scholarly journals Use of Antimicrobials in a French Veterinary Teaching Hospital: A Retrospective Study

Antibiotics ◽  
2021 ◽  
Vol 10 (11) ◽  
pp. 1369
Author(s):  
Caroline Prouillac

Antibiotic resistance has become a major concern for not only human health, but also for animal health. To preserve the efficacy of antibiotics, it has become essential to establish measures to regulate the prescription of antibiotics to ensure their prudent use. In France, these measures have been translated into regulations for animal health since 2015, with the publication of three important regulatory texts. The results obtained on a national scale in terms of reducing the use of antibiotics have been satisfactory. The aim of our study was to evaluate the differences related to the prescription of antimicrobials at the veterinary teaching hospital of the Veterinary School of Lyon (CHUV) before and after the implementation of French regulations. Prescriptions and consumption of antimicrobials were examined, along with bacteriological analyses, for the period of 2014–2020, for companion animals and horses. The most frequently prescribed compounds were broad-spectrum antimicrobials, including penicillins with β-lactamase inhibitors, as well as first-generation cephalosporins tetracyclines and sulfamides. The prescription and consumption of critically important antibiotics (CIA) strongly decreased during the study period, with an increase of bacteriological analyses. This study shows the interest of having computerized tools to monitor the use of antimicrobials to implement corrective measures if needed.

Animals ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 913
Author(s):  
Claudia Chirollo ◽  
Francesca Paola Nocera ◽  
Diego Piantedosi ◽  
Gerardo Fatone ◽  
Giovanni Della Valle ◽  
...  

Over recent decades, antimicrobial resistance has been considered one of the most relevant issues of public health. The aim of our study was to evaluate the differences related to the prescription of antimicrobials at the University Veterinary Teaching Hospital, before and after the mandatory use of veterinary electronic prescription (VEP). In particular, the consumption of antimicrobials was examined, especially taking into consideration the recommendations of prudent use. A comparison of data collected before and after the use of electronic prescription highlighted that during the period chosen for the study, the choice of antimicrobial molecules was appropriate, favoring those of “first” and “second line.” However, prescription and the use of some molecules not registered for veterinary medicine were observed in the period before VEP. Broad-spectrum antimicrobials, including penicillins with β-lactamase inhibitors, as well as first-generation cephalosporins and fluoroquinolones, were the most frequently prescribed compounds. There are few studies conducted in Italy aimed at investigating the use of antimicrobials in companion animals under field conditions and with particular regard to prudent use recommendations. This type of study underlines the importance of electronic medical recording in veterinary practice and, above all, its usefulness in monitoring the use of certain antimicrobial agents classified as of critical importance in human medicine.


2019 ◽  
Vol 40 (11) ◽  
pp. 1287-1289 ◽  
Author(s):  
Jenna R. Wolfe ◽  
Alex M. Bryant ◽  
Jad A. Khoury

AbstractBroad-spectrum antibiotic de-escalation before and after implementation of a 72-hour antibiotic time-out alert within the electronic medical record was analyzed. De-escalation occurred significantly more often after the implementation of the alert (55.0% vs 35.1%; 95% confidence interval, −0.3491 to −0.0488; P < .01).


2021 ◽  
Author(s):  
María Valeria Rumi ◽  
Ezequiel Nuske ◽  
Javier Mas ◽  
Andrea Argüello ◽  
Gabriel Gutkind ◽  
...  

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Cheng Dai ◽  
Meng Liu ◽  
Xiaodong Lv ◽  
Binzhong Li

Abstract Background The purpose of this study was to evaluate the shape of the crystalline lens in terms of biometry and diopters before and after cycloplegia using the CASIA2 swept-source (SS) optical coherence tomography (OCT) system on the anterior segment. Methods This was a retrospective study. Children and adolescents (26 males and 29 females, aged 4–21 years) with simple ametropia were selected for optometry and CASIA2 imaging at 2 separate visits before and after cycloplegia. Diopter values were derived from the spherical power (S) obtained by optometry. Biometric parameters of the crystalline lens, including the anterior chamber depth (ACD), anterior and posterior curvature of the lens (ACL and PCL), lens thickness (LTH), lens decentration (LD), lens tilt (LT), and equivalent diameter of the lens (LED), were measured by the CASIA2 system. The differences in these parameters after compared with before cycloplegia were determined, and their relationships were analyzed. Results Fifty-five participants (106 eyes) were initially enrolled. There was a significant difference (P < 0.05) in the S (t=-7.026, P < 0.001), ACD (t=-8.796, P < 0.001), ACL (t=-13.263, P < 0.001) and LTH (t = 7.363, P < 0.001) after compared with before cycloplegia. The change in the PCL (t = 1.557, P = 0.122), LD (t = 0.876, P = 0.383), LT (t = 0.440, P = 0.661) and LED (t=-0.351, P = 0.726) was not statistically significant (P > 0.05). There was a significant (P < 0.05) correlation of the change in the S with that in the ACL (r = 0.466, P < 0.001), LTH (r=-0.592, P < 0.001), and LED (r = 0.223, P = 0.021) but not the PCL (r = 0.19, P = 0.051), LD (r=-0.048, P = 0.0628) or LT (r=-0.022, P = 0.822). Furthermore, the change in the ACD was closely related to the change in crystalline morphology. However, in children and adolescents, we found that the change in crystalline morphology was unrelated to age. Conclusions Changes in lens morphology after compared with before cycloplegia are mainly related to the ACL and LTH, but there is no difference in the PCL, LD, LT, or LED. In the adolescent population, change in the S is related to change in the ACL, LED and LTH. However, age is unrelated to the shape and tendency of the crystalline lens. Further research is required to determine whether the same conclusion applies to different age groups and different refractive states (myopia, hyperopia, emmetropia) .


2021 ◽  
pp. 014556132110257
Author(s):  
Dongho Shin ◽  
Andrew Ma ◽  
Yvonne Chan

Objective: The primary objective of this study was to review the complication rate of percutaneous tracheostomies performed by a single surgeon in a community teaching hospital. Methods: This retrospective study reviewed the patients who underwent percutaneous tracheostomy with bronchoscopic guidance in a community hospital setting between 2009 and 2017. Patients older than the age of 18 requiring percutaneous tracheostomy were chosen for this retrospective study. Patients who were medically unstable, had no palpable neck landmarks, and inadequate neck extension were excluded. Indications for percutaneous tracheostomy included patients who had failed to wean from mechanical ventilation, required pulmonary toileting, or in whom airway protection was required. Results: Of the 600 patients who received percutaneous tracheostomy, 589 patients were included in the study. Intraoperative complication (2.6%) and postoperative complication rates (11.4%) compared similarly to literature reported rates. The most common intraoperative complications were bleeding, technical difficulties, and accidental extubation. Bleeding, tube obstruction, and infection were the most common postoperative complications. Overall burden of comorbidity, defined by Charlson Comorbidity Index, and coagulopathy were also found to be associated with higher complication rates. The decannulation rate at discharge was 46.3%. Conclusion: Percutaneous tracheostomy is a safe alternative to open tracheostomies in the community setting for appropriately selected patients.


2021 ◽  
pp. 232020682110034
Author(s):  
Hamad Alzoman ◽  
Khalid Alamoud ◽  
Waad K. Alomran ◽  
Abdullazez Almudhi ◽  
Naif A. Bindayel

Aim: To evaluate the periodontal status before and after orthodontic treatment and to analyze the confounding factors associated with it. Materials and Methods: The present retrospective study analyzed pre- and posttreatment records of a total of 60 patients. Intraoral digital photographs before and after the orthodontic treatment were used to measure the following three periodontal variables: (a) width of the keratinized gingiva, (b) gingival recession, and (c) the status of interdental papilla. The ImageJ 46 software imaging program was used to perform the required measurements. The clinical data were then analyzed in an association with the participants’ demographic data, the type of orthodontic tooth movement, and other confounding factors. The data obtained were manually entered into the statistical package and analyzed using a significance level set at P < .05. Descriptive statistics, paired t-tests, and Pearson’s correlation analysis were used to identify differences among the studied variables. Results: Among the 60 patients, the majority (66.7%) were females. Most cases of the treated malocclusion were Class II, and most patients underwent intrusion and retrusion movements. The width of keratinized gingiva increased for most sites of upper teeth. In contrast, the lower teeth showed a mix of improvement and compromised width of keratinized gingiva. As a measure of gingival recession, the difference of clinical crown height revealed the tendency toward a reduced clinical crown height for most sites. Upper left lateral incisors and canines showed significant values with regard to keratinized gingival width measurements and tooth movements such as extrusion and intrusion movements. Likewise, with regard to the clinical crown height, upper right central incisors showed significant differences when correlated with the interincisal angle, lower incisors to the mandibular plane, and upper incisors to the NA line. The upper lateral incisors also showed significant correlations to certain cephalometric measurements. Conclusions: The orthodontic treatment was found to exert a significantly positive impact on the surrounding periodontium, particularly in the upper canine areas. Likewise, various types of tooth movement were found to positively affect the periodontium.


2011 ◽  
Vol 56 (2) ◽  
pp. 989-994 ◽  
Author(s):  
C. Plüss-Suard ◽  
A. Pannatier ◽  
C. Ruffieux ◽  
A. Kronenberg ◽  
K. Mühlemann ◽  
...  

ABSTRACTThe original cefepime product was withdrawn from the Swiss market in January 2007 and replaced by a generic 10 months later. The goals of the study were to assess the impact of this cefepime shortage on the use and costs of alternative broad-spectrum antibiotics, on antibiotic policy, and on resistance ofPseudomonas aeruginosatoward carbapenems, ceftazidime, and piperacillin-tazobactam. A generalized regression-based interrupted time series model assessed how much the shortage changed the monthly use and costs of cefepime and of selected alternative broad-spectrum antibiotics (ceftazidime, imipenem-cilastatin, meropenem, piperacillin-tazobactam) in 15 Swiss acute care hospitals from January 2005 to December 2008. Resistance ofP. aeruginosawas compared before and after the cefepime shortage. There was a statistically significant increase in the consumption of piperacillin-tazobactam in hospitals with definitive interruption of cefepime supply and of meropenem in hospitals with transient interruption of cefepime supply. Consumption of each alternative antibiotic tended to increase during the cefepime shortage and to decrease when the cefepime generic was released. These shifts were associated with significantly higher overall costs. There was no significant change in hospitals with uninterrupted cefepime supply. The alternative antibiotics for which an increase in consumption showed the strongest association with a progression of resistance were the carbapenems. The use of alternative antibiotics after cefepime withdrawal was associated with a significant increase in piperacillin-tazobactam and meropenem use and in overall costs and with a decrease in susceptibility ofP. aeruginosain hospitals. This warrants caution with regard to shortages and withdrawals of antibiotics.


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