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Long term use of antibiotics in children and the effects

Chung-Yen Huang, Ronan W Hsieh, Hung-Teng Yen, Tzu-Chun Hsu, Chun-Yu Chen, Yee-Chun Chen, Chien-Chang Lee
Current practice of long-term antibiotic use in patients with osteomyelitis is controversial. Recent studies showed short-term antibiotic use to be non-inferior to long-term use, but the results of these studies have been inconsistent. In this review, the PubMed and Embase databases were searched from inception through to June 2018 for randomised controlled trials (RCTs), cohort studies or case-control studies comparing two different durations of antibiotic use. Short antibiotic courses were defined as antibiotics administered for a shorter period than the recommended 4-6 weeks...
January 10, 2019: International Journal of Antimicrobial Agents
Anat Stern, Elena Carrara, Roni Bitterman, Dafna Yahav, Leonard Leibovici, Mical Paul
BACKGROUND: People with cancer with febrile neutropenia are at risk of severe infections and mortality and are thus treated empirically with broad-spectrum antibiotic therapy. However, the recommended duration of antibiotic therapy differs across guidelines. OBJECTIVES: To assess the safety of protocol-guided discontinuation of antibiotics regardless of neutrophil count, compared to continuation of antibiotics until neutropenia resolution in people with cancer with fever and neutropenia, in terms of mortality and morbidity...
January 3, 2019: Cochrane Database of Systematic Reviews
R Murphy, X C Morgan, X Y Wang, K Wickens, G Purdie, P Fitzharris, A Otal, B Lawley, T Stanley, C Barthow, J Crane, E A Mitchell, G W Tannock
Probiotic Lactobacillus rhamnosus HN001 given in early life has been shown to reduce infant eczema risk, but its effect on gut microbiota development has not been quantitatively and functionally examined. The aim of this study was to investigate the impact of early life probiotic exposure on the composition and functional capacity of infant gut microbiota from birth to 2 years considering the effects of age, delivery mode, antibiotics, pets and eczema. We performed shotgun metagenomic sequencing analysis of 650 infant faecal samples, collected at birth, 3, 12, and 24 months, as part of a randomised, controlled, 3-arm trial assessing the effect of L...
December 21, 2018: Beneficial Microbes
Leila Ferguson, Masaki Futamura, Efstratios Vakirlis, Reiji Kojima, Hatoko Sasaki, Amanda Roberts, Rintaro Mori
BACKGROUND: Eczema is a common, chronic, inflammatory skin condition that is frequently associated with atopic conditions, including asthma. Leukotriene receptor antagonists (LTRAs) have a corticosteroid-sparing role in asthma, but their role in eczema remains controversial. Currently available topical therapies for eczema are often poorly tolerated, and use of systemic agents is restricted by their adverse effect profile. A review of alternative treatments was therefore warranted. OBJECTIVES: To assess the possible benefits and harms of leukotriene receptor antagonists for eczema...
October 21, 2018: Cochrane Database of Systematic Reviews
Douglas W Storm, Luis H Braga, Christopher S Cooper
Continuous antibiotic prophylaxis (CAP) for urinary tract infection prevention in children with vesicoureteral reflux, hydronephrosis, and hydroureteronephrosis is reviewed. A more selective use of CAP is advocated based on a review of known individual risk factors in each of these conditions that subsequently helps identify the children most likely to benefit from CAP. Both short-term and potential long-term side effects of CAP are reviewed, including the impact of prophylactic antibiotics on bacterial resistance and the microbiome...
November 2018: Urologic Clinics of North America
Wioletta Pietruszewska, Magda Barańska, Jakub Wielgat
Acute infections of the upper respiratory tract and upper gastrointestinal tract (mouth and throat) are still the most common reason for reporting to the general practitioner or ENT specialist. Despite the fact that the most common causative agent of these diseases is a virus, antibiotics are still flavored in about 60-80% of patients who report to the doctor. In consensuses such as EPOS, WHO reports and other local/ / national reports, there is a need to limit antibacterial treatment for and to replace it with symptomatic and anti-inflammatory drugs...
August 31, 2018: Otolaryngologia Polska
Kate Hawke, Mieke L van Driel, Benjamin J Buffington, Treasure M McGuire, David King
BACKGROUND: Acute respiratory tract infections (ARTIs) are common and may lead to complications. Most children experience between three and six ARTIs annually. Although these infections are self-limiting, symptoms can be distressing. Many treatments are used to control symptoms and shorten illness duration. Most have minimal benefit and may lead to adverse effects. Oral homeopathic medicinal products could play a role in childhood ARTI management if evidence for effectiveness is established...
September 9, 2018: Cochrane Database of Systematic Reviews
Y Wenner, C Kuhli-Hattenbach, T Kohnen
OBJECTIVE OF SURGERY: The aim of strabismus surgery to correct esotropia is orthotropic alignment or microstrabismus to achieve best possible binocularity, a larger visual field, better appearance, and a frequently connected improved self-esteem. A widely used technique to correct esotropia is combined unilateral strabismus surgery with recession of the medial rectus muscle and plication of the lateral rectus muscle. INDICATIONS: Indications are esotropia of various origins or decompensating esophoria over 15 prism diopters...
November 2018: Der Ophthalmologe: Zeitschrift der Deutschen Ophthalmologischen Gesellschaft
Axel Kaehne, Stephen J Milan, Lambert M Felix, Emer Sheridan, Paul A Marsden, Sally Spencer
BACKGROUND: The diagnosis of bronchiectasis is defined by abnormal dilation of the airways related to a pathological mechanism of progressive airway destruction that is due to a 'vicious cycle' of recurrent bacterial infection, inflammatory mediator release, airway damage, and subsequent further infection. Antibiotics are the main treatment option for reducing bacterial burden in people with exacerbations of bronchiectasis and for longer-term eradication, but their use is tempered against potential adverse effects and concerns regarding antibiotic resistance...
September 5, 2018: Cochrane Database of Systematic Reviews
Molla Imaduddin Ahmed, Saptarshi Mukherjee
BACKGROUND: Cystic fibrosis is an inherited life-threatening multisystem disorder with lung disease characterized by abnormally thick airway secretions and persistent bacterial infection. Chronic, progressive lung disease is the most important cause of morbidity and mortality in the condition and is therefore the main focus of clinical care and research. Staphylococcus aureus is a major cause of chest infection in people with cystic fibrosis. Early onset, as well as chronic, lung infection with this organism in young children and adults results in worsening lung function, poorer nutrition and increases the airway inflammatory response, thus leading to a poor overall clinical outcome...
July 27, 2018: Cochrane Database of Systematic Reviews
Eugenia Bruzzese, Marcella Pesce, Giovanni Sarnelli, Alfredo Guarino
Rifaximin is a poorly absorbable antibiotic with a broad-spectrum activity against both Gram-negative and -positive bacteria. It is active in the small intestine due to its high bile solubility, whereas in the aqueous environment of the colon, it shows limited efficacy against highly susceptible bacteria. These unique pharmacokinetic properties limit its systemic effects and can correct gut microflora imbalances. Thus, rifaximin has become a major therapeutic agent in several gastrointestinal diseases in which an imbalance in gut microflora may play a role, including diarrhea predominant irritable bowel syndrome (IBS-D)...
July 2018: Expert Opinion on Drug Metabolism & Toxicology
Lambert M Felix, Seamus Grundy, Stephen J Milan, Ross Armstrong, Haley Harrison, Dave Lynes, Sally Spencer
BACKGROUND: Bronchiectasis is a chronic respiratory disease characterised by abnormal and irreversible dilatation of the smaller airways and associated with a mortality rate greater than twice that of the general population. Antibiotics serve as front-line therapy for managing bacterial load, but their use is weighed against the development of antibiotic resistance. Dual antibiotic therapy has the potential to suppress infection from multiple strains of bacteria, leading to more successful treatment of exacerbations, reduced symptoms, and improved quality of life...
June 11, 2018: Cochrane Database of Systematic Reviews
François Graham, Sophia Tsabouri, Jean-Christoph Caubet
PURPOSE OF REVIEW: To present the most recent evidence on beta-lactam hypersensitivity reactions in children. RECENT FINDINGS: Drug provocation tests (DPTs) are the gold standard when investigating beta-lactam allergy in children and evidence is increasingly supporting DPTs without skin tests as a safe approach when evaluating children with nonimmediate mild reactions to beta-lactams. Of note, data are limited in the adolescent population, and this attitude may not apply to this age group...
August 2018: Current Opinion in Allergy and Clinical Immunology
Tim Donovan, Lambert M Felix, James D Chalmers, Stephen J Milan, Alexander G Mathioudakis, Sally Spencer
BACKGROUND: Bronchiectasis is a chronic airway disease characterised by a destructive cycle of recurrent airway infection, inflammation and tissue damage. Antibiotics are a main treatment for bronchiectasis. The aim of continuous therapy with prophylactic antibiotics is to suppress bacterial load, but bacteria may become resistant to the antibiotic, leading to a loss of effectiveness. On the other hand, intermittent prophylactic antibiotics, given over a predefined duration and interval, may reduce antibiotic selection pressure and reduce or prevent the development of resistance...
June 3, 2018: Cochrane Database of Systematic Reviews
Mahyar Etminan, Michael Guo, Bruce Carleton
BACKGROUND: Fluoroquinolone (FQ) prescription rates have increased over the last 10 years despite recent warnings of serious adverse effects such as peripheral neuropathy and tendinopathy. Currently, there are no published data on the extent or appropriateness of FQ prescribing in children METHODS:: Drug prescription data from the PharMetrics Plus™ health claims database (United States) were analyzed to examine dispensing of ciprofloxacin, levofloxacin, moxifloxacin, ofloxacin, or gemifloxacin to children from 2006 to 2015...
May 24, 2018: Pediatric Infectious Disease Journal
Nirit Kronenfeld, Tomer Ziv Baran, Maya Berlin, Nour Karra, Natalie Dinavitser, Rana Cohen, Yifat Wiener, Eyal Schwartzberg, Matitiahu Bercovitch
BACKGROUND: Current knowledge regarding chronic use of psychotropic medications during breastfeeding is limited. The objective of this study was to evaluate the long-term effects of psychotropic monotherapy use during lactation on the breastfed infant. MATERIALS AND METHODS: In this prospective study, we followed 280 infants whose mothers contacted the Drug Consultation Center (DCC) at Assaf Harofeh Medical Center between January 2011 and December 2015, seeking information regarding the chronic use of psychotropic medications during lactation...
2018: PloS One
Roderick P Venekamp, Paul Mick, Anne Gm Schilder, Desmond A Nunez
BACKGROUND: Acute otitis media (AOM) is one of the most common childhood illnesses. While many children experience sporadic AOM episodes, an important group suffer from recurrent AOM (rAOM), defined as three or more episodes in six months, or four or more in one year. In this subset of children AOM poses a true burden through frequent episodes of ear pain, general illness, sleepless nights and time lost from nursery or school. Grommets, also called ventilation or tympanostomy tubes, can be offered for rAOM...
May 9, 2018: Cochrane Database of Systematic Reviews
Biljana Ilievska-Poposka, Maja Zakoska, Stefan Talevski
BACKGROUND: Among the adults and children aged 5 yrs who attend PHC settings, 20-30% seeks to care for respiratory symptoms. Over 80-90% of the respiratory patients suffer from acute respiratory infections (ARI), followed by chronic obstructive pulmonary diseases (COPD), asthma, and less frequently with pneumonia and tuberculosis (TB). To improve the quality of care in patients who seek assistance for respiratory symptoms in PHC settings and the efficiency of respiratory service delivery within healthcare systems, WHO has designated several initiatives among which one is PAL (Practical Approach to Lung Health)...
April 15, 2018: Open Access Macedonian Journal of Medical Sciences
Diana A Freitas, Gabriela Ss Chaves, Thayla A Santino, Cibele Td Ribeiro, Fernando Al Dias, Ricardo O Guerra, Karla Mpp Mendonça
BACKGROUND: Postural drainage is used primarily in infants with cystic fibrosis from diagnosis up to the moment when they are mature enough to actively participate in self-administered treatments. However, there is a risk of gastroesophageal reflux associated with this technique.This is an update of a review published in 2015. OBJECTIVES: To compare the effects of standard postural drainage (15º to 45º head-down tilt) with modified postural drainage (15º to 30º head-up tilt) with regard to gastroesophageal reflux in infants and young children up to six years old with cystic fibrosis in terms of safety and efficacy...
March 9, 2018: Cochrane Database of Systematic Reviews
K Ross Turbyfill, Kristen A Clarkson, Anthony R Vortherms, Edwin V Oaks, Robert W Kaminski
The native Invaplex (InvaplexNAT ) vaccine and adjuvant is an ion exchange-purified product derived from the water extract of virulent Shigella species. The key component of InvaplexNAT is a high-molecular-mass complex (HMMC) consisting of the Shigella lipopolysaccharide (LPS) and the invasin proteins IpaB and IpaC. To improve product purity and immunogenicity, artificial Invaplex (InvaplexAR ) was developed using recombinant IpaB and IpaC proteins and purified Shigella LPS to assemble an HMMC consisting of all three components...
March 2018: MSphere
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