scholarly journals Cervical Fracture with Piriform Sinus Laceration

2021 ◽  
Vol 26 (1) ◽  
pp. 34-35
Author(s):  
Mihaela Chialda
Keyword(s):  
Conservative Treatment ◽  
Contrast Agent ◽  
Broad Spectrum ◽  
Nasogastric Tube ◽  
Cervical Fracture ◽  
Broad Spectrum Antibiotic ◽  
Cervical Trauma ◽  
Piriform Sinus ◽  
Delayed Onset ◽  
Zone Ii

Abstract Particular case of complex cervical trauma by associating a cervical fracture with piriform sinus laceration. The trauma is located in the anatomo-topographic zone II. Delayed onset at 24 hours of digestive symptoms, swallowing disorders, sialorrhea, dysphagia, subcutaneous cervical emphysema. CT with Optiray contrast agent is performed, an investigation that reveals a gap in the left piriform sinus of 5-6 mm. The evolution is favourable under conservative treatment, nasogastric tube, broad spectrum antibiotic treatment.

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 Broad-Spectrum Antibiotic Regimen Affects Survival in Patients Receiving Nivolumab for Non-Small Cell Lung Cancer

2021 ◽  
Vol 14 (5) ◽  
pp. 445
Author(s):  
Min Jung Geum ◽  
Chungsoo Kim ◽  
Ji Eun Kang ◽  
Jae Hee Choi ◽  
Jae Song Kim ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Broad Spectrum ◽  
Small Cell ◽  
Defined Daily Dose ◽  
Small Cell Lung ◽  
Broad Spectrum Antibiotic ◽  
Negatively Associated ◽  
Daily Dose

Antibiotic-induced dysbiosis may affect the efficacy of immune checkpoint inhibitors. We investigated the impact of antibiotics on the clinical outcomes of nivolumab in patients with non-small cell lung cancer (NSCLC). Patients who received nivolumab for NSCLC between July 2015 and June 2018 and who were followed up until June 2020 were included in a retrospective cohort analysis. Of 140 eligible patients, 70 were on antibiotics. Overall survival (OS) was shorter in patients on antibiotics (ABX) compared to those not on antibiotics (NoABX) (p = 0.014). OS was negatively associated with piperacillin/tazobactam (PTZ) (HR = 3.31, 95% CI: 1.77–6.18), days of therapy (DOT) ≥ 2 weeks (HR = 2.56, 95% CI: 1.30–5.22) and DOT of PTZ. The defined daily dose (DDD) in PTZ (r = 0.27) and glycopeptides (r = 0.21) showed weak correlations with mortality. There was no difference in progression-free survival (PFS) between ABX and NoABX; however, PFS was negatively associated with the antibiotic class PTZ and DOT of PTZ. Therefore, the use of a broad-spectrum antibiotic, such as PTZ, the long-term use of antibiotics more than 2 weeks in total and the large amount of defined daily dose of specific antibiotics were associated with decreased survival in patients receiving nivolumab for NSCLC.

scholarly journals Broad Spectrum Antibiotic Xanthocillin X Effectively Kills Acinetobacter baumannii via Dysregulation of Heme Biosynthesis

2021 ◽  
Author(s):  
Ines Hübner ◽  
Justin A. Shapiro ◽  
Jörn Hoßmann ◽  
Jonas Drechsel ◽  
Stephan M. Hacker ◽  
...  
Keyword(s):  
Acinetobacter Baumannii ◽  
Broad Spectrum ◽  
Heme Biosynthesis ◽  
Broad Spectrum Antibiotic

Quantifying Empiric Antibiotic Use in US Children’s Hospitals

2021 ◽  
Author(s):  
Kathleen Chiotos ◽  
Lauren D’Arinzo ◽  
Eimear Kitt ◽  
Rachael Ross ◽  
Jeffrey S. Gerber
Keyword(s):  
Broad Spectrum ◽  
Antibiotic Use ◽  
Level Variation ◽  
Hospital Level ◽  
Broad Spectrum Antibiotic ◽  
Children's Hospitals ◽  
Broad Spectrum Antibiotics ◽  
Children’S Hospitals ◽  
Days Of Therapy ◽  
Rule Out

OBJECTIVES Empirical broad-spectrum antibiotics are routinely administered for short durations to children with suspected bacteremia while awaiting blood culture results. Our aim for this study was to estimate the proportion of broad-spectrum antibiotic use accounted for by these “rule-outs.” METHODS The Pediatric Health Information System was used to identify children aged 3 months to 20 years hospitalized between July 2016 and June 2017 who received broad-spectrum antibiotics for suspected bacteremia. Using an electronic definition for a rule-out, we estimated the proportion of all broad-spectrum antibiotic days of therapy accounted for by this indication. Clinical and demographic characteristics, as well as antibiotic choice, are reported descriptively. RESULTS A total of 67 032 episodes of suspected bacteremia across 42 hospitals were identified. From these, 34 909 (52%) patients were classified as having received an antibiotic treatment course, and 32 123 patients (48%) underwent an antibiotic rule-out without a subsequent treatment course. Antibiotics prescribed for rule-outs accounted for 12% of all broad-spectrum antibiotic days of therapy. Third-generation cephalosporins and vancomycin were the most commonly prescribed antibiotics, and substantial hospital-level variation in vancomycin use was identified (range: 16%–58% of suspected bacteremia episodes). CONCLUSIONS Broad-spectrum intravenous antibiotic use for rule-out infections appears common across children’s hospitals, with substantial hospital-level variation in the use of vancomycin in particular. Antibiotic stewardship programs focused on intervening on antibiotics prescribed for longer durations may consider this novel opportunity to further standardize antibiotic regimens and reduce antibiotic exposure.

The Impact of a National Antimicrobial Stewardship Program on Antibiotic Prescribing in Primary Care: An Interrupted Time Series Analysis

2018 ◽  
Vol 69 (2) ◽  
pp. 227-232 ◽  
Author(s):  
Violeta Balinskaite ◽  
Alan P Johnson ◽  
Alison Holmes ◽  
Paul Aylin
Keyword(s):  
Primary Care ◽  
Time Series ◽  
Broad Spectrum ◽  
Interrupted Time Series ◽  
Series Data ◽  
Antibiotic Prescribing ◽  
Segmented Regression ◽  
Broad Spectrum Antibiotic ◽  
Stewardship Program ◽  
The Impact

Abstract Background The Quality Premium was introduced in 2015 to financially reward local commissioners of healthcare in England for targeted reductions in antibiotic prescribing in primary care. Methods We used a national antibiotic prescribing dataset from April 2013 until February 2017 to examine the number of antibiotic items prescribed, the total number of antibiotic items prescribed per STAR-PU (specific therapeutic group age/sex-related prescribing units), the number of broad-spectrum antibiotic items prescribed, and broad-spectrum antibiotic items prescribed, expressed as a percentage of the total number of antibiotic items. To evaluate the impact of the Quality Premium on antibiotic prescribing, we used a segmented regression analysis of interrupted time series data. Results During the study period, over 140 million antibiotic items were prescribed in primary care. Following the introduction of the Quality Premium, antibiotic items prescribed decreased by 8.2%, representing 5933563 fewer antibiotic items prescribed during the 23 post-intervention months, as compared with the expected numbers based on the trend in the pre-intervention period. After adjusting for the age and sex distribution in the population, the segmented regression model also showed a significant relative decrease in antibiotic items prescribed per STAR-PU. A similar effect was found for broad-spectrum antibiotics (comprising 10.1% of total antibiotic prescribing), with an 18.9% reduction in prescribing. Conclusions This study shows that the introduction of financial incentives for local commissioners of healthcare to improve the quality of prescribing was associated with a significant reduction in both total and broad-spectrum antibiotic prescribing in primary care in England.

Pediatric antibiotic stewardship: successful interventions to reduce broad-spectrum antibiotic use on general pediatric wards

Infection ◽  
2017 ◽  
Vol 45 (4) ◽  
pp. 493-504 ◽  
Author(s):  
Katharina Kreitmeyr ◽  
Ulrich von Both ◽  
Alenka Pecar ◽  
Johannes P. Borde ◽  
Rafael Mikolajczyk ◽  
...  
Keyword(s):  
Broad Spectrum ◽  
Antibiotic Stewardship ◽  
Antibiotic Use ◽  
Broad Spectrum Antibiotic

Broad-spectrum antibiotic prescriptions are discontinued unevenly throughout the week

2019 ◽  
Vol 101 (4) ◽  
pp. 471-474 ◽  
Author(s):  
R. Kokado ◽  
H. Hagiya ◽  
D. Morii ◽  
H. Okuno ◽  
N. Yamamoto ◽  
...  
Keyword(s):  
Broad Spectrum ◽  
Broad Spectrum Antibiotic

scholarly journals EFFECT OF LARVAE NUTRITION WITH ANTIBIOTICS ON THE PHYSIOLOGICAL PARAMETERS OF WAX MOTH GALLERIA MELLONELLA (L.) IN A SERIES OF GENERATIONS

2020 ◽  
Author(s):  
T.N. Klementeva ◽  
◽  
A.S. Artemchenko ◽  
M.V. Tyurin ◽  
E.S. Kosman ◽  
...  
Keyword(s):  
Broad Spectrum ◽  
Artificial Diet ◽  
Galleria Mellonella ◽  
Physiological Parameters ◽  
Enzymatic Antioxidants ◽  
Broad Spectrum Antibiotic ◽  
Antibiotic Selection ◽  
Enzymes Activity ◽  
Lepidoptera Pyralidae ◽  
Wax Moth

The wax moth (Galleria mellonella; Lepidoptera: Pyralidae) lines have been obtained as a result of the artificial diet with broad-spectrum antibiotic selection. An influence of that diet on the insect’s physiological parameters was examined through several generations. A significant increase in the activity of a number of enzymatic and non-enzymatic antioxidants because of artificial diet with antibiotic has been observed in the midgut of the wax moth daughter generations. Observed changes in the midgut enzymes activity and increase of antioxidants level are denote a damage in the gut tissues.

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