Principles of antibiotic therapy

2019 ◽  
Vol 98 (4) ◽  
pp. 137-144
Keyword(s):  
Antibiotic Therapy ◽  
Antibiotic Prophylaxis ◽  
Antibiotic Stewardship ◽  
Bacterial Infections ◽  
Bacterial Resistance ◽  
Antimicrobial Agents ◽  
Bacterial Pathogens ◽  
Comprehensive Approach ◽  
Contemporary Medicine ◽  
Selection Of

The paper describes the basic sources and principles of antibiotic therapy in contemporary medicine in which the ability to treat bacterial infections may be lost. The main reason for that is the increasing resistance of bacterial pathogens to antibiotics. A possible solution is to implement a comprehensive program of antibiotic stewardship incorporating adequate consideration of indication and selection of antimicrobial agents including appropriate duration and way of administration. Another important component of the comprehensive approach to bacterial resistance and antibiotic therapy is adequately applied antibiotic prophylaxis in surgery.

scholarly journals Antibiotics and Antimicrobials for Treatment of the Oral Microbiota: Myths and Facts in Research and Clinical Practice

Antibiotics ◽  
2020 ◽  
Vol 9 (2) ◽  
pp. 95 ◽  
Author(s):  
Gaetano Isola
Keyword(s):  
Antibiotic Therapy ◽  
Bacterial Infections ◽  
Bacterial Resistance ◽  
Antimicrobial Agents ◽  
Periodontal Diseases ◽  
Oral Bacteria ◽  
Aetiological Factor ◽  
Oral Microbiota ◽  
Therapeutic Effects ◽  
Periodontal Debridement

In the dental field, the most common oral diseases include periodontitis, apical periodontitis, abscesses, phlegmons and pulpits, all of which are determined by the same aetiological factor, bacterial infections. For these reasons, it is important to choose the right approach through a target antibiotic therapy against oral bacteria. More specifically, during periodontitis, antibiotics are used, often in association with periodontal debridement, to reduce disease-associated periodontopathogens. However, international guidelines are not unanimous in recommending the use of local and/or systemic antimicrobials to reduce infection by oral bacteria, especially in cases in which there is a danger of spreading systemic infection such as cellulitis, diffuse swelling, and abscesses. The lack of consensus is mainly due to the side effects of antibiotic therapy in dentistry, maybe due to recent scientific evidence regarding the development of bacterial resistance to antibiotics. Therefore, the purpose of this editorial is to analyze the therapeutic effects of antibiotics against the main forms of oral and periodontal diseases, and whether there is a significant clinical benefit, especially in the long term, of antimicrobial therapies in dentistry. The most recent evidence regarding antimicrobial agents will also be discussed.

scholarly journals A Strategy for Hospital Pharmacists to Control Antimicrobial Resistance (AMR) in Japan

Antibiotics ◽  
2021 ◽  
Vol 10 (11) ◽  
pp. 1284
Author(s):  
Yukihiro Hamada ◽  
Fumiya Ebihara ◽  
Ken Kikuchi
Keyword(s):  
Antibiotic Resistance ◽  
Therapeutic Drug Monitoring ◽  
Antimicrobial Stewardship ◽  
Bacterial Resistance ◽  
Antimicrobial Agents ◽  
Action Plan ◽  
Therapeutic Drug ◽  
Optimal Selection ◽  
Inappropriate Use ◽  
Selection Of

In Japan, there is concern regarding the relation between the inappropriate use of antibiotics and antibiotic resistance (AMR). Increased bacterial resistance is due in part to the inappropriate use of antimicrobial agents. The support of the pharmacist becomes important, and there is growing interest in antimicrobial stewardship to promote the appropriate and safe use of antimicrobials needed for the optimal selection of drugs, doses, durations of therapy, therapeutic drug monitoring (TDM), and implementations of cost containment strategies in Japan. Pharmacists should strive to disseminate the concept of “choosing wisely” in relation to all medicines, implement further interventions, and put them into practice. In this article, we present data for antimicrobial stewardship and Japan’s AMR action plan, focusing on how pharmacists should be involved in enabling physicians to choose antimicrobials wisely.

scholarly journals 43. Impact of a Five-Year Intervention of an Antimicrobial Stewardship Program on the Optimal Antibiotic Prophylaxis Selection in Surgery in a Hospital without Restrictions on Antibiotics Prescription in Costa Rica

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S143-S143
Author(s):  
José P Díaz-Madriz ◽  
Esteban Zavaleta-Monestel ◽  
Jorge A Villalobos-Madriz ◽  
Alison V Meléndez-Alfaro ◽  
Priscilla Castrillo-Portillo ◽  
...  
Keyword(s):  
Antibiotic Prophylaxis ◽  
Antimicrobial Stewardship ◽  
Bacterial Resistance ◽  
Positive Impact ◽  
Surgical Site Infections ◽  
Antimicrobial Stewardship Program ◽  
Defined Daily Doses ◽  
Stewardship Program ◽  
The Impact ◽  
Selection Of

Abstract Background In a private hospital without restrictions on antibiotic prescription, the success of an Antimicrobial Stewardship Program (ASP) depends mainly on prospective feedback and education. Previously, the ASP of this hospital (PROA-HCB) managed to achieve a positive impact on the antibiotic prophylaxis in cesarean delivery. The purpose of this study is to characterize the impact after implementing the PROA-HCB on the optimal prophylaxis selection of all the procedures included in the clinical guideline for surgical antibiotic prophylaxis in adult patients. Methods A retrospective observational study that compares the selection, duration, antibiotic consumption, bacterial resistance profiles and patient’s safety outcomes regarding antibiotic use for all surgical prophylaxis prescription over six months for the periods before (pre-ASP) and after a five-year intervention of PROA-HCB (post-ASP). Results After a five-year intervention, the percentage of optimal selection of antibiotic prophylaxis in Surgery was 21.0% (N=1598) in the pre-ASP period and 80.0% (N=841) in the post-ASP period (59% absolute improvement, p < 0.001). Percentage of optimal duration was 69,1% (N=1598) in the pre-ASP period and 78.0% (N=841) in the post-ASP period (8.9% absolute improvement, p < 0.001). Mean ceftriaxone utilization was 217.7 defined daily doses (DDD) per 1,000 patient days DDD for the pre-ASP period and 139.8 DDD per 1,000 patient days for the ASP period (35.8% decrease; p = 0.019). Mean cefazolin utilization was 14.9 DDD per 1,000 patient days for the pre-ASP period and 153.3 DDD per 1,000 patient days for the ASP period (928.6% increase; p = 0.021). Regarding percentage of bacterial resistance, there was detected an improvement in some isolates like Escherichia coli with a decrease of ESBL detection (11% decrease; p = 0.007). In addition, no serious adverse reactions or an increase in surgical site infections were detected after the intervention. Conclusion The implementation of an ASP in the surgical ward showed an overall positive impact on selection and duration of antibiotic prophylaxis. Furthermore, this intervention could have had a positive impact on antimicrobial resistance and at the same time had no negative effects on the patients. Disclosures All Authors: No reported disclosures

scholarly journals Polymeric Nanomaterials for Efficient Delivery of Antimicrobial Agents

Pharmaceutics ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 2108
Author(s):  
Yin Wang ◽  
Hui Sun
Keyword(s):  
Biomedical Applications ◽  
Bacterial Infections ◽  
Bacterial Resistance ◽  
Antimicrobial Agents ◽  
Silver Ions ◽  
Delivery Systems ◽  
Human Beings ◽  
Antimicrobial Substances ◽  
Efficient Delivery ◽  
Healing Tissue

Bacterial infections have threatened the lives of human beings for thousands of years either as major diseases or complications. The elimination of bacterial infections has always occupied a pivotal position in our history. For a long period of time, people were devoted to finding natural antimicrobial agents such as antimicrobial peptides (AMPs), antibiotics and silver ions or synthetic active antimicrobial substances including antimicrobial peptoids, metal oxides and polymers to combat bacterial infections. However, with the emergence of multidrug resistance (MDR), bacterial infection has become one of the most urgent problems worldwide. The efficient delivery of antimicrobial agents to the site of infection precisely is a promising strategy for reducing bacterial resistance. Polymeric nanomaterials have been widely studied as carriers for constructing antimicrobial agent delivery systems and have shown advantages including high biocompatibility, sustained release, targeting and improved bioavailability. In this review, we will highlight recent advances in highly efficient delivery of antimicrobial agents by polymeric nanomaterials such as micelles, vesicles, dendrimers, nanogels, nanofibers and so forth. The biomedical applications of polymeric nanomaterial-based delivery systems in combating MDR bacteria, anti-biofilms, wound healing, tissue engineering and anticancer are demonstrated. Moreover, conclusions and future perspectives are also proposed.

Enhancing the antibacterial efficacy of low-dose gentamicin with 5 minute assistance of photothermy at 50 °C

2019 ◽  
Vol 7 (4) ◽  
pp. 1437-1447 ◽  
Author(s):  
Mengxue Ma ◽  
Xiangmei Liu ◽  
Lei Tan ◽  
Zhenduo Cui ◽  
Xianjin Yang ◽  
...  
Keyword(s):  
Antibiotic Therapy ◽  
Bacterial Infections ◽  
Low Dose ◽  
Bacterial Resistance ◽  
Treatment Cycle ◽  
Antibacterial Efficacy ◽  
Implant Materials

Implant materials are prone to bacterial infections and cause serious consequences, while traditional antibiotic therapy has a long treatment cycle and even causes bacterial resistance.

DIAGNOSTIC MARKERS IN NEONATAL SEPSIS

2007 ◽  
Vol 18 (1) ◽  
pp. 53-65
Author(s):  
HUGH S. LAM ◽  
PAK C NG
Keyword(s):  
Bronchopulmonary Dysplasia ◽  
Bacterial Infections ◽  
Bacterial Resistance ◽  
Antimicrobial Agents ◽  
Very Low Birth Weight ◽  
Late Onset ◽  
Significant Proportion ◽  
Control Measures ◽  
Exogenous Surfactant ◽  
Vlbw Infants

Breakthroughs in the management of sick newborns, including exogenous surfactant therapy, advance ventilation techniques, inhaled nitric oxide, and use of antenatal corticosteroids have led to substantial improvements in the survival of vulnerable preterm infants. Neonatal clinicians now have access to an ever increasing armament of antimicrobial agents to help combat infections. However, even with the support of such advanced therapeutic modalities, strict infection control measures and low thresholds for use of broad-spectrum antibiotics, the threat of bacterial infections especially in the most susceptible group of preterm, very low birth weight (VLBW) infants have persisted. A recent survey suggests that a significant proportion of VLBW infants (21%) have at least one episode of late-onset culture proven sepsis during their stay in the neonatal unit. Infected infants require longer hospital stay and have higher risk of developing complications, such as bronchopulmonary dysplasia and adverse long-term neurodevelopment. Neonates with infection often present with subtle and non-specific signs of sepsis. Some may be asymptomatic at the initial stages of infection. Even those infants with signs may not be clinically distinguishable from patients suffering from transient tachypnoea of the newborn, respiratory distress syndrome, apnoea of prematurity or acute exacerbation of bronchopulmonary dysplasia, during early phases of the disease. Such presentations can lead to both delayed treatment of genuinely infected infants and indiscriminate use of antibiotics in non-infected cases, resulting in acceleration of emergence of bacterial resistance, alteration of patterns of bacterial infection, and inefficient treatment of septicaemia. Both early and late-onset infections are important causes of neonatal morbidity and mortality. Methods to assist neonatal clinicians diagnose infants in the early stages of infection are, therefore, highly desirable.

scholarly journals Multidrug-Resistant Acinetobacter baumannii Genetic Characterization and Spread in Lithuania in 2014, 2016, and 2018

Life ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 151
Author(s):  
Tatjana Kirtikliene ◽  
Aistė Mierauskaitė ◽  
Ilona Razmienė ◽  
Nomeda Kuisiene
Keyword(s):  
Acinetobacter Baumannii ◽  
Resistance Genes ◽  
Bacterial Infections ◽  
Bacterial Resistance ◽  
Antimicrobial Agents ◽  
Variable Number Tandem Repeat ◽  
Multidrug Resistant ◽  
Resistant Bacteria ◽  
Essential Information ◽  
Acinetobacter Spp

Bacterial resistance to antimicrobial agents plays an important role in the treatment of bacterial infections in healthcare institutions. The spread of multidrug-resistant bacteria can occur during inter- and intra-hospital transmissions among patients and hospital personnel. For this reason, more studies must be conducted to understand how resistance occurs in bacteria and how it moves between hospitals by comparing data from different years and looking out for any patterns that might emerge. Multidrug-resistant (MDR) Acinetobacter spp. was studied at 14 healthcare institutions in Lithuania during 2014, 2016, and 2018 using samples from human bloodstream infections. In total, 194 isolates were collected and identified using MALDI-TOF and VITEK2 analyzers as Acinetobacter baumannii group bacteria. After that, the isolates were analyzed for the presence of different resistance genes (20 genes were analyzed) and characterized by using the Rep-PCR and MLVA (multiple-locus variable-number tandem repeat analysis) genotyping methods. The results of the study showed the relatedness of the different Acinetobacter spp. isolates and a possible circulation of resistance genes or profiles during the different years of the study. This study provides essential information, such as variability and diversity of resistance genes, genetic profiling, and clustering of isolates, to better understand the antimicrobial resistance patterns of Acinetobacter spp. These results can be used to strengthen the control of multidrug-resistant infections in healthcare institutions and to prevent potential outbreaks of this pathogen in the future.

Synergism between Host Defence Peptides and Antibiotics Against Bacterial Infections

2020 ◽  
Vol 20 (14) ◽  
pp. 1238-1263 ◽  
Author(s):  
Jiarui Li ◽  
Pablo Fernández-Millán ◽  
Ester Boix
Keyword(s):  
Bacterial Infections ◽  
Bacterial Resistance ◽  
Antimicrobial Agents ◽  
Resistance Mechanisms ◽  
Adjuvant Activity ◽  
Biofilm Growth ◽  
Intracellular Target ◽  
Conventional Antibiotics ◽  
Available Information ◽  
Toxic Concentrations

Background: Antimicrobial resistance (AMR) to conventional antibiotics is becoming one of the main global health threats and novel alternative strategies are urging. Antimicrobial peptides (AMPs), once forgotten, are coming back into the scene as promising tools to overcome bacterial resistance. Recent findings have attracted attention to the potentiality of AMPs to work as antibiotic adjuvants. Methods: In this review, we have tried to collect the currently available information on the mechanism of action of AMPs in synergy with other antimicrobial agents. In particular, we have focused on the mechanisms of action that mediate the inhibition of the emergence of bacterial resistance by AMPs. Results and Conclusion: We find in the literature many examples where AMPs can significantly reduce the antibiotic effective concentration. Mainly, the peptides work at the bacterial cell wall and thereby facilitate the drug access to its intracellular target. Complementarily, AMPs can also contribute to permeate the exopolysaccharide layer of biofilm communities, or even prevent bacterial adhesion and biofilm growth. Secondly, we find other peptides that can directly block the emergence of bacterial resistance mechanisms or interfere with the community quorum-sensing systems. Interestingly, the effective peptide concentrations for adjuvant activity and inhibition of bacterial resistance are much lower than the required for direct antimicrobial action. Finally, many AMPs expressed by innate immune cells are endowed with immunomodulatory properties and can participate in the host response against infection. Recent studies in animal models confirm that AMPs work as adjuvants at non-toxic concentrations and can be safely administrated for novel combined chemotherapies.

scholarly journals PROPAGATION OF ANTIMICROBIAL RESISTANT Salmonella spp. IN BIVALVE MOLLUSKS FROM ESTUARY AREAS OF BAHIA, BRAZIL

2016 ◽  
Vol 29 (2) ◽  
pp. 450-457 ◽  
Author(s):  
CARLA SILVA DA SILVEIRA ◽  
OSCARINA VIANA DE SOUSA ◽  
NORMA SUELY EVANGELISTA-BARRETO
Keyword(s):  
Nalidixic Acid ◽  
Bacterial Infections ◽  
Bacterial Resistance ◽  
Antimicrobial Agents ◽  
Resistance Index ◽  
Multidrug Resistant ◽  
Resistance Mechanisms ◽  
Bivalve Mollusks ◽  
Salmonella Spp ◽  
Development Of Resistance

ABSTRACT: In recent years, the emergence of resistant pathogens has complicated the treatment of bacterial infections in livestock production as well as in the medical field, due to the development of resistance mechanisms by microorganisms. The objective of this study was to delineate the antimicrobial resistance profile of Salmonella spp. strains isolated from bivalve mollusks (oysters and mussels) and from estuarine environment water of two regions of Bahia, Brazil. Twenty-seven strains, 12 isolated from bivalve mollusks and 15 from estuarine water, were tested. Eight antimicrobial agents (phenicol, beta-lactams, tetracyclines, quinolones and fluoroquinolones classes) were used for a susceptibility test, Minimum Inhibitory Concentration (MIC) and extended-spectrum beta-lactamases (ESBLs) production. Isolates showed high susceptibility to the classes of antimicrobial agents tested, with resistance only to nalidixic acid (27%), ampicillin (25%) and tetracycline (25%). Bacterial resistance was of chromosomal origin and the multidrug resistance index (MAR) among isolates of shellfish (mussels in natura) was 0.25. The MIC was found to be 100 µg/mL, 500 µg/mL and 350 µg/mL to nalidixic acid, ampicillin and tetracycline, respectively. None of the isolates presented ESBLs production. The presence of multidrug-resistant and high MIC Salmonella spp. is being conveyed in extraction areas of bivalve mollusks in the State of Bahia, Brazil.

scholarly journals Indications and Limitations of Phage Therapy in Human Medicine: Personal Experience and Literature Review

2018 ◽  
Author(s):  
Alain Dublanchet ◽  
Olivier Patey ◽  
Hubert Mazure ◽  
Max Liddle ◽  
Anthony M. Smithyman
Keyword(s):  
Antibiotic Therapy ◽  
Bacterial Infections ◽  
Bacterial Resistance ◽  
Phage Therapy ◽  
Single Species ◽  
Regulatory Standards ◽  
Benefit Risk Assessment ◽  
The World ◽  
Definitive Solution ◽  
Biologic Drug

Bacteriophages, viruses that are widespread throughout the world, are highly specific for bacteria, usually of a single species and often of a particular strain. After being discovered and isolated 100 years ago, their use, called phage therapy, was instituted in medicine two years later and quickly used around the world to treat various bacterial infections. In the West, phage therapy was overshadowed in the second half of the 20th century by antibiotic therapy, which was then thought to be the definitive solution. But because of the increase in bacterial resistance to antibiotics, the idea of using bacteriophages in medicine has been reawakened. The innumerable observations reported over the years in the literature constitute an invaluable experience. We and some of our colleagues have, in the last decade treated some patients compassionately. With the available documentation and our own experience we discuss the potential indications and limitations of phage therapy. The observation of the increasing number of therapeutic failures in the announced perspective of a post-antibiotic era, we believe, that the introduction of bacteriophages into the therapeutic arsenal seems conceivable today to two preconditions: that their production as biologic drug meets current regulatory standards and that the benefit-risk assessment was conducted in a modern setting. Phage therapy could be applied as a substitution or supplement to antibiotic therapy under multiple circumstances in different modes, precise indications and limits.

Sign in / Sign up

Export Citation Format

Share Document