characteristics and risk factors associated with stroke sub-types among patients admitted to JUMC. Methods and materials: A retrospective cross sectional study was conducted from May 2017 to May 2018 in stroke unit of Jimma University Medical Center. A total of 106 medical charts of patients diagnosed with stroke were reviewed. Checklist comprising of relevant variables was used to collect data. SPSS version 21 was employed for data entry and analysis. Chi-square test was used to point-out association and difference among stroke sub-types. The data was presented using text, tables and figures. Result: From a total of 106 patients, 67(63.2%) were men. The mean ± SD of age was 52.67±12.46 years, and no significant association was found. Of all the patients, 59(55.6%) had ischemic strokes and 47(44.4%) had hemorrhagic strokes. The most common risk factor in the patients was alcohol use with a prevalence of 69.9%. Of all the risk factors, only sex, cigarettes smoking and dyslipidemia were significantly associated to sub-types of stroke. Conclusion: Ischemic stroke was the most common subtype of stroke. Sex of patient, cigarette smoking and dyslipidemia are significantly associated with the two stroke subtypes.

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Assessment of General Public’s Knowledge and Opinions towards Antibiotic Use and Bacterial Resistance: A Cross-Sectional Study in an Urban Setting, Rufisque, Senegal

Pharmacy ◽

10.3390/pharmacy6040103 ◽

2018 ◽

Vol 6 (4) ◽

pp. 103 ◽

Cited By ~ 2

Author(s):

Oumar Bassoum ◽

Ndèye Sougou ◽

Mayassine Diongue ◽

Mamadou Lèye ◽

Mouhamad Mbodji ◽

...

Keyword(s):

Bacterial Resistance ◽

Public Health Problem ◽

Antibiotic Use ◽

Cross Sectional Study ◽

Urban Setting ◽

Major Public Health Problem ◽

Sources Of Information ◽

Sectional Study ◽

Cross Sectional ◽

Awareness Campaigns

Background: Bacterial resistance is a major public health problem worldwide. One solution to this scourge is to sensitize the general public on rational use of antibiotics. Our goal was to assess people’s knowledge and opinions about antibiotic use and bacterial resistance in an urban setting. Method: We performed a cross-sectional study. A convenience sampling was done. A questionnaire was administered to 400 persons during face-to-face interviews. Results: Most respondents thought that antibiotics are effective against colds/flu (69.8%), cough (72.3%) and sore throat (64.4%). At the same time, 42.8% stated that antibiotic therapy can be stopped as soon as the symptoms disappear. Only 8.8% and 41.8% of people knew that handwashing and vaccination prevented bacterial resistance. Globally, 7% of people had a good knowledge. Socio-demographic variables were not associated with the level of knowledge. The main sources of information were entourage and pharmacy staff. Regarding the opinions, 78.3% of surveyed participants the people thought that that people overuse antibiotics. Additionally, 28% said that they have no role to play against bacterial resistance. Conclusion: People living in an urban setting had a low knowledge about antibiotic use and bacterial resistance. There is a need to implement awareness campaigns. Further studies on population practices toward antibiotic use are necessary.

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Antibiotic Prescription Patterns for Acute Diarrhea in a Hospital in Shanghai in 2016: A Cross-sectional Study

Open Forum Infectious Diseases ◽

10.1093/ofid/ofx163.770 ◽

2017 ◽

Vol 4 (suppl_1) ◽

pp. S326-S326

Author(s):

Yanhong Hu ◽

Shanjuan Wang ◽

Sunying Hua ◽

Merlin Willcox ◽

Michael Moore ◽

...

Keyword(s):

Acute Diarrhea ◽

Respiratory Infections ◽

Final Analysis ◽

Antibiotic Use ◽

Negative Resistance ◽

Cross Sectional Study ◽

Antibiotic Prescribing ◽

Cross Sectional ◽

Oral Rehydration ◽

Stewardship Program

Abstract Background Unnecessary antibiotic use increases the risk for antibiotic resistance. The rates of antibiotic use for upper respiratory infections are high in hospitals in China. Although most guidelines advise against the use of antibiotics for acute diarrhea, little is known about antibiotic use practices for acute diarrhea in China. Methods A retrospective prescription review from a Shanghai hospital outpatient electronic health records system was conducted from 1 January 2016 to 30 December 2016. Records were included for adult patients. The microbial resistance seasonal data in 2016 were extracted. Chi-squared and multivariable logistic regression and adjusted odd ratio (aOR) were used to assess the relationships between demographic characteristics and antibiotic prescribing. Results In total, there were 16,565 prescriptions, 16,060 prescriptions were included in the final analysis after excluding the follow up visits. There were 12,131 (76%) prescriptions with antibiotics prescribed. 5505 (45%) of the antibiotics prescribed were injectable. Of the antibiotics prescribed, levofloxacin was the most frequent (85%), followed by various cephalosporins (14%). Of the cephalosporin prescriptions, third-generation products were the most common (97%). Treatment with oral rehydration salts (ORS) was prescribed 34 (0.2%) times, probiotics were prescribed 3414 (21%) times and smectite was prescribed 2209 (14%) times. Multivariable regression analysis showed that those more likely to receive antibiotics were age 31–50 aOR 1.3 (1.1–1.4), P < 0.001, evaluated in the late evening (11pm to 7am) aOR 2.6 (2.2–2.9) P < 0.001, in the early evening (6pm-11pm) aOR 2.0 (1.8–2.2) P < 0.001, in the summer (June-August) aOR 1.7 (1.5–1.9) P < 0.001. At the same time, the Gram-positive and Gram-negative resistance rates to levofloxacin exceeded 40%, including 50% of E. coliisolates. Conclusion High rates of antibiotic use were observed for acute diarrhea in this hospital. Given the inappropriateness of antibiotics for acute diarrhea and the nonsensical high rates of of intravenous levofloxacin use and the concurrent high rates of the levofloxacin resistance, a more effective antibiotic stewardship program is needed to improve patient outcomes, reduce costs, reinforce policy and address the underlying causes of antibiotic abuse. Disclosures All authors: No reported disclosures.

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Clinical differences between eosinophilic and non-eosinophilic acute exacerbation of chronic obstructive pulmonary disease (AECOPD), a multicenter cross-sectional study

10.21203/rs.3.rs-27485/v1 ◽

2020 ◽

Author(s):

Guangming Dai ◽

Yajuan Ran ◽

Jiajia Wang ◽

Xingru Chen ◽

Junnan Peng ◽

...

Keyword(s):

Logistic Regression ◽

Demographic Data ◽

Univariate Analysis ◽

Underlying Disease ◽

Cross Sectional Study ◽

Chronic Obstructive ◽

Multiple Logistic Regression ◽

Sectional Study ◽

Laboratory Findings ◽

Cross Sectional

Abstract Background AECOPD is highly heterogeneous with respect to etiology and inflammation. COPD with higher blood eosinophils is associated with increased readmission rates and better corticosteroid response. However, the clinical features of eosinophilic AECOPD aren’t well explored. Then, the aim of this study was to investigate the clinical differences between eosinophilic and non-eosinophilic AECOPD. Methods A total of 643 AECOPD patients were enrolled in this multicenter cross-sectional study. Finally, 455 were included, 214 in normal eosinophils AECOPD (NEOS-AECOPD) group, 63 in mild increased eosinophils AECOPD (MEOS-AECOPD) group, and 138 in severe increased eosinophils AECOPD (SEOS-AECOPD) group. Then, demographic data, underlying diseases, symptoms, and laboratory findings were collected. Multiple logistic regression was performed to identify the independent factors associated with blood EOS. Correlations between blood EOS and its associated independent factors were evaluated. Results The significant differences in 19 factors, including underlying disease, clinical symptom, and laboratory parameters, were identified by univariate analysis. Subsequently, multiple logistic regression revealed that lymphocytes%, neutrophils% (NS%), procalcitonin (PCT), and anion gap (AG) were associated with blood EOS in AECOPD. Both blood EOS counts and EOS% significantly correlated with lymphocytes%, NS%, PCT, and AG. Conclusions The blood EOS was independently associated with lymphocytes%, NS%, PCT, and AG in AECOPD patients. Lymphocytes% was lower, and, NS%, PCT, and AG were higher in eosinophilic AECOPD. Our results indicate that viral dominant infections probably were the major etiology of eosinophilic AECOPD. Non-eosinophilic AECOPD was more likely associated with bacterial dominant infections. The systemic inflammation in non-eosinophilic AECOPD was more severe.

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Prevalence of violence and associated factors among Youth in Northwest Ethiopia: Community-based Cross-sectional study.

10.21203/rs.3.rs-17582/v2 ◽

2020 ◽

Author(s):

Alehegn Bishaw Geremew ◽

Abebaw Addis Gelagay ◽

Telake Azale Bisetegn ◽

Yohannes Ayanaw Habitu ◽

Solomon Mekonen Abebe ◽

...

Keyword(s):

Logistic Regression ◽

Regression Model ◽

Associated Factors ◽

Logistic Regression Model ◽

Public Health Problem ◽

Cross Sectional Study ◽

Northwest Ethiopia ◽

Sectional Study ◽

Community Based ◽

Cross Sectional

Abstract Background Violence as a known serious public health problem affects people in all stages of life, from childhood to the elderly. In society, one of the most visible forms of violence is young people violence, whereas they, adolescents and young adults, are the main victims of such violence. There was limited information on the burden of violence and factors among this age group. Therefore, this study aimed to determine the prevalence of violence and its associated factors among youth in Northwest, Ethiopia. Methods A community-based cross-sectional study design was conducted to estimate the magnitude of violence among youth in Northwest, Ethiopia. The calculated sample size was 1765. A structured and pretested interviewer administered questionnaire was used to collect the data. A multi-stage cluster sampling technique was employed to get the study participants. Data were entered using Epi Info version 7 and then exported to STATA 14 for data analysis. The bivariate logistic regression model was employed to identify associated factors. An adjusted odds ratio with a 95% confidence interval was used to determine factors associated with violence. Results From the total 1765 representatives of the youth population, 1597 (90.5%) youth participated in the study. Overall, the prevalence of violence among youth aged 15–24 years for the last 12 months was 21.5%. In the multivariate logistic regression model, factors significantly associated with violence were being married and divorced (AOR= 1.77, 95% CI: 1.13, 2.79) and (AOR=5.67, 95%CI: 2.93, 10.99), respectively, Living with mother’s only (AOR= 1.85, 95% CI: 1.28, 2.66) and father’s only (AOR=2.45, 95% CI: 1.30, 4.63), and substance use (AOR= 2.38, 95% CI: 1.56, 3.66). Conclusions The prevalence of violence among youth was high compared to other studies. Special emphasis should be given to reduce the burden of youth violence and preventing and controlling the identified factors by modifying the existing policies/strategies or developing new strategies and interventions program. Keywords: Violence, Youth, Physical violence, Sexual violence, Psychological violence

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Antibiotic use in Moshi Urban: A cross-sectional Study of Knowledge and Practices among Caretakers of Children in Kilimanjaro Tanzania

Rwanda Journal of Medicine and Health Sciences ◽

10.4314/rjmhs.v4i3.4 ◽

2021 ◽

Vol 4 (3) ◽

pp. 347-356

Author(s):

Benedicto J Petro ◽

Sixbert Isdory Mkumbaye ◽

Rukia Rajab Bakar ◽

Nassra Is-hak Yussuf ◽

Pius G. Horumpende ◽

...

Keyword(s):

Antibiotic Use ◽

Cross Sectional Study ◽

Good Knowledge ◽

Sectional Study ◽

Self Medication ◽

Cross Sectional ◽

Media Campaigns ◽

Antibiotics Use ◽

Sick Children ◽

Rational Use Of Antibiotics

IntroductionAntibiotics are commonly accessed and used for the management of illness in children without a prescription. We investigated the caretaker’s knowledge and practices on antibiotics and antibiotics use to their children.MethodThis was the hospital-based cross-sectional study conducted from April to July 2017 in three facilities located in Moshi Municipality. A convenience sampling was employed to select for caretakers with their sick children at KCMC, Mawenzi hospital, and Longuo dispensary. Face-to-face interviews were conducted with 224 caretakers who had visited health facilities with their children seeking health care.ResultsThe majority (87.9%, 197/224) of all interviewed caretakers had good knowledge of the use of antibiotics. Irrespective of knowing that it is not safe to self-medicate a child with any antibiotics (95.1%, 213/224), most (61.6%, 138/224) caretakers practiced self-medication with the medicines. Having two children (aOR = 7.75, 95% CI: 1.89-31.67) and having three children (aOR=7.23, 95%CI: 1.08-48.51) were significantly associated with good knowledge of antibiotics.ConclusionThis study has revealed that caretakers in Moshi had a good knowledge of antibiotic use. However, despite such good knowledge, malpractices were observed. We call upon the use of media campaigns to advocate for the importance of the rational use of antibiotics and its effect on human health and the risk of antimicrobial resistance development.Rwanda J Med Health Sci 2021;4(3):347-356

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ASSESSMENT OF KNOWLEDGE, ATTITUDE AND PRACTICE REGARDING ANTIBIOTICS MISUSE AMONG THE PUBLIC IN SAUDI ARABIA

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v4i10.1487 ◽

2020 ◽

Vol 4 (10) ◽

Author(s):

Khaled Hassan

Keyword(s):

Bacterial Resistance ◽

Antibiotic Prescription ◽

Antibiotic Use ◽

Cross Sectional Study ◽

Antibiotics Resistance ◽

Upper Respiratory Tract ◽

Cross Sectional ◽

The Public ◽

Improper Use ◽

Self Administered Questionnaire

Background: improper use of antibiotics lead to one of the serious problems of bacterial resistance. Aim: to assess the frequency of antibiotic use and to obtain information about antibiotic prescription, in two centers in Northern Lima, Peru. Methods: it is cross sectional study using a self-administered questionnaire. Results: 1961surveys were considered, Two thirds received antibiotics in the last year, to obtain these drugs, were prescribed by a physician, most of physicians agreed in the importance of inadequate use of antibiotics and 85.1%prescribed antibiotics more than once every day. Internet is a useful resource of information as suggested by physicians to develop educative programs about use of antibiotics. Conclusions: No enough knowledge about adequate use of antibiotics in the community, three quarters would go to hospital if they presented upper respiratory tract symptoms and half received an antibiotic prescription by the physician, if physicians prescribed antibiotics more than once every day, it leads to resistance. Keywords: Knowledge, attitudes, practices, antibiotics, resistance

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Assessment of Knowledge, Attitude, and Practice toward Antibiotic Use among Harar City and Its Surrounding Community, Eastern Ethiopia

Interdisciplinary Perspectives on Infectious Diseases ◽

10.1155/2018/8492740 ◽

2018 ◽

Vol 2018 ◽

pp. 1-6 ◽

Cited By ~ 4

Author(s):

ALemnesh Jifar ◽

Yohanes Ayele

Keyword(s):

Antibiotic Use ◽

Educational Interventions ◽

Cross Sectional Study ◽

Cross Sectional ◽

Eastern Ethiopia ◽

Full Dose ◽

Attitude And Practice ◽

Antibiotics Use ◽

Knowledge And Attitude ◽

Knowledge Attitude And Practice

Purpose. Community plays significant role in the process of emergence and spread of antibiotic resistance. The aim of this study is to assess knowledge, attitude, and practice toward antibiotic use among Harar city and its surrounding community, Eastern Ethiopia. Patient and Methods. A cross-sectional study was conducted among 384 subjects from February 1 to May 1, 2017, through interview using pretested structured questionnaires. The data was entered into EpiData 3.1 and analyzed using Statistical Package for Social Science for windows version 20. Results. A large number of the respondents (83%) replied that antibiotics speed up the recovery from coughs and colds. The majority of participants (78.4%) agreed that the unnecessarily use of antibiotics can increase the resistance of bacteria. Many respondents agreed on the importance of taking full dose (92.1%) and not to keep antibiotics for future use in their home (87.2%). They (90%) also had belief that antibiotics should not be shared from family or friends without a physician consultation and significant participants (73.1%) emphasized on the need for prescription to collect antibiotics from pharmacy. Around 79% of the subjects reported the use of antibiotic 1 year prior to study period at least once. During this period many subjects (65.3%) self-prescribed antibiotics without consulting physicians. Conclusion. In the present study, widespread use of antibiotics was reported, most of this antibiotics being accessed without prescription. Respondent exhibited poor knowledge and attitude toward antibiotics use. There were also malpractices such as failing to take full dose. Therefore, educational interventions on antibiotics use and its association with drug resistance are needed to promote judicious use of antibiotic. Introducing and enforcing antibiotics regulations should be also considered to reduce antibiotics self-prescription.

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Oral candidiasis in HIV-uninfected pediatric population in areas with limited fungal diagnosis: A case study from a tertiary hospital, Tanzania

Therapeutic Advances in Infectious Disease ◽

10.1177/20499361211016964 ◽

2021 ◽

Vol 8 ◽

pp. 204993612110169

Author(s):

Martha F. Mushi ◽

Neema Loi ◽

Stephen E. Mshana

Keyword(s):

Medical Center ◽

Pediatric Population ◽

Oral Candidiasis ◽

Multivariate Logistic Regression Analysis ◽

Antibiotic Use ◽

Tertiary Hospital ◽

Cross Sectional Study ◽

Candida Spp ◽

Cross Sectional ◽

History Of

Background: Oral candidiasis (OC) is an indirect indicator of cell-mediated immunodeficiency with a high predictive value of disseminated candidiasis. Here, we report the prevalence and factors associated with laboratory-confirmed OC in human immunodeficiency virus (HIV)-uninfected children with clinical OC attending the outpatient clinic or admitted in pediatric wards of the Bugando Medical Center (BMC). Methods: A cross-sectional study was conducted between January and June 2017. Social demographic and clinical data were collected using a pre-tested data collection tool. Oral swabs were collected using a sterile cotton swab and mycological culture was done to detect Candida spp. followed by susceptibility testing as per European Committee on Antimicrobial Testing (EUCAST) guidelines. Data were analyzed using STATA version 13 following study objectives. Results: A total of 325 non-repetitive oral swabs from HIV-uninfected children aged between 2 and 156 months were collected. Candida spp. were detected in 123 (37.8%) children. One (1.8%) C. albicans isolate was resistant to fluconazole, voriconazole, and posaconazole with minimum inhibitory concentrations (MIC) of 256 μg/ml, 32 μg/ml, and 0.31 μg/ml, respectively. Upon multivariate logistic regression analysis, being a male child (OR 2, 95% CI 1.2–3.2, p = 0.008) and having a history of antibiotic use (OR 1.8, 95% CI 1.1–2.8, p = 0.017) independently predicted laboratory-confirmed OC among HIV-uninfected children. Conclusion: Only a third of children with clinical OC were laboratory confirmed, and this was more likely in male children with a history of antibiotic use. Most of the isolates were highly susceptible to commonly used antifungal agents like fluconazole. Treatment of children at risk should be prioritized to reduce associated morbidity.

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