scholarly journals The Antibiotic Use in Osteomyelitis Infection: A Systematic Review

2021 ◽  
Vol 9 (F) ◽  
pp. 720-723
Author(s):  
Panji Sananta ◽  
Thomas Erwin Christian Junus Huwae ◽  
Daniel Ronadi ◽  
Lasa Dhakka Siahaan
Keyword(s):  
Systematic Review ◽  
Antibiotic Treatment ◽  
English Language ◽  
Chronic Osteomyelitis ◽  
Antibiotic Use ◽  
Long Bone ◽  
Publication Date ◽  
Acute Osteomyelitis ◽  
Antibiotics Use ◽  
Long Bone Osteomyelitis

Introduction: Osteomyelitis is a serious infection of the bone. One of the therapies for osteomyelitis is antibiotic treatment. Antibiotic treatment has evolved substantially, but bone infections are still a challenge. Antimicrobial therapy is also difficult, caused by antibiotic-resistant organisms.  Therefore, a systematic review is needed to assess antibiotic use in osteomyelitis infection. Method: Articles were searched using Pubmed with keywords “antibiotics”, “osteomyelitis”, and its combination. The authors used five years publication date and English language to select the appropriate journal. Result: The author identified 13 relevant articles with antibiotics use in osteomyelitis. All of the cases were about chronic osteomyelitis and osteomyelitis in diabetic foot ulcers. Osteomyelitis in other sites of long bones needs longer duration treatment than long bone osteomyelitis. In acute osteomyelitis in children, antibiotic treatment can switch from IV to oral antibiotics. Furthermore, chronic osteomyelitis needs longer treatment to resolve than acute osteomyelitis. Conclusion: Antibiotics still mainstay treatment with surgery for osteomyelitis treatment. With acute, children, and long bone only need shorter treatment than chronic, adult, and non-long bone osteomyelitis.

Glyphosate effects on the female reproductive systems: a systematic review

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Sakineh Kaboli Kafshgiri ◽  
Tahereh Farkhondeh ◽  
Ebrahim Miri-Moghaddam
Keyword(s):  
Systematic Review ◽  
Reproductive System ◽  
English Language ◽  
Interstitial Fibrosis ◽  
Serum Levels ◽  
Female Reproductive Tract ◽  
Publication Date ◽  
Female Reproductive System ◽  
Reproductive Systems ◽  
Histological Changes

Abstract Glyphosate-based herbicides (GBHs) are organophosphate pesticides, which interrupt the chemicals involved in the endocrine system and cause lifelong disorders in women's reproductive system. The current study was designed to systematically evaluate the association between GBH exposure and the female reproductive tract. According to PRISMA Guidelines, the systematic review was performed, searching online databases, including Google Scholar, Web of Science, PubMed, and Scopus, throughout April 2020. Studies with Rodent, lamb, and fish or exposed to GBH to affect the female reproductive system were selected. All studies were in the English language. Two investigators independently assessed the articles. The first author's name, publication date, animal model, age, sample size, gender, dose, duration, and route of exposure and outcomes were extracted from each publication. The present review summarizes 14 publications on uterus alterations and oocytes, histological changes ovary, and assessed mRNA expression, protein expression, serum levels progesterone, and estrogen and intracellular Reaction Oxygen Species (ROS) in rodents, fish, and lamb exposed to GHB exposure. Most of the studies reported histological changes in ovarian and uterus tissue, alterations in serum levels, and increased oxidative stress level following exposure to GBH. Additionally, due to alterations in the reproductive systems (e.g., histomorphological changes, reduction of the mature follicles, higher atretic follicles, and interstitial fibrosis), it seems the GBH-induced female these alterations are both dose- and time-dependent. The present findings support an association between GBH exposure and female reproductive system diseases. However, more studies are needed to identify the mechanisms disrupting the effects of GBH and their underlying mechanisms. Considering the current literature, it is recommended that further investigations be focused on the possible effects of various pesticides on the human reproductive system.

scholarly journals The impact of early life antibiotic use on atopic and metabolic disorders

2020 ◽  
Vol 2020 (1) ◽  
pp. 279-289
Author(s):  
Semeh Bejaoui ◽  
Michael Poulsen
Keyword(s):  
Metabolic Disorders ◽  
English Language ◽  
Antibiotic Use ◽  
Symbiotic Associations ◽  
Antibiotics Use ◽  
Newcastle Ottawa Scale ◽  
Meta Analyses ◽  
Induced Changes ◽  
Lifestyle Diseases ◽  
The Impact

Abstract Background and objectives The impact of antibiotics use early in life on later-in-life morbidities has received substantial attention as explanations for atopic and metabolic disorders with a surge as modern lifestyle diseases. The objective of this study was to perform meta-analyses to determine if antibiotics administration during the first 2 years of infant life is associated with increased risks of atopic or metabolic disorders later in life. Methodology We screened more than 100 English-language prospective and retrospective studies published between January 2002 and March 2020 and assessed study quality using the Newcastle–Ottawa scale. We performed overall and subgroup meta-analyses on 31 high-quality comparable studies on atopic and 23 on metabolic disorders, involving more than 3.5 million children. Results Antibiotic exposure prenatally and during the first 2 years of life significantly impacts the risk of developing atopic and metabolic disorders. Exposure during the first 6 months of life appears most critical, consistent with this being the time when the microbiome is most susceptible to irreversible perturbations. The presence of dose−response associations and stronger impacts of broad- than narrow-spectrum antibiotics further point to effects being mediated by microbiota-induced changes. Conclusions and implications Our findings support that antibiotics use is a mismatch to modernity that can negatively affect the symbiotic associations we rely on for proper immune function and metabolism. Improving our understanding of these associations, the underlying proximate mechanisms and the impact of antibiotics use on future human−symbiont evolution will be important to improve human health. Lay Summary The use of antibiotics in infancy has been suggested to increase the risks of atopic and metabolic disorders later in life. Through meta-analyses of more than 100 studies of >3.5 million children, we confirm these risks, and show that patterns are consistent with effects being due to microbiota-driven changes.

scholarly journals European citizens’ perspectives on direct-to-consumer genetic testing: an updated systematic review

2020 ◽  
Author(s):  
Ilda Hoxhaj ◽  
Jovana Stojanovic ◽  
Stefania Boccia
Keyword(s):  
Systematic Review ◽  
Data Privacy ◽  
English Language ◽  
Population Group ◽  
Original Data ◽  
European Countries ◽  
Common Disease ◽  
Publication Date ◽  
Genetic Tests ◽  
Direct To Consumer

Abstract Background Direct-to-consumer genetic tests (DTC-GTs) are genetic tests for a medical or non-medical trait that are sold directly to the public, usually ordered without the engagement of a healthcare professional. Our aim was to explore the knowledge, attitudes and behaviors toward DTC-GTs among European citizens. Methods We updated the most recent systematic review on citizens’ perspectives toward DTC-GTs. Relevant English language studies were searched on PubMed, ISI Web of Science, Scopus, Embase and Google Scholar from October 2014 to April 2019. We extended our search on Scopus without publication date restriction, since it was not included in the former review. Eligible studies were conducted in European countries and reported original data. The quality of the studies was evaluated using a checklist developed by Kmet et al. Results We included six studies conducted in European countries between 2015 and 2018. The studies were performed among general population in the Netherlands, students in Italy and Greece, laypeople in Germany and older adults in Switzerland. The level of awareness, in overall low, differed by country and population group. Most of the participants were interested in undergoing a DTC-GT, mainly for knowing the risk predisposition to a common disease. Concerns were raised about tests’ validity and utility and data privacy. Conclusions Our review shows that European citizens, overall, have a low level of knowledge on DTC-GTs and a high interest in their purchase. This understanding might contribute to the development of educational programs in order to the increase of general public capabilities to make appropriate health decisions.

Long-term Antibiotic Treatment in Pouchitis—Patterns of Use and Safety

2021 ◽  
Author(s):  
Nir Bar ◽  
Yoav Avraham ◽  
Vadim Dubinsky ◽  
Nathaniel A Cohen ◽  
Guy A Weiss ◽  
...  
Keyword(s):  
Adverse Events ◽  
Antibiotic Treatment ◽  
Antibiotic Use ◽  
Control Analysis ◽  
Patterns Of Use ◽  
Antibiotics Use ◽  
Case Control Analysis ◽  
Favorable Safety ◽  
Nested Case Control

Abstract Introduction Pouchitis, often developing after colectomy and ileal pouch-anal anastomosis for ulcerative colitis, is highly responsive to antibiotics. Ciprofloxacin and/or metronidazole are commonly used, often for prolonged periods. We report patterns of antibiotic use, adverse events, and resistant infections in patients with pouchitis with long-term antibiotic treatment. Methods In a cohort of patients following pouch surgery, a retrospective nested case-control analysis was performed between 2010 and 2017. Ultra-long-term use, defined as the top 10% of users, was compared with the remaining users. Patterns of antibiotic use, adverse events, and resistant infections were analyzed. Results The cohort included 205 patients with UC, of whom 167 (81.5%) used antibiotics for pouchitis, predominantly ciprofloxacin. The long-term antibiotic use rate was 18% and 42% at 5 and 20 years postsurgery, respectively. Mean antibiotic use of at least 1, 3, and 6 months/year was noted in 54 (26.3%), 31 (15.1%), and 14 (6.8%) patients, respectively. Twenty-two (13.2%) and 4 (2.4%) patients reported mild and severe (transient) adverse events, respectively, without mortalities, tendinopathies or arrhythmias. Adverse event rates for ciprofloxacin and metronidazole were 1per 10,000 and 6 per 10,000 use-days, respectively. Longer, but not ultra-long antibiotic use, was associated with mild adverse events. There was no association between antibiotic use and resistant infections. Thirteen (6.3%) patients required ileostomy procedures—more commonly in the ultra-long-term antibiotic users. Conclusions Patients with pouchitis may require prolonged antibiotic treatment, reflecting clinical benefit and favorable safety profile. Few adverse events and resistant infections were observed with long-term antibiotics use. However, resistant microbial strains selection, which are potentially transmittable, warrants consideration of different therapeutic alternatives.

scholarly journals Use of C-reactive protein to tailor antibiotic use: a systematic review and meta-analysis

BMJ Open ◽  
2018 ◽  
Vol 8 (12) ◽  
pp. e022133 ◽  
Author(s):  
Dara Petel ◽  
Nicholas Winters ◽  
Genevieve C Gore ◽  
Jesse Papenburg ◽  
Marc Beltempo ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cohort Studies ◽  
Antibiotic Treatment ◽  
Treatment Duration ◽  
Treatment Initiation ◽  
Meta Analysis ◽  
Antibiotic Use ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Antibiotic Treatment Duration

Background and objectivesC-reactive protein (CRP) has been proposed to guide the use of antibiotics. However, study results are controversial regarding the benefits of such a strategy. We synthesised the evidence of CRP-based algorithms on antibiotic treatment initiation and on antibiotic treatment duration in adults, children and neonates, as well as their safety profile.DesignSystematic review and meta-analysis.Data sourcesMEDLINE, EMBASE, CENTRAL and CINAHL from inception to 20 July 2017.Eligibility criteria for selecting studiesWe included randomised controlled trials (RCTs), non-RCTs and cohort studies (prospective or retrospective) investigating CRP-guided antibiotic use in adults, children and neonates with bacterial infection.Data extraction and synthesisTwo researchers independently screened all identified studies and retrieved the data. Outcomes were duration of antibiotic use, antibiotic initiation, mortality, infection relapse and hospitalisation. We assessed the quality of the included studies using the Cochrane Collaboration’s tool (RCTs), and A Cochrane Risk Of Bias Assessment Tool: for Non-Randomized Studies of Interventions and the Newcastle-Ottawa scale (non-RCTs). We analysed our results using descriptive statistics and random effects models.ResultsOf 11 165 studies screened, 15 were included. In five RCTs in adult outpatients, the risk difference for antibiotic treatment initiation in the CRP group was −7% (95% CI: −10% to –4%), with no difference in hospitalisation rate. In neonates, CRP-based algorithms shortened antibiotic treatment duration by −1.45 days (95% CI −2.61 to –0.28) in two RCTs, and by −1.15 days (95% CI −2.06 to –0.24) in two cohort studies, with no differences in mortality or infection relapse.ConclusionThe use of CRP-based algorithms seems to reduce antibiotic treatment duration in neonates, as well as to decrease antibiotic treatment initiation in adult outpatients. However, further high-quality studies are still needed to assess safety, particularly in children outside the neonatal period.PROSPERO registration numberCRD42016038622

scholarly journals Antibiotic Use and Misuse in Dentistry in India—A Systematic Review

Antibiotics ◽  
2021 ◽  
Vol 10 (12) ◽  
pp. 1459
Author(s):  
Aarthi Bhuvaraghan ◽  
Rebecca King ◽  
Harriet Larvin ◽  
Vishal R. Aggarwal
Keyword(s):  
Systematic Review ◽  
General Population ◽  
Antibiotic Use ◽  
Fixed Dose ◽  
Secondary Outcome ◽  
Publication Date ◽  
Self Medication ◽  
Cross Sectional ◽  
Low Middle Income Countries ◽  
Dental Practitioners

Infections caused by antibiotic resistance pose a serious global health threat, undermining our ability to treat common infections and deliver complex medical procedures. Antibiotic misuse, particularly in low-–middle-income countries, is accelerating this problem. Aim: The aim of this systematic review was to investigate the use and misuse of antibiotics in dentistry in India. Method: We included studies carried out on Indian populations evaluating the prescription of prophylactic or therapeutic antibiotics by dental practitioners or other healthcare providers, along with antibiotic self-medication by the general population. The primary outcome measure was prescription rate/use of antibiotics for dental/oral problems. The secondary outcome measures included indications for antibiotic use in dentistry, their types and regimens, factors influencing practitioners’ prescription patterns and any differences based on prescriber and patient characteristics. Multiple databases were searched with no restrictions on language or publication date. The quality assessment of all included studies was carried out using the AXIS tool for cross-sectional studies and the Joanna Briggs Institute checklist for qualitative studies. Results: Of the 1377 studies identified, 50 were eligible for review, comprising 35 questionnaire surveys, 14 prescription audits and one qualitative study (semi-structured interviews). The overall quality of the included studies was found to be low to moderate. The proportion of antibiotic prescriptions amongst all prescriptions made was found to range from 27% to 88%, with most studies reporting antibiotics in over half of all prescriptions; studies also reported a high proportion of prescriptions with a fixed dose drug combination. Worryingly, combination doses not recommended by the WHO AWaRe classification were being used. The rate of antibiotic self-medication reported for dental problems varied from 5% to 35%. Conclusions: Our review identified the significant misuse of antibiotics for dental diseases, with inappropriate use therapeutically and prophylactically, the use of broad spectrum and combination antibiotics not recommended by WHO, and self-medication by the general population. There is an urgent need for targeted stewardship programmes in this arena.

scholarly journals Strategies to reduce antibiotic use in women with uncomplicated urinary tract infection in primary care: protocol of a systematic review and meta-analysis including individual patient data

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e035883
Author(s):  
Judith Heinz ◽  
Christian Röver ◽  
Ghefar Furaijat ◽  
Yvonne Kaußner ◽  
Eva Hummers ◽  
...  
Keyword(s):  
Systematic Review ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Antibiotic Treatment ◽  
Individual Patient Data ◽  
Meta Analysis ◽  
Treatment Strategies ◽  
Antibiotic Use ◽  
Uncomplicated Urinary Tract Infection ◽  
Effect Of Treatment

IntroductionUncomplicated urinary tract infection (UTI) in women is a common reason to present in general practice and is usually treated with antibiotics to reduce symptom severity and duration. Results of recent clinical trials indicate that non-antibiotic treatment approaches can also be effective. However, it remains unclear which patients would benefit from antibiotic treatment and which can effectively and safely be treated without antibiotics. This systematic review and meta-analysis aims to estimate the effect of treatment strategies to reduce antibiotic use in comparison with immediate antibiotic treatment and to identify prognostic factors and moderators of treatment effects. A further aim is to identify subgroups of patients benefiting from a specific therapy.Methods and analysisA systematic literature search will be performed to identify randomised controlled trials which investigated the effect of treatment strategies to reduce antibiotic use in female adults with uncomplicated UTI compared with immediate antibiotic treatment. Therefore, the primary outcome of the meta-analysis is incomplete recovery. Anonymised individual patient data (IPD) will be collected. Aggregate data will be used for pairwise comparisons of treatment strategies using meta-analysis models with random effects accounting for potential between-study heterogeneity. Potential effect moderators will be explored in meta-regressions. For IPD, generalised linear mixed models will be used, which may be adjusted for baseline characteristics. Interactions of baseline variables with treatment effects will be explored. These models will be used to assess direct comparisons of treatment, but might be extended to networks.Ethics and disseminationThe local institutional review and ethics board judged the project a secondary analysis of existing anonymous data which meet the criteria for waiver of ethics review. Dissemination of the results will be via published scientific papers and presentations. Key messages will be promoted for example, via social media or press releases.PROSPERO registration numberCRD42019125804.

scholarly journals The Classification of Long Bone Osteomyelitis: A Systemic Review of the Literature

2017 ◽  
Vol 2 (4) ◽  
pp. 167-174 ◽  
Author(s):  
Andrew J. Hotchen ◽  
Martin A. McNally ◽  
Parham Sendi
Keyword(s):  
Systematic Review ◽  
Soft Tissue ◽  
Classification System ◽  
Classification Systems ◽  
Bone Involvement ◽  
Long Bone ◽  
Soft Tissue Coverage ◽  
Host Status ◽  
Long Bone Osteomyelitis

Abstract. Background: Osteomyelitis is a complex disease. Treatment involves a combination of bone resection, antimicrobials and soft-tissue coverage. There is a difficulty in unifying a classification system for long bone osteomyelitis that is generally accepted.Objectives: In this systematic review, we aim to investigate the classification systems for long bone osteomyelitis that have been presented within the literature. By doing this, we hope to elucidate the important variables that are required when classifying osteomyelitis.Methods: A complete search of the Medline, EMBASE, Cochrane and Ovid databases was undertaken. Following exclusion criteria, 13 classification systems for long-bone osteomyelitis were included for review.Results: The 13 classification systems that were included for review presented seven different variables that were used for classification. Ten of them used only one main variable, two used two variables and one used seven variables. The variables included bone involvement (used in 7 classification systems), acute versus chronic infection (used in 6), aetiopathogenesis (used in 3), host status (used in 3), soft tissue (used in 2), microbiology (used in 1) and location of infected bone (used in 1). The purpose of each classification system could be grouped as either descriptive (3 classification systems), prognostic (4) or for management (4). Two of the 13 classification systems were for both prognostic and management purposes.Conclusions: This systematic review has demonstrated a variety of variables used for classification of long bone osteomyelitis. While some variables are used to guide management and rehabilitation after surgery (e.g., bone defect, soft tissue coverage), others were postulated to provide prognostic information (e.g., host status). Finally, some variables were used for descriptive purposes only (aetiopathogenesis). In our view and from today's perspective, bone involvement, antimicrobial resistance patterns of causative micro-organisms, the need for soft-tissue coverage and host status are important variables to include in a classification system.

A systematic review on the metabolic effects of chlorpyrifos

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Tahereh Farkhondeh ◽  
Omid Mehrpour ◽  
Mahmood Sadeghi ◽  
Michael Aschner ◽  
Hamed Aramjoo ◽  
...  
Keyword(s):  
Systematic Review ◽  
Body Weight ◽  
English Language ◽  
Metabolic Diseases ◽  
Meta Analysis ◽  
Metabolic Effects ◽  
Publication Date ◽  
Weight Changes ◽  
Route Of Exposure ◽  
Underlying Mechanisms

Abstract Organophosphate (OP) pesticides, including chlorpyrifos (CPF), can alter metabolic hemostasis. The current systematic study investigated blood glucose, lipid profiles, and body weight alterations in rodents and fish exposed to CPF. The systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) Guidelines, querying online databases, including Web of Science, PubMed, and Scopus and also search engine including Google Scholar, through January 2021. Studies on rodent and fish exposed to CPF assessing metabolic functions were selected. All studies were in the English language, with other languages being excluded from the review. Two investigators independently assessed each of the articles. The first author’s name, publication date, animal model, age, sample size, gender, dose, duration, and route of exposure and outcomes were extracted from each publication. The present review summarizes findings from 61 publications on glycemic, lipid profile, insulin, and body weight changes in rodents and fish exposed to CPF exposure. Most of the studies reported hyperglycemia, hyperlipidemia, and decreased insulin levels and body weight following exposure to CPF. Additionally, we confirmed that the CPF-induced metabolic alterations were both dose- and time-dependent. Our findings support an association between CPF exposure and metabolic diseases. However, more studies are needed to identify the metabolic-disrupting effects of CPF and their underlying mechanisms.

scholarly journals Mid-term clinical results of chronic cavitary long bone osteomyelitis treatment using S53P4 bioactive glass: a multi-center study

2021 ◽  
Vol 6 (9) ◽  
pp. 413-421
Author(s):  
Tom A. G. Van Vugt ◽  
Jeffrey Heidotting ◽  
Jacobus J. Arts ◽  
Joris J. W. Ploegmakers ◽  
Paul C. Jutte ◽  
...  
Keyword(s):  
Treatment Failure ◽  
Bioactive Glass ◽  
Chronic Osteomyelitis ◽  
Clinical Results ◽  
Long Bone ◽  
One Stage ◽  
Eradication Of Infection ◽  
Multi Center Study ◽  
Long Bone Osteomyelitis ◽  
Systemic Antibiotics

Abstract. Introduction: Chronic osteomyelitis is a challenging condition in the orthopedic practice and traditionally treated using local and systemic antibiotics in a two-stage surgical procedure. With the introduction of the antimicrobial biomaterial S53P4 bioactive glass (Bonalive®), chronic osteomyelitis can be treated in a one-stage procedure. This study evaluated the mid-term clinical results of patients treated with S53P4 bioactive glass for long bone chronic osteomyelitis. Methods: In this prospective multi-center study, patients from two different university medical centers in the Netherlands were included. One-stage treatment consisted of debridement surgery, implantation of S53P4 bioactive glass, and treatment with culture-based systemic antibiotics. If required, wound closure by a plastic surgeon was performed. The primary outcome was the eradication of infection, and a secondary statistical analysis was performed on probable risk factors for treatment failure. Results: In total, 78 patients with chronic cavitary long bone osteomyelitis were included. Follow-up was at least 12 months (mean 46; standard deviation, SD, 20), and 69 patients were treated in a one-stage procedure. Overall infection eradication was 85 %, and 1-year infection-free survival was 89 %. Primary closure versus local/muscular flap coverage is the only risk factor for treatment failure. Conclusion: With 85 % eradication of infection, S53P4 bioactive glass is an effective biomaterial in the treatment of chronic osteomyelitis in a one-stage procedure. A major risk factor for treatment failure is the necessity for local/free muscle flap coverage. These results confirm earlier published data, and together with the fundamentally different antimicrobial pathways without antibiotic resistance, S53P4 bioactive glass is a recommendable biomaterial for chronic osteomyelitis treatment and might be beneficial over other biomaterials.

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