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Guideline* AND Antibiotic* AND outcome*

Da Wei Thong, Jason Kim, Benjamin Dobson, Henry Cheung, Thomas Arthur
BACKGROUND: This study aims to establish compliance levels to prescription guidelines among Australian surgeons in the use of antibiotics in the surgical management of appendicitis. The secondary outcomes are predictors of post-operative infective complications; surgical site infection (SSI) and intra-abdominal abscess (IAA) at 30 days. METHODS: A multi-centre, prospective, observational study was conducted over a period of 2 months with a 30-day follow-up. Patients were eligible for recruitment if they underwent appendicectomy for suspected appendicitis...
February 18, 2019: ANZ Journal of Surgery
Joseph R Paonessa, Raj D Shah, Chiagozie I Pickens, Bryan D Lizza, Helen K Donnelly, Michael Malczynski, Chao Qi, Richard G Wunderink
BACKGROUND: Guidelines recommend empirical vancomycin or linezolid for suspected pneumonia patients at-risk for methicillin-resistant Staphylococcus aureus (MRSA). Unneeded vancomycin or linezolid use may unnecessarily alter host flora and expose patients to toxicity. We therefore sought to determine if rapid testing for MRSA in bronchoalveolar lavage (BAL) can safely decrease use of vancomycin or linezolid for suspected MRSA pneumonia. METHODS: Operating characteristics of the assay were initially validated against culture on residual BAL...
February 15, 2019: Chest
Asmaa O Bakr And Maysaa E S Zaki
BACKGROUND: Klebsiella pneumoniae (K. pneumoniae) is a common pathogen associated with hospital acquired infections. The presence of virulence genes and antibiotic resistance genes are known risk factors for the infection by this bacterial species. METHODS: The aims of the present study were to i) investigate the coexistence of capsular genes of K. pneumoniae (rmpA and wcaG) with integron genes in clinical isolates of K. pneumoniae by polymerase chain reaction (PCR) from hospital acquired infections and to ii) correlate the presence of these genes with extended spectrum β-lactamase (ESBLs) and carbapenem-resistant phenotypes...
January 1, 2019: Clinical Laboratory
Patricia Maritim, Joseph Mumba Zulu, Choolwe Jacobs, Mumbi Chola, Gershom Chongwe, Jessy Zyambo, Hikabasa Halwindi, Charles Michelo
BACKGROUND: The SAFE strategy (surgery for trichiasis, antibiotics for active infection, facial cleanliness and environmental improvement) is the World Health Organization (WHO) recommended guideline for the elimination of blindness by trachoma by the year 2020. OBJECTIVE: While evaluations on the implementation of the SAFE strategy have been done, systematic reviews on the factors that have shaped implementation are lacking. This review sought to identify these factors...
2019: Global Health Action
Adam Gyedu, Micah Katz, Kwabena Agbedinu, Peter Donkor, Charles Mock
BACKGROUD: Groin hernia repairs (GHR), though classified as clean surgeries, are associated with varying rates of surgical site infections. We assessed the practices of surgeons in Ghana regarding antibiotic use for GHR in comparison to evidence-based international guidelines (EBIG). METHODS: We interviewed surgeons trained by the Ghana College of Physicians and Surgeons (GCPS), from inception (2003) through 2016, about their use of antibiotics for GHR. We defined the outcome variable of consistently following EBIG in antibiotics use for GHR...
February 12, 2019: Journal of Surgical Research
Felicia Skelton, Lindsey Ann Martin, Charlesnika T Evans, Jennifer Kramer, Larissa Grigoryan, Peter Richardson, Mark E Kunik, Ivy Oiyee Poon, S Ann Holmes, Barbara W Trautner
BACKGROUND: Bacteriuria, either asymptomatic (ASB) or symptomatic, urinary tract infection (UTI), is common in persons with spinal cord injury (SCI). Current Veterans Health Administration (VHA) guidelines recommend a screening urinalysis and urine culture for every veteran with SCI during annual evaluation, even when asymptomatic, which is contrary to other national guidelines. Our preliminary data suggest that a positive urine culture (even without signs or symptoms of infection) drives antibiotic use...
February 14, 2019: JMIR Research Protocols
Mariëlle Rockland, Mike Marvin Ruth, Nicole Aalders, Lian Pennings, Wouter Hoefsloot, Melanie Wattenberg, Jakko van Ingen
Nontuberculous mycobacteria (NTM) cause severe opportunistic infections and have a rising incidence in most settings. Rising diagnostic need must be met by national reference laboratories, which rely on Clinical & Laboratory Standards Institute (CLSI) guideline approved manual readout of microtiter plates for antimicrobial susceptibility testing (AST) to determine antibiotic minimum inhibitory concentrations (MICs). Interpretation of these plates leads to different outcomes between laboratories. The SensiTitre™ Vizion™ Digital MIC Viewing System (Vizion) offers a more streamlined approach using semi-automated reading...
February 13, 2019: Journal of Clinical Microbiology
Niels van der Naald, Diederik P J Smeeing, Roderick M Houwert, Falco Hietbrink, Geertje A M Govaert, Detlef van der Velde
Introduction: Brodie's abscess is a form of osteomyelitis. Since its first appearance in the medical literature in 1832, numerous cases have been described. The aim of this article is to provide the first comprehensive overview of published cases of Brodie's abscess, and to describe diagnostic methods, therapeutic consequences and outcomes. Methods: According to PRISMA guidelines a systematic review of the literature was performed. All published data in English or Dutch were considered for inclusion with no limitations on publication date...
2019: Journal of Bone and Joint Infection
Robert M Rossi, Eric Hall, Emily A DeFranco
OBJECTIVE: In 2014, the Society for Maternal-Fetal Medicine, the Eunice Kennedy Shriver National Institute of Child Health and Human Development, the American Academy of Pediatrics, and the American College of Obstetricians and Gynecologists published an executive summary of a joint workshop to establish obstetric interventions to be considered for periviable births. We sought to evaluate changes in practice patterns since the publication of these guidelines. METHODS: We conducted a population-based cohort study of all singleton live births delivered between 22 0/7 and 23 6/7 weeks of gestation in the United States within two time epochs: pre-executive summary (Epoch 1: 2012-2013) and post-executive summary (Epoch 2: 2015-2016) guideline release...
February 4, 2019: Obstetrics and Gynecology
D C van Duijvenbode, J W P Kuiper, R M Holewijn, A Stadhouder
Introduction: Treatment and risk factors for Parvimonas micra spinal infections are scarcely researched. This study reports a case and presents a systematic review of the literature to provide evidence-based ground for diagnosis and treatment of P. micra spinal infections. Case Report: This is a case of a 78-year-old male with severe back and leg pain. Advanced imaging demonstrated the destruction of L2-L3 with an extensive fluid collection in the remaining intervertebral space, paravertebral myositis, and multiple abscesses...
September 2018: Journal of Orthopaedic Case Reports
Brita Skodvin, Jannicke S Wathne, P Christoffer Lindemann, Stig Harthug, Roy M Nilsen, Esmita Charani, Heidi Syre, Baard R Kittang, Lars K S Kleppe, Ingrid Smith
Background: Effective use of microbiology test results may positively influence patient outcomes and limit the use of broad-spectrum antibiotics. However, studies indicate that their potential is not fully utilized. We investigated microbiology test ordering practices and the use of test results for antibiotic decision-making in hospitals. Methods: A multicentre cohort study was conducted during five months in 2014 in Medical departments across three hospitals in Western Norway...
2019: Antimicrobial Resistance and Infection Control
Archana Chacko, Sophie Ch Wen, Gunter Hartel, Nitin Kapur, Claire E Wainwright, Julia E Clark
BACKGROUND: Mycobacterium abscessus complex pulmonary disease (M. abscessus PD) in cystic fibrosis (CF) is challenging to treat. Current guideline therapeutic regimens involving an intensive phase of intravenous antibiotics followed by a consolidation phase of inhaled and oral antibiotics are not evidence-based. The objectives of this study were to characterize the clinical outcomes and clearance of Mycobacterium abscessus complex (M. abscessus) from respiratory cultures in children with CF M...
February 4, 2019: Pediatric Infectious Disease Journal
Zoe Allaway, Robert S Phillips, Karin A Thursky, Gabrielle M Haeusler
To date, very few studies have addressed nonneutropenic fever (NNF) in children with cancer, and there are no consensus guidelines. This scoping review aims to describe the rate of bacteremia, risk factors for infection and management, and outcomes of NNF in this population. Across 15 studies (n = 4106 episodes), the pooled-average bacteremia rate was 8.2%, and risk factors included tunneled external central venous catheter, clinical instability, and higher temperature. In two studies, antibiotics were successfully withheld in a subset of low-risk patients...
February 5, 2019: Pediatric Blood & Cancer
Xiaolin Wei, Zhitong Zhang, Joseph P Hicks, John D Walley, Rebecca King, James N Newell, Jia Yin, Jun Zeng, Yan Guo, Mei Lin, Ross E G Upshur, Qiang Sun
BACKGROUND: Inappropriate antibiotic prescribing causes widespread serious health problems. To reduce prescribing of antibiotics in Chinese primary care to children with upper respiratory tract infections (URTIs), we developed an intervention comprising clinical guidelines, monthly prescribing review meetings, doctor-patient communication skills training, and education materials for caregivers. We previously evaluated our intervention using an unblinded cluster-randomised controlled trial (cRCT) in 25 primary care facilities across two rural counties...
February 2019: PLoS Medicine
Mark E Nunnally, Arpit Patel
PURPOSE OF REVIEW: Sepsis-3 guidelines have implications in a deeper understanding of the biopathology of the disease. Further, the review focuses on timely topics and new literature on fluid resuscitation, the value of steroids in sepsis, and new therapeutic options such as angiotensin II, vitamin C, and thiamine as well as the emerging role of procalcitonin (PCT) in managing antibiotics. RECENT FINDINGS: Traditional therapies such as type of crystalloid fluid administration and steroid therapy for sepsis are currently under re-evaluation...
January 31, 2019: Current Opinion in Anaesthesiology
Ursula Patricia Hebeisen, Andrew Atkinson, Jonas Marschall, Niccolò Buetti
Background: Catheter-related bloodstream infections (CRBSI) with coagulase-negative Staphylococci (CoNS) are a common source of hospital-acquired bloodstream infections. The main objective of this study was to elucidate the role of systemic antibiotic therapy in the setting of catheter removal in adult patients with CoNS-CRBSI. Methods: We conducted a retrospective cohort study on patients with CoNS-CRBSI diagnosed between 2008 and 2016 with follow-up for up to 12 months...
2019: Antimicrobial Resistance and Infection Control
Xihui Liu, Xiaoyan Zuo, Xia Sun, Zhao Hu
BACKGROUND: Peritoneal dialysis (PD) related infections, such as peritonitis, are still the main obstacle for the development of PD. Prophylactic antibiotic as one of the interventions to prevent early peritonitis was recommended to use before PD catheter insertion by International Society for Peritoneal Dialysis (ISPD) guidelines, In our hospital, however, since 2012, the prophylactic antibiotics for insertion of PD catheters were not allowed to use because of our hospital's regulation...
November 2019: Renal Failure
Sajal K Saha, Lesley Hawes, Danielle Mazza
Background: The use of community antibiotic stewardship programmes (ASPs) is rising; however, their effectiveness when pharmacists are involved is uncertain. Objectives: To assess the effectiveness of ASPs involving pharmacists at improving antibiotic prescribing by general practitioners (GPs). Methods: Medline, Embase, Emcare, PubMed, PsycINFO, Cochrane CENTRAL, CINAHL Plus and Web of Science databases were searched to February 2018. Randomized and non-randomized studies of ASPs involving pharmacists as interventionists to GPs were included...
January 28, 2019: Journal of Antimicrobial Chemotherapy
Jennifer H Lee, Thangamani Muthukumar, Jim Kim, Meredith J Aull, Anthony Watkins, Sandip Kapur, Choli Hartono
There are no guidelines for antibiotic prophylaxis for ureteral stent removal after kidney transplantation. We reviewed the charts of 277 adult kidney transplant recipients with ureteral stents transplanted at our center between September 2014 and December 2015 and investigated whether antibiotic prophylaxis for stent removal was associated with reduced incidence of urinary tract infections (UTI). We defined UTI as a urine culture ≥104 CFU/mL of bacterial isolates irrespective of symptoms. Primary outcome was the incidence of UTI within four weeks of stent removal...
January 29, 2019: Clinical Transplantation
Cynthia L Gong, Shom Dasgupta-Tsinikas, Kenneth M Zangwill, Michael Bolaris, Joel W Hay
OBJECTIVE: To determine potential net monetary benefit of an early onset sepsis calculator-based approach for management of neonates exposed to maternal intrapartum fever, compared to existing guidelines. STUDY DESIGN: We performed a cost-benefit analysis comparing two management approaches for newborns >34 weeks gestational age exposed to maternal intrapartum fever. Probabilities of sepsis and meningitis, consequences of infection and antibiotic use, direct medical costs, and indirect costs for long-term disability and mortality were considered...
January 28, 2019: Journal of Perinatology: Official Journal of the California Perinatal Association
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