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Optimal duration of antibiotic

Godfrey Ja Walker, Damian Walker, Daniel Molano Franco, Carlos F Grillo-Ardila
BACKGROUND: Congenital syphilis continues to be a substantial public health problem in many parts of the world. Since the first use of penicillin for the treatment of syphilis in 1943, which was a notable early success, it has remained the preferred and standard treatment including for congenital syphilis. However, the treatment of congenital syphilis is largely based on clinical experience and there is extremely limited evidence on the optimal dose or duration of administration of penicillin or the use of other antibiotics...
February 15, 2019: Cochrane Database of Systematic Reviews
Janneke Evelyne Stalenhoef, Cees van Nieuwkoop, Darius Cameron Wilson, Willize Elizabeth van der Starre, Tanny J K van der Reijden, Nathalie Manon Delfos, Eliane Madeleine Sophie Leyten, Ted Koster, Hans Christiaan Ablij, Johannes Jan Willem van 't Wout, Jaap Tamino van Dissel
BACKGROUND: A reduction in duration of antibiotic therapy is crucial in minimizing the development of antimicrobial resistance, drug-related side effects and health care costs. The minimal effective duration of antimicrobial therapy for febrile urinary tract infections (fUTI) remains a topic of uncertainty, especially in male patients, those of older age or with comorbidities. Biomarkers have the potential to objectively identify the optimal moment for cessation of therapy. METHODS: A secondary analysis of a randomized placebo-controlled trial among 35 primary care centers and 7 emergency departments of regional hospitals in the Netherlands...
February 14, 2019: BMC Infectious Diseases
Radoslaw Jaworski, Andrzej Kansy, Katarzyna Dzierzanowska-Fangrat, Bohdan Maruszewski
BACKGROUND: Prophylactic antibiotic therapy is given routinely in the peri-operative period to prevent surgical site infection. However, in pediatric cardiac surgery, an optimal schedule has not been defined. Pediatric recommendations follow the guidelines for adults, which might be improper because of the inherent challenges in pediatric research and the heterogeneity of the population. Implementation of an effective prophylaxis protocol is needed for children undergoing cardiac surgery, especially in view of worldwide antibiotic overuse and the development of drug resistance...
February 14, 2019: Surgical Infections
Yongjian Liu, Yan Xu, Xinlun Tian, Hui Huang, Xiaomeng Hou, Minjiang Chen, Wei Zhong, Jing Zhao, Jinming Gao, Jinglan Wang, Juhong Shi, Mengzhao Wang
BACKGROUND: Bronchiectasis is a rare complication in patients with thymic neoplasm. The aim of this study was to investigate the clinical and radiological manifestations, laboratory tests, pathologic features, and outcome of treatment of bronchiectasis in patients with thymic neoplasm. METHODS: From January 2000 to January 2018, 20 patients with a diagnosis of thymic neoplasm and bronchiectasis were hospitalized at the Peking Union Medical College Hospital. Clinical data was retrospectively analyzed...
February 13, 2019: Thoracic Cancer
Dmitrii M Bubnov, Tigran V Yuzbashev, Tatiana V Vybornaya, Alexander I Netrusov, Sergey P Sineoky
The introduction of chromosomal mutations into the E. coli genome using λRed-mediated recombineering includes two consecutive steps-the insertion of an antibiotic resistance gene and the subsequent excision of the marker. The second step usually requires a counterselection method, because the efficiency of recombination is not high enough to find recombinants among non-recombinant cells. Most counterselection methods require the introduction of additional mutations into the genome or the use of expensive chemicals...
February 6, 2019: Journal of Microbiological Methods
Yaping Chang, Mohit Bhandari, Kan Lun Zhu, Reza Donald Mirza, Melody Ren, Sean Alexander Kennedy, Ahmed Negm, Neera Bhatnagar, Faysal N Naji, Lazar Milovanovic, Yutong Fei, Arnav Agarwal, Rakhshan Kamran, Sung Min Cho, Stefan Schandelmaier, Li Wang, Lin Jin, Shiyun Hu, Yanping Zhao, Luciane Cruz Lopes, Mei Wang, Brad Petrisor, Bill Ristevski, Reed A C Siemieniuk, Gordon H Guyatt
BACKGROUND: Evidence with regard to antibiotic prophylaxis for patients with open fractures of the extremities is limited. We therefore conducted a systematic survey addressing current practice and recommendations. METHODS: We included publications from January 2007 to June 2017. We searched Embase, MEDLINE, CINAHL, the Cochrane Central Registry of Controlled Trials (CENTRAL), and the Cochrane Database of Systematic Reviews for clinical studies and surveys of surgeons; WorldCat for textbooks; and web sites for guidelines and institutional protocols...
February 5, 2019: JBJS Reviews
Philipp Schuetz, Albertus Beishuizen, Michael Broyles, Ricard Ferrer, Gaetan Gavazzi, Eric Howard Gluck, Juan González Del Castillo, Jens-Ulrik Jensen, Peter Laszlo Kanizsai, Andrea Lay Hoon Kwa, Stefan Krueger, Charles-Edouard Luyt, Michael Oppert, Mario Plebani, Sergey A Shlyapnikov, Giulio Toccafondi, Jennifer Townsend, Tobias Welte, Kordo Saeed
Background Procalcitonin (PCT)-guided antibiotic stewardship (ABS) has been shown to reduce antibiotics (ABxs), with lower side-effects and an improvement in clinical outcomes. The aim of this experts workshop was to derive a PCT algorithm ABS for easier implementation into clinical routine across different clinical settings. Methods Clinical evidence and practical experience with PCT-guided ABS was analyzed and discussed, with a focus on optimal PCT use in the clinical context and increased adherence to PCT protocols...
February 6, 2019: Clinical Chemistry and Laboratory Medicine: CCLM
Steven L Shein, Michele Kong, Bryan McKee, MaryAnn O'Riordan, Philip Toltzis, Adrienne G Randolph
OBJECTIVES: To describe antibiotic prescribing practices during the first 2 days of mechanical ventilation among previously healthy young children with respiratory syncytial virus-associated lower respiratory tract infection and evaluate associations between the prescription of antibiotics at onset of mechanical ventilation with clinical outcomes. DESIGN: Retrospective cohort study. SETTING: Forty-six children's hospitals in the United States...
February 2019: Pediatric Critical Care Medicine
Jessica Breton, Arthur Kastl, Natalie Hoffmann, Rachel Rogers, Andrew B Grossman, Petar Mamula, Judith R Kelsen, Robert N Baldassano, Lindsey Albenberg
Background: Recent studies have shown that oral combination antibiotics may improve disease course in refractory inflammatory bowel disease (IBD). Here, we describe the use of combination oral antibiotics as salvage therapy in refractory ulcerative colitis (UC), Crohn's colitis, and IBD-unclassified (IBD-U) at a large pediatric IBD center. Methods: Clinical response, disease activity indices, adverse events, and clinical outcomes were measured up to 1 year after antibiotic treatment in this retrospective cohort study of children with medically refractory IBD colitis...
February 4, 2019: Inflammatory Bowel Diseases
Rakesh Kumar, Harohalli Masthigowda Mamrutha, Amandeep Kaur, Karnam Venkatesh, Davinder Sharma, Gyanendra Pratap Singh
Wheat is the most widely grown staple food crop in the world and accounts for dietary needs of more than 35% of the human population. Current status of transgenic wheat development is slow all over the world due to the lack of a suitable transformation system. In the present study, an efficient and reproducible Agrobacterium-mediated transformation system in bread wheat (Triticum aestivum L.) is established. The mature and immature embryos of six recently released high yielding spring bread wheat genotypes were used to standardize various parameters using Agrobacterium tumefaciens strain EHA105 harbouring binary vector pCAMBIA3301 having gus and bar as marker genes...
February 1, 2019: Molecular Biology Reports
Yasuhiro Tanabe, Yukio Sato, Masaki Izumo, Yuki Ishibashi, Takumi Higuma, Tomoo Harada, Yoshihiro J Akashi
The current guidelines recommend a minimum of 6 months of antithrombotic and antibiotic prophylaxis following septal occluding device placement for transcatheter closure of atrial septal defect. Full neoendothelialization is thought to be completed within 6 months of device implantation; however, there is no method available that can assess the level of neoendothelialization in vivo. This report therefore evaluates endothelialization in vivo and demonstrates that 6 months of postimplantation prophylactic therapy may not provide sufficient time for adequate endothelialization...
February 2019: Journal of Invasive Cardiology
Kamilla Møller Gundersen, Jette Nygaard Jensen, Lars Bjerrum, Malene Plejdrup Hansen
BACKGROUND: It is well known that antibiotic use is the main driver for the increasing problems with resistant bacteria. Consequently, some countries have recommended shortening the duration of antibiotic treatment of community-acquired pneumonia (CAP). The aim of this study was to investigate if the effectiveness of a short-course antibiotic is comparable to a longer course of antibiotics in adults with CAP and to assess if the duration of an antibiotic course influences the development of resistant bacteria...
January 29, 2019: Basic & Clinical Pharmacology & Toxicology
Jay Menaker, Samuel Galvagno, Ronald Rabinowitz, Vesselin Penchev, Allison Hollis, Zachary Kon, Kristopher Deatrick, Anthony Amoroso, Daniel Herr, Michael Mazzeffi
PURPOSE: The purpose of our study was to characterize the epidemiology of blood stream infection (BSI) in adult extracorporeal membrane oxygenation (ECMO) patients at a single tertiary care academic medical center with standardized post-cannulation antibiotic prophylaxis practices. METHODS: A single-center retrospective cohort study was performed over a five-year period. BSI incidence was characterized and patients who developed BSI during ECMO were compared with those who did not...
January 24, 2019: Heart & Lung: the Journal of Critical Care
Martin Schmidt-Hieber, Daniel Teschner, Georg Maschmeyer, Enrico Schalk
Infections are among the most frequent complications in patients with hematological and oncological diseases. They might be classified as fever of unknown origin, and microbiologically or clinically documented infections. Optimal duration of antimicrobial treatment is still unclear in these patients. Areas covered: We provide an overview on the management of febrile neutropenia in the perspective of antimicrobial de-escalation and discontinuation. Expert opinion: Patients with febrile high-risk neutropenia should be treated empirically with an anti-pseudomonal agent such as piperacillin/tazobactam...
January 28, 2019: Expert Review of Anti-infective Therapy
Adrian Sousa, María Teresa Pérez-Rodríguez, Milagros Suárez, Nuria Val, Lucía Martínez-Lamas, Andrés Nodar, Rebeca Longueira, Manuel Crespo
Bacteremia due to gram-negative bacilli (GNB) is one of the most frequent causes of admission and prolongation of hospital stay. Nevertheless, optimal duration of antibiotic treatment is not clearly established. We designed an observational, prospective study of a cohort of adult patients with uncomplicated GNB bacteremia. They were classified according to the duration of treatment in short (7-10 days) or long (> 10 days) course. Mortality and bacteremia recurrence rate were evaluated, and propensity score for receiving short-course treatment was calculated...
January 24, 2019: European Journal of Clinical Microbiology & Infectious Diseases
Jean-François Timsit, Matteo Bassetti, Olaf Cremer, George Daikos, Jan de Waele, Andre Kallil, Eric Kipnis, Marin Kollef, Kevin Laupland, Jose-Artur Paiva, Jesús Rodríguez-Baño, Étienne Ruppé, Jorge Salluh, Fabio Silvio Taccone, Emmanuel Weiss, François Barbier
The massive consumption of antibiotics in the ICU is responsible for substantial ecological side effects that promote the dissemination of multidrug-resistant bacteria (MDRB) in this environment. Strikingly, up to half of ICU patients receiving empirical antibiotic therapy have no definitively confirmed infection, while de-escalation and shortened treatment duration are insufficiently considered in those with documented sepsis, highlighting the potential benefit of implementing antibiotic stewardship programs (ASP) and other quality improvement initiatives...
January 18, 2019: Intensive Care Medicine
Dustin D Flannery, Rachael K Ross, Sagori Mukhopadhyay, Alison C Tribble, Karen M Puopolo, Jeffrey S Gerber
Importance: Premature infants are frequently administered empirical antibiotic therapy at birth. Early and prolonged antibiotic exposures among infants without culture-confirmed infection have been associated with increased risk of adverse outcomes. Objective: To examine early antibiotic use among premature infants over time and across hospitals in the United States. Design, Setting, and Participants: This retrospective cohort study used a comprehensive administrative database of inpatient encounters from 297 academic and community hospitals across the United States to examine data concerning very low-birth-weight (VLBW) infants (<1500 g), including extremely low-birth-weight (ELBW) infants (<1000 g), who were admitted to the neonatal intensive care unit and survived for at least 1 day...
May 18, 2018: JAMA network open
Sofanne J Ravensbergen, Christina Louka, Alewijn Ott, John W Rossen, Darren Cornish, Spyros Pournaras, Erik Bathoorn, Ymkje Stienstra
Background: Several studies have shown a high prevalence of multi-drug resistant organisms (MDRO) amongst asylum seekers when compared to the general population. The aim of this study is to assess the duration of MDRO carriage in this population. Methods: Data were retrospectively collected between January 1st 2014 through December 31st 2016. Study material included screening samples for MDRO carriage and clinical samples from asylum seekers in need of medical care...
2019: Antimicrobial Resistance and Infection Control
Andrea J Zimmer, Alison G Freifeld
Febrile neutropenia remains an important complication of treatment with cytotoxic chemotherapy. It is often the first and sometimes the only sign or symptom of infection in this vulnerable patient population. Urgent and appropriate evaluation and treatment are imperative because delay in initiating appropriate antibiotic therapy may be life threatening. Selection of antibiotics should be based on the patient's symptoms, previous culture data, and institutional antibiograms. Ongoing therapy should be guided by culture and clinical data...
January 2019: Journal of Oncology Practice
Hideki Ban, Kenichiro Miura, Kiyonobu Ishizuka, Naoto Kaneko, Yohei Taniguchi, Takeshi Nagasawa, Yoko Shirai, Tomoo Yabuuchi, Yoko Takagi, Aeko Goto, Motoshi Hattori
BACKGROUND: There are few reports of patients with Campylobacter enteritis after renal transplantation, and only a few case reports of bacteremia have been published. Although antibiotic therapy for 3 to 5 days has been recommended for immunocompromised patients, the optimal treatment for Campylobacter enteritis after renal transplantation has not been established. This study aimed to clarify the clinical characteristics and treatment outcomes of Campylobacter enteritis after pediatric renal transplantation...
December 20, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
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