CLINICAL AND LABORATORY JUSTIFICATION FOR USE OF POLYVALENT BACTERIOPHAGE IN TECHNIQUE OF DELAYED PRESCRIBING OF ANTIBIOTICS IN PATIENTS WITH ARS

2021 ◽  
Vol 74 (6) ◽  
pp. 1445-1450
Author(s):  
Vasyl I. Popovych ◽  
Ivanna V. Koshel ◽  
Mahmoud J. Al Hariri
Keyword(s):  
Staphylococcus Aureus ◽  
Sea Water ◽  
Nasal Congestion ◽  
Bacterial Load ◽  
Intervention Group ◽  
Control Group ◽  
Isotonic Solution ◽  
Haemophilus Influenza ◽  
Acute Rhinosinusitis ◽  
The Third

The aim: Of research was to evaluate the effectiveness of bacteriophage in patients with acute rhinosinusitis in respect of technique of delayed prescribing of antibiotics. Materials and methods: There were examined 155 patients who were given irrigation therapy with isotonic solution of sea water 4 times a day and mometasone furoate of 100 mg twice a day for 10 days. The patients of intervention group (n - 80) were additionally prescribed the polyvalent bacteriophage endonasally, in drops of 2-10 ml 3 times a day. Results: The patients in the control group were observed the decrease in intensity of rhinorrhea, nasal congestion and post-nasal drip on the third day of supervision (p < 0.05), the reduction in bacterial load with Staphylococcus aureus, S. pneumoniae, Haemophilus influenza and M. Catarrhalis (р <0,005), the increase of IgА and sIgA levels (p<0,005) and the reduction in prescription of antibacterial medications by 20%. Conclusions: Adding of polyvalent bacteriophage contributes to reducing the use of antibiotics and is recommended in the framework of the strategy of delayed prescribing of antibiotics.

scholarly journals Clinical and microbiological parallels of delayed prescribing of antibiotics in patients with acute rhinosinusitis

2020 ◽  
pp. 49-57
Author(s):  
Mahmoud Joumaa Al Hariri ◽  
Ivanna V. Koshel ◽  
Vasil I. Popovich
Keyword(s):  
Standard Therapy ◽  
Negative Impact ◽  
Nasal Congestion ◽  
Intervention Group ◽  
Evaluation Criteria ◽  
Additional Treatment ◽  
Control Group ◽  
Antibiotic Prescribing ◽  
Acute Rhinosinusitis ◽  
Clinically Significant

Topicality: The rate of acute bacterial rhinosinusitisis 0,5-2% of all cases of acute rhinosinusitis, however, up to 60 % of patients receive the course of antibiotics since the first day of disease. It is well known that earlier use of antibiotics has almost no effect on the development of bacterial ARS and its complications. The purpose of study was to examine the bacterial spectrum of post-viral RS and evaluate clinical and bac-teriological efficiency of polyvalent bacteriophage in technique of delayed prescribing of antibiotics in comparison with the patients receiving standard APVRS therapy. Material and methods: 155 adult patients with acute post-viral RS participated in the trial who were given either standard therapy or polyvalent bacteriophage in addition to the standard therapy. In conjunction with the treatment, the microbiological composition of nasal microflora was examined and its comparison with clinical dynamics was undertaken. Evaluation criteria: decrease in intensity of disease symptoms evaluated in accordance with MSS scale system during each visit in comparison with the 1st visit, antibiotic prescribing frequency, dynamics of microbiological changes. Outcomes and discussion: The use of polyvalent bacteriophagein addition to the standard therapy of acute post-viral rhinosinusitis as a part of technique of delayed prescribing of antibioticsensures clinically significant decrease in the intensity of rhinorrhea symptoms, nasal congestion and post-nasal drip on the third day of supervision (p<0.05). It reduces the prescription of antibacterial medicines by 20%without negative impact on overall treatment results. Decrease in the number of prescription of antibacterial therapy correlates with the fair reduction in bacterial loadwith Staphylococcus aureus and typical representative of ABRS – S. pneumoniae, Haemophilus influenza and M. catarrhalis. Therefore, the intervention group in comparison with the control group has had “therapeutic advantage” during the first days of treatment which allowed to assess the course of disease as a “positive” and avoid in appropriate use of antibiotics. There have been documented no patients with adverse effects during the course of treatment. Conclusion: polyvalent bacteriophage is a safe and effective medication for additional treatment of acute post-viral rhinosinusitis intended to reduce the use of antibiotics. The inclusion of the medication into the treatment regimen could be recommended to the patients as a part of technique of delayed prescribing of antibiotics.

scholarly journals THE EFFECT OF PRENATAL GENTLE YOGA AND HYPNOTHERAPY ON ANXIETY LEVEL AND SLEEP QUALITY IN THE THIRD TRIMESTER PREGNANT WOMAN AT PUSKESMAS SUMBER CIREBON REGENCY IN 2019

2021 ◽  
Vol 1 (1) ◽  
pp. 32-38
Author(s):  
Nurlaela Kurnia Rahayu ◽  
Pepi Hapitria ◽  
Rani Widiyanti
Keyword(s):  
Sleep Quality ◽  
Pregnant Women ◽  
Intervention Group ◽  
Anxiety Level ◽  
Control Group ◽  
P Value ◽  
Third Trimester ◽  
Control Groups ◽  
The Third ◽  
And Control

As the pregnancy gets older, the attention and thoughts of pregnant women begin to focus on something that is considered as a climax, so that the anxiety experienced will intensify just before the childbirth. Excessive anxiety and sleep disorders during pregnancy can cause mental disorders in pregnant women and inhibit fetal growth. To determine the effect of prenatal gentle yoga and hypnotherapy on anxiety level and sleep quality in the third trimester pregnant women. This is a quasi-experimental study with a pre-post test with a control group. The sample was 32 respondents consisting of 16 respondents as an intervention group and 16 respondents as a control group taken by purposive sampling. The analysis used was the Paired T-test. There is a difference in the average of anxiety level in the third trimester pregnant women in the intervention and control groups with a p value 0,000; there is a difference in the average of sleep quality in the third trimester pregnant women in the intervention and control groups with a p value 0,000; and there is no difference in the average of anxiety level and sleep quality in the third trimester pregnant women in the intervention and control groups with a p value 0,64. Prenatal Gentle Yoga and Hypnotherapy have an effect in reducing the anxiety level and improving the sleep quality in the third trimester pregnant women.

scholarly journals The Impact of a Pharmacist-Driven Staphylococcus aureus Bacteremia Initiative in a Community Hospital: A Retrospective Cohort Analysis

Pharmacy ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. 191
Author(s):  
Nate Berger ◽  
Michael Wright ◽  
Jonathon Pouliot ◽  
Montgomery Green ◽  
Deborah Armstrong
Keyword(s):  
Staphylococcus Aureus ◽  
Hospital Mortality ◽  
Community Hospital ◽  
Cohort Analysis ◽  
Intervention Group ◽  
Blood Cultures ◽  
Control Group ◽  
Staphylococcus Aureus Bacteremia ◽  
Retrospective Cohort Analysis ◽  
Bundle Compliance

Purpose: Staphylococcus aureus is a leading cause of bacteremia with a 30-day mortality of 20%. This study evaluated outcomes after implementation of a pharmacist-driven Staphylococcus aureus bacteremia (SAB) initiative in a community hospital. Methods: This retrospective cohort analysis compared patients admitted with SAB between May 2015 and April 2018 (intervention group) to those admitted between May 2012 and April 2015 (historical control group). Pharmacists were notified of and responded to blood cultures positive for Staphylococcus aureus by contacting provider(s) with a bundle of recommendations. Components of the SAB bundle included prompt source control, selection of appropriate intravenous antibiotics, appropriate duration of therapy, repeat blood cultures, echocardiography, and infectious diseases consult. Demographics (age, gender, and race) were collected at baseline. Primary outcome was in-hospital mortality. Compliance with bundle components was also assessed. Results: Eighty-three patients in the control group and 110 patients in the intervention group were included in this study. Demographics were similar at baseline. In-hospital mortality was lower in the intervention group (3.6% vs. 15.7%; p = 0.0033). Bundle compliance was greater in the intervention group (69.1% vs. 39.8%; p < 0.0001). Conclusions: We observed a significant reduction in in-hospital mortality and increased treatment bundle compliance in the intervention cohort with implementation of a pharmacist-driven SAB initiative. Pharmacists’ participation in the care of SAB patients in the form of recommending adherence to treatment bundle components drastically improved clinical outcomes. Widespread adoption and implementation of similar practice models at other institutions may reduce in-hospital mortality for this relatively common and life-threatening infection.

scholarly journals Psikoedukasi Dzikr Menurunkan Kadar Kortisol dan Meningkatkan Kadar IGG pada Ibu Primipara

2018 ◽  
Vol 5 (2) ◽  
pp. 82
Author(s):  
Sri Wahyuni ◽  
Anies Anies ◽  
Ariawan Soejoenoes ◽  
Suhartono Taat Putra
Keyword(s):  
Hormonal Regulation ◽  
Intervention Group ◽  
Perinatal Period ◽  
Control Group ◽  
P Value ◽  
Third Trimester ◽  
Midwifery Care ◽  
The Third ◽  
The Difference ◽  
Primiparous Women

Background: Unstable emotions that are common during the perinatal period affect hormonal regulation and affect immunity. Research of psychoeducation dhikr be important was done to reduce perceived stress so that cortisol levels can be controlled hence IgG increases.Purposes: to prove additional psychoeducation of dhikr in routine midwifery care more influential on decreasing cortisol and increasing IgG among primiparous women.Methods: This study was an experimental study. A number of 24 participants as intervention group and a number of 23 participants as control group. Cortisol and IgG levels measured using ELIZA kits in the third trimester of pregnancy, the three days and tenth days after birth. Statistical test using General Linear Model and independent t test to compare Δ score.Results: The result showed mean difference between groups on the end of interventions, cortisol 18.95, CI 95% (-13.42 – 51.33) and p value is 0.245. The difference of the IgG between groups 482.72, CI 95% (55,51 - 909,93) and p value is 0.028.Conclusions: Additional psychoeducation of dhikr in routine midwifery care has more decrease Cortisol and increase IgG levels in primiparous women. Keywords: Cortisol, Psychoeducation Dzikr, IgG, Primiparous

scholarly journals The skin microbiota in pregnant women suffering from atopic dermatitis

2016 ◽  
Vol 97 (2) ◽  
pp. 222-229
Author(s):  
A Yu Lonshakova-Medvedeva ◽  
K N Monakhov ◽  
A N Suvorov ◽  
O V Lavrova
Keyword(s):  
Staphylococcus Aureus ◽  
Atopic Dermatitis ◽  
Pregnant Women ◽  
Bacterial Load ◽  
Life Quality ◽  
Reproductive Age ◽  
Control Group ◽  
Skin Microbiota ◽  
Healthy Women ◽  
Basic Care

Aim. To study the skin microbiota of pregnant women suffering from atopic dermatitis.Methods. 53 women of reproductive age suffering from atopic dermatitis (28 pregnant and 25 non-pregnant) were examined. The control group included dermatologically healthy women (25 pregnant and 25 non-pregnant). Prior to treatment initiation and on 15-day of study pathological process spread, the SCORAD index (scoring of atopic dermatitis - atopic dermatitis severity assessment), dermatology life quality index determination were conducted. In addition, microbiological study of material taken from the forehead, elbow bend skin and visually unaltered forearm skin was performed.Results. In women (pregnant and non-pregnant), suffering from atopic dermatitis skin total bacterial load is increased. In all groups, the skin microbiota is presented mainly by staphylococci: in dermatologically healthy people - coagulase-negative, in atopic dermatitis - Staphylococcusя aureus. In atopic dermatitis Staphylococcus aureus is isolated from both lesions and visually unaltered skin. In pregnant women with atopic dermatitis skin bacterial load was higher, Staphylococcus aureus was found more commonly. The skin microbiota in dermatologically healthy women was more diverse in respect of species comparing with patients with atopic dermatitis. Basic care remedies use leads to clinical improvement and a decrease in the skin total bacterial load and Staphylococcus aureus load. Daily use of emollients has no effect on saprophytic microorganisms.Conclusion. In pregnant patients with atopic dermatitis higher skin total bacterial load and higher rate of skin colonization by Staphylococcus aureus are observed.

scholarly journals Different Doses of Intraumbilical Oxytocin on the Third Stage of Labor

2018 ◽  
pp. 155
Author(s):  
Nurul Islamy ◽  
Nuswil Bernolian ◽  
Firmansyah BasiR ◽  
Theodorus Theodorus
Keyword(s):  
Intervention Group ◽  
Control Group ◽  
Chi Square ◽  
Randomised Study ◽  
The Third ◽  
Third Stage Of Labor ◽  
Treatment Dose ◽  
Third Stage ◽  
The Mean ◽  
Post Hoc

  Objective: To compare the dose of oxytocin injected intraumbilicalltowards the duration of the third stage, blood loss volume, hemoglobinand hematocrit.   Methods: This study is a prospective randomised study with acontrol. The control group was given an intramuscular injection of10 IU oxytocin. The intervention of the three groups intraumbilicaloxytocin treatment dose of 10 IU, 20 IU and 30 IU diluted in 50 ml ofnormal saline solution and administered intraumbilically. Thesample selection by purposive sampling and the distribution groupbased on systematic random sampling (10 samples each). Data weretaken from the period April 2016-January 2017 with the inclusionand exclusion criteria. Data were analysed using Chi-square, T-test,ANOVA and Post hoc tests.   Results: Characteristics study for variables of age, occupation,parity, education, episiotomy and neonates weight showed homogeneouscharacteristics. The mean duration of the third stage forall groups was between 366.7  159.0 seconds and 440.1  244.99seconds. While the average number of postpartum haemorrhage forall group 61.894  226.3ml and 309.5  110.26 ml. There were nodifferences in the dose of oxytocin on the duration of the thirdstage (p> 0.05) and the amount of bleeding (p> 0.005). There was adifference of haemoglobin between intervention group of oxytocindose of 10 IU and 30 IU intraumbilical (p = 0.031). There was nodifference between the mean hematocrit levels between the groups(p> 0.005).   Conclusion: There were no differences in the dose of oxytocinintraumbilical towards the duration of the third stage, the amountof bleeding and hematocrit levels. The decrease of haemoglobingreater in 30 IU intraumbilical significantly. Keywords: duration of the third stage, haemoglobin and hematocrit,oxytocin intraumbilical, the amount of bleeding

scholarly journals The Difference Of Comfort And Anxiety Level In Third Trimester Pregnant Women With Osoc And Conventional Assistance

2019 ◽  
Vol 7 (1) ◽  
pp. 11
Author(s):  
Arum Meiranny ◽  
Muliatul Jannah
Keyword(s):  
Pregnant Women ◽  
Health Center ◽  
Intervention Group ◽  
Control Group ◽  
Research Subjects ◽  
Third Trimester ◽  
Control Groups ◽  
District Health ◽  
Pregnancy Care ◽  
The Third

<p><em>Anxiety in pregnant women when facing labor is different. Midwives have to be able to increase the comfort to reduce anxiety. One of the ways is with OSOC assistance, this is an assistance during pregnancy, childbirth, postpartum, newborns until family planning in order to increase maternal and infant health. The aims of this study are to determine the differences in comfort and anxiety of third trimester pregnant women who were given OSOC assistance and conventional</em> <em>pregnancy care at Kendal District Health Center (Puskesmas Kendal) .This research is a quasi experimental study with non equivalent control group design. Samples in this study were 124 third trimester pregnant women at Kendal District Health Center (Puskesmas Kendal). The research subjects were divided into intervention and control groups. In the intervention group, pregnant women were give intervention by OSOC assistance, and the control groups were given conventional pregnancy care. This research was held on July-September 2018. The analysis design used Chi Square. The results showed that there were significant differences (p &lt;0.05), and the influence of OSOC assistance on comforting pregnant women was 2.357, and there were significant differences between anxiety in the third trimester pregnant women with OSOC assistance and conventional pregnancy care, and the influence of OSOC assistance on anxiety pregnant women was 7,703. The conclusion of this study is that there are significant differences between the comfort and anxiety of the third trimester pregnant women with OSOC assistance and conventional pregnancy care.</em></p>

Integration of FDG-PET/CT in the Diagnostic Workup for Staphylococcus aureus Bacteremia: A Prospective Interventional Matched-cohort Study

2020 ◽  
Author(s):  
Nesrin Ghanem-Zoubi ◽  
Olga Kagna ◽  
Jawad Abu-Elhija ◽  
Mona Mustafa-Hellou ◽  
Majd Qasum ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Cohort Study ◽  
Fdg Pet ◽  
Intervention Group ◽  
Control Group ◽  
Matched Cohort ◽  
Matched Cohort Study ◽  
Staphylococcus Aureus Bacteremia ◽  
Pet Ct ◽  
Fdg Pet Ct

Abstract Background Staphylococcus aureus bacteremia (SAB) is uniquely characterized by focal pyogenic complications that might not be apparent clinically. We investigated the benefit of adding fluorodeoxyglucose–positron emission tomography/computed tomography (FDG-PET/CT) in the workup of patients with SAB. Methods In a matched-cohort study patients with SAB (intervention group) were prospectively recruited to undergo FDG-PET/CT 7–14 days after diagnosis. Treatment was directed by FDG-PET/CT findings. Clinical outcomes were compared with a control group of patients with SAB who had not undergone FDG-PET/CT, matched by age, Charlson score, methicillin susceptibility, and survival duration to FDG-PET/CT. The primary outcome was 90-day mortality. Residual confounding was controlled through regression analyses. Results During the study period 149 patients with 151 separate episodes of SAB underwent FDG-PET/CT and were compared with 150 matched patients with 151 SAB episodes. Patients in the intervention group acquired infections more frequently in the community and had less frequently solid malignancies and more frequently high-risk SAB. Ninety-day mortality in the intervention group was significantly lower than in the control group (21/151 [13.9%] vs 43/151 [28.5%], P = .002). The difference remained significant in a subgroup analysis of patients with community-onset infections without malignancy and among patients with low-risk SAB. Controlling for other risk factors for mortality, FDG-PET/CT performance among all patients was independently associated with lower mortality (OR, .39; 95% CI, .18–.84). Patients in the intervention group had longer duration of treatment and more focus control procedures performed compared with the control group. Conclusions FDG-PET/CT in patients with SAB seems to improve survival through guidance of treatment duration and co-interventions.

scholarly journals Role of Daptomycin on Burn Wound Healing in an Animal Methicillin-Resistant Staphylococcus aureus Infection Model

2017 ◽  
Vol 61 (9) ◽  
Author(s):  
Oriana Simonetti ◽  
Guendalina Lucarini ◽  
Fiorenza Orlando ◽  
Elisa Pierpaoli ◽  
Roberto Ghiselli ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Wound Healing ◽  
Growth Factor ◽  
Bacterial Load ◽  
Histological Evaluation ◽  
Control Group ◽  
Burn Wound ◽  
Burn Scar ◽  
Methicillin Resistant ◽  
Content Type

ABSTRACT Prolonged hospitalization and antibiotic therapy are risk factors for the development of methicillin-resistant Staphylococcus aureus (MRSA) infections in thermal burn patients. We used a rat model to study the in vivo efficacy of daptomycin in the treatment of burn wound infections by S. aureus, and we evaluated the wound healing process through morphological and immunohistochemical analysis. A copper bar heated in boiling water was applied on a paraspinal site of each rat, resulting in two full-thickness burns. A small gauze was placed over each burn and inoculated with 5 × 107 CFU of S. aureus ATCC 43300. The study included two uninfected control groups with and without daptomycin treatment, an infected control group that did not receive any treatment, and two infected groups treated, respectively, with intraperitoneal daptomycin and teicoplanin. The main outcome measures were quantitative culture, histological evaluation of tissue repair, and immunohistochemical expression of wound healing markers: epidermal growth factor receptor (EGFR) and fibroblast growth factor 2 (FGF-2). The highest inhibition of infection was achieved in the group that received daptomycin, which reduced the bacterial load from 107 CFU/ml to about 103 CFU/g (P < 0.01). The groups treated with daptomycin showed better overall healing with epithelialization and significantly higher collagen scores than the other groups, and these findings were also confirmed by immunohistochemical data. In conclusion, our results support the hypothesis that daptomycin is an important modulator of wound repair by possibly reducing hypertrophic burn scar formation.

scholarly journals The effect of fibrin glue on the postoperative lymphatic leakage after D2-lymphadenectomy and gastrectomy in patients with gastric cancer

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Habibollah Mahmoodzadeh ◽  
Ehsanollah Rahimi-Movaghar ◽  
Ramesh Omranipour ◽  
Mohammad Shirkhoda ◽  
Amirmohsen Jalaeefar ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Fibrin Glue ◽  
Intervention Group ◽  
Length Of Hospital Stay ◽  
Study Groups ◽  
Control Group ◽  
P Value ◽  
D2 Dissection ◽  
The Third ◽  
The Difference

Abstract Introduction Disturbance in the lymphatic drainage during D2 dissection is associated with significant morbidity. We aimed to assess the effect of fibrin glue on the reduction of postoperative lymphatic leakage. Methods Prospective double-blinded randomized clinical trial with forty patients in each study arm was conducted. All patients diagnosed, staged, and became a candidate for D2 dissection based on NCCN 2019 guideline for gastric cancer. The intervention group received 1 cc of IFABOND® applied to the surgical bed. Results The difference between study groups regarding age, gender, tumor stage was insignificant. (All p-values > 0.05). The median daily drainage volume was 120 ml with the first and the third interquartile being 75 and 210 ml, respectively for the intervention group. The control group had median, the first, and the third interquartile of 350, 290, and 420 ml. The difference between daily drainage volumes was statistically significant (p-value < 0.001). The length of hospital stay was significantly different between the two groups. Notably, the intervention group was discharged sooner (median of 7 Vs 9 days, p-value: 0.001). Conclusion This study showed the possible role of fibrin glue in reducing postoperative lymphatic leakage after gastrectomy and D2 dissection. Registration trial number: IRCT20200710048071N1, 2020.08.16

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