Non-Clinical Factors Determining the Prescription of Antibiotics by Veterinarians: A Systematic Review

The misuse of antibiotics in humans, animals, and plants is related to the spread of resistant antibiotic strains among humans and animals. In this paper, we carry out a bibliographic search of Medline, Web of Knowledge, and Cab Abstracts with the main objective of ascertaining the available evidence on non-clinical factors and attitudes that could influence the prescription of antibiotics by veterinarians. A total of 34 studies fulfilled the inclusion criteria. Whereas, veterinary health professionals’ prescribing habits did not appear to be influenced by their socio-demographic characteristics, they were influenced by different attitudes, such as fear (identified in 19 out of 34 studies), self-confidence (19/34), business factors (19/34), and by complacency (16/34). Certain owner-related factors, such as lack of awareness (16/34) and demand for antibiotics (12/34), were also important, as were concurrent factors, ranging from a lack of appropriate regulations (10/34) to the expense and delays involved in performing culture and sensitivity tests (10/34) and inadequate farm hygiene (8/34). Our results appear to indicate that the non-clinical factors are potentially modifiable. This may be useful for designing interventions targeted at improving antibiotic use in animals, as part of an overall strategy to reduce the global spread of multi-resistant strains.

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Perceptions of Antibiotic Use and Resistance: Are Antibiotics the Dentists’ Anxiolytics?

Antibiotics ◽

10.3390/antibiotics10060735 ◽

2021 ◽

Vol 10 (6) ◽

pp. 735

Author(s):

Julie Dormoy ◽

Marc-Olivier Vuillemin ◽

Silvia Rossi ◽

Jean-Marc Boivin ◽

Julie Guillet

Keyword(s):

Public Health ◽

Antibiotic Resistance ◽

Qualitative Method ◽

Oral Surgery ◽

Antibiotic Use ◽

Public Health Issue ◽

Clinical Factors ◽

Structured Interviews ◽

Health Crisis ◽

The Public

Background: Antibiotic resistance is a global health crisis. The aim of this study was to explore dentists’ perceptions of antibiotic resistance. Methods: A qualitative method was used. Seventeen dentists practising in the Nancy (Lorraine, France) region were surveyed. They were general practitioners or specialised in oral surgery, implantology, or periodontology. The practitioners took part in semi-structured interviews between September 2019 and July 2020. All of the interviews were transcribed in full and analysed thematically. Results: Four major themes have been selected: attitudes of the dentists in regard to the guidelines, clinical factors that influence prescriptions, non-clinical factors that influence prescriptions, and the perception of antibiotic resistance. The dentists stated that they were very concerned regarding the public health issue of antibiotic resistance. However, they often prescribe according to their own interests and habits rather than according to the relevant guidelines. Conclusions: Although dentists are generally well aware of antibiotic resistance, they often do not adequately appreciate the link between their prescribing habits and the phenomenon of antibiotic resistance. Regular updating of practitioners’ knowledge in this regard is necessary, but patients and the general public should also be made more aware of the issue.

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Expressed emotion and socio-demographic and clinical factors in families of Brazilian patients with schizophrenia

International Journal of Social Psychiatry ◽

10.1177/0020764018815207 ◽

2018 ◽

Vol 65 (1) ◽

pp. 56-63 ◽

Cited By ~ 1

Author(s):

Ana Carolina Guidorizzi Zanetti ◽

Kelly Graziani Giacchero Vedana ◽

Camila Corrêa Matias Pereira ◽

João Mazzoncini de Azevedo Marques ◽

Amanda Heloisa Santana da Silva ◽

...

Keyword(s):

Cultural Context ◽

Expressed Emotion ◽

Family Care ◽

Clinical Factors ◽

Related Factors ◽

Family Dynamic ◽

Mental Health Clinics ◽

Health Clinics ◽

Brazilian Version ◽

Improve Patient

Background: Families are the main caregivers of people with schizophrenia. Family dynamic and expressed emotion (EE) of relatives are fundamental determinants on the course of schizophrenia. Method: This study analyzed socio-demographic and clinical factors related to EE components. A total of 94 dyads (patients with schizophrenia and their relatives) were recruited from three mental health clinics. A form containing socio-demographic and clinical variables and the Brazilian version of Family Questionnaire were used and the data were analyzed through regression model. Results: Results showed that factors such as patients’ occupation status and patients’ age, as well as relatives’ gender and the degree of relatedness, were related to emotional overinvolvement and critical comments levels. Conclusion: This is the first study in the Brazilian cultural context that evaluates EE components and related factors on families of patients with schizophrenia. Other studies concerning EE on different cultural contexts and possible interventions must be carried out to help health professionals to improve patient and family care.

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Evaluation of Th2 and Th17 Immunity-Related Factors as Indicators of Brucellosis

Frontiers in Cellular and Infection Microbiology ◽

10.3389/fcimb.2021.786994 ◽

2022 ◽

Vol 11 ◽

Author(s):

Reza Gheitasi ◽

Fariba Keramat ◽

Sara Khosravi ◽

Mehrdad Hajilooi ◽

Mathias W. Pletz ◽

...

Keyword(s):

Acute Infection ◽

18S Rrna Gene ◽

Control Group ◽

Rrna Gene ◽

Inclusion Criteria ◽

Related Factors ◽

Expression Levels ◽

Acute Group ◽

Relapse Group ◽

Gene Expression Levels

ObjectiveBrucellosis is a common bacterial zoonotic infection, and greater than half a million new cases are diagnosed annually. This study investigates the expression of Th2 and Th17 immunity-related factors (Th2-LCR lncRNA, IL-25, TRAF3IP2, and IL-17RB) in different stages of Brucella infections.Material and MethodsIn total, 99 brucellosis patients were divided into three groups (acute = first infection before treatment, relapse = before treatment, and treated = after treatment for 6–8 weeks with doxycycline and rifampin). Thirty-three healthy volunteers represented the control group. Gene expression levels were assessed by quantitative amplification in reference to the 18S rRNA gene and statistically evaluated.ResultsNo significant differences in the expression of these genes were observed between the control group and patients after completion of antibiotic treatment. Compared to these two groups, only Th2-LCR lncRNA and TRAF3IP2 were significantly more highly expressed in the acute group. Th2-LCR lncRNA was also significantly elevated in the relapse group. TRAF3IP2 expression was additionally significantly increased in the acute group compared to the relapse group.ConclusionIL-25 and IL-17RB failed to differentiate between the infected and noninfected groups. TRAF3IP2 and Th2-LCR lncRNA might be good indicators of brucellosis during the acute phase, but the expression levels varied strongly among patients. To verify the suitability of these factors as an indicator for brucellosis, acute infection or relapse should be investigated in further studies on larger cohorts with well-defined inclusion criteria.

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Radon Exposure and Neurodegenerative Disease

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17207439 ◽

2020 ◽

Vol 17 (20) ◽

pp. 7439

Author(s):

Silvia Gómez-Anca ◽

Juan Miguel Barros-Dios

Keyword(s):

Neurodegenerative Diseases ◽

Scientific Evidence ◽

Subsequent Development ◽

Brain Anatomy ◽

Inclusion Criteria ◽

Motor Neuron Diseases ◽

Radon Exposure ◽

Bibliographic Search ◽

The Brain ◽

Lateral Sclerosis

Background: To carry out a systematic review of scientific literature about the association between radon exposure and neurodegenerative diseases. Methods: We performed a bibliographic search in the following databases: Pub med (Medline), Cochrane, BioMed Central and Web of Science. We collected the data by following a predetermined search strategy in which several terms werecombined. After an initial search, 77 articles were obtained.10 of which fulfilled the inclusion criteria. Five of these 10 studies were related to multiple sclerosis (MS), 2 were about motor neuron diseases (MND), in particular amyotrophic lateral sclerosis (ALS) and 3 were related to both Alzheimer’s disease (AD) and Parkinson’s disease (PD). Results: The majority of the included articles, suggested a possible association between radon exposure and a subsequent development of neurodegenerative diseases. Some of the studies that obtained statistically significant resultsrevealed a possible association between radon exposure and an increase in MS prevalence. Furthermore, it was also suggested that radon exposure increases MND and AD mortality. Regarding AD and PD, it was observed that certainde cay products of radon-222 (222Rn), specifically polonium-210 (210Po) and bismuth-210 (210Bi), present a characteristic distributionpattern within the brain anatomy. However, the study with the highest scientific evidence included in this review, which investigated a possible association between the concentration of residential radon gas and the MS incidence, revealed no significant results. Conclusions: It cannot be concluded, although it is observed, that there is a possible causal association between radon exposure and neurodegenerative diseases. Most of the available studies are ecological so, studies of higher statistical evidence are needed to establish a causal relationship. Further research is needed on this topic.

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Phenoconversion of Cytochrome P450 Metabolism: A Systematic Review

Journal of Clinical Medicine ◽

10.3390/jcm9092890 ◽

2020 ◽

Vol 9 (9) ◽

pp. 2890 ◽

Cited By ~ 3

Author(s):

Sylvia D. Klomp ◽

Martijn L. Manson ◽

Henk-Jan Guchelaar ◽

Jesse J. Swen

Keyword(s):

Systematic Review ◽

Cytochrome P450 ◽

Study Data ◽

Inclusion Criteria ◽

Extrinsic Factors ◽

Related Factors ◽

Genotype Group ◽

The Individual ◽

Cancer And Inflammation ◽

The Impact

Phenoconversion is the mismatch between the individual’s genotype-based prediction of drug metabolism and the true capacity to metabolize drugs due to nongenetic factors. While the concept of phenoconversion has been described in narrative reviews, no systematic review is available. A systematic review was conducted to investigate factors contributing to phenoconversion and the impact on cytochrome P450 metabolism. Twenty-seven studies met the inclusion criteria and were incorporated in this review, of which 14 demonstrate phenoconversion for a specific genotype group. Phenoconversion into a lower metabolizer phenotype was reported for concomitant use of CYP450-inhibiting drugs, increasing age, cancer, and inflammation. Phenoconversion into a higher metabolizer phenotype was reported for concomitant use of CYP450 inducers and smoking. Moreover, alcohol, pregnancy, and vitamin D exposure are factors where study data suggested phenoconversion. The studies reported genotype–phenotype discrepancies, but the impact of phenoconversion on the effectiveness and toxicity in the clinical setting remains unclear. In conclusion, phenoconversion is caused by both extrinsic factors and patient- and disease-related factors. The mechanism(s) behind and the extent to which CYP450 metabolism is affected remain unexplored. If studied more comprehensively, accounting for phenoconversion may help to improve our ability to predict the individual CYP450 metabolism and personalize drug treatment.

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Thrombectomy for acute ischemic stroke in nonagenarians compared with octogenarians

Journal of NeuroInterventional Surgery ◽

10.1136/neurintsurg-2019-015147 ◽

2019 ◽

Vol 12 (3) ◽

pp. 266-270 ◽

Cited By ~ 7

Author(s):

Eric S Sussman ◽

Blake Martin ◽

Michael Mlynash ◽

Michael P Marks ◽

David Marcellus ◽

...

Keyword(s):

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Functional Independence ◽

Inclusion Criteria ◽

Related Factors ◽

Vessel Occlusion ◽

Endovascular Thrombectomy ◽

Improved Outcomes ◽

Symptomatic Intracranial Hemorrhage ◽

The Difference

IntroductionMultiple randomized trials have shown that endovascular thrombectomy (EVT) leads to improved outcomes in acute ischemic stroke (AIS) due to large vessel occlusion (LVO). Elderly patients were poorly represented in these trials, and the efficacy of EVT in nonagenarian patients remains uncertain.MethodsWe performed a retrospective cohort study at a single center. Inclusion criteria were: age 80–99, LVO, core infarct <70 mL, and salvageable penumbra. Patients were stratified into octogenarian (80–89) and nonagenarian (90–99) cohorts. The primary outcome was the ordinal score on the modified Rankin Scale (mRS) at 90 days. Secondary outcomes included dichotomized functional outcome (mRS ≤2 vs mRS ≥3), successful revascularization, symptomatic intracranial hemorrhage (ICH), and mortality.Results108 patients met the inclusion criteria, including 79 octogenarians (73%) and 29 nonagenarians (27%). Nonagenarians were more likely to be female (86% vs 58%; p<0.01); there were no other differences between groups in terms of demographics, medical comorbidities, or treatment characteristics. Successful revascularization (TICI 2b–3) was achieved in 79% in both cohorts. Median mRS at 90 days was 5 in octogenarians and 6 in nonagenarians (p=0.09). Functional independence (mRS ≤2) at 90 days was achieved in 12.5% and 19.7% of nonagenarians and octogenarians, respectively (p=0.54). Symptomatic ICH occurred in 21.4% and 6.4% (p=0.03), and 90-day mortality rate was 63% and 40.9% (p=0.07) in nonagenarians and octogenarians, respectively.ConclusionsNonagenarians may be at higher risk of symptomatic ICH than octogenarians, despite similar stroke- and treatment-related factors. While there was a trend towards higher mortality and worse functional outcomes in nonagenarians, the difference was not statistically significant in this relatively small retrospective study.

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Clinical simulation with dramatization: gains perceived by students and health professionals

Revista Latino-Americana de Enfermagem ◽

10.1590/1518-8345.1807.2916 ◽

2017 ◽

Vol 25 (0) ◽

Cited By ~ 10

Author(s):

Elaine Cristina Negri ◽

Alessandra Mazzo ◽

José Carlos Amado Martins ◽

Gerson Alves Pereira Junior ◽

Rodrigo Guimarães dos Santos Almeida ◽

...

Keyword(s):

Latin American ◽

Web Of Science ◽

Cochrane Library ◽

Inclusion Criteria ◽

National Library ◽

Electronic Library ◽

Clinical Simulation ◽

Self Confidence ◽

The Cochrane Library ◽

Latin American And Caribbean

ABSTRACT Objective: to identify in the literature the gains health students and professionals perceive when using clinical simulation with dramatization resources. Method: integrative literature review, using the method proposed by the Joanna Briggs Institute (JBI). A search was undertaken in the following databases: Latin American and Caribbean Health Sciences Literature, Web of Science, National Library of Medicine, Cumulative Index to Nursing and Allied Health Literature, The Cochrane Library, Scopus, Scientific Electronic Library Online. Results: 53 studies were analyzed, which complied with the established inclusion criteria. Among the different gains obtained, satisfaction, self-confidence, knowledge, empathy, realism, reduced level of anxiety, comfort, communication, motivation, capacity for reflection and critical thinking and teamwork stand out. Conclusion: the evidence demonstrates the great possibilities to use dramatization in the context of clinical simulation, with gains in the different health areas, as well as interprofessional gains.

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QUALITATIVE REVIEW OF ANTIBIOTIC USE FOR NEONATAL SEPSIS

International Journal of Applied Pharmaceutics ◽

10.22159/ijap.2018.v10s1.80 ◽

2018 ◽

Vol 10 (1) ◽

pp. 364

Author(s):

Tjio Ie Wei ◽

Purwantyastuti Ascobat ◽

Rinawati Rohsiswatmo ◽

Insti Instiaty

Keyword(s):

Neonatal Sepsis ◽

Neonatal Intensive Care ◽

Late Onset ◽

Antibiotic Use ◽

Klebsiella Pneumonia ◽

First Line ◽

Normal Birth ◽

Late Onset Sepsis ◽

Sensitivity Tests ◽

Blood Specimens

Objective: The aim of this study is to evaluate the antibiotic use in neonates with sepsis.Methods: An observational retrospective study was conducted using medical records of neonates diagnosed with early-/late-onset sepsis who wereprescribed antibiotics and who were treated in the neonatal intensive care unit (NICU) at the Dr. Cipto Mangunkusumo Hospital between January 1 andDecember 31, 2015. Patient records were screened for antibiotic use; qualitative analyses were performed using the Gyssens algorithm. Concordanceof empirical antibiotic prescriptions with subsequent blood culture and sensitivity tests was evaluated.Results: A total of 176 sepsis cases included 80 and 96 neonates with normal and low birth weights (LBWs), respectively. Ampicillinsulbactam+gentamycin, which is indicated in local guidelines as the first-line antibiotic combination for neonatal sepsis, was most frequentlyprescribed. In the normal birth weight group, appropriate antibiotic use (Gyssens Category I) was found in 89.7% of cases, whereas Gyssens Category V(no indication) was found in 4.54% of cases. In the LBW group, 88.1% and 6.2% of cases were included in Gyssens Categories I and V, respectively.Only 17.5% and 13.5% cultured blood specimens from normal and LBW groups, respectively, yielded positive results; the most commonly identifiedbacteria were Acinetobacter baumannii and Klebsiella pneumonia. All isolates were resistant to ampicillin-sulbactam; only 7.4% were sensitive togentamicin.Conclusion: Antibiotic use for neonatal sepsis in NICU in this study can be considered appropriate, suggesting proper implementation of antimicrobialguidelines. However, high rates of resistance to the first-line antibiotics for neonatal sepsis are concerning.

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Clinical Factors Associated with a Shorter or Longer Course of Antibiotic Treatment in Patients with Exacerbations of Bronchiectasis: A Prospective Cohort Study

Journal of Clinical Medicine ◽

10.3390/jcm8111950 ◽

2019 ◽

Vol 8 (11) ◽

pp. 1950

Author(s):

Giulia Scioscia ◽

Rosanel Amaro ◽

Victoria Alcaraz-Serrano ◽

Albert Gabarrús ◽

Patricia Oscanoa ◽

...

Keyword(s):

Antibiotic Therapy ◽

Antibiotic Treatment ◽

Prospective Observational Study ◽

Antibiotic Use ◽

Community Acquired Pneumonia ◽

Clinical Factors ◽

Treatment Results ◽

Factors Associated ◽

Long Term Oxygen Therapy

Background: Bronchiectasis exacerbations are often treated with prolonged antibiotic use, even though there is limited evidence for this approach. We therefore aimed to investigate the baseline clinical and microbiological findings associated with long courses of antibiotic treatment in exacerbated bronchiectasis patients. Methods: This was a bi-centric prospective observational study of bronchiectasis exacerbated adults. We compared groups receiving short (≤14 days) and long (15–21 days) courses of antibiotic treatment. Results: We enrolled 191 patients (mean age 72 (63, 79) years; 108 (56.5%) females), of whom 132 (69%) and 59 (31%) received short and long courses of antibiotics, respectively. Multivariable logistic regression of the baseline variables showed that long-term oxygen therapy (LTOT), moderate–severe exacerbations, and microbiological isolation of Pseudomonas aeruginosa were associated with long courses of antibiotic therapy. When we excluded patients with a diagnosis of community-acquired pneumonia (n = 49), in the model we found that an etiology of P. aeruginosa remained as factor associated with longer antibiotic treatment, with a moderate and a severe FACED score and the presence of arrhythmia as comorbidity at baseline. Conclusions: Decisions about the duration of antibiotic therapy should be guided by clinical and microbiological assessments of patients with infective exacerbations.

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Broad Spectrum project: factors determining the quality of antibiotic use in primary care: an observational study protocol from Italy

BMJ Open ◽

10.1136/bmjopen-2020-038843 ◽

2020 ◽

Vol 10 (7) ◽

pp. e038843

Author(s):

Peter Konstantin Kurotschka ◽

Alice Serafini ◽

Marco Massari ◽

Roberto Da Cas ◽

Adolfo Figueiras ◽

...

Keyword(s):

Drug Prescription ◽

National Health System ◽

Antibiotic Use ◽

Antibiotic Consumption ◽

Prescription Data ◽

Italian Region ◽

Related Factors ◽

Knowledge And Attitudes ◽

The Impact

IntroductionThe overuse of antibiotics is causing worldwide spread of antimicrobial resistance (AMR). Compared with other countries, Italy has both high antibiotic consumption rates and high rates of AMR. Due to the fact that around 90% of antibiotics are prescribed by general practitioners (GPs), this study aims to measure the impact of knowledge, attitudes and sociodemographic and workplace-related factors on the quality of antibiotic prescriptions filled by GPs in the Italian Region of Sardinia.Methods and analysisKnowledge, attitude, sociodemographic and workplace-related factors deemed to influence physicians prescribing behaviour will be evaluated in a cross-sectional study conducted among all GPs of the Italian Region of Sardinia (n=1200). A knowledge and attitudes questionnaire (Knowledge and Attitudes on Antibiotics and Resistance - Italian version: ITA-KAAR) accompanied by a sociodemographic form will be linked to drug prescription data reimbursed by the National Health System. European Surveillance of Antibiotic Consumption quality indicators for outpatient antibiotic use will be calculated from drug prescription records. Every GP will be deemed to have demonstrated an adequate quality of prescriptions of antibiotics if half of the indicator score plus one is better than the median of the region. A multivariate Poisson regression model with robust variance estimation will be used to evaluate the impact of the determinants of antibiotic prescriptions on the actual prescribing quality of each physician.Ethics and disseminationThe project has been approved by the ethics committee of the Regional Health Trust of Sardinia (176/2019/CE, 24 September 2019). The results will be useful to inform evidence-based interventions to tackle irrational antibiotic use in the community.

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