WorldWideScience

Sample records for antibiotics therapeutic use

  1. Antibiotics: Use and misuse in pediatric dentistry

    Directory of Open Access Journals (Sweden)

    F C Peedikayil

    2011-01-01

    Full Text Available Antibiotics are commonly used in dentistry for prophylactic as well as for therapeutic purposes. Most often antibiotics are used in unwarranted situations, which may give rise to resistant bacterial strains. Dentists want to make their patients well and to prevent unpleasant complications. These desires, coupled with the belief that many oral problems are infectious, stimulate the prescribing of antibiotics. Good knowledge about the indications of antibiotics is the need of the hour in prescribing antibiotics for dental conditions.

  2. Use of Xylitol To Enhance the Therapeutic Efficacy of Polymethylmethacrylate-Based Antibiotic Therapy in Treatment of Chronic Osteomyelitis

    Science.gov (United States)

    Beenken, Karen E.; Bradney, Laura; Bellamy, William; Skinner, Robert A.; McLaren, Sandra G.; Gruenwald, M. Johannes; Spencer, Horace J.; Smith, James K.; Haggard, Warren O.

    2012-01-01

    Using a rabbit model of postsurgical osteomyelitis, we demonstrate that incorporation of xylitol into polymethylmethacrylate (PMMA) bone cement enhances the elution of daptomycin under in vivo conditions. We also demonstrate that this can be correlated with an improved therapeutic outcome in the treatment of a chronic bone infection following surgical debridement. PMID:22948866

  3. Fighting antibiotic resistance in the intensive care unit using antibiotics.

    Science.gov (United States)

    Plantinga, Nienke L; Wittekamp, Bastiaan H J; van Duijn, Pleun J; Bonten, Marc J M

    2015-01-01

    Antibiotic resistance is a global and increasing problem that is not counterbalanced by the development of new therapeutic agents. The prevalence of antibiotic resistance is especially high in intensive care units with frequently reported outbreaks of multidrug-resistant organisms. In addition to classical infection prevention protocols and surveillance programs, counterintuitive interventions, such as selective decontamination with antibiotics and antibiotic rotation have been applied and investigated to control the emergence of antibiotic resistance. This review provides an overview of selective oropharyngeal and digestive tract decontamination, decolonization of methicillin-resistant Staphylococcus aureus and antibiotic rotation as strategies to modulate antibiotic resistance in the intensive care unit.

  4. Response to "Antibiotic Use and Resistance"

    DEFF Research Database (Denmark)

    Malo, Sara; Rabanaque, María José; Feja, Christina;

    2014-01-01

    As mentioned, antibiotic consumption in heavy users, especially in children, is really striking. Certainly, our results revealed an antibiotic use in this age group higher than published in previous studies, and in line with different reports repeatedly presenting the high antibiotic consumption...... existing in Spain compared with other European countries (1). Determinants involved in antibiotic prescribing are numerous and varied. It is true that therapeutic failures lead to repeated courses of antibiotic treatment. However, it is not probably the only reason. Frequent and high consumption...... of antibiotics, as observed in heavy users, could also be due to factors related to the GP, patient and parents' expectations or the influence exerted by the pharmaceutical industry (2). This article is protected by copyright. All rights reserved....

  5. Detection of residues antibiotics in food using a microbiological method

    International Nuclear Information System (INIS)

    Antibiotics are effective therapeutic agents because of their property of selective bacterial toxicity which helps controlling infections. Animals, just like humans, can be treated with antibiotics. This use of antibiotics can lead to the development of resistance. Resistant strains may cause severe infections in humans and animals. In addition, antibiotic residues might represent a problem for human health. Our objective is to develop a microbiological method for the detection of antibiotic residues in poultry(muscle, liver,...). For this purpose, antibiotic sensitive bacteria and selective agar media were used. An inhibition growth zone surrounds each of the food samples containing antibiotic residues after a prescribed incubation time. (Author). 23 refs

  6. Antibiotic resistance - the interplay between antibiotic use in animals and human beings

    DEFF Research Database (Denmark)

    Singer, R.S.; Finch, R.; Wegener, Henrik Caspar;

    2003-01-01

    Antibiotic-resistant bacteria were first identified in the 1940s, but while new antibiotics were being discovered at a steady rate, the consequences of this phenomenon were slow to be appreciated. Today, the excessive use of antibiotics compounded by the paucity of new agents on the market has...... meant the problem of antibiotic resistance is fast escalating into a global health crisis. There is no doubt that misuse of these drugs in human beings has contributed to the increasing rates of resistance, but recently the use of antibiotics in food animals and its consequent effect on resistance...... of antibiotics in animals-whether therapeutic or as growth promoters-pales by comparison with human use, and that efforts should be concentrated on the misuse of antibiotics in people. Others warn of the dangers of unregulated and unnecessary use of antibiotics, especially growth promoters in animal husbandry...

  7. Fighting antibiotic resistance in the intensive care unit using antibiotics

    NARCIS (Netherlands)

    Plantinga, Nienke L.; Wittekamp, Bastiaan H J; Van Duijn, Pleun J.; Bonten, Marc J M

    2015-01-01

    Antibiotic resistance is a global and increasing problem that is not counterbalanced by the development of new therapeutic agents. The prevalence of antibiotic resistance is especially high in intensive care units with frequently reported outbreaks of multidrug-resistant organisms. In addition to cl

  8. Antibiotics

    Science.gov (United States)

    Antibiotics are powerful medicines that fight bacterial infections. Used properly, antibiotics can save lives. They either kill bacteria or ... natural defenses can usually take it from there. Antibiotics do not fight infections caused by viruses, such ...

  9. Pharmacology and therapeutic applications of enediyne antitumor antibiotics.

    Science.gov (United States)

    Shao, Rong-Guang

    2008-01-01

    The natural compounds that interfere with cellular DNA such as enediyne antitumor antibiotics might be important chemotherapeutic agents for the treatment of cancer. In this article, the pharmacology and anticancer activity of the enediyne antitumor agents that are approved for clinical use and undergoing pre-clinical or clinical evaluation are reviewed. Most enediyne compounds have shown potent activity against the proliferation of various cancer cells, including cells that display resistance to other chemotherapeutic drugs. Enediyne derivatives, such as an immunoconjugate composed of an enediyne compound and monoclonal antibody, reveal stronger activity and selectivity for human cancer cells. The mechanism underlying the anticancer activity of these enediyne antitumor agents may mainly lie in their generation of DNA double-strand breaks. Increasing evidence shows that the enediyne-induced DNA double-strand breaks can engage the activation of DNA damage response proteins, arresting cell cycle progression and eventually leading to apoptotic cell death. Continued investigation of the mechanisms of action and development of new enediyne derivatives and conjugates may provide more effective therapeutics for cancer treatments. PMID:20021423

  10. The effects of antibiotics on the microbiome throughout development and alternative approaches for therapeutic modulation.

    Science.gov (United States)

    Langdon, Amy; Crook, Nathan; Dantas, Gautam

    2016-04-13

    The widespread use of antibiotics in the past 80 years has saved millions of human lives, facilitated technological progress and killed incalculable numbers of microbes, both pathogenic and commensal. Human-associated microbes perform an array of important functions, and we are now just beginning to understand the ways in which antibiotics have reshaped their ecology and the functional consequences of these changes. Mounting evidence shows that antibiotics influence the function of the immune system, our ability to resist infection, and our capacity for processing food. Therefore, it is now more important than ever to revisit how we use antibiotics. This review summarizes current research on the short-term and long-term consequences of antibiotic use on the human microbiome, from early life to adulthood, and its effect on diseases such as malnutrition, obesity, diabetes, and Clostridium difficile infection. Motivated by the consequences of inappropriate antibiotic use, we explore recent progress in the development of antivirulence approaches for resisting infection while minimizing resistance to therapy. We close the article by discussing probiotics and fecal microbiota transplants, which promise to restore the microbiota after damage of the microbiome. Together, the results of studies in this field emphasize the importance of developing a mechanistic understanding of gut ecology to enable the development of new therapeutic strategies and to rationally limit the use of antibiotic compounds.

  11. Suppression of antibiotic resistance acquisition by combined use of antibiotics.

    Science.gov (United States)

    Suzuki, Shingo; Horinouchi, Takaaki; Furusawa, Chikara

    2015-10-01

    We analyzed the effect of combinatorial use of antibiotics with a trade-off relationship of resistance, i.e., resistance acquisition to one drug causes susceptibility to the other drug, and vice versa, on the evolution of antibiotic resistance. We demonstrated that this combinatorial use of antibiotics significantly suppressed the acquisition of resistance.

  12. Use of Antibiotics in Children

    DEFF Research Database (Denmark)

    Pottegård, Anton; Broe, Anne; Aabenhus, Rune;

    2015-01-01

    Background: We aimed to describe the use of systemic antibiotics among children in Denmark. Methods: National data on drug use in Denmark were extracted from the Danish National Prescription Database. We used prescription data for all children in Denmark aged 0 to 11 years from January 1, 2000...... to December 31, 2012. Results: We obtained data on 5,884,301 prescriptions for systemic antibiotics issued to 1,206,107 children. The most used single substances were phenoxymethylpenicillin (45%), amoxicillin (34%) and erythromycin (6%). The highest incidence rate of antibiotic treatment episodes......–1. There was little evidence of heavy users. Conclusion: Prescribing rate of antibiotics to children in Denmark remained stable at a high level from 2000 to 2012. An increase in the use of broad-spectrum beta-lactam penicillin was noted, but otherwise the prescribing pattern adhered well to National guidelines...

  13. Botanical alternatives to antibiotics for use in organic poultry production.

    Science.gov (United States)

    Diaz-Sanchez, Sandra; D'Souza, Doris; Biswas, Debrabrata; Hanning, Irene

    2015-06-01

    The development of antibiotic resistant pathogens has resulted from the use of sub-therapeutic concentrations of antibiotics delivered in poultry feed. Furthermore, there are a number of consumer concerns regarding the use of antibiotics in food animals including residue contamination of poultry products and antibiotic resistant bacterial pathogens. These issues have resulted in recommendations to reduce the use of antibiotics as growth promoters in livestock in the United States. Unlike conventional production, organic systems are not permitted to use antibiotics. Thus, both conventional and organic poultry production need alternative methods to improve growth and performance of poultry. Herbs, spices, and various other plant extracts are being evaluated as alternatives to antibiotics and some do have growth promoting effects, antimicrobial properties, and other health-related benefits. This review aims to provide an overview of herbs, spices, and plant extracts, currently defined as phytobiotics as potential feed additives. PMID:25743421

  14. Optimizing Antibiotic Use in Nursing Homes Through Antibiotic Stewardship.

    Science.gov (United States)

    Sloane, Philip D; Huslage, Kirk; Kistler, Christine E; Zimmerman, Sheryl

    2016-01-01

    Antibiotic stewardship is becoming a requirement for nursing homes. Programs should be interdisciplinary and multifaceted; should have support from nursing home administrators; and should aim to promote antibiotics only when needed, not just in case. Recommended components include use of evidence-based guidelines; ongoing monitoring of antibiotic prescriptions, cultures, and study results; monitoring of health outcomes; use of nursing home-specific antibiograms; regular reporting and feedback to medical providers and nurses; and education of residents and families. PMID:27621341

  15. Trends in antibiotic use among outpatients in New Delhi, India

    Directory of Open Access Journals (Sweden)

    Holloway Kathleen

    2011-04-01

    Full Text Available Abstract Background The overall volume of antibiotic consumption in the community is one of the foremost causes of antimicrobial resistance. There is much ad-hoc information about the inappropriate consumption of antibiotics, over-the-counter availability, and inadequate dosage but there is very little actual evidence of community practices. Methods This study surveyed antibiotic use in the community (December 2007-November 2008 using the established methodology of patient exit interviews at three types of facilities: 20 private retail pharmacies, 10 public sector facilities, and 20 private clinics to obtain a complete picture of community antibiotic use over a year. The Anatomical Therapeutic Chemical (ATC classification and the Defined Daily Dose (DDD measurement units were assigned to the data. Antibiotic use was measured as DDD/1000 patients visiting the facility and also as percent of patients receiving an antibiotic. Results During the data collection period, 17995, 9205, and 5922 patients visiting private retail pharmacies, public facilities and private clinics, respectively, were included in our study. 39% of the patients attending private retail pharmacies and public facilities and 43% of patients visiting private clinics were prescribed at least one antibiotic. Consumption patterns of antibiotics were similar at private retail pharmacies and private clinics where fluoroquinolones, cephalosporins, and extended spectrum penicillins were the three most commonly prescribed groups of antibiotics. At public facilities, there was a more even use of all the major antibiotic groups including penicillins, fluoroquinolones, macrolides, cephalosporins, tetracyclines, and cotrimoxazole. Newer members from each class of antibiotics were prescribed. Not much seasonal variation was seen although slightly higher consumption of some antibiotics in winter and slightly higher consumption of fluoroquinolones during the rainy season were observed

  16. Sub-therapeutic Antibiotics and Productivity in U.S. Hog Production

    OpenAIRE

    McBride, William D.; Key, Nigel D.; Mathews, Kenneth H., Jr.

    2006-01-01

    Antimicrobial drugs are fed to hogs at sub-therapeutic levels to prevent disease and promote growth. However, there is concern that the presence of antimicrobial drugs in hog feed is a factor promoting the development of antimicrobial drug-resistant bacteria. This study uses a sample-selection model to examine the impact that use has on the productivity of U.S. hog operations. The analysis did not find a relationship between productivity and sub-therapeutic antibiotics fed during finishing, b...

  17. Re-sensitizing drug-resistant bacteria to antibiotics by designing Antisense Therapeutics

    Science.gov (United States)

    Courtney, Colleen; Chatterjee, Anushree

    2014-03-01

    ``Super-bugs'' or ``multi-drug resistant organisms'' are a serious international health problem, with devastating consequences to patient health care. The Center for Disease Control has identified antibiotic resistance as one of the world's most pressing public health problems as a significant fraction of bacterial infections contracted are drug resistant. Typically, antibiotic resistance is encoded by ``resistance-genes'' which express proteins that carryout the resistance causing functions inside the bacterium. We present a RNA based therapeutic strategy for designing antimicrobials capable of re-sensitizing resistant bacteria to antibiotics by targeting labile regions of messenger RNAs encoding for resistance-causing proteins. We perform in silico RNA secondary structure modeling to identify labile target regions in an mRNA of interest. A synthetic biology approach is then used to administer antisense nucleic acids to our model system of ampicillin resistant Escherichia coli. Our results show a prolonged lag phase and decrease in viability of drug-resistant E. colitreated with antisense molecules. The antisense strategy can be applied to alter expression of other genes in antibiotic resistance pathways or other pathways of interest.

  18. The analysis of the antibiotic resistome offers new opportunities for therapeutic intervention.

    Science.gov (United States)

    Corona, Fernando; Blanco, Paula; Alcalde-Rico, Manuel; Hernando-Amado, Sara; Lira, Felipe; Bernardini, Alejandra; Sánchez, María B; Martínez, José L

    2016-06-01

    Most efforts in the development of antimicrobials have focused on the screening of lethal targets. Nevertheless, the constant expansion of antimicrobial resistance makes the antibiotic resistance determinants themselves suitable targets for finding inhibitors to be used in combination with antibiotics. Among them, inhibitors of antibiotic inactivating enzymes and of multidrug efflux pumps are suitable candidates for improving the efficacy of antibiotics. In addition, the application of systems biology tools is helping to understand the changes in bacterial physiology associated to the acquisition of resistance, including the increased susceptibility to other antibiotics displayed by some antibiotic-resistant mutants. This information is useful for implementing novel strategies based in metabolic interventions or combination of antibiotics for improving the efficacy of antibacterial therapy. PMID:27304087

  19. The effect of discontinued use of antimicrobial growth promoters on the risk of therapeutic antibiotic treatment in Danish farrow-to-finish pig farms

    DEFF Research Database (Denmark)

    Vigre, Håkan; Larsen, P.B.; Andreasen, Morten;

    2008-01-01

    proportion of days per farm where treatment was performed (PDT) and (2) the proportion of pigs treated per day per farm at days where treatment was performed (PPT) before and after duAGPs at 68 farrow-to-finish farms. The farms were selected using, a two-stage (veterinarian/farm) convenience sampling. On...

  20. Broad spectrum antibiotic compounds and use thereof

    Energy Technology Data Exchange (ETDEWEB)

    Koglin, Alexander; Strieker, Matthias

    2016-07-05

    The discovery of a non-ribosomal peptide synthetase (NRPS) gene cluster in the genome of Clostridium thermocellum that produces a secondary metabolite that is assembled outside of the host membrane is described. Also described is the identification of homologous NRPS gene clusters from several additional microorganisms. The secondary metabolites produced by the NRPS gene clusters exhibit broad spectrum antibiotic activity. Thus, antibiotic compounds produced by the NRPS gene clusters, and analogs thereof, their use for inhibiting bacterial growth, and methods of making the antibiotic compounds are described.

  1. Alliance for the Prudent Use of Antibiotics

    Science.gov (United States)

    ... strains Novel innovations offer promise in infection control Harvard chemists use novel platform to create new antibiotics ... M., professor at the Boston University School of Law and Boston University School of Public Health, as ...

  2. The risk of acute liver injury associated with the use of antibiotics--evaluating robustness of results in the pharmacoepidemiological research on outcomes of therapeutics by a European consortium (PROTECT) project

    DEFF Research Database (Denmark)

    Udo, Renate; Tcherny-Lessenot, Stéphanie; Brauer, Ruth;

    2016-01-01

    PURPOSE: To examine the robustness of findings of case-control studies on the association between acute liver injury (ALI) and antibiotic use in the following different situations: (i) Replication of a protocol in different databases, with different data types, as well as replication in the same ...

  3. Antibiotic use: how to improve it?

    Science.gov (United States)

    Hulscher, Marlies E J L; van der Meer, Jos W M; Grol, Richard P T M

    2010-08-01

    Antibiotics are an extremely important weapon in the fight against infections. However, antimicrobial resistance is a growing problem. That is why the appropriate use of antibiotics is of great importance. A proper analysis of factors influencing appropriate antibiotic use is at the heart of an effective improvement programme, as interventions can only result in improved medical behaviour if they are well attuned to the problems, the target group, and the setting in which the change is to take place. Determinants of appropriate and inappropriate prescribing are not only found in patient knowledge and behaviour, in the way medical professionals think and act, and in the way in which patient care is organised, but also in the wider, socio-cultural environment of doctors and their patients. We present several relevant factors at each of these 4 levels and various possible measures that could be an effective response to them. The reasons why antibiotic use is inappropriate are complex. This means that any programme to rationalise antibiotic use - if it is to be effective - will have to include activities at all 4 levels discussed above. A national programme for 'appropriate antibiotic use' could be considered, including patient, professional and organisational-oriented activities. In addition, close international cooperation is required involving international guidelines, agreements, monitoring and feedback of information, and implementation programmes. PMID:20434950

  4. Systematically Altering Bacterial SOS Activity under Stress Reveals Therapeutic Strategies for Potentiating Antibiotics.

    Science.gov (United States)

    Mo, Charlie Y; Manning, Sara A; Roggiani, Manuela; Culyba, Matthew J; Samuels, Amanda N; Sniegowski, Paul D; Goulian, Mark; Kohli, Rahul M

    2016-01-01

    The bacterial SOS response is a DNA damage repair network that is strongly implicated in both survival and acquired drug resistance under antimicrobial stress. The two SOS regulators, LexA and RecA, have therefore emerged as potential targets for adjuvant therapies aimed at combating resistance, although many open questions remain. For example, it is not well understood whether SOS hyperactivation is a viable therapeutic approach or whether LexA or RecA is a better target. Furthermore, it is important to determine which antimicrobials could serve as the best treatment partners with SOS-targeting adjuvants. Here we derived Escherichia coli strains that have mutations in either lexA or recA genes in order to cover the full spectrum of possible SOS activity levels. We then systematically analyzed a wide range of antimicrobials by comparing the mean inhibitory concentrations (MICs) and induced mutation rates for each drug-strain combination. We first show that significant changes in MICs are largely confined to DNA-damaging antibiotics, with strains containing a constitutively repressed SOS response impacted to a greater extent than hyperactivated strains. Second, antibiotic-induced mutation rates were suppressed when SOS activity was reduced, and this trend was observed across a wider spectrum of antibiotics. Finally, perturbing either LexA or RecA proved to be equally viable strategies for targeting the SOS response. Our work provides support for multiple adjuvant strategies, while also suggesting that the combination of an SOS inhibitor with a DNA-damaging antibiotic could offer the best potential for lowering MICs and decreasing acquired drug resistance. IMPORTANCE Our antibiotic arsenal is becoming depleted, in part, because bacteria have the ability to rapidly adapt and acquire resistance to our best agents. The SOS pathway, a widely conserved DNA damage stress response in bacteria, is activated by many antibiotics and has been shown to play central role in

  5. Systematically Altering Bacterial SOS Activity under Stress Reveals Therapeutic Strategies for Potentiating Antibiotics.

    Science.gov (United States)

    Mo, Charlie Y; Manning, Sara A; Roggiani, Manuela; Culyba, Matthew J; Samuels, Amanda N; Sniegowski, Paul D; Goulian, Mark; Kohli, Rahul M

    2016-01-01

    The bacterial SOS response is a DNA damage repair network that is strongly implicated in both survival and acquired drug resistance under antimicrobial stress. The two SOS regulators, LexA and RecA, have therefore emerged as potential targets for adjuvant therapies aimed at combating resistance, although many open questions remain. For example, it is not well understood whether SOS hyperactivation is a viable therapeutic approach or whether LexA or RecA is a better target. Furthermore, it is important to determine which antimicrobials could serve as the best treatment partners with SOS-targeting adjuvants. Here we derived Escherichia coli strains that have mutations in either lexA or recA genes in order to cover the full spectrum of possible SOS activity levels. We then systematically analyzed a wide range of antimicrobials by comparing the mean inhibitory concentrations (MICs) and induced mutation rates for each drug-strain combination. We first show that significant changes in MICs are largely confined to DNA-damaging antibiotics, with strains containing a constitutively repressed SOS response impacted to a greater extent than hyperactivated strains. Second, antibiotic-induced mutation rates were suppressed when SOS activity was reduced, and this trend was observed across a wider spectrum of antibiotics. Finally, perturbing either LexA or RecA proved to be equally viable strategies for targeting the SOS response. Our work provides support for multiple adjuvant strategies, while also suggesting that the combination of an SOS inhibitor with a DNA-damaging antibiotic could offer the best potential for lowering MICs and decreasing acquired drug resistance. IMPORTANCE Our antibiotic arsenal is becoming depleted, in part, because bacteria have the ability to rapidly adapt and acquire resistance to our best agents. The SOS pathway, a widely conserved DNA damage stress response in bacteria, is activated by many antibiotics and has been shown to play central role in

  6. Systematically Altering Bacterial SOS Activity under Stress Reveals Therapeutic Strategies for Potentiating Antibiotics

    Science.gov (United States)

    Mo, Charlie Y.; Manning, Sara A.; Roggiani, Manuela; Culyba, Matthew J.; Samuels, Amanda N.; Sniegowski, Paul D.; Goulian, Mark

    2016-01-01

    ABSTRACT The bacterial SOS response is a DNA damage repair network that is strongly implicated in both survival and acquired drug resistance under antimicrobial stress. The two SOS regulators, LexA and RecA, have therefore emerged as potential targets for adjuvant therapies aimed at combating resistance, although many open questions remain. For example, it is not well understood whether SOS hyperactivation is a viable therapeutic approach or whether LexA or RecA is a better target. Furthermore, it is important to determine which antimicrobials could serve as the best treatment partners with SOS-targeting adjuvants. Here we derived Escherichia coli strains that have mutations in either lexA or recA genes in order to cover the full spectrum of possible SOS activity levels. We then systematically analyzed a wide range of antimicrobials by comparing the mean inhibitory concentrations (MICs) and induced mutation rates for each drug-strain combination. We first show that significant changes in MICs are largely confined to DNA-damaging antibiotics, with strains containing a constitutively repressed SOS response impacted to a greater extent than hyperactivated strains. Second, antibiotic-induced mutation rates were suppressed when SOS activity was reduced, and this trend was observed across a wider spectrum of antibiotics. Finally, perturbing either LexA or RecA proved to be equally viable strategies for targeting the SOS response. Our work provides support for multiple adjuvant strategies, while also suggesting that the combination of an SOS inhibitor with a DNA-damaging antibiotic could offer the best potential for lowering MICs and decreasing acquired drug resistance. IMPORTANCE Our antibiotic arsenal is becoming depleted, in part, because bacteria have the ability to rapidly adapt and acquire resistance to our best agents. The SOS pathway, a widely conserved DNA damage stress response in bacteria, is activated by many antibiotics and has been shown to play central role

  7. Nonmedical Uses of Antibiotics: Time to Restrict Their Use?

    Science.gov (United States)

    Meek, Richard William; Vyas, Hrushi; Piddock, Laura Jane Violet

    2015-10-01

    The global crisis of antibiotic resistance has reached a point where, if action is not taken, human medicine will enter a postantibiotic world and simple injuries could once again be life threatening. New antibiotics are needed urgently, but better use of existing agents is just as important. More appropriate use of antibiotics in medicine is vital, but the extensive use of antibiotics outside medical settings is often overlooked. Antibiotics are commonly used in animal husbandry, bee-keeping, fish farming and other forms of aquaculture, ethanol production, horticulture, antifouling paints, food preservation, and domestically. This provides multiple opportunities for the selection and spread of antibiotic-resistant bacteria. Given the current crisis, it is vital that the nonmedical use of antibiotics is critically examined and that any nonessential use halted. PMID:26444324

  8. Nonmedical Uses of Antibiotics: Time to Restrict Their Use?

    Directory of Open Access Journals (Sweden)

    Richard William Meek

    2015-10-01

    Full Text Available The global crisis of antibiotic resistance has reached a point where, if action is not taken, human medicine will enter a postantibiotic world and simple injuries could once again be life threatening. New antibiotics are needed urgently, but better use of existing agents is just as important. More appropriate use of antibiotics in medicine is vital, but the extensive use of antibiotics outside medical settings is often overlooked. Antibiotics are commonly used in animal husbandry, bee-keeping, fish farming and other forms of aquaculture, ethanol production, horticulture, antifouling paints, food preservation, and domestically. This provides multiple opportunities for the selection and spread of antibiotic-resistant bacteria. Given the current crisis, it is vital that the nonmedical use of antibiotics is critically examined and that any nonessential use halted.

  9. Antibiotic resistance and therapeutic management of sepsis in a Malaysian public Hospital

    Directory of Open Access Journals (Sweden)

    Forouzan Bayat Nejad

    2009-12-01

    Full Text Available This study aims to document the microbial profile and pattern of use of antibiotics in the government hospital of Penang state, Malaysia. An audit was conducted in 2007 in the general medical ward of Hospital Pulau Pinang, Malaysia. The mortality rate was 54.22% with severesepsis or septicaemia. Mithicillin resistant staphylococcus aureus caused 37% of deaths, while 33% of deaths involved Klebsiella Spp. Commonly prescribed antibiotics included; cloxacillin 500mg (qid 20%, tazocin 2gm (bid1.1%, and vancomycin 1gm (od 27%. We report the useof high doses of antibiotics in the six months prior to anotable rise in resistant infections.

  10. Rational use of antibiotics: a quality improvement initiative in hospital setting

    International Nuclear Information System (INIS)

    Objectives: To minimise irrational use of antibiotics by implementing guidelines for antibiotic usage in obstetrics and Gynaecology. Methods: The observational study was conducted from January to December 2010 at the maternity unit of Aga Khan Hospital for Women and children, Kharadar, a secondary care facility in Karachi, Pakistan. Data was collected from medical records related to the study period. Prophylactic antibiotics were given according to the American College of Obstetricians and Gynaecologists recommendation 2009. Surveillance was done by surgical site infection rates and infectious morbidity. Data was analysed on SPSS 13. Results: Therapeutic antibiotic use was rationalized, reducing the use of therapeutic antibiotics from 97% (n= 160/165) in January 2010 to 8% (n=10/125) in December 2010. Surgical site infection rates were less than 5%. Cost of antibiotics per patient decreased by 90%. Decrease in the length of stay and workload on nursing staff was also observed. Conclusion: Implementing guidelines for antibiotic use in obstetrics and gynaecology and translating it into our protocols was effective in decreasing the irrational antibiotic consumption and increasing the rational use of antibiotics in the hospital. (author)

  11. Patterns of antibiotic use in the community in Denmark

    NARCIS (Netherlands)

    Muscat, Mark; Monnet, Dominique L.; Klemmensen, Thomas; Grigoryan, Larissa; Jensen, Maria Hummelshoj; Andersen, Morten; Haaijer-Ruskamp, Flora M.

    2006-01-01

    A cross-sectional descriptive population survey was conducted in 2003 to examine epidemiological characteristics of antibiotic use in the community in Denmark and particularly in the area of self-medication with antibiotics. Self-medication with antibiotics was rare in Denmark. 97% of antibiotics us

  12. How to Use Equipment Therapeutically.

    Science.gov (United States)

    Bowne, Douglas

    1986-01-01

    Shares therapeutic and economic practices surrounding equipment used in New York's Higher Horizons adventure program of therapy for troubled youth. Encourages educators, therapists, and administrators to explore relationship between equipment selection, program goals, and clients. (NEC)

  13. Antibiotic use and resistance in long term care facilities.

    OpenAIRE

    Buul, L.W. van; Steen, J.T. van der; Veenhuizen, R.B.; Achterberg, W.P.; Schellevis, F.G.; Essink, R.T.G.M.; Benthem, B.H.B. van; Natsch, S.; Hertogh, C.M.P.M.

    2012-01-01

    Introduction: The common occurrence of infectious diseases in nursing homes and residential care facilities may result in substantial antibiotic use, and consequently antibiotic resistance. Focusing on these settings, this article aims to provide a comprehensive overview of the literature available on antibiotic use, antibiotic resistance, and strategies to reduce antibiotic resistance. Methods: Relevant literature was identified by conducting a systematic search in the MEDLINE and EMBASE dat...

  14. Identification of Antibiotic Use Pattern as an Effort to Control Antibiotic Resistance

    Directory of Open Access Journals (Sweden)

    Ivan S. Pradipta

    2012-03-01

    Full Text Available The objective of this study is to determine quantity and pattern of antibiotic use in hospitalized patients at one of Bandung’s private hospital that can give benefit in control of antibiotic resistance and procurement planning of antibiotic. Data of antibiotic consumption were obtained from hospital pharmacy department on February–September 2011. Data were processed using the ATC/DDD and DU90% method. There were 390,98 DDD/100 bed days and 381,34 DDD/100 bed days total of an-tbiotic use in 2009 and 2010. Thirty nine antibiotic were consumed in 2009 within 11 kind of antibiotics in DU90% segment (ceftriaxone, amoxicillin, cefotaxime, ciprofloxacin, levofloxacin, metronidazole, cefixime, doxycycline, thiamphenicol, cefodoxime, cefalexin and 44 antibiotic were consumed in 2010 within 18 kind of antibiotics in DU90% segment (ceftriaxone, ciprofloxacin, amoxicillin, cefixime, levofloxacin, cefadroxil, cefotaxime, metronidazole, thiamphenicol, doxycycline, clindamycin, chloramphenicol, amikacin, sulbactam, gentamycin, streptomycin, cefoperazone, canamycin. There were decline of antibiotic use that followed decline number of bed days/year in 2009–2010, but in both antibiotic kind and quantity of DU90% antibiotic group were increased.

  15. A Review of Antibiotic Use in Pregnancy.

    Science.gov (United States)

    Bookstaver, P Brandon; Bland, Christopher M; Griffin, Brooke; Stover, Kayla R; Eiland, Lea S; McLaughlin, Milena

    2015-11-01

    During pregnancy, untreated sexually transmitted or urinary tract infections are associated with significant morbidity, including low birth weight, preterm birth, and spontaneous abortion. Approximately one in four women will be prescribed an antibiotic during pregnancy, accounting for nearly 80% of prescription medications in pregnant women. Antibiotic exposures during pregnancy have been associated with both short-term (e.g., congenital abnormalities) and long-term effects (e.g., changes in gut microbiome, asthma, atopic dermatitis) in the newborn. However, it is estimated that only 10% of medications have sufficient data related to safe and effective use in pregnancy. Antibiotics such as beta-lactams, vancomycin, nitrofurantoin, metronidazole, clindamycin, and fosfomycin are generally considered safe and effective in pregnancy. Fluoroquinolones and tetracyclines are generally avoided in pregnancy. Physiologic changes in pregnancy lead to an increase in glomerular filtration rate, increase in total body volume, and enhanced cardiac output. These changes may lead to pharmacokinetic alterations in antibiotics that require dose adjustment or careful monitoring and assessment. PMID:26598097

  16. Intensive Care Unit Infections and Antibiotic Use

    Directory of Open Access Journals (Sweden)

    Ayşegül Yeşilkaya

    2011-07-01

    Full Text Available Burn wound infections is the leading cause of morbidity and mortality in burn trauma patients. Although burn wound is sterile at the beginning, because of risk factors such as prolonged hospital stay, immunesuppression and burn affecting large body surface area, colonisation firstly with Staphylococcus aureus and then Pseudomonas aeruginosa will occur later. Delay in wound closure and treatment with broad-spectrum antibiotic will result wound colonisation with antibiotic-resistant bacteria. To control colonization and to prevent burn wound infection topical antimicrobial dressings are used. The criteria used for the diagnosis of sepsis and wound infections are different in burn victims. Surface swabs from burn wounds must be cultured for the early assestment of infection. Although histopathological examination and quantitative culture of wound tissue biopsy has been known as the gold standard for the verification of invasive burn wound infection, many burn centers cannot do histopathological examination. When the traditional treatment modalities such as debridement of necrotic tissue, cleaning of wound and topical antimicrobial dressing application fails in the management of burn patient, cultures must be taken from possible foci of infection for the early diagnosis. After specimen collection, empirical bactericidal systemic antibiotic treatment should be started promptly. Inappropriate utilization of antibiotics may cause selection of resistant bacteria in the flora of the patient and of the burn unit which facilitates an infection or an outbreak at the end. Infection control in the burn unit includes surveillance cultures, cohort patient care staff, standard isolation precautions, strict hand hygiene compliance and appropariate antibiotic utilization. (Journal of the Turkish Society Intensive Care 2011; 9 Suppl: 55-61

  17. Doctors' Decision-Making Tool Could Cut Unnecessary Antibiotic Use

    Science.gov (United States)

    ... html Doctors' Decision-Making Tool Could Cut Unnecessary Antibiotic Use A drop of about 10 percent is ... for doctors may help reduce unnecessary use of antibiotics in children with respiratory tract infections and cough, ...

  18. Identification of Antibiotic Use Pattern as an Effort to Control Antibiotic Resistance

    OpenAIRE

    Ivan S. Pradipta; Ellin Febrina; Muhammad H. Ridwan; Rani Ratnawati

    2012-01-01

    The objective of this study is to determine quantity and pattern of antibiotic use in hospitalized patients at one of Bandung’s private hospital that can give benefit in control of antibiotic resistance and procurement planning of antibiotic. Data of antibiotic consumption were obtained from hospital pharmacy department on February–September 2011. Data were processed using the ATC/DDD and DU90% method. There were 390,98 DDD/100 bed days and 381,34 DDD/100 bed days total of an-tbiotic use i...

  19. Antibióticos em tonsilectomias: terapêutico ou profilático? Necessário ou abusivo? Antibiotic use in tonsillectomies: therapeutic or prophylactic? Required or excessive?

    Directory of Open Access Journals (Sweden)

    Otávio Bejzman Piltcher

    2005-10-01

    minimize the local inflammation, stimulate the healing process and hasten recovery triggered a considerable number of studies addressing the relation between the use of perioperative antibiotics and postoperative morbidity of adenotonsillectomy. In spite of the fact that those studies claim to perform an assessment of the surgical prophylactic use of antibiotics, their outline is not in compliance with the worldwide-accepted principles of surgical antibiotic prophylaxis. By performing a critical review of the literature, the authors discuss the advantages and disadvantages of using antibiotics in tonsillectomies or adenotonsillectomies, as well as the most appropriate definition for its utilization.

  20. Quality indicators to measure appropriate antibiotic use in hospitalized adults

    NARCIS (Netherlands)

    Bosch, C.M.A. van den; Geerlings, S.E.; Natsch, S.S.; Prins, J.M.; Hulscher, M.

    2015-01-01

    BACKGROUND: An important requirement for an effective antibiotic stewardship program is the ability to measure appropriateness of antibiotic use. The aim of this study was to develop quality indicators (QIs) that can be used to measure appropriateness of antibiotic use in the treatment of all bacter

  1. Improving antibiotic use for complicated urinary tract infections

    NARCIS (Netherlands)

    V. Spoorenberg

    2014-01-01

    Guidelines for antimicrobial treatment are important in the process of improving antibiotic use, because they describe appropriate antibiotic use. In this thesis, we demonstrated the value of appropriate antibiotic use (i.e. guideline adherence) in patients with a complicated urinary tract infection

  2. Many Adults Use Antibiotics without Consulting Doctor, Survey Finds

    Science.gov (United States)

    ... gov/news/fullstory_159803.html Many Adults Use Antibiotics Without Consulting Doctor, Survey Finds 1 in 20 ... News) -- Adding to fears about the overuse of antibiotics, a new Texas study finds that one in ...

  3. Antibiotic use and resistance in long term care facilities

    NARCIS (Netherlands)

    Buul, L.W. van; Steen, J.T. van der; Veenhuizen, R.B.; Achterberg, W.P.; Schellevis, F.G.; Essink, R.T.G.M.; Benthem, B.H. van; Natsch, S.S.; Hertogh, C.M.P.M.

    2012-01-01

    INTRODUCTION: The common occurrence of infectious diseases in nursing homes and residential care facilities may result in substantial antibiotic use, and consequently antibiotic resistance. Focusing on these settings, this article aims to provide a comprehensive overview of the literature available

  4. Antibiotic use and resistance in long term care facilities.

    NARCIS (Netherlands)

    Buul, L.W. van; Steen, J.T. van der; Veenhuizen, R.B.; Achterberg, W.P.; Schellevis, F.G.; Essink, R.T.G.M.; Benthem, B.H.B. van; Natsch, S.; Hertogh, C.M.P.M.

    2012-01-01

    Introduction: The common occurrence of infectious diseases in nursing homes and residential care facilities may result in substantial antibiotic use, and consequently antibiotic resistance. Focusing on these settings, this article aims to provide a comprehensive overview of the literature available

  5. Status Report from the Scientific Panel on Antibiotic Use in Dermatology of the American Acne and Rosacea Society: Part 1: Antibiotic Prescribing Patterns, Sources of Antibiotic Exposure, Antibiotic Consumption and Emergence of Antibiotic Resistance, Impact of Alterations in Antibiotic Prescribing, and Clinical Sequelae of Antibiotic Use.

    Science.gov (United States)

    Del Rosso, James Q; Webster, Guy F; Rosen, Ted; Thiboutot, Diane; Leyden, James J; Gallo, Richard; Walker, Clay; Zhanel, George; Eichenfield, Lawrence

    2016-04-01

    Oral and topical antibiotics are commonly prescribed in dermatologie practice, often for noninfectious disorders, such as acne vulgaris and rosacea. Concerns related to antibiotic exposure from both medical and nonmedical sources require that clinicians consider in each case why and how antibiotics are being used and to make appropriate adjustments to limit antibiotic exposure whenever possible. This first article of a three-part series discusses prescribing patterns in dermatology, provides an overview of sources of antibiotic exposure, reviews the relative correlations between the magnitude of antibiotic consumption and emergence of antibiotic resistance patterns, evaluates the impact of alterations in antibiotic prescribing, and discusses the potential relevance and clinical sequelae of antibiotic use, with emphasis on how antibiotics are used in dermatology. PMID:27462384

  6. Approaching the quality of antibiotic prescriptions in primary care using reimbursement data.

    Science.gov (United States)

    Pulcini, C; Lions, C; Ventelou, B; Verger, P

    2013-03-01

    Our objectives for this investigation were: (i) to design quality measures of outpatient antibiotic use that could be calculated at the individual general practitioner (GP) level using reimbursement data only; and (ii) to analyse the variability in antibiotic prescriptions between GPs regarding these measures in south-eastern France. Based on the literature and international therapeutic guidelines, we designed a set of quality measures in an exploratory attempt to assess the quality of antibiotic prescriptions. We performed a cross-sectional study of antibiotic prescriptions in adults in south-eastern France in 2009, using data from the outpatient reimbursement database of the French National Health Insurance (NHI). We carried out a cluster analysis to group GPs according to their antibiotic prescribing behaviour. Six quality measures were calculated at the GP level, with wide variations in practice regarding all these measures. A six-cluster solution was identified, with one cluster grouping 56 % of the sample and made up of GPs having the most homogeneous pattern of prescription for all six quality measures, probably reflecting better antibiotic prescribing. Total pharmaceutical expenses (per patient), penicillin combinations use, quinolone use and seasonal variation of quinolone use were all positively associated with a more heterogeneous and possibly less appropriate use of antibiotics in a multivariate analysis. These quality measures could be useful to assess GPs' antibiotic prescribing behaviour in countries where no information system provides easy access to data linking drug use to a clinical condition.

  7. [Therapeutic use of cannabis derivatives].

    Science.gov (United States)

    Benyamina, Amine; Reynaud, Michel

    2014-02-01

    The therapeutic use of cannabis has generated a lot of interest in the past years, leading to a better understanding of its mechanisms of action. Countries like the United States and Canada have modified their laws in order to make cannabinoid use legal in the medical context. It's also the case in France now, where a recent decree was issued, authorizing the prescription of medication containing "therapeutic cannabis" (decree no. 2013-473, June 5, 2013). Cannabinoids such as dronabinol, Sativex and nabilone have been tested for the treatment of acute and chronic pain. These agents are most promising to relieve chronic pain associated with cancer, with human immunodeficiency virus infection and with multiple sclerosis. However, longer-term studies are required to determine potential long-term adverse effects and risks of misuse and addiction. PMID:24701869

  8. Ananyeva Rational antibiotic use in rheumatology

    Directory of Open Access Journals (Sweden)

    Boris Sergeyevich Belov

    2012-01-01

    Full Text Available To control infections and infectious complications is one of the most urgent challenges in medicine under present-day conditions. At the same time, rational therapy with anti-infective drugs occupies a highly importance place. In rheumatology, the necessity of using antibiotics is associated with at least two factors, such as eradication of a pathogen trigger (an infectious agent that triggers the immunopathological mechanisms of inflammation and treatment of comorbid infection. The paper gives information on etiological agents and detailed antimicrobial therapy regimens for the major infections observed in modern rheumatology.

  9. Ananyeva Rational antibiotic use in rheumatology

    Directory of Open Access Journals (Sweden)

    Boris Sergeyevich Belov

    2012-06-01

    Full Text Available To control infections and infectious complications is one of the most urgent challenges in medicine under present-day conditions. At the same time, rational therapy with anti-infective drugs occupies a highly importance place. In rheumatology, the necessity of using antibiotics is associated with at least two factors, such as eradication of a pathogen trigger (an infectious agent that triggers the immunopathological mechanisms of inflammation and treatment of comorbid infection. The paper gives information on etiological agents and detailed antimicrobial therapy regimens for the major infections observed in modern rheumatology.

  10. Reprogrammable microbial cell-based therapeutics against antibiotic-resistant bacteria.

    Science.gov (United States)

    Hwang, In Young; Koh, Elvin; Kim, Hye Rim; Yew, Wen Shan; Chang, Matthew Wook

    2016-07-01

    The discovery of antimicrobial drugs and their subsequent use has offered an effective treatment option for bacterial infections, reducing morbidity and mortality over the past 60 years. However, the indiscriminate use of antimicrobials in the clinical, community and agricultural settings has resulted in selection for multidrug-resistant bacteria, which has led to the prediction of possible re-entrance to the pre-antibiotic era. The situation is further exacerbated by significantly reduced antimicrobial drug discovery efforts by large pharmaceutical companies, resulting in a steady decline in the number of new antimicrobial agents brought to the market in the past several decades. Consequently, there is a pressing need for new antimicrobial therapies that can be readily designed and implemented. Recently, it has become clear that the administration of broad-spectrum antibiotics can lead to collateral damage to the human commensal microbiota, which plays several key roles in host health. Advances in genetic engineering have opened the possibility of reprogramming commensal bacteria that are in symbiotic existence throughout the human body to implement antimicrobial drugs with high versatility and efficacy against pathogenic bacteria. In this review, we discuss recent advances and potentialities of engineered bacteria in providing a novel antimicrobial strategy against antibiotic resistance. PMID:27449598

  11. Use of Antibiotics in Pediatrics: 8-Years Survey in Italian Hospitals.

    Directory of Open Access Journals (Sweden)

    Elena Buccellato

    Full Text Available To evaluate antibiotic consumption in the pediatric wards of Emilia-Romagna Region, from 2004 to 2011, with a focus on the antibiotics reserved to the most serious infections, and to analyse the ADRs reported for antibiotics by the pediatric wards of Emilia-Romagna hospitals.Reference population was represented by all the patients (0-14 years old admitted to the pediatric wards of all the hospitals of Emilia-Romagna Region. Drug consumption was expressed as number of DDDs per 100 Bed-Days (BD and data were analysed by active substance, by therapeutic subgroups or by ward type. The time trends of antibiotic consumption were statistically analysed by linear regression. All the suspected ADR reports associated with antibiotics, reported between January 2004 and December 2011 were drawn by the Italian Spontaneous Reporting Database.Overall antibiotic consumption showed only a slight increase (p = 0.224. Among the pediatric wards, pediatric surgery showed the highest increase from 2004 to 2011 (p = 0.011. Penicillins and β-lactamase inhibitors was the first therapeutic group with a statistically significant increase over years (p = 0.038, whereas penicillins with extended spectrum presented a statistically significant reduction (p = 0.008. Moreover, only 5 drugs out of the 8 antibiotics reserved to the most serious infections were used. Pharmacovigilance data showed 27 spontaneous ADR reports associated to ATC J01 drugs. Amoxicillin/clavulanic acid had the highest number of ADR reports (n = 7.The steadily increasing consumption in penicillins and β-lactamase inhibitors, in association with a considerable decrease of plain penicillins, raises a serious concern. Pharmacovigilance reports seem to suggest a safe use of antibiotics in the hospital setting of Emilia-Romagna. Further studies to investigate the reason for prescribing antibiotics in children inpatients are needed.

  12. [Radioimmunotargeting: diagnosis and therapeutic use].

    Science.gov (United States)

    Vuillez, J P

    2000-11-01

    Monoclonal antibodies labeled with a radionuclide make feasible the in vivo radioimmunotargeting of tumor cells. This targeting could be performed for diagnosis, using gamma emitters, or for therapeutic purpose when antibodies are labeled with beta- and in the future alpha-emitters. Diagnosis applications (tumor detection and caracterization), i.e. immunoscintigraphy, have been widely investigated during 20 last years. This technic appeared quite interesting, complementary of morphological imaging, and clinically useful, but difficult on a practical point of view because of several pharmacological and immunological limitations. For these reasons, despite several consequent improvements (especially two-steps or pre-targeting methods), immunoscintigraphy is currently not widely used; furthermore, other scintigraphic methods, mainly positron emission tomography with 18F-fluorodeoxyglucose, are efficient and easier to perform. On the other hand, knowledge of the biodistribution of radiolabeled antibodies allows the development of their therapeutic use, i.e. radioimmunotherapy, which represents a new method of cancer treatment. Radioimmunotherapy has several particular radiobiological and dosimetric aspects, which remain widely under investigation. Understanding of these aspects, together with a better delineation of the indications, allow to be really optimist concerning this new way of cancer treatment, as shown by clinical results that have been obtained in non Hodgkin's lymphoma. Radiolabeled immunoconjugates appears as a growing field in nuclear medicine, which sustains numerous preclinical and clinical studies. PMID:11125290

  13. Use of antibiotics by primary care doctors in Hong Kong

    Directory of Open Access Journals (Sweden)

    Lam Tai

    2009-05-01

    Full Text Available Abstract Objectives To determine the use of antibiotics by primary care doctors. Methods General practitioners in Hong Kong were invited to fill in a short questionnaire on every patient with infection that they had seen on the first full working day once every three months for four consecutive quarters starting from December 2005. Results Forty six primary care doctors took part and a total of 3096 completed questionnaires were returned. The top three diagnoses were upper respiratory tract infection (46.7%, gastrointestinal infection (8.2% and pharyngitis (7.1%. Thirty percent of patient encounters with infections were prescribed antibiotics but only 5.2% of patient encounters with upper respiratory tract infection (URTI were prescribed antibiotics. Amino-penicillins were the most commonly used antibiotics while beta-lactam/beta-lactamase inhibitor combinations (BLBLIs were the second most commonly used antibiotics and they accounted for 16.5% and 14.0% of all antibiotics used respectively. Of all patients or their carers, those who demanded or wished for antibiotics were far more likely to be prescribed antibiotics (Pearson chi-square test, p Conclusion The antibiotic prescribing patterns of primary care doctors in Hong Kong are broadly similar to primary care doctors in other developed countries but a relatively low rate of antibiotics is used for URTI.

  14. Therapeutical uses of 131I

    International Nuclear Information System (INIS)

    Physiology of thyroid gland, pathology of thyroid , papillary, follicular cancer is considered together as differentiated thyroid cancer with very good results under therapy with iodine, invitro determination of calcitonin, search of metastasis, anaplastic carcinoma, as indifferentiated carcinoma with similar results as medullary carcinoma. This work gives a protocol for therapeutical use of 131I , in hyperthyroidism due to Graves-Basedow disease, thyrotoxic adenoma or Plummer disease, toxic multi nodular goiter, subacute thyroiditis. Is studied too the treatment with pharmaceuticals, surgery and radioactive iodine. A recommended use of each and protocol for iodine administration, fixed dose technique, dose estimation,absorbed dose, recommendations about when to use and not use 131I are included in this work

  15. A Prospective Study of Inpatients to Determine Microbial Etiology and Therapeutic Outcome of Antibiotics for Community-Acquired Pneumonia in Pakistan

    Directory of Open Access Journals (Sweden)

    Sahar Rehman

    2013-06-01

    Full Text Available Introduction: Community-acquired pneumonia (CAP is among the common diseases that causes illness and death world-wide. Limited data is available for the treatment of patients with CAP and/or medical outcome of CAP patients in Pakistan. This cross-sectional and prospective study was done to determine etiology of CAP patients and to evaluate the therapeutic effects of antibiotics commonly used in treating CAP patients in two different inner-city hospitals, Pakistan. Methods: The study was conducted on 200 hospitalized patients presenting clinical and radiographic evidences of CAP. The patients were assessed for the causative pathogen and their prescriptions were analyzed for the management and treatment of CAP and associated symptoms of pneumonia. Finally the medical outcomes were evaluated. Results: On establishing the microbial etiology of pneumonia among different CAP causing pathogens, K. pneumoniae was found to be the most identified causative agent (30% followed by S. pneumoniae (23%. Majority of the patients received cephalosporin antibiotics (80% followed by aminoglycosides (65% and penicillins (50% either as monotherapy or combination treatment. Therapeutic success was observed to occur in majority of the patients. The recovery of CAP patients occurred probably because they received antibiotics which are recommended by WHO and American Thoracic Society. Another reason for successful therapeutic outcome was found to be the significant patient compliance for treatment. Conclusion: There is a great need for such types of investigational studies to be conducted in developing countries which may guide the empirical therapy and help in defining proper treatment guidelines.

  16. Antibiotic use in acute upper respiratory tract infections.

    Science.gov (United States)

    Zoorob, Roger; Sidani, Mohamad A; Fremont, Richard D; Kihlberg, Courtney

    2012-11-01

    Upper respiratory tract infections account for millions of visits to family physicians each year in the United States. Although warranted in some cases, antibiotics are greatly overused. This article outlines the guidelines and indications for appropriate antibiotic use for common upper respiratory infections. Early antibiotic treatment may be indicated in patients with acute otitis media, group A beta-hemolytic streptococcal pharyngitis, epiglottitis, or bronchitis caused by pertussis. Persistent cases of rhinosinusitis may necessitate the use of antibiotics if symptoms persist beyond a period of observation. Antibiotics should not be considered in patients with the common cold or laryngitis. Judicious, evidence-based use of antibiotics will help contain costs and prevent adverse effects and drug resistance.

  17. Antibiotic Resistance

    Science.gov (United States)

    ... lives. But there is a growing problem of antibiotic resistance. It happens when bacteria change and become able ... resistant to several common antibiotics. To help prevent antibiotic resistance Don't use antibiotics for viruses like colds ...

  18. Intensive Care Unit Infections and Antibiotic Use

    OpenAIRE

    Ayşegül Yeşilkaya; Hande Arslan

    2011-01-01

    Burn wound infections is the leading cause of morbidity and mortality in burn trauma patients. Although burn wound is sterile at the beginning, because of risk factors such as prolonged hospital stay, immunesuppression and burn affecting large body surface area, colonisation firstly with Staphylococcus aureus and then Pseudomonas aeruginosa will occur later. Delay in wound closure and treatment with broad-spectrum antibiotic will result wound colonisation with antibiotic-resistant bacteria. T...

  19. Use of Antibiotics and Risk of Type 2 Diabetes

    DEFF Research Database (Denmark)

    Mikkelsen, Kristian Hallundbæk; Knop, Filip Krag; Frost, Morten;

    2015-01-01

    CONTEXT AND OBJECTIVE: Evidence that bacteria in the human gut may influence nutrient metabolism is accumulating. We investigated whether use of antibiotics influences the risk of developing type 2 diabetes and whether the effect can be attributed to specific types of antibiotics. METHODS: We....... RESULTS: The odds ratio (OR) associating type 2 diabetes with exposure to antibiotics of any type was 1.53 (95% confidence interval 1.50-1.55) with redemption of more than or equal to 5 versus 0-1 prescriptions. Although no individual group of antibiotics was specifically associated with type 2 diabetes...... risk, slightly higher ORs for type 2 diabetes were seen with narrow-spectrum and bactericidal antibiotics (OR 1.55 and 1.48) compared to broad-spectrum and bacteriostatic types of antibiotics (OR 1.31 and 1.39), respectively. A clear dose-response effect was seen with increasing cumulative load...

  20. Reducing antibiotic use in marine larviculture by probiotics

    DEFF Research Database (Denmark)

    Gram, Lone; D'Alvise, Paul; Grotkjær, Torben;

    2014-01-01

    to the industry.Vaccines are not effective at the larval stages and antibiotics are used for disease control, although thereare serious concerns about development of bacterial antibiotic resistance and its transfer to humanpathogenic bacteria. There is a strong need for development of non-antibiotic disease...... control strategies,especially at the larval stages.The objective of our work is to reduce the need for antibiotics in marine larviculture by developingprobiotic strategies; probiotics being defined by WHO as “live microbial cultures that excert a beneficialeffect on the host”. Rearing of marine larvae...

  1. Trends in Antibiotic Use in Massachusetts Children, 2000–2009

    Science.gov (United States)

    Greene, Sharon K.; Kleinman, Kenneth P.; Lakoma, Matthew D.; Rifas-Shiman, Sheryl L.; Lee, Grace M.; Huang, Susan S.

    2012-01-01

    OBJECTIVE: Antibiotic use rates have declined dramatically since the 1990s. We aimed to determine if, when, and at what level the decline in antibiotic-dispensing rates ended and which diagnoses contributed to the trends. METHODS: Antibiotic dispensings and diagnoses were obtained from 2 health insurers for 3- to <72-month-olds in 16 Massachusetts communities from 2000 to 2009. Population-based antibiotic-dispensing rates per person-year (p-y) were determined according to year (September–August) for 3 age groups. Fit statistics were used to identify the most likely year for a change in trend. Rates for the first and last years were compared according to antibiotic category and associated diagnosis. RESULTS: From 2000–2001 to 2008–2009, the antibiotic-dispensing rate for 3- to <24-month-olds decreased 24% (2.3–1.8 antibiotic dispensings per p-y); for 24- to <48-month-olds, it decreased 18% (1.6–1.3 antibiotic dispensings per p-y); and for 48- to <72-month-olds, it decreased 20% (1.4–1.1 antibiotic dispensings per p-y). For 3- to <48-month-olds, rates declined until 2004–2005 and remained stable thereafter; the downward trend for 48- to <72-month-olds ended earlier in 2001–2002. Among 3- to <24-month-olds, first-line penicillin use declined 26%. For otitis media, the dispensing rate decreased 14% and the diagnosis rate declined 9%, whereas the treatment fraction was stable at 63%. CONCLUSIONS: The downward trend in antibiotic dispensings to young children in these communities ended by 2004–2005. This trend was driven by a declining otitis media diagnosis rate. Continued monitoring of population-based dispensing rates will support efforts to avoid returning to previous levels of antibiotic overuse. PMID:22732172

  2. Educational Effectiveness, Target, and Content for Prudent Antibiotic Use

    Directory of Open Access Journals (Sweden)

    Chang-Ro Lee

    2015-01-01

    Full Text Available Widespread antimicrobial use and concomitant resistance have led to a significant threat to public health. Because inappropriate use and overuse of antibiotics based on insufficient knowledge are one of the major drivers of antibiotic resistance, education about prudent antibiotic use aimed at both the prescribers and the public is important. This review investigates recent studies on the effect of interventions for promoting prudent antibiotics prescribing. Up to now, most educational efforts have been targeted to medical professionals, and many studies showed that these educational efforts are significantly effective in reducing antibiotic prescribing. Recently, the development of educational programs to reduce antibiotic use is expanding into other groups, such as the adult public and children. The investigation of the contents of educational programs for prescribers and the public demonstrates that it is important to develop effective educational programs suitable for each group. In particular, it seems now to be crucial to develop appropriate curricula for teaching medical and nonmedical (pharmacy, dentistry, nursing, veterinary medicine, and midwifery undergraduate students about general medicine, microbial virulence, mechanism of antibiotic resistance, and judicious antibiotic prescribing.

  3. Educational effectiveness, target, and content for prudent antibiotic use.

    Science.gov (United States)

    Lee, Chang-Ro; Lee, Jung Hun; Kang, Lin-Woo; Jeong, Byeong Chul; Lee, Sang Hee

    2015-01-01

    Widespread antimicrobial use and concomitant resistance have led to a significant threat to public health. Because inappropriate use and overuse of antibiotics based on insufficient knowledge are one of the major drivers of antibiotic resistance, education about prudent antibiotic use aimed at both the prescribers and the public is important. This review investigates recent studies on the effect of interventions for promoting prudent antibiotics prescribing. Up to now, most educational efforts have been targeted to medical professionals, and many studies showed that these educational efforts are significantly effective in reducing antibiotic prescribing. Recently, the development of educational programs to reduce antibiotic use is expanding into other groups, such as the adult public and children. The investigation of the contents of educational programs for prescribers and the public demonstrates that it is important to develop effective educational programs suitable for each group. In particular, it seems now to be crucial to develop appropriate curricula for teaching medical and nonmedical (pharmacy, dentistry, nursing, veterinary medicine, and midwifery) undergraduate students about general medicine, microbial virulence, mechanism of antibiotic resistance, and judicious antibiotic prescribing.

  4. Reducing inappropriate antibiotic use among children with influenza infection

    OpenAIRE

    Friedman, Bat-Chen; Schwabe-Warf, Derek; Goldman, Ran

    2011-01-01

    Question With the influenza season reaching a peak, I see numerous children in my clinic with fever and influenza-like illnesses. Parents are concerned and at times ask for antibiotic treatment in hopes that the treatment will shorten the duration of illness. What strategies can I use in order to minimize inappropriate prescription of antibiotics during the influenza season?

  5. Development of antibiotic regimens using graph based evolutionary algorithms.

    Science.gov (United States)

    Corns, Steven M; Ashlock, Daniel A; Bryden, Kenneth M

    2013-12-01

    This paper examines the use of evolutionary algorithms in the development of antibiotic regimens given to production animals. A model is constructed that combines the lifespan of the animal and the bacteria living in the animal's gastro-intestinal tract from the early finishing stage until the animal reaches market weight. This model is used as the fitness evaluation for a set of graph based evolutionary algorithms to assess the impact of diversity control on the evolving antibiotic regimens. The graph based evolutionary algorithms have two objectives: to find an antibiotic treatment regimen that maintains the weight gain and health benefits of antibiotic use and to reduce the risk of spreading antibiotic resistant bacteria. This study examines different regimens of tylosin phosphate use on bacteria populations divided into Gram positive and Gram negative types, with a focus on Campylobacter spp. Treatment regimens were found that provided decreased antibiotic resistance relative to conventional methods while providing nearly the same benefits as conventional antibiotic regimes. By using a graph to control the information flow in the evolutionary algorithm, a variety of solutions along the Pareto front can be found automatically for this and other multi-objective problems.

  6. Multiple antibiotic-resistant bacteria on fluted pumpkin leaves, a herb of therapeutic value.

    Science.gov (United States)

    Igbeneghu, Oluwatoyin A; Abdu, Abdulrasheed B

    2014-06-01

    Fluted pumpkin (Telfairia occidentalis) is a minimally-processed green leafy vegetable traditionally used for its antianaemic properties in the form of leaf juice without a heating or inactivation step before consumption. The aim of the study was to assess the presence of surface microbiota on T. occidentalis leaves and also to determine the antimicrobial susceptibility of isolated organisms. Bacterial contaminants on 50 samples of T. occidentalis leaves were isolated and characterized using standard biochemical methods and the antimicrobial susceptibility of isolated organisms was determined using the antibiotic disc diffusion assay. The results obtained show that the leaves of T. occidentalis is contaminated with organisms which included Enterobacter agglomerans (25.9%), Proteus vulgaris (24.9%), Klebsiella spp. (2.6%), and Serratia liquefaciens (2.1%). Other bacterial isolates recovered in order of frequency included: Staphylococcus spp. (33.7%), Bacillus spp. (8.3%), and Pseudomonas fluorescens (2.6%). Of the 193 bacterial isolates from the leaves of T. occidentalis samples tested for antimicrobial resistance, all (100%) were found to be resistant to ampicillin, cloxacillin, augmentin, erythromycin, and tetracycline while 96% of the isolates were resistant to cephalothin. Resistance to trimethoprim (93%) and gentamicin (83%) was also observed. Approximately, 22% of the isolates were resistant to ciprofloxacin; however, only 11 (5.8%) were resistant to ofloxacin. Thus, uncooked T. occidentalis is a potential source of highly-resistant epiphytic bacteria which could be opportunistic pathogens in consumers. PMID:25076655

  7. Restricted use of antibiotics in organic pig farming

    DEFF Research Database (Denmark)

    Aabo, Søren; Jensen, Annette Nygaard

    2013-01-01

    Can the restricted use of antibiotics in organic pig farming be documented to provide a safer, high quality meat product with less antibiotic resistant bacteria? The project SafeOrganic aims to document that the restricted use of antimicrobials in organic pig production leads to lower levels...... of antibiotic resistant bacteria compared with the level in conventional pigs. However, the project will also address the risk of losing this quality parameter, due to a widespread practice of slaughtering organic pigs together with conventional pigs, implying a risk of cross-contamination....

  8. Antibiotic use in Brazilian broiler and pig production: an indication and forecast of trends

    NARCIS (Netherlands)

    Bokma-Bakker, M.H.; Bondt, N.; Neijenhuis, F.; Mevius, D.J.; Ruiter, S.J.M.

    2014-01-01

    To gain insight in antibiotic use in relation to imported products the current use of antibiotics in pork and broiler production in Brazil are identified and trend forecasting of antibiotic use in the coming 3-5 years is performed.

  9. Questions about the use of antibiotics in acute pancreatitis

    Directory of Open Access Journals (Sweden)

    Assef Jose

    2006-07-01

    Full Text Available Abstract Background and objective The use of antibiotics in acute pancreatitis despite recent clinical trials remains controversial. The aim of this study is to review the latest clinical trials and guidelines about antibiotics in acute pancreatitis and determine its proper use. Methods Through a Medline search, we selected and analyzed pertinent randomized clinical trials and guidelines that evaluated the use of antibiotics in acute pancreatitis. We answered the most frequent questions about this topic. Results and conclusion Based on these clinical trials and guidelines, we conclude that the best treatment currently is the use of antibiotics in patients with severe acute pancreatitis with more than 30% of pancreatic necrosis. The best option for the treatment is Imipenem 3 × 500 mg/day i.v. for 14 days. Alternatively, Ciprofloxacin 2 × 400 mg/day i.v. associated with Metronidazole 3 × 500 mg for 14 days can also be considered as an option.

  10. Significant reduction of antibiotic use in the community after a nationwide campaign in France, 2002-2007.

    Directory of Open Access Journals (Sweden)

    Elifsu Sabuncu

    2009-06-01

    Full Text Available BACKGROUND: Overuse of antibiotics is the main force driving the emergence and dissemination of bacterial resistance in the community. France consumes more antibiotics and has the highest rate of beta-lactam resistance in Streptococcus pneumoniae than any other European country. In 2001, the government initiated "Keep Antibiotics Working"; the program's main component was a campaign entitled "Les antibiotiques c'est pas automatique" ("Antibiotics are not automatic" launched in 2002. We report the evaluation of this campaign by analyzing the evolution of outpatient antibiotic use in France 2000-2007, according to therapeutic class and geographic and age-group patterns. METHODS AND FINDINGS: This evaluation is based on 2000-2007 data, including 453,407,458 individual reimbursement data records and incidence of flu-like syndromes (FLSs. Data were obtained from the computerized French National Health Insurance database and provided by the French Sentinel Network. As compared to the preintervention period (2000-2002, the total number of antibiotic prescriptions per 100 inhabitants, adjusted for FLS frequency during the winter season, changed by -26.5% (95% confidence interval [CI] -33.5% to -19.6% over 5 years. The decline occurred in all 22 regions of France and affected all antibiotic therapeutic classes except quinolones. The greatest decrease, -35.8% (95% CI -48.3% to -23.2%, was observed among young children aged 6-15 years. A significant change of -45% in the relationship between the incidence of flu-like syndromes and antibiotic prescriptions was observed. CONCLUSIONS: The French national campaign was associated with a marked reduction of unnecessary antibiotic prescriptions, particularly in children. This study provides a useful method for assessing public-health strategies designed to reduce antibiotic use.

  11. Time- and concentration-dependent cytotoxicity of antibiotics used in endodontic therapy

    OpenAIRE

    Marina Beloti Ferreira; Suely Myiagi; Carlos Goes Nogales; Marcia Sampaio Campos; José Luiz Lage-Marques

    2010-01-01

    OBJECTIVE: New drugs have to be assessed in endodontic therapy due to the presence of microorganisms resistant to therapeutic procedures. Thus, this study evaluated the time- and concentration-dependent cytotoxicity of different antibiotics used in endodontic therapy. MATERIAL AND METHODS: Human gingival fibroblasts were treated and divided into the following experimental groups: Group I - control; Group II - ciprofoxacin hydrochloride; Group III - clyndamicin hydrochloride; and Group IV - me...

  12. [Antibiotic use in Mexico: review of problems and policies].

    Science.gov (United States)

    Dreser, Anahí; Wirtz, Veronika J; Corbett, Kitty K; Echániz, Gabriela

    2008-01-01

    The inappropriate use of antibiotics signifies a risk for individual health and a waste of health resources. It triggers the development of antibiotic resistance, which increases expenditures and mortality related to infectious disease, and is hence considered a serious public health problem. The World Health Organization has thus recommended a series of strategies to be included within national pharmaceutical policies. In Mexico, diverse factors related to the inappropriate use of antibiotics have been documented. While the response has been mainly in the form of educational and managerial interventions directed toward physicians in public health services, as well as epidemiological surveillance, there is a paucity of research and interventions focused on consumers, pharmacies, and the private sector. Fundamentally, a comprehensive national strategy for antibiotics is not incorporated into health and pharmaceutical policies.

  13. [Sanitary safety of GMOs used in therapeutics].

    Science.gov (United States)

    Trouvin, Jean-Hugues

    2002-01-01

    The recent progress in human therapeutics has been made possible thanks to molecular biology and its use in producing proteins having the same sequence and structure as that of human proteins. The use of GMOs allows production of proteins with high added value in therapeutics, which are of satisfactory quality. GMOs may also be directly administered to patients as gene therapy vectors. However, the use of GMOs in therapeutics must take into consideration some risks, particularly those of microbiological contamination, of neo-antigenicity as well as environmental risks with regard to the way of use of the GMO. Nevertheless, those risks are taken in due consideration in the development of those new medicinal products; solutions have been found to allow their use in therapeutics with a very positive benefit/risk ratio. Medicinal products from biotechnology have permitted considerable therapeutic progress without compromising health security. PMID:12669359

  14. Overview on the Current Antibiotic Containing Agents Used in Endodontics

    OpenAIRE

    Ramta Bansal; Aditya Jain

    2014-01-01

    Antibiotics are systemically and locally used extensively in endodontics. However, local antibiotic application mode is considered more effective than systemic administration. The local mode enables the dentist to target bacteria in every nook and corner of root canal system, which is otherwise beyond reach if targeted by instrumentation or conventional root canal treatment protocols. Therefore, they are an important adjunct to conventional treatment of root canal. The present study reviews t...

  15. Etiological diagnosis reduces the use of antibiotics in infants with bronchiolitis

    Directory of Open Access Journals (Sweden)

    Ângela Esposito Ferronato

    2012-09-01

    Full Text Available OBJECTIVE: Acute bronchiolitis is a leading cause of infant hospitalization and is most commonly caused by respiratory syncytial virus. Etiological tests are not required for its diagnosis, but the influence of viral screening on the therapeutic approach for acute bronchiolitis remains unclear. METHODS: A historical cohort was performed to assess the impact of viral screening on drug prescriptions. The study included infants up to one year of age who were hospitalized for bronchiolitis. Virus screening was performed using immunofluorescence assays in nasopharyngeal aspirates. The clinical data were obtained from the patients' medical records. Therapeutic changes were considered to be associated with viral screening when made within 24 hours of the release of the results. RESULTS: The frequency of prescriptions for beta agonists, corticosteroids and antibiotics was high at the time of admission and was similar among the 230 patients. The diagnosis of pneumonia and otitis was associated with the introduction of antibiotics but did not influence antibiotics maintenance after the results of the virus screening were obtained. Changes in the prescriptions were more frequent for the respiratory syncytial virus patients compared to patients who had negative viral screening results (p =0.004, especially the discontinuation of antibiotics (p<0.001. The identification of respiratory syncytial virus was associated with the suspension of antibiotics (p= 0.003, even after adjusting for confounding variables (p = 0.004; however, it did not influence the suspension of beta-agonists or corticosteroids. CONCLUSION: The identification of respiratory syncytial virus in infants with bronchiolitis was independently associated with the discontinuation of antibiotics during hospitalization

  16. Rapid determination of antibiotic resistance in E. coli using dielectrophoresis

    Energy Technology Data Exchange (ETDEWEB)

    Hoettges, Kai F [School of Engineering, University of Surrey, Guildford, Surrey GU2 7XH (United Kingdom); Dale, Jeremy W [School of Biomedical and Life Sciences, University of Surrey, Guildford, Surrey GU2 7XH (United Kingdom); Hughes, Michael P [School of Engineering, University of Surrey, Guildford, Surrey GU2 7XH (United Kingdom)

    2007-09-21

    In recent years, infections due to antibiotic-resistant strains of bacteria such as methillicin-resistant Staphylococcus aureus and ciprofloxacin-resistant Escherichia coli are on the rise, and with them the demand for rapid antibiotic testing is also rising. Conventional tests, such as disc diffusion testing, require a primary sample to be tested in the presence of a number of antibiotics to verify which antibiotics suppress growth, which take approximately 24 h to complete and potentially place the patient at severe risk. In this paper we describe the use of dielectrophoresis as a rapid marker of cell death, by detecting changes in the electrophysiology of the cell caused by the administration of an antibiotic. In contrast to other markers, the electrophysiology of the cell changes rapidly during cell death allowing live cells to be distinguished from dead (or dying) cells without the need for culturing. Using polymyxin B as an example antibiotic, our studies indicate that significant changes in cell characteristics can be observed as soon as 1 h passes after isolating a culture from nutrient broth.

  17. New Developments in Vaccines, Inhibitors of Anthrax Toxins, and Antibiotic Therapeutics for Bacillus anthracis

    OpenAIRE

    Beierlein, J.M.; Anderson, A. C.

    2011-01-01

    Bacillus anthracis, the causative agent responsible for anthrax infections, poses a significant biodefense threat. There is a high mortality rate associated with untreated anthrax infections; specifically, inhalation anthrax is a particularly virulent form of infection with mortality rates close to 100%, even with aggressive treatment. Currently, a vaccine is not available to the general public and few antibiotics have been approved by the FDA for the treatment of inhalation anthrax. With the...

  18. Antibiotic use and its consequences for the normal microbiome.

    Science.gov (United States)

    Blaser, Martin J

    2016-04-29

    Anti-infectives, including antibiotics, are essentially different from all other drugs; they not only affect the individual to whom they are given but also the entire community, through selection for resistance to their own action. Thus, their use resides at the intersection of personal and public health. Antibiotics can be likened to a four-edged sword against bacteria. The first two edges of the antibiotic sword were identified immediately after their discovery and deployment in that they not only benefit an individual in treating their infection but also benefit the community in preventing the spread of that infectious agent. The third edge was already recognized by Alexander Fleming in 1945 in his Nobel acceptance speech, which warned about the cost to the community of antibiotic resistance that would inevitably evolve and be selected for during clinical practice. We have seen this cost mount up, as resistance curtails or precludes the activities of some of our most effective drugs for clinically important infections. But the fourth edge of the antibiotic sword remained unappreciated until recently, i.e., the cost that an antibiotic exerts on an individual's own health via the collateral damage of the drug on bacteria that normally live on or in healthy humans: our microbiota. These organisms, their genes, metabolites, and interactions with one another, as well as with their host collectively, represent our microbiome. Our relationship with these symbiotic bacteria is especially important during the early years of life, when the adult microbiome has not yet formed. PMID:27126037

  19. A surveillance study of antibiotic use in Pondicherry- 2012

    Directory of Open Access Journals (Sweden)

    Revathysaravanan

    2012-06-01

    Full Text Available Background: An alarming increase in antibiotic use and antimicrobial resistance especially in India is reported by WHO based on the reports from 5 pilot projects. As WHO and GARP India Working Group State have stressed the importance of repeated co-ordinate surveillance to monitor, this study is undertaken in Pondicherry with the objectives of identifying Commonly used antibiotics, the most exposed age group in Pondicherry and the determining factors for inappropriate use of antibiotics among professionals and community. Methods: A surveillance study was done by using convenient sampling technique on 50 physicians and 100 people in community in the form of questionnaires after getting informed consent. The role of pharmacy was not included due to possible non reliability. The results are expressed by analyzing the data using descriptive statistics. Results: Experience and cost had been the main deciding factors for choosing the antibiotic for prescription. Third generation Cephalosporin was more prescribed and adults were exposed more to antibiotics with 81.56% and 75% from urban and rural respectively. Self medication was practiced by 14 out of 100 participants and more than 75% were not aware about proper use of antibiotics. Conclusions: No significant difference was observed in prescribing pattern among doctors of various qualifications from both urban and rural setup and lack of knowledge about proper use of antibiotics was seen in community. Hence it is essential to create awareness by means of public education programmes, media and CME targeting both rural and urban areas. [Int J Basic Clin Pharmacol 2012; 1(3.000: 202-210

  20. Therapeutic concentrations of antibiotics inhibit Shiga toxin release from enterohemorrhagic E. coli O104:H4 from the 2011 German outbreak

    Directory of Open Access Journals (Sweden)

    Corogeanu Diana

    2012-08-01

    Full Text Available Abstract Background The shiga toxin-producing E. coli (STEC O104:H4 caused a major outbreak in Germany in spring 2011. STEC are usually susceptible to common antibiotics. However, antibiotic treatment of STEC-infected patients is not recommended because STEC may enhance production and release of shiga toxins (STX in response to antibiotics, which eventually enhances the frequency and severity of clinical symptoms, including haemolytic uraemic syndrome (HUS and fatalities. Results We characterized the response to antibiotics of STEC O104:H4 isolates from two HUS patients during the German STEC outbreak in spring 2011 in comparison to the common STEC O157:H7. Liquid cultures of STEC O157:H7 and O104:H4 were incubated with graded dilutions of the antibiotics ciprofloxacin, meropenem, fosfomycin, gentamicin, rifampicin, and chloramphenicol. At defined times of antibiotic treatment, transcriptional activation of the STX2 gene, contents of STX and STX-activity in the culture supernatants were quantified. Unlike the common serotype O157:H7, STEC O104:H4 does not release STX in response to therapeutic concentrations of ciprofloxacin, meropenem, fosfomycin, and chloramphenicol. Conclusions In future outbreaks, the response of the respective epidemiologic STEC strain to antibiotics should be rapidly characterized in order to identify antibiotics that do not enhance the release of STX. This will eventually allow clinical studies tackling the question whether antibiotic treatment impacts on the eradication of STEC, clinical course of disease, and frequency of carriers.

  1. Antibiotics dispensing for URTIs by community pharmacists and general medical practitioners in Penang, Malaysia: A comparative study using simulated patients

    OpenAIRE

    Alabid, Alamin Hassan M.A.; Ibrahim, Mohamed Izham Mohamed; Hassali, Mohamed Azmi

    2014-01-01

    Background: In Malaysia, doctors in private clinics (often called dispensing doctors) are permitted to dispense medicines. This potentially may compromise rational dispensing of medicines in general and antibiotics in particular. Aim: This study explored, assessed and compared dispensing of antibiotics between Community Pharmacist (CP) and General Practitioners (GPs) regarding symptomatic diagnosis, antibiotic categories, adherence to therapeutic doses and promotion of generic antibiotics...

  2. Drug Use Evaluation of Three Widely Prescribed Antibiotics in a

    Directory of Open Access Journals (Sweden)

    Mehdi Mohammadi

    2015-10-01

    Full Text Available Background: Drug utilization studies are helpful in understanding the current practice. We have conducted a retrospective study to evaluate the relevant use of a group of most commonly prescribed antibiotics in a teaching hospital in Iran.  The results of this study may be of help for clinicians to improve the patient care.Methods: Patients who received parenteral ceftazidim, vancomycin and amikacin from December2010 to May 2011 were enrolled in this study. Patient’s data including demographic, length of Hospital stay, drug allergy, first and final diagnosis were recorded in a predesigned data collection form. American Hospital Formulary Services (AHFS book were used as a reference for evaluation of study drug indication and dosing according to diagnosis and microbiological culture. Defined Daily Dose (DDD of each drug extracted from Anatomic and Therapeutic Chemical classification system (ATC/DDD and drug usage data evaluated by calculating the ratio of prescribed drug to its DDD.Results: The ratio of prescribed daily dose to DDD was 0.78, 0.95 and 0.86 for amikacin, ceftazidime and vancomycin respectively. Between amikacin group, 43 patients (86% received drug empirically, the number of empiric treatments for ceftazidim and vancomycin were 45(90% and 44 patients (88%. The renal function tests (Blood Urea Nitrogen, Serum Creatinin were evaluated in 56% of amikacin group, 64% in ceftazidime group and 78% in vancomycin group.Conclusion: The results of this study indicate the need to establish continuing medical education (CME courses for physicians to familiarize them with standards required to use and monitor these agents.

  3. Fate and transport of antibiotic residues and antibiotic resistance genetic determinants during manure storage, treatment, and land application

    Science.gov (United States)

    Antibiotics are used in swine production for therapeutic treatment of disease and at sub-therapeutic levels for growth promotion and improvement of feed efficiency. It is estimated that ca.75% of antibiotics are not absorbed by animals and are excreted in waste. Antibiotic resistance selection occur...

  4. THE THERAPEUTIC USE OF SYMBIOTICS

    OpenAIRE

    FLESCH, Aline Gamarra Taborda; POZIOMYCK, Aline Kirjner; DAMIN, Daniel De Carvalho

    2014-01-01

    Introduction Functional foods are health promoters and their use is associated with reduced risk of chronic degenerative and non-transmissible diseases. Examples are symbiotic. The association of one (or more) probiotic with a one (or more) prebiotic is called symbiotic, being the prebiotics complementary and probiotics synergistic, thus presenting a multiplicative factor on their individual actions. Objective To assess the evidences on the benefits of the use of symbiotics in the treatment o...

  5. Implementation of a Computerized Decision Support System to Improve the Appropriateness of Antibiotic Therapy Using Local Microbiologic Data

    Directory of Open Access Journals (Sweden)

    Manuel Rodriguez-Maresca

    2014-01-01

    Full Text Available A prospective quasi-experimental study was undertaken in 218 patients with suspicion of nosocomial infection hospitalized in a polyvalent ICU where a new electronic device (GERB has been designed for antibiotic prescriptions. Two GERB-based applications were developed to provide local resistance maps (LRMs and preliminary microbiological reports with therapeutic recommendation (PMRTRs. Both applications used the data in the Laboratory Information System of the Microbiology Department to report on the optimal empiric therapeutic option, based on the most likely susceptibility profile of the microorganisms potentially responsible for infection in patients and taking into account the local epidemiology of the hospital department/unit. LRMs were used for antibiotic prescription in 20.2% of the patients and PMRTRs in 78.2%, and active antibiotics against the finally identified bacteria were prescribed in 80.0% of the former group and 82.4% of the latter. When neither LMRs nor PMRTRs were considered for empiric treatment prescription, only around 40% of the antibiotics prescribed were active. Hence, the percentage appropriateness of the empiric antibiotic treatments was significantly higher when LRM or PMRTR guidelines were followed rather than other criteria. LRMs and PMRTRs applications are dynamic, highly accessible, and readily interpreted instruments that contribute to the appropriateness of empiric antibiotic treatments.

  6. Marker-free plasmids for gene therapeutic applications--lack of antibiotic resistance gene substantially improves the manufacturing process.

    Science.gov (United States)

    Mairhofer, Jürgen; Cserjan-Puschmann, Monika; Striedner, Gerald; Nöbauer, Katharina; Razzazi-Fazeli, Ebrahim; Grabherr, Reingard

    2010-04-01

    Plasmid DNA is being considered as a promising alternative to traditional protein vaccines or viral delivery methods for gene therapeutic applications. DNA-based products are highly flexible, stable, are easily stored and can be manufactured on a large scale. Although, much safer than viral approaches, issues have been raised with regard to safety due to possible integration of plasmid DNA into cellular DNA or spread of antibiotic resistance genes to intestinal bacteria by horizontal gene transfer. Accordingly, there is interest in methods for the production of plasmid DNA that lacks the antibiotic resistance gene to further improve their safety profile. Here, we report for the first time the gram-scale manufacturing of a minimized plasmid that is devoid of any additional sequence elements on the plasmid backbone, and merely consists of the target expression cassette and the bacterial origin of replication. Three different host/vector combinations were cultivated in a fed-batch fermentation process, comparing the progenitor strain JM108 to modified strains JM108murselect, hosting a plasmid either containing the aminoglycoside phosphotransferase which provides kanamycin resistance, or a marker-free variant of the same plasmid. The metabolic load exerted by expression of the aminoglycoside phosphotransferase was monitored by measuring ppGpp- and cAMP-levels. Moreover, we revealed that JM108 is deficient of the Lon protease and thereby refined the genotype of JM108. The main consequences of Lon-deficiency with regard to plasmid DNA production are discussed herein. Additionally, we found that the expression of the aminoglycoside phosphotransferase, conferring resistance to kanamycin, was very high in plasmid DNA producing processes that actually inclusion bodies were formed. Thereby, a severe metabolic load on the host cell was imposed, detrimental for overall plasmid yield. Hence, deleting the antibiotic resistance gene from the vector backbone is not only beneficial

  7. Overview on the current antibiotic containing agents used in endodontics.

    Science.gov (United States)

    Bansal, Ramta; Jain, Aditya

    2014-08-01

    Antibiotics are systemically and locally used extensively in endodontics. However, local antibiotic application mode is considered more effective than systemic administration. The local mode enables the dentist to target bacteria in every nook and corner of root canal system, which is otherwise beyond reach if targeted by instrumentation or conventional root canal treatment protocols. Therefore, they are an important adjunct to conventional treatment of root canal. The present study reviews the various antibiotic containing dental agents used in endodontics. A web-based research on MedLine was performed with terms Review Articles published in the last 10 year's dental journals in English for literature researching, extracting, and synthesizing data. Relevant articles were shortlisted. Important cross-reference articles were also reviewed. PMID:25210667

  8. Therapeutic use of radioactive isotopes

    CERN Document Server

    Caroline Duc

    2013-01-01

    In December, researchers from ISOLDE-CERN, the Paul Scherrer Institute (PSI) and the Institut Laue-Langevin (ILL) published the results of an in vivo study which successfully proved the effectiveness of four terbium isotopes for diagnosing and treating cancerous tumours.   Four terbium isotopes suitable for clinical purposes. “ISOLDE is the only installation capable of supplying terbium isotopes of such purity and intensity in the case of three out of the four types used in this study,” explains Karl Johnson, a physicist at ISOLDE.  “Producing over a thousand different isotopes, our equipment offers the widest choice of isotopes in the world!” Initially intended for fundamental physics research, ISOLDE has diversified its activities over time to invest in various projects in the materials science, biochemistry and nuclear medicine fields. The proof-of-concept study has confirmed that the four terbium isotopes 149Tb, 152Tb, 155Tb produ...

  9. The use of platensimycin and platencin to fight antibiotic resistance.

    Science.gov (United States)

    Allahverdiyev, Adil M; Bagirova, Melahat; Abamor, Emrah Sefik; Ates, Sezen Canim; Koc, Rabia Cakir; Miraloglu, Meral; Elcicek, Serhat; Yaman, Serkan; Unal, Gokce

    2013-01-01

    Infectious diseases are known as one of the most life-threatening disabilities worldwide. Approximately 13 million deaths related to infectious diseases are reported each year. The only way to combat infectious diseases is by chemotherapy using antimicrobial agents and antibiotics. However, due to uncontrolled and unnecessary use of antibiotics in particular, surviving bacteria have evolved resistance against several antibiotics. Emergence of multidrug resistance in bacteria over the past several decades has resulted in one of the most important clinical health problems in modern medicine. For instance, approximately 440,000 new cases of multidrug-resistant tuberculosis are reported every year leading to the deaths of 150,000 people worldwide. Management of multidrug resistance requires understanding its molecular basis and the evolution and dissemination of resistance; development of new antibiotic compounds in place of traditional antibiotics; and innovative strategies for extending the life of antibiotic molecules. Researchers have begun to develop new antimicrobials for overcoming this important problem. Recently, platensimycin - isolated from extracts of Streptomyces platensis - and its analog platencin have been defined as promising agents for fighting multidrug resistance. In vitro and in vivo studies have shown that these new antimicrobials have great potential to inhibit methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, and penicillin-resistant Streptococcus pneumoniae by targeting type II fatty acid synthesis in bacteria. Showing strong efficacy without any observed in vivo toxicity increases the significance of these antimicrobial agents for their use in humans. However, at the present time, clinical trials are insufficient and require more research. The strong antibacterial efficacies of platensimycin and platencin may be established in clinical trials and their use in humans for coping with multidrug resistance may be

  10. Ketone bodies, potential therapeutic uses.

    Science.gov (United States)

    Veech, R L; Chance, B; Kashiwaya, Y; Lardy, H A; Cahill, G F

    2001-04-01

    Ketosis, meaning elevation of D-beta-hydroxybutyrate (R-3hydroxybutyrate) and acetoacetate, has been central to starving man's survival by providing nonglucose substrate to his evolutionarily hypertrophied brain, sparing muscle from destruction for glucose synthesis. Surprisingly, D-beta-hydroxybutyrate (abbreviated "betaOHB") may also provide a more efficient source of energy for brain per unit oxygen, supported by the same phenomenon noted in the isolated working perfused rat heart and in sperm. It has also been shown to decrease cell death in two human neuronal cultures, one a model of Alzheimer's and the other of Parkinson's disease. These observations raise the possibility that a number of neurologic disorders, genetic and acquired, might benefit by ketosis. Other beneficial effects from betaOHB include an increased energy of ATP hydrolysis (deltaG') and its linked ionic gradients. This may be significant in drug-resistant epilepsy and in injury and anoxic states. The ability of betaOHB to oxidize co-enzyme Q and reduce NADP+ may also be important in decreasing free radical damage. Clinical maneuvers for increasing blood levels of betaOHB to 2-5 mmol may require synthetic esters or polymers of betaOHB taken orally, probably 100 to 150 g or more daily. This necessitates advances in food-science technology to provide at least enough orally acceptable synthetic material for animal and possibly subsequent clinical testing. The other major need is to bring the technology for the analysis of multiple metabolic "phenotypes" up to the level of sophistication of the instrumentation used, for example, in gene science or in structural biology. This technical strategy will be critical to the characterization of polygenic disorders by enhancing the knowledge gained from gene analysis and from the subsequent steps and modifications of the protein products themselves.

  11. Acute and chronic toxicity of veterinary antibiotics to Daphnia magna

    DEFF Research Database (Denmark)

    Wollenberger, Leah; Halling-Sørensen, B.; Kusk, Kresten Ole

    2000-01-01

    The acute and chronic toxicity of nine antibiotics used both therapeutically and as growth promoters in intensive farming was investigated on the freshwater crustacean Daphnia magna. The effect of the antibiotics metronidazole (M), olaquindox (OL), oxolinic acid (OA), oxytetracycline (OTC...

  12. Antibiotic use and its consequences for the normal microbiome

    Science.gov (United States)

    Blaser, Martin J.

    2016-01-01

    Anti-infectives, including antibiotics, are essentially different from all other drugs; they not only affect the individual to whom they are given but also the entire community, through selection for resistance to their own action. Thus, their use resides at the intersection of personal and public health. Antibiotics can be likened to a four-edged sword against bacteria. The first two edges of the antibiotic sword were identified immediately after their discovery and deployment in that they not only benefit an individual in treating their infection but also benefit the community in preventing the spread of that infectious agent. The third edge was already recognized by Alexander Fleming in 1945 in his Nobel acceptance speech, which warned about the cost to the community of antibiotic resistance that would inevitably evolve and be selected for during clinical practice. We have seen this cost mount up, as resistance curtails or precludes the activities of some of our most effective drugs for clinically important infections. But the fourth edge of the antibiotic sword remained unappreciated until recently, i.e., the cost that an antibiotic exerts on an individual’s own health via the collateral damage of the drug on bacteria that normally live on or in healthy humans: our microbiota. These organisms, their genes, metabolites, and interactions with one another, as well as with their host collectively, represent our microbiome. Our relationship with these symbiotic bacteria is especially important during the early years of life, when the adult microbiome has not yet formed (1). PMID:27126037

  13. Educational interventions to improve antibiotic use in the community: report from the International Forum on Antibiotic Resistance (IFAR) colloquium, 2002.

    Science.gov (United States)

    Finch, Roger G; Metlay, Joshua P; Davey, Peter G; Baker, Lee J

    2004-01-01

    National and international strategies for the control of antibiotic resistance recommend education for health-care professionals and the public to promote prudent antibiotic use. This paper, based on discussions at the 2002 colloquium of the International Forum on Antibiotic Resistance (IFAR), provides an international discourse between theoretical approaches to behaviour change and practical experience gained in large-scale antibiotic use educational campaigns. Interventions are more likely to be effective if their aim is to change behaviour, rather than provide information. They should target all relevant groups, especially parents, children, day-care staff, and health-care professionals. They should use clear and consistent messages concerning bacterial versus viral infection, prudent antibiotic use, symptomatic treatment, and infection-control measures (eg, handwashing). Campaigns should use a range of communications using pilot-testing, strong branding, and sociocultural adaptation. Prime-time television is likely to be the most effective public medium, while academic detailing is especially useful for health-care professionals. Multifaceted interventions can improve antibiotic prescribing to some degree. However, there are few data on their effects on resistance patterns and patient outcomes, and on their cost-effectiveness. Current research aims include the application of behaviour-change models, the development and validation of prudent antibiotic prescribing standards, and the refinement of tools to assess educational interventions. PMID:14720568

  14. 21 CFR 510.106 - Labeling of antibiotic and antibiotic-containing drugs intended for use in milk-producing animals.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Labeling of antibiotic and antibiotic-containing... ANIMAL DRUGS Specific Administrative Rulings and Decisions § 510.106 Labeling of antibiotic and antibiotic-containing drugs intended for use in milk-producing animals. Whenever the labeling of...

  15. An additional measure for quantifying antibiotic use in hospitals.

    NARCIS (Netherlands)

    Filius, P.M.; Liem, T.B.; Linden, P.D. van der; Janknegt, R.; Natsch, S.S.; Vulto, A.G.; Verbrugh, H.A.

    2005-01-01

    OBJECTIVES: The number of defined daily doses (DDD) per 100 patient days is often used as an indicator for the selection pressure exerted by antibiotics in the hospital setting. However, this unit of measurement does not fully describe the selection pressure and is sensitive to changes in hospital r

  16. Community Intervention Model to Reduce Inappropriate Antibiotic Use

    Science.gov (United States)

    Alder, Stephen; Wuthrich, Amy; Haddadin, Bassam; Donnelly, Sharon; Hannah, Elizabeth Lyon; Stoddard, Greg; Benuzillo, Jose; Bateman, Kim; Samore, Matthew

    2010-01-01

    Background: The Inter-Mountain Project on Antibiotic Resistance and Therapy (IMPART) is an intervention that addresses emerging antimicrobial resistance and the reduction of unnecessary antimicrobial use. Purpose: This study assesses the design and implementation of the community intervention component of IMPART. Methods: The study was conducted…

  17. The multifaceted roles of antibiotics and antibiotic resistance in nature

    Directory of Open Access Journals (Sweden)

    Saswati eSengupta

    2013-03-01

    Full Text Available Antibiotics are chemotherapeutic agents, which have been a very powerful tool in the clinical management of bacterial diseases since the 1940s. However, benefits offered by these magic bullets have been substantially lost in subsequent days following the widespread emergence and dissemination of antibiotic resistant strains. While it is obvious that excessive and imprudent use of antibiotics significantly contributes to the emergence of resistant strains, antibiotic-resistance is also observed in natural bacteria of remote places unlikely to be impacted by human intervention. Both antibiotic biosynthetic genes and resistance-conferring genes have been known to evolve billions of years ago, long before clinical use of antibiotics. Hence it appears that antibiotics and antibiotics resistance determinants have some other roles in nature, which often elude our attention because of overemphasis on the therapeutic importance of antibiotics and the crisis imposed by the antibiotic-resistance in pathogens. In the natural milieu, antibiotics are often found to be present in subinhibitory concentrations acting as signalling molecules supporting quorum sensing and biofilm formation. They also play an important role in the production of virulence factors and influence host-parasite interactions (e.g., phagocytosis, adherence to the target cell and so on. The evolutionary and ecological aspects of antibiotics and antibiotic-resistance in the naturally occurring microbial community are little understood. Therefore, the actual role of antibiotics in nature warrants in-depth investigations. Studies on such an intriguing behaviour of the microorganisms promise insight into the intricacies of the microbial physiology and are likely to provide some lead in controlling the emergence and subsequent dissemination of antibiotic resistance. This article highlights some of the recent findings on the role of antibiotics and genes that confer resistance to antibiotics in

  18. Hazard assessment of commonly used agricultural antibiotics on aquatic ecosystems.

    Science.gov (United States)

    Park, Sujung; Choi, Kyungho

    2008-08-01

    In this study, eleven commonly used antibiotics including sulfonamides, tetracyclines, aminoglycosides, fluoroquinolones, and beta-lactams were evaluated for their acute and chronic aquatic toxicities using standard test organisms e.g., Vibrio fischeri, Daphnia magna, Moina macrocopa, and Oryzias latipes. Among the antibiotics tested for acute toxicity, neomycin was most toxic followed by trimethoprim, sulfamethoxazole and enrofloxacin. Sulfamethazine, oxytetracycline, chlortetracycline, sulfadimethoxine and sulfathiazole were of intermediate toxicity, while ampicillin and amoxicillin were least toxic to the test organisms. There were no trends in sensitivity among test organisms or among different classes of the antibiotics. Only the beta-lactam class was the least toxic. In chronic toxicity test, neomycin affected reproduction and adult survival of D. magna and M. macrocopa with low mg/l levels exposure. Predicted no effect concentrations (PNECs) were derived from the acute and chronic toxicity information gleaned from this study and from literature. When the PNECs were compared with measured environmental concentrations (MECs) reported elsewhere for the test compounds, hazard quotients for sulfamethoxazole, sulfathiazole, chlortetracycline, oxytetracycline, and amoxicillin exceeded unity, which suggests potential ecological implication. Therefore, further studies including monitoring and detailed toxicological studies are required to assess potential ecological risk of these frequently used veterinary antibiotics. PMID:18449638

  19. A rational quantitative approach to determine the best dosing regimen for a target therapeutic effect: a unified formalism for antibiotic evaluation.

    Science.gov (United States)

    Li, Jun; Nekka, Fahima

    2013-02-21

    The determination of an optimal dosing regimen is a critical step to enhance the drug efficacy and avoid toxicity. Rational dosing recommendations based on mathematical considerations are increasingly being adopted in the process of drug development and use. In this paper, we propose a quantitative approach to evaluate the efficacy of antibiotic agents. By integrating both pharmacokinetic (PK) and pharmacodynamic (PD) information, this approach gives rise to a unified formalism able to measure the cause-effect of dosing regimens. This new pharmaco-metric allows to cover a whole range of antibiotics, including the two well known concentration and time dependent classes, through the introduction of the Hill-dependency concept. As a direct fallout, our formalism opens a new path toward the bioequivalence evaluation in terms of PK and PD, which associates the in vivo drug concentration and the in vitro drug effect. Using this new approach, we succeeded to reveal unexpected, but relevant behaviors of drug performance when different drug regimens and drug classes are considered. Of particular notice, we found that the doses required to reach the same therapeutic effect, when scheduled differently, exhibit completely different tendencies for concentration and time dependent drugs. Moreover, we theoretically confirmed the previous experimental results of the superiority of the once daily regimen of aminoglycosides. The proposed methodology is appealing for its computational features and can easily be applicable to design fair clinical protocols or rationalize prescription decisions. PMID:23201275

  20. The use of platensimycin and platencin to fight antibiotic resistance

    Directory of Open Access Journals (Sweden)

    Allahverdiyev AM

    2013-09-01

    Full Text Available Adil M Allahverdiyev,1 Melahat Bagirova,1 Emrah Sefik Abamor,1 Sezen Canim Ates,1 Rabia Cakir Koc,2 Meral Miraloglu,3 Serhat Elcicek,4 Serkan Yaman,1 Gokce Unal1 1Department of Bioengineering, Yildiz Technical University, Istanbul, Turkey; 2Department of Biomedical Engineering, Yeni Yuzyil University, Istanbul, Turkey; 3Vocational School of Health Services, Cukurova University, Adana, Turkey; 4Department of Bioengineering, Firat University, Elazig, Turkey Abstract: Infectious diseases are known as one of the most life-threatening disabilities worldwide. Approximately 13 million deaths related to infectious diseases are reported each year. The only way to combat infectious diseases is by chemotherapy using antimicrobial agents and antibiotics. However, due to uncontrolled and unnecessary use of antibiotics in particular, surviving bacteria have evolved resistance against several antibiotics. Emergence of multidrug resistance in bacteria over the past several decades has resulted in one of the most important clinical health problems in modern medicine. For instance, approximately 440,000 new cases of multidrug-resistant tuberculosis are reported every year leading to the deaths of 150,000 people worldwide. Management of multidrug resistance requires understanding its molecular basis and the evolution and dissemination of resistance; development of new antibiotic compounds in place of traditional antibiotics; and innovative strategies for extending the life of antibiotic molecules. Researchers have begun to develop new antimicrobials for overcoming this important problem. Recently, platensimycin – isolated from extracts of Streptomyces platensis – and its analog platencin have been defined as promising agents for fighting multidrug resistance. In vitro and in vivo studies have shown that these new antimicrobials have great potential to inhibit methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, and penicillin

  1. Antibiotic resistance: what is the impact of agricultural uses of antibiotics on children's health?

    Science.gov (United States)

    Shea, Katherine M

    2003-07-01

    Antimicrobial resistance has reached crisis stage in human medicine. The rapid acceleration of multidrug-resistant bacteria in the past 2 decades has overtaken new drug development, and patients and clinicians are faced with the prospect of untreatable infections. Although much of the problem stems from overuse and misuse of antimicrobial agents in human medicine, large-scale use of antimicrobials in agriculture also contributes to the crisis. Agricultural uses of antibiotics produce environmental exposures in a variety of reservoirs, which select for resistant microbes and microbial genes. This article presents the major lines of evidence documenting the risks to human health of some of the agricultural uses of antimicrobials. A brief review of the microbiologic antecedents of resistance is followed by a discussion of agricultural uses of antimicrobials and a targeted review of the literature, which provides the background knowledge and evidence necessary for pediatricians and other clinicians to be informed and to advocate for judicious use of antimicrobials in all sectors.

  2. Infections in neurologic surgery. The intraventricular use of antibiotics.

    Science.gov (United States)

    Wen, D Y; Bottini, A G; Hall, W A; Haines, S J

    1992-04-01

    Intraventricular antibiotic therapy appears to be a useful treatment modality in those CSF infections in which systemic therapy may fail. Consideration should be given to using this form of treatment when infecting organisms are only sensitive to antibiotics with poor penetration of the CSF (e.g., aminoglycosides and vancomycin) and for cases in which intravenous therapy has failed to sterilize the CSF, toxicity from systemic therapy precludes further increases in dosages, and shunts or other CSF hardware might be expected to reduce the efficacy of systemic therapy by providing a foreign body to harbor organisms. Shunts or reservoirs that are infected may be successfully sterilized with IVT therapy alone or in conjunction with systemic therapy, but this has a lower success rate than cases in which the shunt is removed. There is a wealth of clinical experience with IVT vancomycin and gentamicin that suggests that they are relatively safe. Until more data are available on other aminoglycosides and newer antibiotics, these two agents should be considered the antibiotics of choice for IVT therapy. In situations in which the organism is sensitive to both vancomycin and gentamicin, vancomycin should be used in view of the documented neurotoxicity seen with gentamicin. When gentamicin resistance occurs, amikacin and tobramycin are appropriate alternatives. The high risk of epilepsy with the penicillins and cephalosporins makes them less suited for IVT therapy, although the newer cephalosporins have some promise for IVT therapy. CNS fungal infections can be treated effectively with IVT amphotericin B but with a high risk of significant toxicity. Miconazole appears to be safer than amphotericin B but there is less clinical experience with this drug. Table 1 summarizes the dosages, indications, and toxicity of those antibiotics commonly used for intraventricular administration, which have been reported previously.

  3. Assessing Antibiotic Resistance of Staphyloccocus: Students Use Their Own Microbial Flora To Explore Antibiotic Resistance.

    Science.gov (United States)

    Omoto, Charlotte K.; Malm, Kirstin

    2003-01-01

    Describes a microbiology laboratory experiment in which students test their own microbial flora of Staphylococcus for antibiotic resistance. Provides directions on how to conduct the experiment. (YDS)

  4. 慎用抗生素%Using Antibiotics with Caution

    Institute of Scientific and Technical Information of China (English)

    周丽丽

    2012-01-01

    中国是抗生素生产大国,也是抗生素使用大国。抗生素不仅能杀灭细菌而且对霉菌、支原体、衣原体等其它致病微生物也有良好的抑制和杀灭作用。但是近年来,抗生素滥用的情况日益突出。本文对抗生素滥用的原因、滥用的危害和如何合理使用抗生素作一简单的阐述。%China is not only a biggest producer of antibiotics, but also a biggest consumer of it. Due to its merits that exhibit good inhibition on mould, mycoplasma, Chlamydia and other pathogenic microorganism while sterilizing bacteria, problem of antibiotics abuse has become increasingly prominent. This paper summarizes the reasons and harm for antibiotics abuse, and discusses how to use antibiotics reasonably.

  5. Chronic plaque psoriasis: streptococcus pyogenes throat carriage rate and therapeutic response to oral antibiotics in comparison with oral methotrexate

    International Nuclear Information System (INIS)

    To determine the throat carriage rate of Streptococcus pyogenes in patients having chronic plaque psoriasis and the effect of antibiotics as compared with that of oral methotrexate. Forty patients and 40 age and gender-matched controls were selected. Throat swab for culture of Streptococcus pyogenes was taken from each patient and control. All patients were treated with oral Penicillin V 250 mg, 6 hourly, and oral Rifampicin, 600 mg daily, for 10 days. Pre- and post therapy 'Psoriasis Area and Severity Index' (PASI) were compared. Thirty of these 40 patients were later given oral methotrexate, 5-10 mg weekly, for 04 weeks and pre- and post-therapy PASI were compared. Chi-square and paired-samples t-test were used for data analysis. Throat swab cultures were positive for Streptococcus pyogenes in 05 (12.5%) patients and none (0%) of the controls (p=0.02). Mean pre- and postantibiotic therapy PASI were 15.92 + 05.94 and 15.19 + 06.17 respectively (p=0.078). Mean pre- and postmethotrexate PASI were 15.81+ 5.55 and 8.79 + 4.19 respectively (p <0.01). Throat carriage of Streptococcus pyogenes is common in patients with chronic plaque psoriasis. Short-term antibiotic treatment has no role in routine treatment of chronic plaque psoriasis. However, it would be worthwhile to consider the effects of long term antibiotics on chronic plaque psoriasis. (author)

  6. Otitis media: diagnosis, management, and judicious use of antibiotics.

    Science.gov (United States)

    Stool, Sylvan; Carlson, Linda H; Johnson, Candice E

    2002-07-01

    Otitis media continues to present a major challenge to practitioners in the clinical setting. With the ever-increasing trend toward the use of a sound research-structured approach to health care and the use of evidence-based guidelines, it is important to have an understanding of these findings related to otitis media. A review of research-supported literature regarding the diagnosis and management of this disease, and suggestions for the judicious use of antibiotics, are presented in this paper.

  7. Dragon's blood: botany, chemistry and therapeutic uses.

    Science.gov (United States)

    Gupta, Deepika; Bleakley, Bruce; Gupta, Rajinder K

    2008-02-12

    Dragon's blood is one of the renowned traditional medicines used in different cultures of world. It has got several therapeutic uses: haemostatic, antidiarrhetic, antiulcer, antimicrobial, antiviral, wound healing, antitumor, anti-inflammatory, antioxidant, etc. Besides these medicinal applications, it is used as a coloring material, varnish and also has got applications in folk magic. These red saps and resins are derived from a number of disparate taxa. Despite its wide uses, little research has been done to know about its true source, quality control and clinical applications. In this review, we have tried to overview different sources of Dragon's blood, its source wise chemical constituents and therapeutic uses. As well as, a little attempt has been done to review the techniques used for its quality control and safety. PMID:18060708

  8. Treatment of Antibiotic Pharmaceutical Wastewater Using a Rotating Biological Contactor

    OpenAIRE

    Rongjun Su; Guangshan Zhang; Peng Wang; Shixiong Li; Ryan M. Ravenelle; JOHN C. CRITTENDEN

    2015-01-01

    Rotating biological contactors (RBC) are effective for treating wastewater, while they are rarely reported to be used for treating antibiotic pharmaceutical wastewater (APW). The current study investigates treatment of APW using an RBC. The effects of influent concentration, number of stages, and temperature on the remediation of APW were studied. The results indicated, even at low ambient temperature, 45% COD and 40% NH4+-N removal efficiencies. Moreover, the BOD5 removal efficiency was 85%....

  9. Investigating the Extremes of Antibiotic Use with an Epidemiologic Framework.

    Science.gov (United States)

    Scheetz, Marc H; Crew, Page E; Miglis, Cristina; Gilbert, Elise M; Sutton, Sarah H; O'Donnell, J Nick; Postelnick, Michael; Zembower, Teresa; Rhodes, Nathaniel J

    2016-06-01

    Benchmarks for judicious use of antimicrobials are needed. Metrics such as defined daily doses (DDDs) and days of therapy (DOTs) quantify antimicrobial consumption. However, benchmarking with these metrics is complicated by interhospital variability. Thus, it is important for each hospital to monitor its own temporal consumption trends. Time series analyses allow trends to be detected; however, many of these methods are complex. We present simple regressive methods and caveats in using them to define potential antibiotic over- and underutilizations. PMID:27001807

  10. Antibiotics in Canadian poultry productions and anticipated alternatives

    OpenAIRE

    Diarra, Moussa S.; Malouin, François

    2014-01-01

    The use of antibiotics in food-producing animals has significantly increased animal health by lowering mortality and the incidence of diseases. Antibiotics also have largely contributed to increase productivity of farms. However, antibiotic usage in general and relevance of non-therapeutic antibiotics (growth promoters) in feed need to be reevaluated especially because bacterial pathogens of humans and animals have developed and shared a variety of antibiotic resistance mechanisms that can ea...

  11. Antibiotics in Canadian poultry productions and anticipated alternatives

    OpenAIRE

    Moussa Sory Diarra; Francois eMalouin

    2014-01-01

    The use of antibiotics in food-producing animals has significantly increased animal health by lowering mortality and the incidence of diseases. Antibiotics also have largely contributed to increase productivity of farms. However, antibiotic usage in general and relevance of non-therapeutic antibiotics in feed (growth promoters) need to be reevaluated especially because bacterial pathogens of humans and animals have developed and shared a variety of antibiotic resistance mechanisms that can ea...

  12. Monitoring Antibiotic Use and Residue in Freshwater Aquaculture for Domestic Use in Vietnam.

    Science.gov (United States)

    Pham, Dang Kim; Chu, Jacqueline; Do, Nga Thuy; Brose, François; Degand, Guy; Delahaut, Philippe; De Pauw, Edwin; Douny, Caroline; Nguyen, Kinh Van; Vu, Ton Dinh; Scippo, Marie-Louise; Wertheim, Heiman F L

    2015-09-01

    Vietnam is an important producer of aquaculture products, and aquatic products are essential to the Vietnamese diet. However, Vietnam also has very little enforced regulation pertaining to antibiotic usage in domestic aquaculture, which raises concerns for antibiotic resistance in pathogenic bacteria. In this study, analysis was conducted on the presence of antibiotic residues in domestically sold fish and shrimp raised in freshwater farms in Vietnam, and an assessment of farmers' knowledge of proper antibiotics usage was performed. The results indicated that a quarter of tested aquaculture products were antibiotic screening test positive, and there is a general lack of knowledge about the purpose and proper usage of antibiotics by aquaculture producers. Farmers' decision-making processes about antimicrobial use are influenced by biased sources of information, such as drug manufacturers and sellers, and by financial incentives. PMID:25561382

  13. Selection of antibiotic resistance at very low antibiotic concentrations.

    Science.gov (United States)

    Sandegren, Linus

    2014-05-01

    Human use of antibiotics has driven the selective enrichment of pathogenic bacteria resistant to clinically used drugs. Traditionally, the selection of resistance has been considered to occur mainly at high, therapeutic levels of antibiotics, but we are now beginning to understand better the importance of selection of resistance at low levels of antibiotics. The concentration of an antibiotic varies in different body compartments during treatment, and low concentrations of antibiotics are found in sewage water, soils, and many water environments due to natural production and contamination from human activities. Selection of resistance at non-lethal antibiotic concentrations (below the wild-type minimum inhibitory concentration) occurs due to differences in growth rate at the particular antibiotic concentration between cells with different tolerance levels to the antibiotic. The minimum selective concentration for a particular antibiotic is reached when its reducing effect on growth of the susceptible strain balances the reducing effect (fitness cost) of the resistance determinant in the resistant strain. Recent studies have shown that resistant bacteria can be selected at concentrations several hundred-fold below the lethal concentrations for susceptible cells. Resistant mutants selected at low antibiotic concentrations are generally more fit than those selected at high concentrations but can still be highly resistant. The characteristics of selection at low antibiotic concentrations, the potential clinical problems of this mode of selection, and potential solutions will be discussed.

  14. Time- and concentration-dependent cytotoxicity of antibiotics used in endodontic therapy

    Directory of Open Access Journals (Sweden)

    Marina Beloti Ferreira

    2010-06-01

    Full Text Available OBJECTIVE: New drugs have to be assessed in endodontic therapy due to the presence of microorganisms resistant to therapeutic procedures. Thus, this study evaluated the time- and concentration-dependent cytotoxicity of different antibiotics used in endodontic therapy. MATERIAL AND METHODS: Human gingival fibroblasts were treated and divided into the following experimental groups: Group I - control; Group II - ciprofoxacin hydrochloride; Group III - clyndamicin hydrochloride; and Group IV - metronidazole. Each drug was used at concentrations of 5, 50, 150, and 300 mg/L for 24, 48, 72, and 96 h. Cytotoxicity was evaluated by the MTT assay [3-(4,5-dimethylthiazol-2-yl-2,5-diphenyltetrazolium bromide] and spectrophotometric reading of ELISA plates. The results were analyzed by BioEstat 4.0 software using Kruskal-Wallis and Dunn's tests at a signifcance level of 5%. Cell viability was assessed for the different concentrations and times. RESULTS: All drugs presented dose-dependent cytotoxicity. Concentrations of 5 and 50 mgjL produced viable fibroblasts at all experimental times in all groups. CONCLUSIONS: Cell viability at 24 h was greater than in the other experimental times. Comparison between the same concentrations of antibiotics at different times showed that metronidazole presented the highest cell viability at 72 and 96 h compared to the other antibiotics, whereas clyndamicin hydrochloride showed higher cell viability at 72 h than ciprofoxacin hydrochloride.

  15. Changes in antibiotic use in Dutch hospitals over a six-year period: 1997 to 2002.

    NARCIS (Netherlands)

    Liem, T.B.; Filius, F.M.; Linden, P.D. van der; Janknegt, R.; Natsch, S.S.; Vulto, A.G.

    2005-01-01

    OBJECTIVE: To analyse trends in antibiotic use in Dutch hospitals over the period 1997 to 2002. METHODS: Data on the use of antibiotics and hospital resource indicators were obtained by distributing a questionnaire to all Dutch hospital pharmacies. Antibiotic use was expressed as the number of defin

  16. Use, fate and ecological risks of antibiotics applied in tilapia cage farming in Thailand

    NARCIS (Netherlands)

    Rico, A.; Oliveira, R.; McDonough, S.; Matser, A.; Khatikarn, J.; Satapornvanit, K.; Nogueira, A.J.A.; Soares, A.M.V.M.; Domingues, I.; Brink, van den P.J.

    2014-01-01

    The use, environmental fate and ecological risks of antibiotics applied in tilapia cage farming were investigated in the Tha Chin and Mun rivers in Thailand. Information on antibiotic use was collected through interviewing 29 farmers, and the concentrations of the most commonly used antibiotics, oxy

  17. 21 CFR 510.110 - Antibiotics used in food-producing animals.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Antibiotics used in food-producing animals. 510... Rulings and Decisions § 510.110 Antibiotics used in food-producing animals. (a) The Food and Drug... has requested an evaluation of the public health aspects of the use of antibiotics in...

  18. 21 CFR 510.112 - Antibiotics used in veterinary medicine and for nonmedical purposes; required data.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Antibiotics used in veterinary medicine and for... DRUGS Specific Administrative Rulings and Decisions § 510.112 Antibiotics used in veterinary medicine... Medical and Nonmedical Uses of Antibiotics, was formed by the Food and Drug Administration to study,...

  19. Use of antibiotics for urinary tract infection in women undergoing surgery for urinary incontinence

    DEFF Research Database (Denmark)

    Guldberg, Rikke; Kesmodel, Ulrik Schiøler; Brostrøm, Søren;

    2014-01-01

    OBJECTIVE: To describe the use of antibiotics for urinary tract infection (UTI) before and after surgery for urinary incontinence (UI); and for those with use of antibiotics before surgery, to estimate the risk of treatment for a postoperative UTI, relative to those without use of antibiotics...

  20. Surveillance of antibiotic and analgesic use in the Oral Surgery Department of the University Dentistry Clinical Center of Kosovo

    Directory of Open Access Journals (Sweden)

    Haliti NR

    2015-10-01

    Full Text Available Naim R Haliti,1 Fehim R Haliti,2 Ferit K Koçani,3 Ali A Gashi,4 Shefqet I Mrasori,3 Valon I Hyseni,5 Samir I Bytyqi,5 Lumnije L Krasniqi,2 Ardiana F Murtezani,5 Shaip L Krasniqi5 1Department of Forensic Medicine, Faculty of Medicine, University of Prishtina “Hasan Prishtina”, 2Department of Children Dentistry, University Dentistry Clinical Center of Kosovo, 3Department of Oral Disease, University Dentistry Clinical Center of Kosovo, 4Department of Oral Surgery, University Dentistry Clinical Center of Kosovo, 5Institute of Pharmacology and Toxicology and Clinical Pharmacology, Faculty of Medicine, University of Prishtina “Hasan Prishtina”, Prishtina, Kosovo Background: Because Kosovo has no reliable information on antimicrobial and analgesic use in dental practice, the survey reported here evaluated the antibiotic and analgesic prescriptions in the Oral Surgery Department of the University Dentistry Clinical Center of Kosovo (UDCCK.Methods: The data of 2,442 registered patients for a 1-year period were screened and analyzed concerning antibiotic and analgesic use as per standards of rational prescription.Results: Dentistry doctors prescribed antibiotics significantly more often than analgesics. Antibiotics were prescribed in 8.11% of all cases, while only 1.35% of total prescriptions were for analgesics. The total consumption of antibiotic drugs in the UDCCK was 4.53 Defined Daily Doses [DDD]/1,000 inhabitants/day, compared with only 0.216 DDD/1,000 inhabitants/day for analgesics. From a total number of 117 patients, 32 patients received combinations of two antibiotics.Conclusion: Pharmacotherapy analysis showed that the prescription rates of antibiotics and analgesics in the UDCCK are not rational in terms of the qualitative aspects of treatment. For the qualitative improvement of prescription of these drug groups, we recommend the implementation of treatment guidelines following rational standards. Keywords: antibiotic, analgesics

  1. POSSIBLE CARDIAC ADVERSE EFFECTS OF THERAPEUTIC DOSES OF MACROLIDE ANTIBIOTICS (AZITHROMYCIN AND CLARITHROMYCIN IN HEALTHY JUVENILE RATS: BIOCHEMICAL ASSESSMENT

    Directory of Open Access Journals (Sweden)

    Kassim Hassoon Ali

    2012-09-01

    Full Text Available The macrolides antibiotics inhibit bacterial protein synthesis by an effect on translocation. They include erythromycin, azithromycin, clarithromycin, and roxithromycin . Their antimicrobial spectrum is varied. The drugs are associated with QT interval prolongation and cardiac dysrhythmias. This study was designed to determine whether or not a therapeutic oral dose of either azithromycin or clarithromycin administered for 5 or 10 days, respectively have cardiac adverse effects in healthy juvenile rats by assessing serum enzymes (CK-MB, LDH, AST and ALT, as markers of cardiac function. Twenty-eight healthy juvenile rats of both sexes weighing approximately 30gm were utilized and were randomly subdivided into 4 groups, control group orally-administered distilled water (DW every 12hrs for 5 days via gavage tube, azithromycin suspension 12 mg/ kg every 12 hrs for 5 days via gavage tube, control group orally-administered DW every 12 hrs for 10 days via gavage tube and clarithromycin suspension 7.5 mg per kg for every 12 hrs for10 days via gavage tube. After scarification of animals by cervical dislocation, blood samples were taken by intra-cardiac puncture and utilized immediately to get serum in order to assess enzymes activities {heart creatin kinase isoform (CK-MB, lactate dehydrogenase (LDH, aspartate aminotransferase (AST and alanine aminotransferase (ALT}.The results of the present study demonstrated that were significant increase in serum activities of both CK-MB and LDH in group of animals treated with therapeutic oral dose of (12mg/kg azithromycin for 5 days compared to the corresponding serum enzyme activities of control animals. While, there were no significant increase in serum activities of both AST and ALT in group of animals treated with therapeutic oral dose of (12mg/kg azithromycin for 5 days compared to the corresponding serum enzyme activities of control group. Moreover, in groups of animals treated with therapeutic oral dose of (7

  2. Therapeutic effect of antibiotics in the compromised host : an experimental study

    NARCIS (Netherlands)

    R. Roosendaal (Robert)

    1988-01-01

    textabstractThe present study was performed in a model of Klebsiella pneumoniae pneumonia and septicemia in rats. This experimental model was used because in leukopenic patients septicemia is a real threat, and K.pneumoniae is one of the pathogens that may be recovered [68, 74, 99, 116, 122, 124]. T

  3. Antibiotic therapeutic options for infections caused by drug-resistant Gram-positive cocci.

    Science.gov (United States)

    Banwan, K; Senok, A C; Rotimi, V O

    2009-01-01

    Serious infections caused by Gram-positive bacteria are currently difficult to treat because many of these pathogens are now resistant to standard antimicrobial agents. As a result of the emergence and spread of multidrug-resistant Gram-positive pathogens, new antimicrobial agents are urgently needed for clinical use. In recent years, there has been an increase in the number of drugs that have activity against these Gram-positive pathogens. Daptomycin, tigecycline, linezolid, quinupristin/dalfopristin and dalbavancin are five antimicrobial agents that are useful for the treatment of infections due to drug-resistant Gram-positive cocci. This review focuses on their mechanism of action, pharmacokinetics, spectrum of activity, clinical effectiveness, drug interaction and safety. These antimicrobial agents provide the clinician with additional treatment options among the limited therapies for resistant Gram-positive bacterial infection. PMID:20701863

  4. Evaluation of antibiotic use in a Lebanese hospital

    OpenAIRE

    Ibrahim, Mohamad

    2016-01-01

    Antimicrobial resistance is a significant global health problem. Misuse of antibiotics is associated with antimicrobial resistance which presents clinicians with treatment challenges and increases the complexity of the decision making process related to the selection of appropriate antibiotic therapy. Antibiotic resistant organisms can often lead to nosocomial infections (NIs) and undoubtedly causes patient harm and increases healthcare costs. According to the National Insti...

  5. Indications and Types of Antibiotic Agents Used in 6 Acute Care Hospitals, 2009-2010: A Pragmatic Retrospective Observational Study.

    Science.gov (United States)

    Kelesidis, Theodoros; Braykov, Nikolay; Uslan, Daniel Z; Morgan, Daniel J; Gandra, Sumanth; Johannsson, Birgir; Schweizer, Marin L; Weisenberg, Scott A; Young, Heather; Cantey, Joseph; Perencevich, Eli; Septimus, Edward; Srinivasan, Arjun; Laxminarayan, Ramanan

    2016-01-01

    BACKGROUND To design better antimicrobial stewardship programs, detailed data on the primary drivers and patterns of antibiotic use are needed. OBJECTIVE To characterize the indications for antibiotic therapy, agents used, duration, combinations, and microbiological justification in 6 acute-care US facilities with varied location, size, and type of antimicrobial stewardship programs. DESIGN, PARTICIPANTS, AND SETTING Retrospective medical chart review was performed on a random cross-sectional sample of 1,200 adult inpatients, hospitalized (>24 hrs) in 6 hospitals, and receiving at least 1 antibiotic dose on 4 index dates chosen at equal intervals through a 1-year study period (October 1, 2009-September 30, 2010). METHODS Infectious disease specialists recorded patient demographic characteristics, comorbidities, microbiological and radiological testing, and agents used, dose, duration, and indication for antibiotic prescriptions. RESULTS On the index dates 4,119 (60.5%) of 6,812 inpatients were receiving antibiotics. The random sample of 1,200 case patients was receiving 2,527 antibiotics (average: 2.1 per patient); 540 (21.4%) were prophylactic and 1,987 (78.6%) were therapeutic, of which 372 (18.7%) were pathogen-directed at start. Of the 1,615 empirical starts, 382 (23.7%) were subsequently pathogen-directed and 1,231 (76.2%) remained empirical. Use was primarily for respiratory (27.6% of prescriptions) followed by gastrointestinal (13.1%) infections. Fluoroquinolones, vancomycin, and antipseudomonal penicillins together accounted for 47.1% of therapy-days. CONCLUSIONS Use of broad-spectrum empirical therapy was prevalent in 6 US acute care facilities and in most instances was not subsequently pathogen directed. Fluoroquinolones, vancomycin, and antipseudomonal penicillins were the most frequently used antibiotics, particularly for respiratory indications. Infect. Control Hosp. Epidemiol. 2015;37(1):70-79.

  6. Antibiotic use and emerging resistance—how can resource-limited countries turn the tide?

    OpenAIRE

    Bebell, LM; Muiru, AN

    2014-01-01

    Antibiotic resistance is a global crisis driven by appropriate and inappropriate antibiotic use to treat human illness and promote animal growth. The antimicrobial resistance epidemic continues to spread due to the triple threat of unfettered access, minimal product regulation and oversight of antibiotic prescription, and lack of clinical diagnostic tools to support antibiotic de-escalation in low-resource settings. In high-resource settings, evidence-based strategies have improved appropriat...

  7. Therapeutic use of alpha-emitters

    Energy Technology Data Exchange (ETDEWEB)

    Lassmann, M. [Klinik und Poliklinik fuer Nuklearmedizin der Univ. Wuerzburg (Germany)

    2005-07-01

    In recent years there is a growing interest in the therapeutic use of {alpha}-emitters for patient treatment, {alpha}-particles have much higher energy and their range is only a few cell diameters. Their high LET and the limited ability of cells to repair DNA damage from {alpha}-radiation explain their high relative biological effectiveness and cytotoxicity. Potential {alpha}-emitting isotopes for therapeutic applications are {sup 224}Ra, {sup 223}Ra, {sup 213}Bi and {sup 211}At. The treatment with {alpha}-particles is focused upon targeted cancer therapy using radiolabeled monoclonal antibodies, on palliation of bone metastases or upon pain relief in patients with ankylosing spondylitis (AS). Examples for targeted cancer therapy are the treatment of melanoma with {sup 213}Bi and non-Hodgkin lymphoma with {sup 211}At. For metastatic bone pain palliation {sup 223}Ra was applied in a phase I clinical trial. For amelioration of pain in AS-patients {sup 224}Ra-chloride is used. This radiopharmaceutical is licensed for this particular application in Germany. Today there are some potential clinical applications for {alpha}-emitters although most of them are in the state of scientific, non-routine investigations. In-vivo dosimetry for risk assessment associated with this treatment is even more difficult to perform than for therapies using beta-emitting radiopharmaceuticals. (orig.)

  8. Hepatic safety of antibiotics used in primary care.

    Science.gov (United States)

    Andrade, Raúl J; Tulkens, Paul M

    2011-07-01

    Antibiotics used by general practitioners frequently appear in adverse-event reports of drug-induced hepatotoxicity. Most cases are idiosyncratic (the adverse reaction cannot be predicted from the drug's pharmacological profile or from pre-clinical toxicology tests) and occur via an immunological reaction or in response to the presence of hepatotoxic metabolites. With the exception of trovafloxacin and telithromycin (now severely restricted), hepatotoxicity crude incidence remains globally low but variable. Thus, amoxicillin/clavulanate and co-trimoxazole, as well as flucloxacillin, cause hepatotoxic reactions at rates that make them visible in general practice (cases are often isolated, may have a delayed onset, sometimes appear only after cessation of therapy and can produce an array of hepatic lesions that mirror hepatobiliary disease, making causality often difficult to establish). Conversely, hepatotoxic reactions related to macrolides, tetracyclines and fluoroquinolones (in that order, from high to low) are much rarer, and are identifiable only through large-scale studies or worldwide pharmacovigilance reporting. For antibiotics specifically used for tuberculosis, adverse effects range from asymptomatic increases in liver enzymes to acute hepatitis and fulminant hepatic failure. Yet, it is difficult to single out individual drugs, as treatment always entails associations. Patients at risk are mainly those with previous experience of hepatotoxic reaction to antibiotics, the aged or those with impaired hepatic function in the absence of close monitoring, making it important to carefully balance potential risks with expected benefits in primary care. Pharmacogenetic testing using the new genome-wide association studies approach holds promise for better understanding the mechanism(s) underlying hepatotoxicity.

  9. 'The body gets used to them': patients' interpretations of antibiotic resistance and the implications for containment strategies.

    NARCIS (Netherlands)

    Brookes-Howell, L.; Elwyn, G.; Hood, K.; Wood, F.; Cooper, L.; Goossens, H.; Ieven, M.; Butler, C.C.

    2012-01-01

    BACKGROUND: Interventions promoting evidence based antibiotic prescribing and use frequently build on the concept of antibiotic resistance but patients and clinicians may not share the same assumptions about its meaning. OBJECTIVE: To explore patients' interpretations of 'antibiotic resistance' and

  10. Ondansetron. Therapeutic use as an antiemetic

    Energy Technology Data Exchange (ETDEWEB)

    Milne, R.J.; Heel, R.C. (Adis Drug Information Services, Auckland (New Zealand))

    1991-04-01

    Ondansetron (GR 38032F) is a highly selective 5-HT3 receptor antagonist, one of a new class of compounds which may have several therapeutic applications. Animal and clinical studies show that ondansetron reduces the 24-hour incidence and severity of nausea and vomiting induced by cytotoxic drugs, including cisplatin, and by single exposure, high dose radiation. Ondansetron is more effective than high dose metoclopramide in the 24 hours following chemotherapy, and preliminary clinical evidence suggests that it is equally effective in the following 4 days. It is also more effective than the moderate doses of metoclopramide used to suppress emesis following radiotherapy. The antiemetic efficacy of ondansetron is enhanced by dexamethasone in cisplatin-treated patients. Importantly, extrapyramidal effects have not been reported with ondansetron. Further comparisons are required with standard combination antiemetic therapy to complement the data presently available. Thus, ondansetron is a promising new agent for prophylaxis against nausea and vomiting in chemotherapy and radiotherapy. It may be particularly useful in young and elderly patients who are more susceptible to extrapyramidal symptoms induced by high dose metoclopramide. With its improved tolerability and clinical response profiles, ondansetron represents an important advance in a difficult area of therapeutics. 101 refs.

  11. Resistance-resistant antibiotics.

    Science.gov (United States)

    Oldfield, Eric; Feng, Xinxin

    2014-12-01

    New antibiotics are needed because drug resistance is increasing while the introduction of new antibiotics is decreasing. We discuss here six possible approaches to develop 'resistance-resistant' antibiotics. First, multitarget inhibitors in which a single compound inhibits more than one target may be easier to develop than conventional combination therapies with two new drugs. Second, inhibiting multiple targets in the same metabolic pathway is expected to be an effective strategy owing to synergy. Third, discovering multiple-target inhibitors should be possible by using sequential virtual screening. Fourth, repurposing existing drugs can lead to combinations of multitarget therapeutics. Fifth, targets need not be proteins. Sixth, inhibiting virulence factor formation and boosting innate immunity may also lead to decreased susceptibility to resistance. Although it is not possible to eliminate resistance, the approaches reviewed here offer several possibilities for reducing the effects of mutations and, in some cases, suggest that sensitivity to existing antibiotics may be restored in otherwise drug-resistant organisms.

  12. Combined audit of hospital antibiotic use and a prevalence survey of healthcare-associated infection.

    LENUS (Irish Health Repository)

    O'Neill, E

    2010-05-01

    Appropriate antibiotic use improves patient outcome and prevents the emergence of antibiotic resistance. A point-prevalence audit of antibiotic use at Beaumont Hospital, Dublin was carried out during the collection of data for the 2006 Hospital Infection Society (HIS) Prevalence Survey of Healthcare-Associated Infection. All inpatients who met the HIS survey entry criteria were included in the HIS survey, and all inpatients who were receiving antibiotics at the time of the survey were included in the point-prevalence audit of antibiotic use. Among these, 7.18% and 36.8% of patients had a healthcare-associated infection (HCAI) and were on antibiotics, respectively. Unnecessary collection of duplicate data was avoided by conducting an audit of antibiotic use and a national survey of HCAI simultaneously.

  13. [Study toward practical use of oligonucleotide therapeutics].

    Science.gov (United States)

    Inoue, Takao; Yoshida, Tokuyuki

    2014-01-01

    Over the past decade, oligonucleotide-based therapeutics such as antisense oligonucleotides and small interfering RNAs (siRNAs) have been developed extensively. For example, mipomersen (Kynamro; ISIS Pharmaceuticals), which is a second-generation antisense oligonucleotide administered by subcutaneous injection, has recently been approved by the FDA for the treatment of homozygous familial hypercholesterolemia. On the other hands, methods for the evaluation of quality, efficacy and safety of oligonucleotide therapeutics have not been fully discussed. Furthermore, the regulatory guidance specific for oligonucleotide therapeutics has not been established yet. Under these circumstances, we started to collaborate with Osaka University and PMDA to discuss regulatory science focused on oligonucleotide therapeutics. Through the collaboration, we would like to propose the possible design of quality evaluation and preclinical safety-evaluation of oligonucleotide therapeutics. PMID:25707197

  14. Antibiotic Use as a Tragedy of the Commons: A Cross-Sectional Survey

    Directory of Open Access Journals (Sweden)

    Kieran S. O'Brien

    2014-01-01

    Full Text Available Background. Many believe antibiotic use results in a tragedy of the commons, since overuse may lead to antibiotic resistance and limiting use would benefit society. In contrast, mass antibiotic treatment programs are thought to result in community-wide benefits. A survey was conducted to learn the views of infectious disease experts on the individual- and societal-level consequences of antibiotic use. Methods. The survey instrument was designed to elicit opinions on antibiotic use and resistance. It was sent via SurveyMonkey to infectious disease professionals identified through literature searches. Descriptive statistics were used to analyze the data. Results. A total of 1,530 responses were received for a response rate of 9.9%. Nearly all participants believed antibiotic use could result in a tragedy of the commons, at least in certain circumstances (96.0%. Most participants did not believe mass antibiotic treatment programs could produce societal benefits in an antibiotic-free society (91.4% or in the United States (94.2%, though more believed such programs would benefit antibiotic-free societies compared to the United States (P<0.001. Conclusions. The experts surveyed believe that antibiotic use can result in a tragedy of the commons and do not believe that mass treatment programs benefit individuals or society.

  15. Indications of a new antibiotic in clinical practice: results of the tigecycline initial use registry

    Directory of Open Access Journals (Sweden)

    Daniel Curcio

    2008-06-01

    Full Text Available Tigecycline is the first of a new class of antibiotics named glycylcyclines and it was approved for the treatment of complicated intra-abdominal infections and complicated skin and skin structure infections. Notwithstanding this, tigecycline's pharmacological and microbiological profile which includes multidrug-resistant pathogens encourages physicians' use of the drug in other infections. We analyzed, during the first months after its launch, the tigecycline prescriptions for 113 patients in 12 institutions. Twenty-five patients (22% received tigecycline for approved indications, and 88 (78% for "off label" indications (56% with scientific support and 22% with limited or without any scientific support. The most frequent "off label" use was ventilator associated pneumonia (VAP (63 patients. The etiology of infections was established in 105 patients (93%. MDR-Acinetobacter spp. was the microorganism most frequently isolated (50% of the cases. Overall, attending physicians reported clinical success in 86 of the 113 patients (76%. Our study shows that the "off label" use of tigecycline is frequent, especially in VAP. due to MDR-Acinetobacter spp., where the therapeutic options are limited (eg: colistin. Physicians must evaluate the benefits/risks of using this antibiotic for indications that lack rigorous scientific support.

  16. Antibiotic use during pregnancy alters the commensal vaginal microbiota.

    Science.gov (United States)

    Stokholm, J; Schjørring, S; Eskildsen, C E; Pedersen, L; Bischoff, A L; Følsgaard, N; Carson, C G; Chawes, B L K; Bønnelykke, K; Mølgaard, A; Jacobsson, B; Krogfelt, K A; Bisgaard, H

    2014-07-01

    Antibiotics may induce alterations in the commensal microbiota of the birth canal in pregnant women. Therefore, we studied the effect of antibiotic administration during pregnancy on commensal vaginal bacterial colonization at gestational week 36. Six hundred and sixty-eight pregnant women from the novel unselected Copenhagen Prospective Studies on Asthma in Childhood (COPSAC2010 ) pregnancy cohort participated in this analysis. Detailed information on oral antibiotic prescriptions during pregnancy filled at the pharmacy was obtained and verified prospectively. Vaginal samples were obtained at pregnancy week 36 and cultured for bacteria. Women who received oral antibiotics during any pregnancy trimester had an increased rate of colonization by Staphylococcus species in the vaginal samples as compared with samples obtained from women without any antibiotic treatment during pregnancy (adjusted OR 1.63, 95% CI 1.06-2.52, p 0.028). Oral antibiotic administration in the third trimester were also associated with increased colonization by Staphylococcus species (adjusted OR 1.98, 95% CI 1.04-3.76, p 0.037). These bacteriological changes were associated with urinary tract infection antibiotics. Women treated in the third trimester of pregnancy were more often colonized by Escherichia coli than women without antibiotic treatment in the third trimester (adjusted OR 1.91, 95% CI 1.04-3.52, p 0.038). This change was associated with respiratory tract infection (RTI) antibiotics. We did not observe any significant changes in vaginal Streptococcus agalactiae (group B streptoccocus) or Staphylococcus aureus colonization following antibiotic treatment in pregnancy. Antibiotic administration during pregnancy leads to alterations in the vaginal microbiological ecology prior to birth, with potential morbidity, and long-term effects on the early microbial colonization of the neonate. PMID:24118384

  17. Antibiotic use during the intracoelomic implantation of electronic tags into fish

    Science.gov (United States)

    Mulcahy, D.M.

    2011-01-01

    The use of antibiotics, in particular, the use of a single dose of antibiotics during electronic tag implantation is of unproven value, and carries with it the potential for the development of antibiotic resistance in bacteria and the alteration of the immune response of the fish. Antibiotic use during electronic tag implantation must conform to relevant drug laws and regulations in the country where work is being done, including the requirements for withdrawal times before human consumption is a possibility. Currently, the choice of antibiotics (most often tetracycline or oxytetracycline) and the use of a single dose of the drug are decisions made without knowledge of the basic need for antibiotic usage and of the bacteria involved in infections that occur following electronic tag implantation. Correct perioperative use of an antibiotic is to apply the drug to the animal before surgery begins, to assure serum and tissue levels of the drug are adequate before the incision is made. However, the most common perioperative application of antibiotics during implantation of an electronic tag is to delay the administration of the drug, injecting it into the coelom after the electronic tag is inserted, just prior to closure of the incision. There is little empirical evidence that the present application of antibiotics in fish being implanted with electronic tags is of value. Improvements should first be made to surgical techniques, especially the use of aseptic techniques and sterilized instruments and electronic tags, before resorting to antibiotics. ?? 2010 Springer Science+Business Media B.V.(outside the USA).

  18. Third generation cephalosporin use in a tertiary hospital in Port of Spain, Trinidad: need for an antibiotic policy

    Directory of Open Access Journals (Sweden)

    Teemul Karen

    2004-12-01

    Full Text Available Abstract Background Tertiary care hospitals are a potential source for development and spread of bacterial resistance being in the loop to receive outpatients and referrals from community nursing homes and hospitals. The liberal use of third-generation cephalosporins (3GCs in these hospitals has been associated with the emergence of extended-spectrum beta- lactamases (ESBLs presenting concerns for bacterial resistance in therapeutics. We studied the 3GC utilization in a tertiary care teaching hospital, in warded patients (medical, surgical, gynaecology, orthopedic prescribed these drugs. Methods Clinical data of patients (≥ 13 years admitted to the General Hospital, Port of Spain (POSGH from January to June 2000, and who had received 3GCs based on the Pharmacy records were studied. The Sanford Antibiotic Guide 2000, was used to determine appropriateness of therapy. The agency which procures drugs for the Ministry of Health supplied the cost of drugs. Results The prevalence rate of use of 3GCs was 9.5 per 1000 admissions and was higher in surgical and gynecological admissions (21/1000 compared with medical and orthopedic (8 /1000 services (p Conclusions There is extensive inappropriate 3GC utilization in tertiary care in Trinidad. We recommend hospital laboratories undertake continuous surveillance of antibiotic resistance patterns so that appropriate changes in prescribing guidelines can be developed and implemented. Though guidelines for rational antibiotic use were developed they have not been re-visited or encouraged, suggesting urgent antibiotic review of the hospital formulary and instituting an infection control team. Monitoring antibiotic use with microbiology laboratory support can promote rational drug utilization, cut costs, halt inappropriate 3GC prescribing, and delay the emergence of resistant organisms. An ongoing antibiotic peer audit is suggested.

  19. Analysis of antibiotics from liquid sample using electrospray ionization-ion mobility spectrometry

    Energy Technology Data Exchange (ETDEWEB)

    Li Shu; Jia Jian; Gao Xiaoguang; He Xiuli [State Key Laboratory of Transducer Technology, Institute of Electronics, Chinese Academy of Sciences, Beijing 100190 (China); Li Jianping, E-mail: jpli@mail.ie.ac.cn [State Key Laboratory of Transducer Technology, Institute of Electronics, Chinese Academy of Sciences, Beijing 100190 (China)

    2012-03-30

    Highlights: Black-Right-Pointing-Pointer The reduced mobilities of 18 antibiotics are determined. Black-Right-Pointing-Pointer Establishing antibiotic mass-mobility correlation using (12,4) potential model. Black-Right-Pointing-Pointer Multi-component characteristics of antibiotics can be revealed using ESI-IMS. Black-Right-Pointing-Pointer Most mixtures of antibiotics can be analyzed using ESI-IMS. Black-Right-Pointing-Pointer The detection limit of amoxicillin is 70 pg. - Abstract: The recent findings of antibiotic residues in aquatic environment at trace level have gained much concern for the detrimental effect on ecological and human health due to bacterial resistance. Here, the feasibility of using electrospray ionization ion mobility spectrometry (ESI-IMS) for analysis antibiotics in liquid sample is demonstrated. Reduced mobilities and collision cross sections of 18 antibiotics are experimentally measured and compared with theoretical values according to mass-mobility correlation. Gentamicin is used as an example to investigate the capability of ESI-IMS for multi-component analysis of antibiotics. Mixtures of antibiotics at different concentrations are analyzed. The estimated detection limit for amoxicillin is 0.7 mg L{sup -1} (70 pg) and the linear range of response maintains over two orders. This method will be a potential technique for the analysis of antibiotics in aquatic environment.

  20. Treatment of Antibiotic Pharmaceutical Wastewater Using a Rotating Biological Contactor

    Directory of Open Access Journals (Sweden)

    Rongjun Su

    2015-01-01

    Full Text Available Rotating biological contactors (RBC are effective for treating wastewater, while they are rarely reported to be used for treating antibiotic pharmaceutical wastewater (APW. The current study investigates treatment of APW using an RBC. The effects of influent concentration, number of stages, and temperature on the remediation of APW were studied. The results indicated, even at low ambient temperature, 45% COD and 40% NH4+-N removal efficiencies. Moreover, the BOD5 removal efficiency was 85%. Microscopic observations illustrated that there were various active microorganisms displayed in the biofilms and their distribution changed from stage to stage. Compared with activated sludge, the biofilms in this study have higher content of dry matter and are easier to dehydrate and settle. Compared with current commercial incineration processes or advanced oxidation processes, RBC can greatly reduce the treatment cost. This research shows RBC is effective for such an inherently biorecalcitrant wastewater even at low ambient temperature.

  1. Antibiotic use during pregnancy alters the commensal vaginal microbiota

    DEFF Research Database (Denmark)

    Stokholm, J.; Schjørring, S.; Eskildsen, Carl Emil Aae;

    2014-01-01

    Antibiotics may induce alterations in the commensal microbiota of the birth canal in pregnant women. Therefore, we studied the effect of antibiotic administration during pregnancy on commensal vaginal bacterial colonization at gestational week 36. Six hundred and sixty-eight pregnant women from...... the novel unselected Copenhagen Prospective Studies on Asthma in Childhood (COPSAC2010 ) pregnancy cohort participated in this analysis. Detailed information on oral antibiotic prescriptions during pregnancy filled at the pharmacy was obtained and verified prospectively. Vaginal samples were obtained...... at pregnancy week 36 and cultured for bacteria. Women who received oral antibiotics during any pregnancy trimester had an increased rate of colonization by Staphylococcus species in the vaginal samples as compared with samples obtained from women without any antibiotic treatment during pregnancy (adjusted OR 1...

  2. Health management with reduced antibiotic use - the U.S. experience.

    Science.gov (United States)

    Baker, Rodney

    2006-01-01

    Since World War II the use of antimicrobial products associated with food animal production has increased. Antimicrobials along with evolving production practices have significantly increased throughput, animal welfare, and improved health. Concerns surrounding the growing significance of emerging and in some cases rapidly disseminating antibiotic (antimicrobial) resistant bacterial pathogens among human and livestock populations has stimulated a reassessment of this application. The negative publicity has led many consumers and activist groups to believe that protein derived from food animals grown in the absence of those drugs is safer than products derived from the conventionally reared. There is a general fear that antimicrobial usage in agriculture threatens the sustainability of human therapeutic agents and the public wellbeing. The issue has gradually emerged from "fringe group paranoia" to mainstream - finally impacting consumer choices. Antimicrobial resistance concerns have stimulated a significant reaction by the US animal agriculture industry. Numerous pig production entities, large and small, have attempted to create additional pork product value by developing niche marketing opportunities. Thus far most of the subtherapeutic in-feed antimicrobial reduction has been voluntary in the US. Two production areas have developed where reduced usage occurs. First is the growth of antibiotic free production (ABF) and second is an increased use of treatment levels which avoids subtherapeutic criticism. The bulk of this article is directed at new production practices, pig health management, disease elimination, and biosecurity efforts that result from early industry attempts at reduced or excluded antimicrobial pig production. Raising antimicrobial (antibiotic) free (ABF) pork from birth is challenging for a variety of reasons. Some of these challenges can be cost effectively dealt with while others are difficult if not impossible to control in modern production

  3. Health management with reduced antibiotic use - the U.S. experience.

    Science.gov (United States)

    Baker, Rodney

    2006-01-01

    Since World War II the use of antimicrobial products associated with food animal production has increased. Antimicrobials along with evolving production practices have significantly increased throughput, animal welfare, and improved health. Concerns surrounding the growing significance of emerging and in some cases rapidly disseminating antibiotic (antimicrobial) resistant bacterial pathogens among human and livestock populations has stimulated a reassessment of this application. The negative publicity has led many consumers and activist groups to believe that protein derived from food animals grown in the absence of those drugs is safer than products derived from the conventionally reared. There is a general fear that antimicrobial usage in agriculture threatens the sustainability of human therapeutic agents and the public wellbeing. The issue has gradually emerged from "fringe group paranoia" to mainstream - finally impacting consumer choices. Antimicrobial resistance concerns have stimulated a significant reaction by the US animal agriculture industry. Numerous pig production entities, large and small, have attempted to create additional pork product value by developing niche marketing opportunities. Thus far most of the subtherapeutic in-feed antimicrobial reduction has been voluntary in the US. Two production areas have developed where reduced usage occurs. First is the growth of antibiotic free production (ABF) and second is an increased use of treatment levels which avoids subtherapeutic criticism. The bulk of this article is directed at new production practices, pig health management, disease elimination, and biosecurity efforts that result from early industry attempts at reduced or excluded antimicrobial pig production. Raising antimicrobial (antibiotic) free (ABF) pork from birth is challenging for a variety of reasons. Some of these challenges can be cost effectively dealt with while others are difficult if not impossible to control in modern production

  4. New business models for antibiotic innovation.

    Science.gov (United States)

    So, Anthony D; Shah, Tejen A

    2014-05-01

    The increase in antibiotic resistance and the dearth of novel antibiotics have become a growing concern among policy-makers. A combination of financial, scientific, and regulatory challenges poses barriers to antibiotic innovation. However, each of these three challenges provides an opportunity to develop pathways for new business models to bring novel antibiotics to market. Pull-incentives that pay for the outputs of research and development (R&D) and push-incentives that pay for the inputs of R&D can be used to increase innovation for antibiotics. Financial incentives might be structured to promote delinkage of a company's return on investment from revenues of antibiotics. This delinkage strategy might not only increase innovation, but also reinforce rational use of antibiotics. Regulatory approval, however, should not and need not compromise safety and efficacy standards to bring antibiotics with novel mechanisms of action to market. Instead regulatory agencies could encourage development of companion diagnostics, test antibiotic combinations in parallel, and pool and make transparent clinical trial data to lower R&D costs. A tax on non-human use of antibiotics might also create a disincentive for non-therapeutic use of these drugs. Finally, the new business model for antibiotic innovation should apply the 3Rs strategy for encouraging collaborative approaches to R&D in innovating novel antibiotics: sharing resources, risks, and rewards.

  5. Therapeutic Use of Native and Recombinant Enteroviruses.

    Science.gov (United States)

    Ylä-Pelto, Jani; Tripathi, Lav; Susi, Petri

    2016-03-01

    Research on human enteroviruses has resulted in the identification of more than 100 enterovirus types, which use more than 10 protein receptors and/or attachment factors required in cell binding and initiation of the replication cycle. Many of these "viral" receptors are overexpressed in cancer cells. Receptor binding and the ability to replicate in specific target cells define the tropism and pathogenesis of enterovirus types, because cellular infection often results in cytolytic response, i.e., disruption of the cells. Viral tropism and cytolytic properties thus make native enteroviruses prime candidates for oncolytic virotherapy. Copy DNA cloning and modification of enterovirus genomes have resulted in the generation of enterovirus vectors with properties that are useful in therapy or in vaccine trials where foreign antigenic epitopes are expressed from or on the surface of the vector virus. The small genome size and compact particle structure, however, set limits to enterovirus genome modifications. This review focuses on the therapeutic use of native and recombinant enteroviruses and the methods that have been applied to modify enterovirus genomes for therapy. PMID:26907330

  6. Therapeutic Use of Native and Recombinant Enteroviruses.

    Science.gov (United States)

    Ylä-Pelto, Jani; Tripathi, Lav; Susi, Petri

    2016-02-23

    Research on human enteroviruses has resulted in the identification of more than 100 enterovirus types, which use more than 10 protein receptors and/or attachment factors required in cell binding and initiation of the replication cycle. Many of these "viral" receptors are overexpressed in cancer cells. Receptor binding and the ability to replicate in specific target cells define the tropism and pathogenesis of enterovirus types, because cellular infection often results in cytolytic response, i.e., disruption of the cells. Viral tropism and cytolytic properties thus make native enteroviruses prime candidates for oncolytic virotherapy. Copy DNA cloning and modification of enterovirus genomes have resulted in the generation of enterovirus vectors with properties that are useful in therapy or in vaccine trials where foreign antigenic epitopes are expressed from or on the surface of the vector virus. The small genome size and compact particle structure, however, set limits to enterovirus genome modifications. This review focuses on the therapeutic use of native and recombinant enteroviruses and the methods that have been applied to modify enterovirus genomes for therapy.

  7. Therapeutic Use of Native and Recombinant Enteroviruses

    Directory of Open Access Journals (Sweden)

    Jani Ylä-Pelto

    2016-02-01

    Full Text Available Research on human enteroviruses has resulted in the identification of more than 100 enterovirus types, which use more than 10 protein receptors and/or attachment factors required in cell binding and initiation of the replication cycle. Many of these “viral” receptors are overexpressed in cancer cells. Receptor binding and the ability to replicate in specific target cells define the tropism and pathogenesis of enterovirus types, because cellular infection often results in cytolytic response, i.e., disruption of the cells. Viral tropism and cytolytic properties thus make native enteroviruses prime candidates for oncolytic virotherapy. Copy DNA cloning and modification of enterovirus genomes have resulted in the generation of enterovirus vectors with properties that are useful in therapy or in vaccine trials where foreign antigenic epitopes are expressed from or on the surface of the vector virus. The small genome size and compact particle structure, however, set limits to enterovirus genome modifications. This review focuses on the therapeutic use of native and recombinant enteroviruses and the methods that have been applied to modify enterovirus genomes for therapy.

  8. Biocompatible hydrodispersible magnetite nanoparticles used as antibiotic drug carriers.

    Science.gov (United States)

    Bolocan, Alexandra; Mihaiescu, Dan Eduard; Andronescu, Ecaterina; Voicu, Georgeta; Grumezescu, Alexandru Mihai; Ficai, Anton; Vasile, Bogdan Ştefan; Bleotu, Coralia; Chifiriuc, Mariana Carmen; Pop, Corina Silvia

    2015-01-01

    Here we report a newly synthesized vectorizing nanosystem, based on hydrodispersible magnetite nanoparticles (HMNPs) with an average size less than 10 nm, obtained by precipitation of Fe(II) and Fe(III) in basic solution of p-aminobenzoic acid (PABA), characterized by high-resolution transmission electron microscopy (HR-TEM), dynamic light scattering (DLS), X-ray diffraction (XRD), differential thermal analysis coupled with thermogravimetric analysis (DTA-TGA) and bioevaluated for cytotoxicity and antibiotic delivery in active forms. The obtained data demonstrate that HMNPs can be used as an efficient drug delivery system, for clinically relevant antimicrobial drugs. HMNPs antimicrobial activity depended on the loaded drug structure and the tested microbial strain, being more efficient against Pseudomonas aeruginosa, comparing with the Escherichia coli strain. The novel HMNPs demonstrated an acceptable biocompatibility level, being thus a very good candidate for biomedical applications, such as drug delivery or targeting.

  9. A Bayesian Belief Network to Infer Incentive Mechanisms to Reduce Antibiotic Use in Livestock Production

    OpenAIRE

    Ge, L.; Asseldonk, van, N.; Valeeva, N.I.; Hennen, W.H.G.J.; Bergevoet, R.H.M.

    2011-01-01

    Efficient policy intervention to reduce antibiotic use in livestock production requires knowledge about the rationale underlying antibiotic usage. Animal health status and management quality are considered the two most important factors that influence farmersâ¿¿ decision-making concerning antibiotic use. Information on these two factors is therefore crucial in designing incentive mechanisms. In this paper, a Bayesian belief network (BBN) is built to represent the knowledge on how these factor...

  10. Using interactive family science shows to improve public knowledge on antibiotic resistance: does it work?

    Science.gov (United States)

    Lecky, Donna M; Hawking, Meredith K D; Verlander, Neville Q; McNulty, Cliodna A M

    2014-01-01

    The public plays an important role in controlling the emergence and spread of antibiotic resistance. A large British survey showed that there is still public misunderstanding about microbes and antibiotics. e-Bug, a European DG Sanco sponsored project, aims to disseminate a school antibiotic and hygiene educational pack and website across Europe. Interactive science shows based on the e-Bug educational packs were developed to take the key health and hygiene messages from the e-Bug school resources to families. The science show was evaluated to assess public knowledge and understanding of antibiotics and antibiotic resistance pre and post intervention. An interactive stall comprised of a 3×2 m backing stand with background information, an interactive activity and discussions with a trained demonstrator was on display at a family holiday resort. Pre-piloted knowledge questionnaires were completed by parents and children pre and post intervention. Adult (≥19 years) baseline knowledge regarding antibiotics and antibiotic resistance was high although significant knowledge improvement was observed where baseline knowledge was low. Children's (5-11 years) knowledge around antibiotics and antibiotic resistance was significantly improved for all questions. The science show can be viewed as a success in improving parents' and children's knowledge of antibiotic use thereby highlighting the importance of educating the public through interaction. PMID:25162505

  11. Are cultural dimensions relevant for explaining cross-national differences in antibiotic use in Europe?

    Directory of Open Access Journals (Sweden)

    Kelen Greta

    2008-06-01

    Full Text Available Abstract Background Antibiotics are widely-used medicines for which a more prudent use has been advocated to minimize development of resistance. There are considerable cross-national differences that can only partially be explained by epidemiological difference and variations in health care structure. The aim of this study was to explore whether cross-national differences in use of antibiotics (prescribed and non-prescribed are associated with differences between national cultures as described in Hofstede's model of cultural dimensions (Power Distance, Individualism, Masculinity, Uncertainty Avoidance and Long-Term Orientation. Methods Country-level data of prescribed antibiotic use and self-medication with antibiotics were correlated to country-specific scores of cultural dimensions obtained from Hofstede. Data on use of antibiotics were provided by three European studies, based on different methods and/or countries: Self-medication with Antibiotics and Resistance in Europe (SAR, based on a survey in 2003 on reported use of antibiotics in 19 countries, the European Surveillance on Antimicrobial Consumption, based on distribution and reimbursement of antibiotics in ambulatory care (1997–2002, and the 2002 interview-based Eurobarometer study, asking whether respondents had taken antibiotics in the previous 12 months. These studies provided data on antibiotics use for 27 European countries in total, for which scores of cultural dimensions were also available. The SAR-study differentiated between prescribed antibiotics and self-medication with antibiotics. Results Significant positive correlations were found for Power Distance Index with use of prescribed antibiotics in the three studies (rho between 0.59 and 0.62 and with self-medication (rho = 0.54 in the SAR study. Positive significant correlations were found for the Uncertainty Avoidance Index with the use of antibiotics as reported in two studies (rho between 0.57 and 0.59; for the SAR study

  12. Educational intervention for parents and healthcare providers leads to reduced antibiotic use in acute otitis media.

    Science.gov (United States)

    Småbrekke, Lars; Berild, Dag; Giaever, Anton; Myrbakk, Torni; Fuskevåg, Airin; Ericson, Johanna U; Flaegstad, Trond; Olsvik, Orjan; Ringertz, Signe H

    2002-01-01

    We used a controlled before-and-after design with the aims of reducing both the total consumption of antibiotics and the use of broad-spectrum antibiotics against acute otitis media (AOM), and to study to what extent prescriptions for antibiotics against AOM were dispensed. Information on evidence-based treatment of uncomplicated AOM was provided to doctors and nurses, and written guidelines were implemented. Pamphlets and oral information concerning symptomatic treatment and the limited effect of antibiotic use in AOM were given to parents. Eligible patients were 819 children aged 1-15 y. The proportion of patients receiving a prescription for antibiotics was reduced from 90% at baseline to 74% during the study period. The proportion of prescriptions for penicillin V increased from 72% at baseline to 85% during the study period. There were no significant changes at the control site. The proportion of dispensed prescriptions was 70% both at baseline and during the study period. Educational efforts reduced the total consumption of antibiotics and the use of broad-spectrum antibiotics for AOM in children aged 1-15 y at an emergency call service. Data on antibiotic use in AOM based only on prescribing overestimates the use of antibiotics.

  13. Country-specific antibiotic use practices impact the human gut resistome

    DEFF Research Database (Denmark)

    Forslund, Kristoffer; Sunagawa, Shinichi; Kultima, Jens Roat;

    2013-01-01

    Despite increasing concerns over inappropriate use of antibiotics in medicine and food production, population-level resistance transfer into the human gut microbiota has not been demonstrated beyond individual case studies. To determine the "antibiotic resistance potential" for entire microbial...... communities, we employ metagenomic data and quantify the totality of known resistance genes in each community (its resistome) for 68 classes and subclasses of antibiotics. In 252 fecal metagenomes from three countries, we show that the most abundant resistance determinants are those for antibiotics also used...

  14. Topical corticosteroids: clinical pharmacology and therapeutic use.

    Science.gov (United States)

    Miller, J A; Munro, D D

    1980-02-01

    The development of topical corticosteroids has enabled many dermatoses to be more effectively treated than previously, but there is also no doubt that misuse of these preparations can lead to troublesome local effects and potentially serious systemic problems. The most effective assay for comparing different compounds has been their vasoconstrictive activity, and this on the whole correlates well with clinical effect. To be effective, corticosteroid must be absorbed and the importance of concentration, occlusion, the type of vehicle, added penetrants such as urea and the anatomical site, on the amount of absorption and therefore on clinical activity has been demonstrated. Ointments have been shown to be more effective than creams but because of the considerable choice of potencies now available most dermatologists tend to prescribe the different formulations according to the wishes of the patient. For the same reason, dilution of the commercially marketed preparations is now not generally recommended. The main therapeutic activity of topical corticosteroids is their nonspecific anti-inflammatory effect, thought to be primarily a result of their action on the chemical mediators of inflammation. They have also been shown to be antimitotic which may well be relevant not only to the treatment of scaling dermatoses but also to their dermal thinning effect resulting from inhibition of fibroblasts. Combinations of corticosteroids with antibacterial and antifungal agents have been shown to be very effective in flexural eruptions and secondarily infected dermatoses. As a general rule, the use of topical corticosteroids in outpatients, unless badly misused, is not associated with any significant risk of adrenal axis suppression, but care must be exercised as to the amount prescribed, especially if large areas of the body are to be treated with highly potent preparations. Certain groups such as young children and patients with liver failure, and certain anatomical sites such

  15. Status Report from the Scientific Panel on Antibiotic Use in Dermatology of the American Acne and Rosacea Society

    Science.gov (United States)

    Webster, Guy F.; Rosen, Ted; Thiboutot, Diane; Leyden, James J.; Gallo, Richard; Walker, Clay; Zhanel, George; Eichenfield, Lawrence

    2016-01-01

    Oral and topical antibiotics are commonly prescribed in dermatologie practice, often for noninfectious disorders, such as acne vulgaris and rosacea. Concerns related to antibiotic exposure from both medical and nonmedical sources require that clinicians consider in each case why and how antibiotics are being used and to make appropriate adjustments to limit antibiotic exposure whenever possible. This first article of a three-part series discusses prescribing patterns in dermatology, provides an overview of sources of antibiotic exposure, reviews the relative correlations between the magnitude of antibiotic consumption and emergence of antibiotic resistance patterns, evaluates the impact of alterations in antibiotic prescribing, and discusses the potential relevance and clinical sequelae of antibiotic use, with emphasis on how antibiotics are used in dermatology. PMID:27462384

  16. Antibiotic use and resistance : Assessing and improving utilisation and provision of antibiotics and other drugs in Vietnam

    OpenAIRE

    Larsson, Mattias

    2003-01-01

    Background: In Vietnam there were shortages of drugs until the end of the 1980's. In 1986 the "Doi Moi" economic reforms towards market economy were initiated. An expanding private health care sector emerged and the per capita drug consumption has increased dramatically. Aim: To assess drug provision in the public and private sectors, antibiotic use and resistance in the community, as well as the effect of an intervention package aimed at improving case management in private...

  17. Do antibiotics have environmental side-effects? Impact of synthetic antibiotics on biogeochemical processes.

    Science.gov (United States)

    Roose-Amsaleg, Céline; Laverman, Anniet M

    2016-03-01

    Antibiotic use in the early 1900 vastly improved human health but at the same time started an arms race of antibiotic resistance. The widespread use of antibiotics has resulted in ubiquitous trace concentrations of many antibiotics in most environments. Little is known about the impact of these antibiotics on microbial processes or "non-target" organisms. This mini-review summarizes our knowledge of the effect of synthetically produced antibiotics on microorganisms involved in biogeochemical cycling. We found only 31 articles that dealt with the effects of antibiotics on such processes in soil, sediment, or freshwater. We compare the processes, antibiotics, concentration range, source, environment, and experimental approach of these studies. Examining the effects of antibiotics on biogeochemical processes should involve environmentally relevant concentrations (instead of therapeutic), chronic exposure (versus acute), and monitoring of the administered antibiotics. Furthermore, the lack of standardized tests hinders generalizations regarding the effects of antibiotics on biogeochemical processes. We investigated the effects of antibiotics on biogeochemical N cycling, specifically nitrification, denitrification, and anammox. We found that environmentally relevant concentrations of fluoroquinolones and sulfonamides could partially inhibit denitrification. So far, the only documented effects of antibiotic inhibitions were at therapeutic doses on anammox activities. The most studied and inhibited was nitrification (25-100 %) mainly at therapeutic doses and rarely environmentally relevant. We recommend that firm conclusions regarding inhibition of antibiotics at environmentally relevant concentrations remain difficult due to the lack of studies testing low concentrations at chronic exposure. There is thus a need to test the effects of these environmental concentrations on biogeochemical processes to further establish the possible effects on ecosystem functioning.

  18. Evaluating antibiotics for use in medicine using a poloxamer biofilm model

    Directory of Open Access Journals (Sweden)

    Cochrane Christine A

    2007-02-01

    Full Text Available Abstract Background Wound infections, due to biofilms, are a constant problem because of their recalcitrant nature towards antibiotics. Appropriate antibiotic selection for the treatment of these biofilm infections is important. The traditional in vitro disc diffusion method for antibiotic selection uses bacterial cultures grown on agar plates. However, the form of bacterial growth on agar is not representative of how bacteria grow in wounds and other tissue sites as here bacteria grow naturally in a biofilm. The aim of this research was to test a more appropriate method for testing antimicrobial efficacy on biofilms and compare with the standard methods used for antibiotic sensitivity testing. Methods Outer Membrane Protein analysis was performed on E.coli, Staphylococcus aureus, Pseudomonas aeruginosa, Proteus mirabilis and Acinetobacter juni when grown on Mueller Hinton agar ('quasi-biofilm state' and 30% Poloxamer hydrogel ('true- biofilm state. Susceptibility to antibiotics on 28 clinical isolates was determined using the modified Kirby Bauer disc diffusion method, on agar and 30% Poloxamer. Results Similar outer membrane proteins [OMPs] were identified in bacteria grown in a biofilm state and on a 30% poloxamer hydrogel, which were very different to the OMPs identified in bacteria grown on Mueller-Hinton agar and broth. There was a significant difference between the means of the clearance zones around the antibiotic discs on standard agar and poloxamer gels [P 0.05]. Conclusion The findings of this experiment suggest that poloxamer gel could be used as an appropriate medium on which to conduct biofilm antibiotic susceptibility tests as it enables bacteria to be grown in a state representative of the infected surface from which the culture was taken.

  19. Recent government regulations in the United States seek to ensure the effectiveness of antibiotics by limiting their agricultural use.

    Science.gov (United States)

    Centner, Terence J

    2016-09-01

    The development of bacteria resistant to antibiotics is viewed as a medical health threat. Because thousands of people die every year due to antibiotic-resistant bacteria, efforts are underway to reduce antibiotic usage which in turn will reduce the development of antibiotic-resistant bacteria. In the United States, the use of antibiotics in the production of food animals to enhance animal growth has been identified as contributing to resistance. In 2015, a veterinary feed directive was adopted by the U.S. federal government prohibiting nontherapeutic uses of antibiotics in food animals that should reduce usage. The continued usage of antibiotics by producers for preventing disease may mean the directive is insufficient to reduce nontherapeutic antibiotic administration. This may lead some consumers to seek meat products from animals raised without antibiotics. A governmentally-sponsored labeling program could encourage reduction in antibiotic usage. PMID:27182666

  20. Toward an Alternative Therapeutic Approach for Skin Infections: Antagonistic Activity of Lactobacilli Against Antibiotic-Resistant Staphylococcus aureus and Pseudomonas aeruginosa.

    Science.gov (United States)

    Hafez, Mohamed M; Maghrabi, Ibrahim A; Zaki, Noha M

    2013-09-01

    The wide spread of antimicrobial resistance has urged the need of alternative therapeutic approach. In this context, probiotic lactobacilli have been reported for the prevention and treatment of many gastrointestinal and urogenital infections. However, very little is known about their antagonistic activity against skin pathogens. Accordingly, the present study aimed to investigate the potential of lactobacilli to interfere with pathogenesis features of two antibiotic-resistant skin pathogens, namely methicillin-resistant Staphylococcus aureus and multiple-resistant Pseudomonas aeruginosa. A total of 49 lactobacilli were recovered, identified and tested for their antagonistic activities against the aforementioned pathogens. Of these, eight isolates were capable of blocking the adherence of pathogens to mammalian cells independent of the skin pathogen tested or model adopted. Moreover, three Lactobacillus isolates (LRA4, LC2 and LR5) effectively prevented the pathogen internalization into epithelial cells in addition to potentiating phagocyte-mediated pathogen killing. Interestingly, the lactobacilli LC2, LF9 and LRA4 markedly inhibited the growth of P. aeruginosa and S. aureus isolates in coculture experiments. Besides, the lactobacilli LRA4, LC2, LR5 and LF9 have counteracted pathogen cytotoxicity. Taken together, the present study revealed some inhibitory activities of lactobacilli against two antibiotic-resistant skin pathogens. Moreover, it revealed two lactobacilli, namely LC2 and LRA4, with antagonistic capacity against different virulence determinants of skin pathogens. These lactobacilli are considered promising probiotic candidates that may represent an alternative therapeutic approach for skin infections.

  1. Prevalence of antibiotic use : A comparison across various European health care data sources

    NARCIS (Netherlands)

    Brauer, Ruth; Ruigómez, Ana; Downey, Gerry; Bate, Andrew; Garcia Rodriguez, Luis Alberto; Huerta, Consuelo; Gil, Miguel; de Abajo, Francisco; Requena, Gema; Alvarez, Yolanda; Slattery, Jim; de Groot, Mark C.H.; Souverein, Patrick; Hesse, Ulrik; Rottenkolber, Marietta; Schmiedl, Sven; de Vries, Frank; Tepie, Maurille Feudjo; Schlienger, Raymond; Smeeth, Liam; Douglas, Ian; Reynolds, Robert; Klungel, Olaf

    2016-01-01

    Purpose: There is widespread concern about increases in antibiotic use, but comparative data from different European countries on rates of use are lacking. This study was designed to measure and understand the variation in antibiotic utilization across five European countries. Methods: Seven Europea

  2. Prevalence of antibiotic use : a comparison across various European health care data sources

    NARCIS (Netherlands)

    Brauer, Ruth; Ruigómez, Ana; Downey, Gerry; Bate, Andrew; Garcia Rodriguez, Luis Alberto; Huerta, Consuelo; Gil, Miguel; de Abajo, Francisco; Requena, Gema; Alvarez, Yolanda; Slattery, Jim; de Groot, Mark; Souverein, Patrick; Hesse, Ulrik; Rottenkolber, Marietta; Schmiedl, Sven; de Vries, Frank; Tepie, Maurille Feudjo; Schlienger, Raymond; Smeeth, Liam; Douglas, Ian; Reynolds, Robert; Klungel, Olaf

    2015-01-01

    PURPOSE: There is widespread concern about increases in antibiotic use, but comparative data from different European countries on rates of use are lacking. This study was designed to measure and understand the variation in antibiotic utilization across five European countries. METHODS: Seven Europea

  3. Prevalence of antibiotic use: A methodological comparison across various European health care data sources

    NARCIS (Netherlands)

    Brauer, Ruth; Ruigómez, Ana; Downey, Gerry; Bate, Andrew; Rodriguez, Luis Alberto Garcia; Huerta, Consuelo; Oliva, Belen; Gil, Miguel; Abajo, Franciscode; Requena, Gema; Alvarez, Yolanda; Slattery, Jim; de Groot, Mark; Souverein, Patrick; Hesse, Ulrik; Rottenkolber, Marietta; Schmiedl, Sven; de Vries, Frank; Tepie, Maurille Feudjo; Schlienger, Raymond; Smeeth, Liam; Douglas, Ian; Reynolds, Robert; Klungel, Olaf

    2013-01-01

    Background: There is widespread concern about possible increases in antibiotic use but comparative data from different European countries on levels of use are lacking. Objectives: This study was designed to measure and understand the variation in antibiotic utilization across seven European health c

  4. Pro/Con debate: Is procalcitonin useful for guiding antibiotic decision making in critically ill patients?

    Science.gov (United States)

    Shehabi, Yahya; Seppelt, Ian

    2008-01-01

    You are concerned about the escalating use of antibiotics in your intensive care unit (ICU). This has put a strain on the ICU budget and is possibly resulting in the emergence of resistant bacteria. You review the situation with your team and one suggestion is to consider using biomarkers such as procalcitonin to better guide appropriate antibiotic decision making. PMID:18466649

  5. Is self-medication with antibiotics in Europe driven by prescribed use?

    NARCIS (Netherlands)

    Grigoryan, Larissa; Burgerhof, Johannes G. M.; Haaijer-Ruskamp, Flora M.; Degener, John E.; Deschepper, Reginald; Monnet, Dominique L.; Di Matteo, Antonella; Scicluna, Elizabeth A.; Bara, Ana-Claudia; Lundborg, Cecilia Stalsby; Birkin, Joan

    2007-01-01

    Background: Self-medication with antibiotics may increase the risk of inappropriate use and the selection of resistant bacteria. One of the triggers for using self-medication may be past experience with antibiotics prescribed by health professionals. We examined the association between prescribed us

  6. Attitudes, beliefs and knowledge concerning antibiotic use and self-medication : a comparative European study

    NARCIS (Netherlands)

    Grigoryan, Larissa; Burgerhof, Johannes G. M.; Degener, John E.; Deschepper, Reginald; Lundborg, Cecilia Stalsby; Monnet, Dominique L.; Scicluna, Elizabeth A.; Birkin, Joan; Haaijer-Ruskamp, Flora M.

    2007-01-01

    Purpose Although the relevance of cultural factors for antibiotic use has been recognized, few studies exist in Europe. We compared public attitudes, beliefs and knowledge concerning antibiotic use and self-medication between 11 European countries. Methods In total, 1101 respondents were interviewed

  7. Use, fate and ecological risks of antibiotics applied in tilapia cage farming in Thailand

    International Nuclear Information System (INIS)

    The use, environmental fate and ecological risks of antibiotics applied in tilapia cage farming were investigated in the Tha Chin and Mun rivers in Thailand. Information on antibiotic use was collected through interviewing 29 farmers, and the concentrations of the most commonly used antibiotics, oxytetracycline (OTC) and enrofloxacin (ENR), were monitored in river water and sediment samples. Moreover, we assessed the toxicity of OTC and ENR on tropical freshwater invertebrates and performed a risk assessment for aquatic ecosystems. All interviewed tilapia farmers reported to routinely use antibiotics. Peak water concentrations for OTC and ENR were 49 and 1.6 μg/L, respectively. Antibiotics were most frequently detected in sediments with concentrations up to 6908 μg/kg d.w. for OTC, and 2339 μg/kg d.w. for ENR. The results of this study indicate insignificant short-term risks for primary producers and invertebrates, but suggest that the studied aquaculture farms constitute an important source of antibiotic pollution. - Highlights: • First study assessing the risks of antibiotics applied in freshwater tilapia cages. • Ten antibiotics were reported to be used by tilapia cage farmers in two Thai rivers. • Peak oxytetracycline and enrofloxacin concentrations were in the order of μg/L. • Antibiotic concentrations in river sediments next to cages were up to several mg/kg. • Antibiotics are not posing a short-term risk for pelagic aquatic organisms. - Antibiotics applied in tilapia cage farming in Thailand are released into surrounding aquatic ecosystems and constitute an important source of environmental pollution

  8. Practices and Factors Influencing the Use of Antibiotics in Selected Poultry Farms in Ghana

    DEFF Research Database (Denmark)

    Boamah, VE; Odoi, H; Dalsgaard, Anders

    2016-01-01

    and to assess factors influencing farmers’ choice of antibiotics for use on their farms. A cross-sectional survey using questionnaires and semistructured interviews was conducted among 400 poultry farms in the Ashanti, Brong-Ahafo and Greater Accra regions of Ghana. Data was analysed using IBM SPSS...... and Microsoft Excel. Multivariate analyses were used to evaluate correlations between farm variables and the dependency of antibiotic use on internal and external farm characteristics. Farmers reported the use of 35 different antimicrobial agents for management of conditions such as Newcastle, fowl pox......, coccidiosis, and coryza. From these agents, 20 essential antibiotics belonging to 10 antibiotic classes were extracted. Frequently employed antibiotics were tetracyclines (24.17%), aminoglycosides (17.87%), penicillins (16.51%) and fluoroquinolones (10.55%). Only 63% of the farms completed recommended...

  9. Ethical considerations when using video games as therapeutic tools

    OpenAIRE

    Colman, Jason; Gnanayutham, Paul

    2010-01-01

    Video games have been used in a variety of therapeutic and rehabilitative contexts. However, there are health risks associated with playing video games, including the risk of epileptic seizure. Additionally, video games have been criticised for reasons including their portrayal of women and minorities. For games to be accepted as an ethically valid therapeutic tool, these concerns must be addressed. The authors believe that video games can be used as therapeutic tools when used responsibly

  10. Antibiotic use and cost in a teaching hospital in İstanbul

    Directory of Open Access Journals (Sweden)

    Özgür Dağlı

    2011-12-01

    Full Text Available Objectives: The aims of this study were to determine the usage patterns and the cost of antibiotics, along with theevaluation of the effects of infectious diseases (ID specialists on appropriate antimicrobial use in hospitalized patients.Materials and methods: A one-day, cross-sectional study was conducted in a major tertiary hospital and data on theuse of antibiotics were collected by using a standard form. The appropriateness of the antibiotic usage was evaluatedusing the Council for Appropriate and Rational Antibiotic Therapy (CARAT criteria; and the consumption and daily costof antibiotics were determined.Results: On the study day, antibiotics were prescribed in 199 (35.6% of 553 hospitalized patients, in 109 (32.9% onthe surgical and 90 patients (40.5% on the medical wards. The total empirical antibiotic use was more frequent (49.7%than prophylactic (29.1% and culture-based therapy (21.2%. In 44 patients (22.1% the antibiotics were used inappropriately;any of these antibiotics needed the approval of ID specialist. The inappropriate usage was more common inprophylactic therapy (46.5% than empirical (16.1% and specific antibiotic administration (2.3%. ID consultation rateswere significantly higher in the appropriate antibiotic administrations (69.6% than in the inappropriate group [(6.8%,p<0.0001, odds ratio (OR 10.2, confidence intervals (CI =3.0–3.7]. The total one-day cost of antibiotic therapy in ourhospital was US $3350.6, and the total daily cost for hospital infection was $2137.1. The mean daily cost per patientwas $2.1 for prophylaxis, $10.7 for community-acquired infections and $54.7 for hospital infections (p<0.001, OR 9.8,CI 4.7–20.7.Conclusion: This study showed that antibiotic prescription rates are high, surgical prophylaxis is still a major problemin our hospital, ID approval is effective for appropriate use of antibiotics, and the antibiotic cost of hospital infections isan important part of extra costs. J Microbiol Infect

  11. A Point Prevalence Survey of Antibiotic Use in 18 Hospitals in Egypt

    Directory of Open Access Journals (Sweden)

    Maha Talaat

    2014-09-01

    Full Text Available Inappropriate antibiotic use leads to increased risk of antibiotic resistance and other adverse outcomes. The objectives of the study were to determine the prevalence and characteristics of antibiotic use in Egyptian hospitals to identify opportunities for quality improvement. A point prevalence survey was conducted in 18 hospitals in March 2011. A total of 3408 patients were included and 59% received at least one antibiotic, with the most significant use among persons <12 years and intensive care unit patients (p < 0.05. Third generation cephalosporin were the most commonly prescribed antibiotics (28.7% of prescriptions. Reasons for antibiotic use included treatment of community—(27% and healthcare-associated infections (11% and surgical (39% and medical (23% prophylaxis. Among surgical prophylaxis recipients, only 28% of evaluable cases received the first dose within two hours before incision and only 25% of cases received surgical prophylaxis for <24 h. The prevalence of antibiotic use in Egyptian hospitals was high with obvious targets for antimicrobial stewardship activities including provision of antibiotic prescription guidelines and optimization of surgical and medical prophylaxis practices.

  12. [Antimicrobial resistance forever? Judicious and appropriate use of antibiotics].

    Science.gov (United States)

    Cagliano, Stefano

    2015-06-01

    This article takes its cue from the original work of sir Alexander Fleming on penicillin, published in the first issue of Recenti Progressi in Medicina in 1946 and reproduced here on the occasion of the approaching 70-year anniversary of the journal. In 1928, at the time when penicillin was discovered, it could not be imagined that bacterial resistance to antibiotics would develop so rapidly: the introduction of every new class of antibiotics has been shortly followed by the emergence of new strains of bacteria resistant to that class. Bacterial resistance to antibiotic treatment is a huge concern. In this respect, an action plan against antimicrobial resistance has been devised in the United States that is targeted for a 50% reduction over the next five years.

  13. Understanding Antibiotic Use in Minya District, Egypt: Physician and Pharmacist Prescribing and the Factors Influencing Their Practices

    Directory of Open Access Journals (Sweden)

    Kathleen L. Dooling

    2014-06-01

    Full Text Available Overuse of antibiotics has contributed to the emergence of antibiotic-resistant bacteria globally. In Egypt, patients can purchase antibiotics without a prescription, and we hypothesized frequent inappropriate antibiotic prescribing and dispensing. We interviewed physicians (n = 236 and pharmacists (n = 483 and conducted focus groups in Minya, Egypt, to assess attitudes and practices regarding antibiotic prescribing for outpatient acute respiratory infections (ARI. Antibiotics were reportedly prescribed most of the time or sometimes for colds by 150 (64% physicians and 326 (81% pharmacists. The most commonly prescribed antibiotics were β-lactams. Macrolides were the second most commonly prescribed for colds and sinusitis. The prescription of more than one antibiotic to treat pneumonia was reported by 85% of physicians. Most respondents thought antibiotic overuse contributes to resistance and reported “patient self-medication” as the biggest driver of overuse. Fifty physicians (21% reported that they had prescribed antibiotics unnecessarily, citing patient over-the-counter access as the reason. Physicians <40 years of age and those who treat adults were more likely to prescribe antibiotics for colds. Overall, we found a high rate of unwarranted outpatient antibiotic prescribing and dispensing for ARIs. Patient access to OTC antibiotics contributes to over-prescribing. National guidelines for ARI treatment, provider education and national policy requiring a physician’s prescription for antibiotics may improve appropriate antibiotic use in Egypt.

  14. A method for determining the free (unbound) concentration of ten beta-lactam antibiotics in human plasma using high performance liquid chromatography with ultraviolet detection.

    Science.gov (United States)

    Briscoe, Scott E; McWhinney, Brett C; Lipman, Jeffrey; Roberts, Jason A; Ungerer, Jacobus P J

    2012-10-15

    With the clinical imperative to further research in the area of optimising antibiotic dosing in the intensive care setting, a simple high performance liquid chromatography method was developed and validated for routinely determining the free (unbound) concentration of ten beta-lactam antibiotics in 200 μL of human plasma. Antibiotics determined include three cephalosporins (ceftriaxone, cephazolin and cephalotin); two carbapenems (meropenem and ertapenem); and five penicillins (ampicillin, piperacillin, benzylpenicillin, flucloxacillin and dicloxacillin). There was a single common sample preparation method involving ultracentrifugation and stabilisation. Chromatography was performed on a Waters XBridge C18 column with, depending on analytes, one of four acetonitrile-phosphate buffered mobile phases. Peaks of interest were detected via ultraviolet absorbance at 210, 260 and 304 nm. The method has been validated and used in a pathology laboratory for therapeutic drug monitoring in critically ill patients. The significant variability in the level of protein binding that is common with antibiotics traditionally considered to have high protein binding (e.g. ceftriaxone, cephazolin, ertapenem, flucloxacillin and dicloxacillin) suggests that this assay should be preferred for measuring the pharmacologically active concentration of beta-lactam antibiotics in a therapeutic drug monitoring programme. PMID:23026224

  15. The Use of Therapeutic Cloning in Transplantations: An Aristotelian Perspective

    OpenAIRE

    Labrou, C.

    2012-01-01

    Therapeutic cloning for transplantations is one of the most complex issues in Bioethics. This is because it involves two of the most controversial subjects in today's medicine: cloning and transplantations. Although therapeutic cloning is a modern issue in the scope of transplantations, we consider Aristotle's contribution to be of high importance. On a first level, we will describe the modem phenomenon of therapeutic cloning, concerning the medical technique itself, its aim, its use in trans...

  16. Use of antibiotics in ambulatory care patients and at the Clinic of Infectious Diseases

    Directory of Open Access Journals (Sweden)

    Stefan-Mikić Sandra

    2002-01-01

    Full Text Available Introduction Optimal pharmacotherapy includes utilization of the right drug at the right time, right duration of therapy and adequate dosage. This study analyzed utilization of antimicrobial drugs at the Clinic of Infectious Diseases of the Clinical Center Novi Sad and in outpatients of the Outpatient General Service of the Health Center Novi Sad - Liman. Material and methods Utilization of anti-infective agents was examined according to Anatomic-Therapeutic-Chemical Classification (group J. Drug utilization data were presented in Defined Daily Doses at the Clinic of Infectious Diseases of the Clinical Center Novi Sad in Defined Daily Doses per 100 bed-days, and in the Outpatient General Service of the Health Center Novi Sad - Liman in Defined Daily Doses/1000 inhabitants per day. Results At the Clinic of Infectious Diseases of the Clinical Center Novi Sad penicillins susceptible to beta-lactamase were established as most frequently used (39.33% namely: benzylpenicillin (32.18%, quinolone antibacterial agents ciprofloxacin (12.44% and cephalosporins, cephalexin (8.25%. In the Outpatient General Service of the Health Center Novi Sad - Liman most frequently used were extended-spectrum penicillins (24.20% namely tetracyclines, doxycycline (18.98%, amoxicillin (18.27%, macrolides roxithromycin (17.56%. At the Clinic of Infectious Diseases of the Clinical Center Novi Sad the decision on using antibiotics and establishing whether it was bacterial or virus infection in 92.13% cases was made on the basis of following analyses: throat and nasal swabs, urine culture, virus complement-binding reaction. In Outpatient General Service of the Health Center Novi Sad - Liman it was done only in 18.46%. Conclusion Although treatment performed based on clinical picture and experience usually proves to be correct, antibiotic prescription policy should include antibiograms to provide optimal treatment and decrease the degree of resistance. Thus medicine would be

  17. Complementary or alternative? The use of homeopathic products and antibiotics amongst pre-school children

    Directory of Open Access Journals (Sweden)

    Bishop Jackie

    2008-01-01

    Full Text Available Abstract Background Any intervention to reduce the inappropriate use of antibiotics for infections in children has the potential to reduce the selective pressure on antimicrobial resistance and minimise the medicalisation of self-limiting illness. Little is known about whether homeopathic products might be used by some families as an alternative to antibiotics or the characteristics of such families. We used the Avon Longitudinal Study of Parents and Children (ALSPAC observational dataset to explore the hypothesis that the use of homeopathic products is associated with reduced antibiotic use in pre-school children and to identify characteristics of the families of pre-school children given homeopathic products. Methods Questionnaires data were completed by the parents of 9723 children while aged between 3–4.5 years in Bristol UK. Univariable and multivariable analyses were used to explore the relationships between antibiotic and homeopathic product use. Results Six percent of children had received one or more homeopathic products and 62% one or more antibiotics between the ages of 3 and 4.5 years. After adjustment for factors associated with antibiotic use, there was no association between homeopathic product and antibiotic use (adjusted OR = 1.02, 95% CI 0.84, 1.24. Factors independently associated with child homeopathic product use were: higher maternal education, maternal use of homeopathic products, maternal lack of confidence in doctors, mothers reporting that they were less likely to see doctor when the child was ill, children being given vitamins, watching less television and suffering from wheeze and food allergies. Conclusion In this observational study, the use of homeopathic products was not associated with decreased antibiotic consumption, suggesting the use of homeopathic product complements rather than competes with the use of antibiotics in pre-school children. The characteristics of mothers giving homeopathic products to their

  18. Public Knowledge, Beliefs and Behavior on Antibiotic Use and Self-Medication in Lithuania.

    Science.gov (United States)

    Pavydė, Eglė; Veikutis, Vincentas; Mačiulienė, Asta; Mačiulis, Vytautas; Petrikonis, Kęstutis; Stankevičius, Edgaras

    2015-06-01

    Irrational antibiotic use has led society to antibiotic resistance-a serious health problem worldwide. This study aimed to assess public knowledge, beliefs, and behavior concerning antibiotic use and self-medication in Lithuania. The cross-sectional survey method was processed using a validated questionnaire in different regions of Lithuania. In total, 1005 adults completed the questionnaire and were included in the study. More than half of the respondents (61.1%) had poor knowledge of antibiotics. Almost half of the respondents incorrectly identified antibiotics as being effective either against viral (26.0%) or mixed (bacterial and viral) infections (21.7%). The respondents with lower educational qualifications (OR = 2.515; 95% CI 1.464-4.319; p = 0.001) and those from rural areas (OR = 1.765; 95% CI 1.041-2.991; p = 0.035) were significantly less knowledgeable of antibiotics. There was no significant difference between genders, different age groups, or different parenthood status. The determined level of self-medication with antibiotics was 31.0%. The men (OR = 1.650; 95% CI 1.120-2.430; p = 0.011), the respondents from rural areas (OR = 2.002; 95% CI 1.343-2.985; p = 0.001), and those without children (OR = 2.428; 95% CI 1.477-3.991; p self-medication. Lithuanian residents' knowledge of antibiotics is insufficient. More information about antibiotic use should be provided by physicians and pharmacists. Self-medication with antibiotics is a serious problem in Lithuania and requires considerable attention.

  19. Therapeutic Uses of Active Videogames: A Systematic Review

    OpenAIRE

    Staiano, Amanda E.; Flynn, Rachel

    2014-01-01

    Background: Active videogames (AVGs) may be useful for promoting physical activity for therapeutic uses, including for balance, rehabilitation, and management of illness or disease. The literature from 64 peer-reviewed publications that assessed health outcomes of AVGs for therapeutic purposes was synthesized.

  20. Use of old antibiotics now and in the future from a pharmacokinetic/pharmacodynamic perspective.

    Science.gov (United States)

    Muller, A E; Theuretzbacher, U; Mouton, J W

    2015-10-01

    Because of the increase in bacterial resistance to commonly used antibacterial drugs, old antibiotics are being 'revived' and, once again, are attracting interest. Many of these old antibiotics were approved long ago, in an era when there was no clear process for development, and requirements for efficacy to be demonstrated in rigorous clinical trials did not exist. At the time of these approvals, pharmacokinetic and pharmacodynamic principles were largely unknown, and did not inform the dose-finding process or recommendations for optimal usage. Indeed, the task of generating basic vital information for these old antibiotics remains to be performed. In this review, we provide a brief overview of the most essential data needed for dose justification and optimization. An overview of the shortage of data for selected old antibiotics illustrates the scope of the problem. In order to prevent harming patients with clinical decisions based on inadequate evidence, a redevelopment procedure for old antibiotics is urgently needed, including a regulatory framework.

  1. Topical and oral antibiotics for acne vulgaris.

    Science.gov (United States)

    Del Rosso, James Q

    2016-06-01

    Antibiotics, both oral and topical, have been an integral component of the management of acne vulgaris (AV) for approximately 6 decades. Originally thought to be effective for AV due to their ability to inhibit proliferation of Propionibacterium acnes, it is now believed that at least some antibiotics also exert anti-inflammatory effects that provide additional therapeutic benefit. To add, an increase in strains of P acnes and other exposed bacteria that are less sensitive to antibiotics used to treat AV have emerged, with resistance directly correlated geographically with the magnitude of antibiotic use. Although antibiotics still remain part of the therapeutic armamentarium for AV treatment, current recommendations support the following when used to treat AV: 1) monotherapy use should be avoided; 2) use benzoyl peroxide concomitantly to reduce emergence of resistant P acnes strains; 3) oral antibiotics should be used in combination with a topical regimen for moderate-to-severe inflammatory AV; and 4) use oral antibiotics over a limited duration to achieve control of inflammatory AV with an exit plan in place to discontinue their use as soon as possible. When selecting an oral antibiotic to treat AV, potential adverse effects are important to consider. PMID:27416309

  2. Topical and oral antibiotics for acne vulgaris.

    Science.gov (United States)

    Del Rosso, James Q

    2016-06-01

    Antibiotics, both oral and topical, have been an integral component of the management of acne vulgaris (AV) for approximately 6 decades. Originally thought to be effective for AV due to their ability to inhibit proliferation of Propionibacterium acnes, it is now believed that at least some antibiotics also exert anti-inflammatory effects that provide additional therapeutic benefit. To add, an increase in strains of P acnes and other exposed bacteria that are less sensitive to antibiotics used to treat AV have emerged, with resistance directly correlated geographically with the magnitude of antibiotic use. Although antibiotics still remain part of the therapeutic armamentarium for AV treatment, current recommendations support the following when used to treat AV: 1) monotherapy use should be avoided; 2) use benzoyl peroxide concomitantly to reduce emergence of resistant P acnes strains; 3) oral antibiotics should be used in combination with a topical regimen for moderate-to-severe inflammatory AV; and 4) use oral antibiotics over a limited duration to achieve control of inflammatory AV with an exit plan in place to discontinue their use as soon as possible. When selecting an oral antibiotic to treat AV, potential adverse effects are important to consider.

  3. Comparison of two methods for collecting antibiotic use data on small dairy farms.

    Science.gov (United States)

    Redding, L E; Cubas-Delgado, F; Sammel, M D; Smith, G; Galligan, D T; Levy, M Z; Hennessy, S

    2014-06-01

    Antibiotics are commonly used in animal agriculture; they can improve animal health and productivity, but their use may also represent a public health threat. Very little is known about antibiotic use on small farms in lower/middle income countries. To understand antibiotic use on these farms and promote the judicious use of these drugs, pharmacoepidemiologic data are necessary. However, acquiring such data can be difficult, as farmers are often illiterate (and therefore cannot participate in written surveys or keep treatment records), antibiotics can be obtained over-the-counter (in which case no prescriptions are generated) and monitoring and surveillance systems for drug use are often non-existent. The goal of this study was to compare two methods of acquiring pharmacoepidemiologic data pertaining to antibiotics that are well-adapted to farms in lower-middle income countries: self-report and the collection of discarded drug packaging. A convenience sample of 20 farmers in Cajamarca, Peru, participated in the study. Farmers placed discarded antibiotic packaging in bins for six months. At the end of the six-month period, farmers were interviewed and asked to recall the antibiotic usage that occurred on their farm over the past month and past six months; these self-reported data were quantitatively and qualitatively compared to the bin contents collected in the last month and previous six months. We found that the agreement between the bins and self-report was relatively poor for both the quantity and types of antibiotics used. The bins appeared to perform better than self-report when bottles and mLs of antibiotics were measured, while self-report appeared to perform better for intra-mammary infusions. The bins also appeared to perform better when data pertaining to an extended time period (six months) were collected. The results of this study will provide guidance to investigators seeking to collect pharmacoepidemiologic data in similar environments. PMID:24630404

  4. Comparison of two methods for collecting antibiotic use data on small dairy farms.

    Science.gov (United States)

    Redding, L E; Cubas-Delgado, F; Sammel, M D; Smith, G; Galligan, D T; Levy, M Z; Hennessy, S

    2014-06-01

    Antibiotics are commonly used in animal agriculture; they can improve animal health and productivity, but their use may also represent a public health threat. Very little is known about antibiotic use on small farms in lower/middle income countries. To understand antibiotic use on these farms and promote the judicious use of these drugs, pharmacoepidemiologic data are necessary. However, acquiring such data can be difficult, as farmers are often illiterate (and therefore cannot participate in written surveys or keep treatment records), antibiotics can be obtained over-the-counter (in which case no prescriptions are generated) and monitoring and surveillance systems for drug use are often non-existent. The goal of this study was to compare two methods of acquiring pharmacoepidemiologic data pertaining to antibiotics that are well-adapted to farms in lower-middle income countries: self-report and the collection of discarded drug packaging. A convenience sample of 20 farmers in Cajamarca, Peru, participated in the study. Farmers placed discarded antibiotic packaging in bins for six months. At the end of the six-month period, farmers were interviewed and asked to recall the antibiotic usage that occurred on their farm over the past month and past six months; these self-reported data were quantitatively and qualitatively compared to the bin contents collected in the last month and previous six months. We found that the agreement between the bins and self-report was relatively poor for both the quantity and types of antibiotics used. The bins appeared to perform better than self-report when bottles and mLs of antibiotics were measured, while self-report appeared to perform better for intra-mammary infusions. The bins also appeared to perform better when data pertaining to an extended time period (six months) were collected. The results of this study will provide guidance to investigators seeking to collect pharmacoepidemiologic data in similar environments.

  5. Forgotten antibiotics

    DEFF Research Database (Denmark)

    Pulcini, Céline; Bush, Karen; Craig, William A;

    2012-01-01

    In view of the alarming spread of antimicrobial resistance in the absence of new antibiotics, this study aimed at assessing the availability of potentially useful older antibiotics. A survey was performed in 38 countries among experts including hospital pharmacists, microbiologists, and infectious...... disease specialists in Europe, the United States, Canada, and Australia. An international expert panel selected systemic antibacterial drugs for their potential to treat infections caused by resistant bacteria or their unique value for specific criteria. Twenty-two of the 33 selected antibiotics were...... available in fewer than 20 of 38 countries. Economic motives were the major cause for discontinuation of marketing of these antibiotics. Fourteen of 33 antibiotics are potentially active against either resistant Gram-positive or Gram-negative bacteria. Urgent measures are then needed to ensure better...

  6. Diagnostic and therapeutic direct peroral cholangioscopy using an intraductal anchoring balloon

    Institute of Scientific and Technical Information of China (English)

    Mansour A Parsi; Tyler Stevens; John J Vargo

    2012-01-01

    AIM:To report our experience using a recently introduced anchoring balloon for diagnostic and therapeutic direct peroral cholangioscopy (DPOC).METHODS:Consecutive patients referred for diagnostic or therapeutic peroral cholangioscopy were evaluated in a prospective cohort study.The patients underwent DPOC using an intraductal anchoring balloon,which was recently introduced to allow consistent access to the biliary tree with an ultraslim upper endoscope.The device was later voluntarily withdrawn from the market by the manufacturer.RESULTS:Fourteen patients underwent DPOC using the anchoring balloon.Biliary access with an ultraslim upper endoscope was accomplished in all 14 patients.In 12 (86%) patients,ductal access required sphincteroplasty with a 10-mm dilating balloon.Intraductal placement of the ultraslim upper endoscope allowed satisfactory visualization of the biliary mucosa to the level of the confluence of the right and left hepatic ducts in 13 of 14 patients (93%).Therapeutic interventions by DPOC were successfully completed in all five attempted cases (intraductal biopsy in one and DPOC guided laser lithotripsy in four).Adverse events occurred in a patient on immunosuppressive therapy who developed an intrahepatic biloma at the site of the anchoring balloon.This required hospitalization and antibiotics.Repeat endoscopic retrograde cholangiopancreatography 8 wk after the index procedure showed resolution of the biloma.CONCLUSION:Use of this anchoring balloon allowed consistent access to the biliary tree for performance of diagnostic and therapeutic DPOC distal to the biliary bifurcation.

  7. Antibiotic use in dentistry: A cross-sectional survey from a developing country

    Directory of Open Access Journals (Sweden)

    Sivaramakrishnan Gowri

    2015-01-01

    Full Text Available Introduction: Antimicrobial resistance is a well-known entity and the most common factor leading to this is the irrational use of antibiotics. Several studies from the West have substantiated the irrational use of antibiotics in dentistry. Aims: The aim was to assess the knowledge, attitude, and practice (KAP of antimicrobial drug use among dental fraternity in a tertiary care teaching dental college and hospital. Materials and methods: A cross-sectional survey of various dental fraternities using a structured validated questionnaire. The study was initiated following approval from Institutional Ethics Committee and interns, junior residents and faculty members of various departments in dentistry were enrolled after obtaining written informed consent. A structured validated questionnaire was developed to assess the above-mentioned objectives. Statistical analysis: Descriptive statistics was used for representing each category of response and kappa statistics were used to assess the reliability in the initial cohort. Chi-square test for independence was used to evaluate the difference in proportion between different professional cadres. Results: A total of 120 participants were recruited out of which 81.6% (98/120 of the participants accepted their frequent antibiotic usage. The most common dental indication of antibiotics among dentists was post dental extraction, attributing to 30.8% (37/120, followed by dental abscess 21.6% (26/120 and 60% (72/120 prescribed antibiotics after most minor surgical procedures. Surprisingly, 37.5% (45/120 of the participants opined that they use antibiotics against viral infection. Regarding the spectrum of antibiotic usage, 74.1% (89/120 preferred broad spectrum instead of narrow spectrum 25.8% (31/120. The commonly prescribed antibiotics were amoxicillin 71.7% (86/120, metronidazole 33.3% (40/120, amoxicillin with clavulanic acid 26.6% (32/120. A total of (43/120 35.8% opted generic name for mentioning the

  8. Drug Utilization Study on Antibiotics Use in Lower Respiratory Tract Infection

    Directory of Open Access Journals (Sweden)

    Harish Govind Naik

    2013-08-01

    Full Text Available ABSTRACT Antibiotics are commonly prescribed for the lower respiratory tract infection. But if antibiotics are not used rationally then there will be increase chances of resistance of bacteria as well as increase in the total cost of treatment. This study was conducted to see the antibiotics utilization pattern. Aim: This drug utilization study was conducted to evaluate the pattern of antibiotics use in Medicine Department of a Krishna Hospital, Karad, Maharashtra, India. 96 case records were examined, of which 46.87% were LRTI (nonspecific LRTI and acute bronchitis and 51% were pneumonia. Female accounted for 53.12% and male for 46.87 % of total cases. The World Health Organization (WHO indicators (utilization in defined daily doses (DDD; DDD/1000inhibitant/day were used and the ATC/DDD method was implemented. The most frequently prescribed antibiotic was ceftriaxone, followed by Azithromycin. The DDD/1000inhibitant/day of Azithromycin was the highest (5.74. Average treatment period was found to be 5.42 and 6.52 for LRTI (nonspecific LRTI and Acute Bronchitis and pneumonia respectively. A total of 96 cases studied; in which 33 cases had mono-antibiotic therapy (33.37% and rest contained poly-antibiotics therapy (66.63%. Prescribing by generic names has to be encouraged. [Natl J Med Res 2013; 3(4.000: 324-327

  9. Country-specific antibiotic use practices impact the human gut resistome.

    Science.gov (United States)

    Forslund, Kristoffer; Sunagawa, Shinichi; Kultima, Jens Roat; Mende, Daniel R; Arumugam, Manimozhiyan; Typas, Athanasios; Bork, Peer

    2013-07-01

    Despite increasing concerns over inappropriate use of antibiotics in medicine and food production, population-level resistance transfer into the human gut microbiota has not been demonstrated beyond individual case studies. To determine the "antibiotic resistance potential" for entire microbial communities, we employ metagenomic data and quantify the totality of known resistance genes in each community (its resistome) for 68 classes and subclasses of antibiotics. In 252 fecal metagenomes from three countries, we show that the most abundant resistance determinants are those for antibiotics also used in animals and for antibiotics that have been available longer. Resistance genes are also more abundant in samples from Spain, Italy, and France than from Denmark, the United States, or Japan. Where comparable country-level data on antibiotic use in both humans and animals are available, differences in these statistics match the observed resistance potential differences. The results are robust over time as the antibiotic resistance determinants of individuals persist in the human gut flora for at least a year.

  10. Effectiveness of interventions in reducing antibiotic use for upper respiratory infections in ambulatory care practices.

    Science.gov (United States)

    Vinnard, Christopher; Linkin, Darren R; Localio, A Russell; Leonard, Charles E; Teal, Valerie L; Fishman, Neil O; Hennessy, Sean

    2013-02-01

    The objective was to evaluate the effect of separate interventions on antimicrobial prescribing for uncomplicated upper respiratory tract infections. The authors conducted a quasi-experimental pre-post study with concurrent control groups for each intervention. Academic detailing led to a significant reduction in unnecessary antibiotic prescribing. However, there was no significant change in antibiotic prescribing in response to educational mailings to providers or to provider involvement in patient mailings. Organizations that seek to reduce inappropriate use of antibiotics should use proven approaches, even when they are more expensive.

  11. Maternal antibiotic use and risk of asthma in offspring--Authors' reply

    DEFF Research Database (Denmark)

    Bisgaard, Hans; Stokholm, Jakob; Sevelsted, Astrid;

    2014-01-01

    We thank Martin J Blaser and Maria Bello for their interest in our study.1 Our original discovery of an association between use of antibiotics in pregnancy and an offspring's risk of asthma was replicated in the COPSAC2000 birth cohort and another Danish birth cohort, as well as in national...... registries.2,3 We interpreted this association between use of antibiotics in pregnancy and the child's risk of asthma as one that was mediated through changes in the microbiome. In our study we aimed to test this hypothesis by investigating the temporal associations between maternal antibiotics and childhood...

  12. The role of topical antibiotics used as prophylaxis in surgical site infection prevention.

    LENUS (Irish Health Repository)

    McHugh, S M

    2012-02-01

    Compared with systemic antibiotic therapy, the topical or local delivery of an antibiotic has many potential advantages. However, local antibiotics at the surgical site have received very limited approval in any of the surgical prophylaxis consensus guidelines that we are aware of. A review of the literature was carried out through searches of peer-reviewed publications in PubMed in the English language over a 30 year period between January 1980 and May 2010. Both retrospective and prospective studies were included, as well as meta-analyses. With regard to defining \\'topical\\' or \\'local\\' antibiotic application, the application of an antibiotic solution to the surgical site intraoperatively or immediately post-operatively was included. A number of surgical procedures have been shown to significantly benefit from perioperative topical prophylaxis, e.g. joint arthroplasty, cataract surgery and, possibly, breast augmentation. In obese patients undergoing abdominal surgery, topical surgical prophylaxis is also proven to be beneficial. The selective use of topical antibiotics as surgical prophylaxis is justified for specific procedures, such as joint arthroplasty, cataract surgery and, possibly, breast augmentation. In selective cases, such as obese patients undergoing abdominal surgery, topical surgical prophylaxis is also proven to be beneficial. Apart from these specific indications, the evidence for use of topical antibiotics in surgery is lacking in conclusive randomized controlled trials.

  13. The role of topical antibiotics used as prophylaxis in surgical site infection prevention.

    LENUS (Irish Health Repository)

    McHugh, S M

    2011-04-01

    Compared with systemic antibiotic therapy, the topical or local delivery of an antibiotic has many potential advantages. However, local antibiotics at the surgical site have received very limited approval in any of the surgical prophylaxis consensus guidelines that we are aware of. A review of the literature was carried out through searches of peer-reviewed publications in PubMed in the English language over a 30 year period between January 1980 and May 2010. Both retrospective and prospective studies were included, as well as meta-analyses. With regard to defining \\'topical\\' or \\'local\\' antibiotic application, the application of an antibiotic solution to the surgical site intraoperatively or immediately post-operatively was included. A number of surgical procedures have been shown to significantly benefit from perioperative topical prophylaxis, e.g. joint arthroplasty, cataract surgery and, possibly, breast augmentation. In obese patients undergoing abdominal surgery, topical surgical prophylaxis is also proven to be beneficial. The selective use of topical antibiotics as surgical prophylaxis is justified for specific procedures, such as joint arthroplasty, cataract surgery and, possibly, breast augmentation. In selective cases, such as obese patients undergoing abdominal surgery, topical surgical prophylaxis is also proven to be beneficial. Apart from these specific indications, the evidence for use of topical antibiotics in surgery is lacking in conclusive randomized controlled trials.

  14. The use of antibiotics on small dairy farms in rural Peru.

    Science.gov (United States)

    Redding, L E; Cubas-Delgado, F; Sammel, M D; Smith, G; Galligan, D T; Levy, M Z; Hennessy, S

    2014-01-01

    Very little is known about the use of antibiotics on small dairy farms in lower/middle-income countries. The use of these drugs can have profound impacts on animal health, farmer income and public health. A survey of 156 farmers was conducted in Cajamarca, a major dairy-producing center in the highlands of Peru characterized by small farms (advanced stage of clinical disease. Few farmers were able to define an antibiotic, but many farmers understood that the use of antibiotics carried inherent risks to their animals and potentially to the consumers of dairy products from treated animals. The results of this study are useful for understanding the patterns of antibiotic use and associated management, demographic and knowledge factors of farmers on small dairy farms in rural Peru.

  15. Antibiotics in Wastewater of a Rural and an Urban Hospital before and after Wastewater Treatment, and the Relationship with Antibiotic Use-A One Year Study from Vietnam.

    Science.gov (United States)

    Lien, La Thi Quynh; Hoa, Nguyen Quynh; Chuc, Nguyen Thi Kim; Thoa, Nguyen Thi Minh; Phuc, Ho Dang; Diwan, Vishal; Dat, Nguyen Thanh; Tamhankar, Ashok J; Lundborg, Cecilia Stålsby

    2016-01-01

    Hospital effluents represent an important source for the release of antibiotics and antibiotic resistant bacteria into the environment. This study aims to determine concentrations of various antibiotics in wastewater before and after wastewater treatment in a rural hospital (60 km from the center of Hanoi) and in an urban hospital (in the center of Hanoi) in Vietnam, and it aims to explore the relationship between antibiotic concentrations in wastewater before wastewater treatment and quantities of antibiotics used in the rural hospital, over a period of one year in 2013. Water samples were collected using continuous sampling for 24 h in the last week of every month. The data on quantities of antibiotics delivered to all inpatient wards were collected from the Pharmacy department in the rural hospital. Solid-phase extraction and high performance liquid chromatography-tandem mass spectrometry were used for chemical analysis. Significant concentrations of antibiotics were present in the wastewater both before and after wastewater treatment of both the rural and the urban hospital. Ciprofloxacin was detected at the highest concentrations in the rural hospital's wastewater (before treatment: mean = 42.8 µg/L; after treatment: mean = 21.5 µg/L). Metronidazole was detected at the highest concentrations in the urban hospital's wastewater (before treatment: mean = 36.5 µg/L; after treatment: mean = 14.8 µg/L). A significant correlation between antibiotic concentrations in wastewater before treatment and quantities of antibiotics used in the rural hospital was found for ciprofloxacin (r = 0.78; p = 0.01) and metronidazole (r = 0.99; p < 0.001). PMID:27314366

  16. Recent migrants’ perspectives on antibiotic use and prescribing in primary care: a qualitative study

    Science.gov (United States)

    Lindenmeyer, Antje; Redwood, Sabi; Griffith, Laura; Ahmed, Shazia; Phillimore, Jenny

    2016-01-01

    Background Currently there is great interest in antibiotic prescribing practices in the UK, but little is known about the experiences of the increasing numbers of recent migrants (those present in the UK for >1 year but language by trained community researchers. The research team conducted a thematic analysis, focusing on health beliefs, engaging with health services, transnational medicine, and concepts of fairness. Experiences around antibiotics were a strong emerging theme. Results Three reasons were identified for antibiotics seeking: first, holding an ‘infectious model’ of illness implying that antibiotics are required quickly to avoid illness becoming worse or spreading to others; second, reasoning that other medications will be less effective for people ‘used to’ antibiotics’; and third, perceiving antibiotic prescription as a sign of being taken seriously. Some participants obtained antibiotics from their country of origin or migrant networks in the UK; others changed their mind and accepted alternatives. Conclusion Primary care professionals should aim to understand migrants’ perspectives to improve communication with patients. Further research is needed to identify different strategies needed to respond to the varying understandings of antibiotics held by migrants. PMID:27578814

  17. The appraise of positions of obeying to the antibiotic using principles of mothers

    Directory of Open Access Journals (Sweden)

    Nurten Kırcan

    2006-12-01

    Full Text Available The research was done crosscutly and definely to appraise the position of obeying the principles of antibioticusing of mothers who has children between the age of 0 and 6. 160 mothers whose children between the age of 0-6 andhospitalized at the service of child in Mula State Hospital and Mula Social Insurance Institution Hospital betweenthe dates of 15.11.2002 and 15.01.2003 formed this research precedent, A questionnaie form which was defined by17 datas determined the mother’s obeying to the antibiotic using principles and a sociodemografic data form which has8 guestions related to mothers and children were used. [4]When the sociodemografic features of mothers who were in this research were studied, ıt was determined that66% of them were at the age of 25-34, 62.5 of them graduated from a primary school, 86.9% were housewives,53.8% had two children and 95.0% had health insurance. [5]When the positions of mother’s knowing the principles of antibiotic using were studied, it was determinedthat 55.6% of them knew what the antibiotic is. It was determined that 73.7% of them use it at the antibioticaccording to the doctor’s prescription, 77.5% of them use it at the right dosage, 68.7% use the antibiotic till itfinished, 68.1% keep it in the fridge, 80.6% of them use to waste antibiotic, 14.4% pray attention to the using dateof the antibiotic, 94.4% of them don’t use another child’s antibiotic, for hers, 93.1% dont use her own antibiotic forher child, 93.7% of them don’t use antibiotic without doctor’s prescription, 86.3% of them pay attention to thehunger-full principle, 99.4% of them shake the suspension antibiotics before using them and 67.5% take her child tothe doctor’s control after the antibiotic is finished.

  18. Sampling and Pooling Methods for Capturing Herd Level Antibiotic Resistance in Swine Feces using qPCR and CFU Approaches

    DEFF Research Database (Denmark)

    Schmidt, Gunilla Veslemøy; Mellerup, Anders; Christiansen, Lasse Engbo;

    2015-01-01

    for commonly detected antibiotic resistance genes were developed, and used to quantify antibiotic resistance genes in total DNA from swine fecal samples that were obtained using different sampling and pooling methods. In parallel, the number of antibiotic resistant coliform indicator bacteria was determined...... in the same swine fecal samples. The results showed that the qPCR assays were capable of detecting differences in antibiotic resistance levels in individual animals that the coliform bacteria colony forming units (CFU) could not. Also, the qPCR assays more accurately quantified antibiotic resistance genes......The aim of this article was to define the sampling level and method combination that captures antibiotic resistance at pig herd level utilizing qPCR antibiotic resistance gene quantification and culture-based quantification of antibiotic resistant coliform indicator bacteria. Fourteen qPCR assays...

  19. Increasing use of antibiotics in pregnancy during the period 2000-2010

    DEFF Research Database (Denmark)

    Broe, A; Pottegård, A; Lamont, Ronald Francis;

    2014-01-01

    OBJECTIVE: The aim of this study was to describe the use of antibiotics in a national population-based cohort of pregnant Danish women between 2000 and 2010. DESIGN: Register-based, population-wide, cohort study. SETTING: Denmark, from 2000 to 2010. POPULATION: All pregnancies among Danish......, as well as intravaginally applied antibiotics, were analysed. Associations with demographic variables were assessed using multivariate analysis. MAIN OUTCOME MEASURES: Filled prescriptions for antibiotic drugs during pregnancy. RESULTS: We included 987 973 pregnancies in Denmark from 2000 to 2010; 38.......9% of women with a delivery and 14.8% of women with a miscarriage or termination of pregnancy had one or more antibiotic treatments during pregnancy. Systemic antibacterial drugs were the most frequently used drug group, with filled prescriptions for 33.4% of all deliveries and 12.6% of all abortions...

  20. Determination of the stability of antibiotics in matrix and reference solutions using a straightforward procedure applying mass spectrometric detection

    NARCIS (Netherlands)

    Berendsen, B.J.A.; Elbers, I.J.W.; Stolker, A.A.M.

    2011-01-01

    The stability of an antibiotic is a very important characteristic, especially in the field of antibiotic residue analysis. During method development or validation, the stability of the antibiotic has to be demonstrated no matter if the method is used for screening, confirmation, qualitative or quant

  1. Cost of Illness and Cost Containment Analysis Using Empirical Antibiotic Therapy in Sepsis Patients in Bandung

    Directory of Open Access Journals (Sweden)

    Rano K. Sinuraya

    2012-12-01

    Full Text Available The aims of this study were to analyze cost of illness (COI and cost containment analysis using empirical antibiotic therapy in sepsis patients with respiratory infection in a hospital in Bandung. A cross sectional method was conducted retrospectively. Data were collected from medical record of inpatients sepsis patients with respiratory infections with empirical antibiotic therapy ceftazidime-levofloxacin or cefotaxime-erythromycin. Direct and indirect cost were calculated and analyzed in this study. The result showed that the average COI for patients with combination ceftazidime-levofloxaxin was 13,369,055 IDR whereas combination of cefotaxime-erythromycin was 22,250,495 IDR. In summary, the COI empirical antibiotic therapy ceftazidime-levofloxacin was lower than cefotaxime-erythromycin. Cost containment using empirical antibiotic therapy ceftazidime-levofloxacin which without reducing the service quality was 8,881,440 IDR.

  2. Therapeutic uses ofCurcuma longa (turmeric)

    OpenAIRE

    Luthra, Pratibha Mehta; Singh, Rambir; Chandra, Ramesh

    2001-01-01

    Curcuma longa commonly known as tumeric is traditionally used as a spice in Indian food. A wide range of biological activities e.g. anticancer, antimicrobial, antiinflammatory and free radical scavenging activity of the plant suggests a logical basis for its traditional use in foodstuff. Various phytothreapeutic uses ofCurcuma longa have been reviewed.

  3. Concurrent acute illness and comorbid conditions poorly predict antibiotic use in upper respiratory tract infections: a cross-sectional analysis

    Directory of Open Access Journals (Sweden)

    Perencevich Eli N

    2007-05-01

    Full Text Available Abstract Background Inappropriate antibiotic use promotes resistance. Antibiotics are generally not indicated for upper respiratory infections (URIs. Our objectives were to describe patterns of URI treatment and to identify patient and provider factors associated with antibiotic use for URIs. Methods This study was a cross-sectional analysis of medical and pharmacy claims data from the Pennsylvania Medicaid fee-for-service program database. We identified Pennsylvania Medicaid recipients with a URI office visit over a one-year period. Our outcome variable was antibiotic use within seven days after the URI visit. Study variables included URI type and presence of concurrent acute illnesses and chronic conditions. We considered the associations of each study variable with antibiotic use in a logistic regression model, stratifying by age group and adjusting for confounders. Results Among 69,936 recipients with URI, 35,786 (51.2% received an antibiotic. In all age groups, acute sinusitis, chronic sinusitis, otitis, URI type and season were associated with antibiotic use. Except for the oldest group, physician specialty and streptococcal pharyngitis were associated with antibiotic use. History of chronic conditions was not associated with antibiotic use in any age group. In all age groups, concurrent acute illnesses and history of chronic conditions had only had fair to poor ability to distinguish patients who received an antibiotic from patients who did not. Conclusion Antibiotic prevalence for URIs was high, indicating that potentially inappropriate antibiotic utilization is occurring. Our data suggest that demographic and clinical factors are associated with antibiotic use, but additional reasons remain unexplained. Insight regarding reasons for antibiotic prescribing is needed to develop interventions to address the growing problem of antibiotic resistance.

  4. Toggled RNA Aptamers Against Aminoglycosides Allowing Facile Detection of Antibiotics Using Gold Nanoparticle Assays

    OpenAIRE

    Derbyshire, Nicola; White, Simon J.; Bunka, David H. J.; Song, Lei; Stead, Sara; Tarbin, Jonathan; Sharman, Matthew; Zhou, Dejian; Stockley, Peter G.

    2012-01-01

    We have used systematic evolution of ligands by exponential enrichment (SELEX) to isolate RNA aptamers against aminoglycoside antibiotics. The SELEX rounds were toggled against four pairs of aminoglycosides with the goal of isolating reagents that recognize conserved structural features. The resulting aptamers bind both of their selection targets with nanomolar affinities. They also bind the less structurally related targets, although they show clear specificity for this class of antibiotics....

  5. A questionnaire-based survey to ascertain the views of clinicians regarding rational use of antibiotics in teaching hospitals of Kolkata

    Directory of Open Access Journals (Sweden)

    Dattatreyo Chatterjee

    2015-01-01

    Conclusions: Clinicians acknowledge that the misuse of antibiotics is an important problem in their hospitals. A system of clinical audit of antibiotic usage, improved microbiology support and implementation of antibiotic policy can help to promote rational use of antimicrobial agents.

  6. Antibiotic use and emerging resistance: how can resource-limited countries turn the tide?

    Science.gov (United States)

    Bebell, Lisa M; Muiru, Anthony N

    2014-09-01

    Antibiotic resistance is a global crisis driven by appropriate and inappropriate antibiotic use to treat human illness and promote animal growth. The antimicrobial resistance epidemic continues to spread due to the triple threat of unfettered access, minimal product regulation and oversight of antibiotic prescription, and lack of clinical diagnostic tools to support antibiotic de-escalation in low-resource settings. In high-resource settings, evidence-based strategies have improved the appropriateness of antibiotic use, limiting the spread of drug-resistant organisms and reducing hospital-associated infections, strategies which may also be effective to stop the spread of resistance in resource-poor countries. Current research and surveillance efforts on antimicrobial resistance and hospital-associated infections in low-resource settings are extremely limited and largely focused on intensive care units. Many challenges exist to improving antibiotic use and infection control in resource-limited settings, and turning the tide requires intensifying research and surveillance, antimicrobial stewardship, and developing new bedside diagnostic tools for bacterial infections and antimicrobial susceptibility.

  7. Biolubricant Polypeptides and Therapeutic Uses Thereof

    NARCIS (Netherlands)

    SHARMA PRASHANT, KUMAR; HERRMANN, ANDREAS; KOLBE, ANKE; HALENAHALLY VEEREGOWDA, DEEPAK; VEEREGOWDA DEEPAK, HALENAHALLY

    2015-01-01

    The invention relates to the field of medicine. In particular, it relates to recombinant cationic polypeptides and their use as biolubricant. Provided is a biolubricant substance comprising the amino acid sequence[(GKGVP)9]n, wherein n is >=5.

  8. Detection of 36 antibiotics in coastal waters using high performance liquid chromatography-tandem mass spectrometry

    Institute of Scientific and Technical Information of China (English)

    NA Guangshui; GU Jia; GE Linke; ZHANG Peng; WANG Zhen; LIU Chunyang; ZHANG Lin

    2011-01-01

    Among pharmaceuticals and personal care products released into the aquatic environment,antibiotics are of particular concern,because of their ubiquity and health effects.Although scientists have recently paid more attention to the threat of antibiotics to coastal ecosystems,researchers have often focused on relatively few antibiotics,because of the absence of suitable analytical methods.We have therefore developed a method for the rapid detection of 36 antibiotic residues in coastal waters,including tetracyclines (TCs),sulfanilamides (SAs),and quinolones (QLs).The method consists of solid-phase extraction (SPE) and liquid chromatography-tandem mass spectrometry (LC-MS/MS) analysis,using electrospray ionization (ESI) in positive mode.The SPE was performed with Oasis HLB and Oasis MCX cartridges.Chromatographic separation on a C18 column was achieved using a binary eluent containing methanol and water with 0.1% formic acid.Typical recoveries of the analytes ranged from 67.4% to 109.3% at a fortification level of 100 ng/L.The precision of the method,calculated as relative standard deviation (RSD),was below 14.6% for all the compounds.The limits of detection (LODs) varied from 0.45 pg to 7.97 pg.The method was applied to determine the target analytes in coastal waters of the Yellow Sea in Liaoning,China.Among the tested antibiotics,31 were found in coastal waters,with their concentrations between the LOD and 212.5 ng/L.These data indicate that this method is valid for analysis of antibiotics in coastal waters.The study first reports such a large number of antibiotics along the Yellow Sea coast of Liaoning,and should facilitate future comprehensive evaluation of antibiotics in coastal ecosystems.

  9. On the use of antibiotics to reduce rhizoplane microbial populations in root physiology and ecology investigations

    Science.gov (United States)

    Smart, D. R.; Ferro, A.; Ritchie, K.; Bugbee, B. G.

    1995-01-01

    No straightforward method exists for separating the proportion of ion exchange and respiration due to rhizoplane microbial organisms from that of root ion exchange and respiration. We examined several antibiotics that might be used for the temporary elimination of rhizoplane bacteria from hydroponically grown wheat roots (Triticum aestivum cv. Veery 10). Each antibiotic was tested for herbicidal activity and plate counts were used to enumerate bacteria and evaluate antibiotic kinetics. Only lactam antibiotics (penicillins and cephalosporins) did not reduce wheat growth rates. Aminoglycosides, the pyrimidine trimethoprim, colistin and rifampicin reduced growth rates substantially. Antibiotics acted slowly, with maximum reductions in rhizoplane bacteria occurring after more than 48 h of exposure. Combinations of nonphytotoxic antibiotics reduced platable rhizoplane bacteria by as much as 98%; however, this was generally a reduction from about 10(9) to 10(6) colony forming units per gram of dry root mass, so that many viable bacteria remained on root surfaces. We present evidence which suggests that insufficient bacterial biomass exists on root surfaces of nonstressed plants grown under well-aerated conditions to quantitatively interfere with root nitrogen absorption measurements.

  10. Therapeutic Use of Native and Recombinant Enteroviruses

    OpenAIRE

    Jani Ylä-Pelto; Lav Tripathi; Petri Susi

    2016-01-01

    Research on human enteroviruses has resulted in the identification of more than 100 enterovirus types, which use more than 10 protein receptors and/or attachment factors required in cell binding and initiation of the replication cycle. Many of these “viral” receptors are overexpressed in cancer cells. Receptor binding and the ability to replicate in specific target cells define the tropism and pathogenesis of enterovirus types, because cellular infection often results in cytolytic response, i...

  11. Antibiotic treatments and microbes in the gut.

    Science.gov (United States)

    Macfarlane, Sandra

    2014-04-01

    Antibiotic therapies are important in combating disease-causing microorganisms and maintaining host health. It is widely accepted that exposure of the gut microbiota to antibiotics can lead to decreased susceptibility and the development of multi-drug-resistant disease-causing organisms, which can be a major clinical problem. It is also important to consider that antibiotics not only target pathogenic bacteria in the gut, but also can have damaging effects on the ecology of commensal species. This can reduce intrinsic colonization resistance and contribute to problems with antibiotic resistance, including lateral transfer of resistance genes. Our knowledge of the impact of antibiotic treatment on the ecology of the normal microbiota has been increased by recent advances in molecular methods and use of in vitro model systems to investigate the impact of antibiotics on the biodiversity of gut populations and the spread of antibiotic resistance. These highlight the need for more detailed structural and functional information on the long-term antibiotic-associated alterations in the gut microbiome, and spread of antibiotic resistance genes. This will be crucial for the development of strategies, such as targeted therapeutics, probiotics, prebiotics and synbiotics, to prevent perturbations in the gut microbiota, the restoration of beneficial species and improvements in host health.

  12. Toxicity of three antibiotics used in aquaculture on the marine microalgae Tetraselmis suecica (Kylin Butch.

    Directory of Open Access Journals (Sweden)

    Marta Seoane

    2014-06-01

    Full Text Available Aquaculture facilities are a potential source of antibiotics to the aquatic ecosystems. The presence of these compounds in the environment may have deleterious effects on non-target aquatic organisms such as microalgae, which are often used as biological indicators of pollution. Therefore, the aim of the present study was to evaluate the toxicity induced by chloramphenicol (CHL, florfenicol (FLO and oxytetracycline (OTC, three antibiotics widely used in aquaculture, on the marine microalgae Tetraselmis suecica, a species also used in aquacultural practices. Toxicity was evaluated taking into account alterations on growth and cellular viability and activity, being these parameters monitored using flow cytometry technique. Results showed that all three antibiotics assayed inhibit growth of T. suecica with 96 h IC50 values of 11.16, 9.03 and 17.25 mg l-1 for CHL, FLO and OTC, respectively. After 24 hours of exposure, the integrity of the cell membrane, related with cellular viability and assessed by propidium iodide staining (PI, was not altered; therefore cells remained viable. However, FLO and OTC were found to significant reduce the metabolic activity at higher concentrations assayed, as indicated the fluorescein diacetate assay (FDA. Since growth inhibition and significant physiological alterations were observed, it can be concluded that T. suecica was sensitive to the three antibiotics tested, thus the use of these antibiotics should be carefully monitored to reduce the potential risk of contamination of the marine environment.

  13. Effect and cost of perioperative use of antibiotics in coronary artery bypass grafting: a randomized controlled study

    Institute of Scientific and Technical Information of China (English)

    ZHOU Zi-jun; ZHENG Ying-li; HU Yong-hua

    2011-01-01

    Background Bacterial infections remain a serious complication following coronary artery bypass grafting (CABG). The objective of the study was to determine the effectiveness of a guideline for the appropriate use of antibiotics in CABG during the perioperative period.Methods Six hundred and fourteen hospitalized patients who had undergone CABG from January to June 2006 were randomly allocated to an intervention group and a control group. The data on the hospital stay, days of antibiotic used,types of prophylactic antibiotics used, surgical wound infection and pulmonary infection and antibiotic costs for the patients were compared.Results The postoperative hospitalization days of the intervention group were significantly fewer than that for the control group (P<0.05). The time of antibiotic use and post-infection treatment time were also significantly less in the intervention group than in the control group (P <0.05). The average hospital daily cost and total cost of antibiotics were less in the intervention group than in the control group (P<0.05). Compared with the control group, prophylactic antibiotic use in the intervention group was more reasonable.Conclusions The guideline for the appropriate use of antibiotics in CABG during the perioperative period is effective strategies for reducing antibiotic costs, the time of antibiotic use and post-infection treatment time without compromising the patients' clinical outcome.

  14. Therapeutic Uses of the WebCam in Child Psychiatry

    Science.gov (United States)

    Chlebowski, Susan; Fremont, Wanda

    2011-01-01

    Objective: The authors provide examples for the use of the WebCam as a therapeutic tool in child psychiatry, discussing cases to demonstrate the application of the WebCam, which is most often used in psychiatry training programs during resident supervision and for case presentations. Method: Six cases illustrate the use of the WebCam in individual…

  15. Laser Desorption Postionization Mass Spectrometry of Antibiotic-Treated Bacterial Biofilms using Tunable Vacuum Ultraviolet Radiation

    Energy Technology Data Exchange (ETDEWEB)

    Gasper, Gerald L; Takahashi, Lynelle K; Zhou, Jia; Ahmed, Musahid; Moore, Jerry F; Hanley, Luke

    2010-08-04

    Laser desorption postionization mass spectrometry (LDPI-MS) with 8.0 ? 12.5 eV vacuum ultraviolet synchrotron radiation is used to single photon ionize antibiotics andextracellular neutrals that are laser desorbed both neat and from intact bacterial biofilms. Neat antibiotics are optimally detected using 10.5 eV LDPI-MS, but can be ionized using 8.0 eV radiation, in agreement with prior work using 7.87 eV LDPI-MS. Tunable vacuum ultraviolet radiation also postionizes laser desorbed neutrals of antibiotics and extracellular material from within intact bacterial biofilms. Different extracellular material is observed by LDPI-MS in response to rifampicin or trimethoprim antibiotic treatment. Once again, 10.5 eV LDPI-MS displays the optimum trade-off between improved sensitivity and minimum fragmentation. Higher energy photons at 12.5 eV produce significant parent ion signal, but fragment intensity and other low mass ions are also enhanced. No matrix is added to enhance desorption, which is performed at peak power densities insufficient to directly produce ions, thus allowing observation of true VUV postionization mass spectra of antibiotic treated biofilms.

  16. Learning Processes and Trajectories for the Reduction of Antibiotic Use in Pig Farming: A Qualitative Approach

    Directory of Open Access Journals (Sweden)

    Nicolas Fortané

    2015-10-01

    Full Text Available Since 2011, French public policy has been encouraging a reduction in the use of antibiotics in animal farming. The aim of this article is to look at how some farms have already managed to lower their consumption of antibiotics, and to highlight the levers of change in farming health practices. Our research uses a qualitative study based on 21 semi-structured interviews with farmers and veterinarians in the French pig-farming sector. We use the notion of “trajectory of change” to examine, over time, the intersection of the technical, economic, social and organisational determinants which affect the reduced use of antibiotics. The “learning process” concept makes it possible to take account of the way in which the actors assimilate, appropriate and implement new health practices. We have identified three interdependent levels of learning: technical learning, cognitive learning and organisational learning.

  17. Use of Antibiotics during pregnancy increases the risk of Asthma in early childhood

    DEFF Research Database (Denmark)

    Stensballe, Lone Graff; Simonsen, Jacob; Jensen, Signe Marie;

    2013-01-01

    OBJECTIVES: To investigate the hypothesis that mother's use of antibiotics in pregnancy could influence asthma and eczema in early life. STUDY DESIGN: Subjects were included from the Copenhagen Prospective Study on Asthma in Childhood cohort of children born of mothers with asthma (N = 411). Severe...... National Birth Cohort confirmed increased risk of asthma hospitalization (hazard ratio 1.17 [1.00-1.36]), and inhaled corticosteroids (1.18 [1.10-1.27]) in the children if mothers used antibiotics any time during pregnancy. In the subgroup of mothers using antibiotics for nonrespiratory infection...... asthma exacerbations and eczema were diagnosed by research unit physicians. Replication was sought in children from the Danish National Birth Cohort (N = 30 675). Asthma outcomes were hospitalization and use of inhaled corticosteroids. Eczema was defined by an algorithm developed from cases of clinically...

  18. Estimation of the use of antibiotics in the small ruminant industry in The Netherlands in 2011 and 2012.

    Directory of Open Access Journals (Sweden)

    Inge Santman-Berends

    Full Text Available The aim of this study was to estimate the quantity of antibiotics and classes of antibiotics used in the small ruminant industry in the Netherlands in 2011 and 2012. Twelve large veterinary practices, located throughout the Netherlands were selected for this study. All small ruminant farms associated with these practices that had complete records on the quantity of antibiotics prescribed were included. The veterinary practices provided data on all antibiotics prescribed, and the estimated animal used daily dose of antibiotics per year (AUDD/Y was calculated for each farm. The median AUDD/Y in small ruminant farms was zero in both years (mean 0.60 in 2011, and 0.62 in 2012. The largest quantity of antibiotic use was observed in the professional goat industry (herds of ≥32 goats with a median AUDD/Y of 1.22 in 2011 and 0.73 in 2012. In the professional sheep industry (flocks of ≥32 sheep, the median AUDD/Y was 0 in 2011 and 0.10 in 2012. In the small scale industry (flocks or herds of <32 sheep or goats, the median AUDD/Y never exceeded 0. The most frequently prescribed antibiotics in the small scale industry and professional sheep farms belonged to the penicillin class. In professional goat farms, antibiotics of the aminoglycoside class were most frequently prescribed. This study provides the first assessment on the quantity of antibiotic use in the small ruminant industry. Given a comparable attitude towards antibiotic use, these results might be valid for small ruminant populations in other north-western European countries as well. The antibiotic use in the small ruminant industry appeared to be low, and is expected to play a minor role in the development of antibiotic resistance. Nevertheless, several major zoonotic bacterial pathogens are associated with the small ruminant industry, and it remains important that antibiotics are used in a prudent way.

  19. Septic arthritis of the knee: the use and effect of antibiotics prior to diagnostic aspiration.

    Science.gov (United States)

    Hindle, P; Davidson, E; Biant, L C

    2012-07-01

    Septic arthritis of the native knee joint and total knee arthroplasty both cause diagnostic and treatment issues. There is no gold standard test to diagnose a joint infection and the use of joint aspiration is commonly relied on. It is widely accepted by orthopaedic surgeons that antibiotics should be withheld until aspiration has been performed to increase the odds of identifying an organism. Patients often present to other specialties that may not be as familiar with these principles. Our study found that 25 (51%) of the 49 patients treated for septic arthritis of the native or prosthetic knee in our unit over a 3-year period had received antibiotics prior to discussion or review by the on-call orthopaedic service. Patients were significantly less likely to demonstrate an organism on initial microscopy (entire cohort: p = 0.001, native knees: p = 0.006, prosthetic knees: p = 0.033) or on subsequent culture (entire cohort: p = 0.001, native knees: p = 0.017, prosthetic knees: p = 0.012) of their aspirate if they had received antibiotics. The sensitivity of microscopy in all patients dropped from 58% to 12% when patients had received antibiotics (native knees: 46% to 0%, prosthetic knees: 72% to 27%). The sensitivity of the culture dropped from 79% to 28% in all patients when the patient had received antibiotics (native knees: 69% to 21%, prosthetic knees: 91% to 36%). This study demonstrated how the management of patients with suspected cases of septic arthritis of the knee may be compromised by empirical administration of antibiotics. These patients were significantly less likely to demonstrate an organism on microscopy and culture of their initial aspirate. There is a significant high false negative rate associated with knee aspiration with prior administration of antibiotic therapy.

  20. Knowledge and perceptions on antibiotic use and resistance among high school students and teachers in New Delhi, India: A qualitative study

    Directory of Open Access Journals (Sweden)

    Anita Kotwani

    2016-01-01

    Conclusions: Although students and teachers exhibited poor knowledge about antibiotic use and resistance, they were keen to learn about these issues. School education programs and public education could be used to shape correct perceptions about antibiotic use among all stakeholders including children. This may help in the containment of antibiotic resistance and thus preservation of antibiotics for future generations.

  1. Rational Use of Antibiotics in the Treatment of Functional Bowel Disorders

    Directory of Open Access Journals (Sweden)

    Roberta Fasulo

    2010-07-01

    Full Text Available Functional gastrointestinal symptoms such us bloating, fullness, flatulence, diarrhea, and constipation due to irritable bowel syndrome (IBS were recently attributed to small bowel bacterial overgrowth, a condition depending on the presence of an increased number of bacteria in the small bowel. However, the methodology used to describe this association may be harshly criticized, since it has already been shown to be quite inaccurate. As a result an inappropriate use of antibiotics was consequently generated. In fact, antibiotics could be effective in the treatment of functional complaints, but only in a limited subgroup of patients, characterized by an increase of fermentation at colonic level. In this review, we have examined the papers suggesting a pathophysiological link between IBS and small bowel bacterial overgrowth, underlining its inappropriateness, and put forth our personal view on the rationale for antibiotic use in IBS.

  2. Time lapse investigation of antibiotic susceptibility using a microfluidic linear gradient 3D culture device.

    Science.gov (United States)

    Hou, Zining; An, Yu; Hjort, Karin; Hjort, Klas; Sandegren, Linus; Wu, Zhigang

    2014-09-01

    This study reports a novel approach to quantitatively investigate the antibacterial effect of antibiotics on bacteria using a three-dimensional microfluidic culture device. In particular, our approach is suitable for studying the pharmacodynamics effects of antibiotics on bacterial cells temporally and with a continuous range of concentrations in a single experiment. The responses of bacterial cells to a linear concentration gradient of antibiotics were observed using time-lapse photography, by encapsulating bacterial cells in an agarose-based gel located in a commercially available microfluidics chamber. This approach generates dynamic information with high resolution, in a single operation, e.g., growth curves and antibiotic pharmacodynamics, in a well-controlled environment. No pre-labelling of the cells is needed and therefore any bacterial sample can be tested in this setup. It also provides static information comparable to that of standard techniques for measuring minimum inhibitory concentration (MIC). Five antibiotics with different mechanisms were analysed against wild-type Escherichia coli, Staphylococcus aureus and Salmonella Typhimurium. The entire process, including data analysis, took 2.5-4 h and from the same analysis, high-resolution growth curves were obtained. As a proof of principle, a pharmacodynamic model of streptomycin against Salmonella Typhimurium was built based on the maximal effect model, which agreed well with the experimental results. Our approach has the potential to be a simple and flexible solution to study responding behaviours of microbial cells under different selection pressures both temporally and in a range of concentrations.

  3. APPROPRIATE USE OF ANTIBIOTICS FOR THE MANAGEMENT OF SEPSIS IN NEONATES

    Directory of Open Access Journals (Sweden)

    Samiya Nazeer Khan* and Siby Joseph

    2012-07-01

    Full Text Available Neonatal sepsis is associated with increased mortality and morbidity including neurodevelopmental impairment and prolongation of hospital stay. Clinical features of sepsis are non-specific in neonates and a high index of suspicion is required for timely diagnosis. Antibiotics are a very important group of drugs for the sick neonate and have undoubtedly played a role in their improved survival. But they come with a set of risks like other drugs used in critical care which must be carefully considered and weighed against the benefits in any decision to commence antibiotics. Prophylactic antibiotics are not indicated in almost all situations in neonatology. There is high level of evidence to show that they are not useful for the prevention of infection following umbilical vessel or central venous catheterization. Traditionally, the selection of antibiotics for empirical therapy is based on the local policy, and the duration of therapy is decided by the treating physician based on clinical symptoms and blood culture results. In this paper, we discuss briefly about the causative organisms of neonatal sepsis in both the developed and developing countries; with a special focus on antibiotic therapy in neonates with suspected sepsis, culture proven sepsis, and meningitis.

  4. DALI: Defining Antibiotic Levels in Intensive care unit patients: a multi-centre point of prevalence study to determine whether contemporary antibiotic dosing for critically ill patients is therapeutic

    Directory of Open Access Journals (Sweden)

    Roberts Jason A

    2012-07-01

    Full Text Available Abstract Background The clinical effects of varying pharmacokinetic exposures of antibiotics (antibacterials and antifungals on outcome in infected critically ill patients are poorly described. A large-scale multi-centre study (DALI Study is currently underway describing the clinical outcomes of patients achieving pre-defined antibiotic exposures. This report describes the protocol. Methods DALI will recruit over 500 patients administered a wide range of either beta-lactam or glycopeptide antibiotics or triazole or echinocandin antifungals in a pharmacokinetic point-prevalence study. It is anticipated that over 60 European intensive care units (ICUs will participate. The primary aim will be to determine whether contemporary antibiotic dosing for critically ill patients achieves plasma concentrations associated with maximal activity. Secondary aims will compare antibiotic pharmacokinetic exposures with patient outcome and will describe the population pharmacokinetics of the antibiotics included. Various subgroup analyses will be conducted to determine patient groups that may be at risk of very low or very high concentrations of antibiotics. Discussion The DALI study should inform clinicians of the potential clinical advantages of achieving certain antibiotic pharmacokinetic exposures in infected critically ill patients.

  5. Minocycline: far beyond an antibiotic

    OpenAIRE

    Garrido-Mesa, N; Zarzuelo, A; Gálvez, J

    2013-01-01

    Minocycline is a second-generation, semi-synthetic tetracycline that has been in therapeutic use for over 30 years because of its antibiotic properties against both gram-positive and gram-negative bacteria. It is mainly used in the treatment of acne vulgaris and some sexually transmitted diseases. Recently, it has been reported that tetracyclines can exert a variety of biological actions that are independent of their anti-microbial activity, including anti-inflammatory and anti-apoptotic acti...

  6. Sources identification of antibiotic pollution combining land use information and multivariate statistics.

    Science.gov (United States)

    Li, Jia; Zhang, Haibo; Chen, Yongshan; Luo, Yongming; Zhang, Hua

    2016-07-01

    To quantify the extent of antibiotic contamination and to identity the dominant pollutant sources in the Tiaoxi River Watershed, surface water samples were collected at eight locations and analyzed for four tetracyclines and three sulfonamides using ultra-performance liquid chromatography tandem mass spectrometry (UPLC-MS/MS). The observed maximum concentrations of tetracycline (623 ng L(-1)), oxytetracycline (19,810 ng L(-1)), and sulfamethoxazole (112 ng L(-1)) exceeded their corresponding Predicted No Effect Concentration (PNEC) values. In particular, high concentrations of antibiotics were observed in wet summer with heavy rainfall. The maximum concentrations of antibiotics appeared in the vicinity of intensive aquaculture areas. High-resolution land use data were used for identifying diffuse source of antibiotic pollution in the watershed. Significant correlations between tetracycline and developed (r = 0.93), tetracycline and barren (r = 0.87), oxytetracycline and barren (r = 0.82), and sulfadiazine and agricultural facilities (r = 0.71) were observed. In addition, the density of aquaculture significantly correlated with doxycycline (r = 0.74) and oxytetracycline (r = 0.76), while the density of livestock significantly correlated with sulfadiazine (r = 0.71). Principle Component Analysis (PCA) indicated that doxycycline, tetracycline, oxytetracycline, and sulfamethoxazole were from aquaculture and domestic sources, whereas sulfadiazine and sulfamethazine were from livestock wastewater. Flood or drainage from aquaculture ponds was identified as a major source of antibiotics in the Tiaoxi watershed. A hot-spot map was created based on results of land use analysis and multi-variable statistics, which provided an effective management tool of sources identification in watersheds with multiple diffuse sources of antibiotic pollution. PMID:27338264

  7. Antibiotics in Canadian poultry productions and anticipated alternatives.

    Science.gov (United States)

    Diarra, Moussa S; Malouin, François

    2014-01-01

    The use of antibiotics in food-producing animals has significantly increased animal health by lowering mortality and the incidence of diseases. Antibiotics also have largely contributed to increase productivity of farms. However, antibiotic usage in general and relevance of non-therapeutic antibiotics (growth promoters) in feed need to be reevaluated especially because bacterial pathogens of humans and animals have developed and shared a variety of antibiotic resistance mechanisms that can easily be spread within microbial communities. In Canada, poultry production involves more than 2600 regulated chicken producers who have access to several antibiotics approved as feed additives for poultry. Feed recipes and mixtures vary greatly geographically and from one farm to another, making links between use of a specific antibiotic feed additive and production yields or selection of specific antibiotic-resistant bacteria difficult to establish. Many on-farm studies have revealed the widespread presence of antibiotic-resistant bacteria in broiler chickens. While some reports linked the presence of antibiotic-resistant organisms to the use of feed supplemented with antibiotics, no recent studies could clearly demonstrate the benefit of antimicrobial growth promoters on performance and production yields. With modern biosecurity and hygienic practices, there is a genuine concern that intensive utilization of antibiotics or use of antimicrobial growth promoters in feed might no longer be useful. Public pressure and concerns about food and environmental safety (antibiotic residues, antibiotic-resistant pathogens) have driven researchers to actively look for alternatives to antibiotics. Some of the alternatives include pre- and probiotics, organic acids and essential oils. We will describe here the properties of some bioactive molecules, like those found in cranberry, which have shown interesting polyvalent antibacterial and immuno-stimulatory activities. PMID:24987390

  8. Antibiotics in Canadian poultry productions and anticipated alternatives

    Directory of Open Access Journals (Sweden)

    Moussa Sory Diarra

    2014-06-01

    Full Text Available The use of antibiotics in food-producing animals has significantly increased animal health by lowering mortality and the incidence of diseases. Antibiotics also have largely contributed to increase productivity of farms. However, antibiotic usage in general and relevance of non-therapeutic antibiotics in feed (growth promoters need to be reevaluated especially because bacterial pathogens of humans and animals have developed and shared a variety of antibiotic resistance mechanisms that can easily spread within microbial communities. In Canada, poultry production involves more than 2,600 regulated chicken producers. There are several antibiotics approved as feed additives available for poultry farmers. Feed recipes and mixtures greatly vary geographically and from one farm to another, making links between use of a specific antibiotic feed additive and production yields or selection of specific antibiotic-resistant bacteria difficult to establish. Many on-farm studies have revealed the widespread presence of antibiotic-resistant bacteria in broiler chickens. While sporadic reports linked the presence of antibiotic-resistant organisms to the use of feed supplemented with antibiotics, no recent studies could clearly demonstrate the benefit of antimicrobial growth promoters on performance and production yields. With modern biosecurity and hygienic practices, there is a genuine concern that intensive utilization of antibiotics or use of antimicrobial growth promoters in feed might no longer be useful. Public pressure and concerns about food and environmental safety (antibiotic residues, antibiotic-resistant pathogens have driven researchers to actively look for alternatives to antibiotics. Some of the alternatives include pre- and probiotics, organic acids and essential oils. We will describe here the properties of some bioactive molecules, like those found in cranberry, which have shown interesting polyvalent antibacterial and immuno

  9. Antibiotic microbial assay using kinetic-reading microplate system

    Directory of Open Access Journals (Sweden)

    Felipe Rebello Lourenço

    2011-09-01

    Full Text Available The aim of this study was to determine the optimal experimental conditions to develop a methodology for microbiological assay of apramycin employing microplate and kinetic reading mode, and to validate the developed method, through evaluation of parameters of selectivity, linearity, linear range, limits of detection and quantification, accuracy and precision. The turbidimetric assay principle is simple: the test solution is added to a suspension of test microorganism in culture media, the mixture is incubated under appropriate conditions and the microbial growth is measured by photometric reading. Microplate with kinetic reading mode employed in antibiotic assay is of considerable interest since it allows reduction of material and analysis time and enables a large number of samples to be analyzed simultaneously, with automated reading and calculating. Established conditions considered the standard-curve of apramycin at concentrations from 5.0 to 35.0 μg mL-1, and tryptic soy broth inoculated with 5% Escherichia coli (ATCC 8739 suspension. Satisfactory results were obtained with 2 hours of incubation. The developed method showed appropriate selectivity, linearity in the range from 5.0 to 35.0 μg mL-1, limits of detection and quantification of 0.1 and 0.4 μg mL-1, respectively, as well as satisfactory accuracy (recuperation = 98.5% and precision (RSD = 6.0%. Microplate assay combined the characteristics of microbiological (evaluation of antibiotic activity against sensitive test microorganism and physico-chemical (operationally straightforward and faster results assays.O objetivo deste trabalho é determinar as condições experimentais ideais para o desenvolvimento de metodologia para a dosagem microbiológica de apramicina empregando microplacas e modo de leitura cinético e validar o método desenvolvido, através da avaliação dos parâmetros de especificidade e seletividade, linearidade, faixa ou intervalo linear, limite de detecção e

  10. Assessing the Impact of a School Intervention to Promote Students’ Knowledge and Practices on Correct Antibiotic Use

    Directory of Open Access Journals (Sweden)

    Fátima Baltazar

    2013-07-01

    Full Text Available The clinical efficacy of antibiotics depends on their correct use. Widespread ignorance and inappropriate attitudes to antibiotic use have been identified among consumers. In order to improve the knowledge of middle-school students on antibiotics and their correct use, 82 ninth-grade students were enrolled in a teaching activity. The teaching activity consisted of a slide show presentation followed by discussion in a regular class. To evaluate the impact of the teaching activity the students were asked to answer a questionnaire before and after the activity. This study aimed: (1 to evaluate knowledge on the use of antibiotics in students of two schools in the north of Portugal and (2 to evaluate the efficacy of the school intervention in improving students’ knowledge on correct antibiotic use. We found lack of knowledge among students regarding antibiotic spectra and indications and incorrect attitudes in the pre-test. Significant increases in knowledge were observed after implementation of the teaching activity. Knowledge of the correct use of antibiotics for bacterial diseases rather than viral diseases rose from 43% to 76% in the post-test (p < 0.01. Knowledge of the risk of bacterial resistance to antibiotics from their incorrect use rose from 48% to 74% in the post-test (p < 0.05. We believe that it is important to reinforce the teaching activities on microbiology and antibiotic use at the middle school level.

  11. Therapeutic Uses of Music with Older Adults. Second Edition

    Science.gov (United States)

    Clair, Alicia Ann; Memmott, Jenny

    2008-01-01

    In this comprehensively updated second edition, written by Alicia Ann Clair and Jenny Memmott the extraordinary benefits of music therapy for older adults are detailed. "Therapeutic Uses of Music with Older Adults" not only examines these benefits but also clarifies the reasons that music is beneficial. This important book shows both informal and…

  12. Antibiotic use from conception to diagnosis of child leukaemia as compared to the background population

    DEFF Research Database (Denmark)

    Gradel, Kim Oren; Kaerlev, Linda

    2015-01-01

    BACKGROUND: The role of infection in the aetiology of childhood leukaemia is unknown. We used prescriptions of antibiotics from Danish pharmacies as a proxy measure for the occurrence of infections. PROCEDURE: We investigated the association between exposure to antibiotics, from conception to...... leukaemia diagnosis, and the risk of leukaemia. Incident cases of leukaemia among children in Denmark, 1995-2008, with mothers having their earliest conception date in 1995, were individually matched to population controls by age, sex and municipality. Conditional logistic regression analyses assessed...... antibiotic redemptions in different time periods from conception up to 6 months before the diagnoses of all leukaemia types, acute lymphoblastic leukaemia [ALL] and ALL in 2- to 5-year-old children, adjusting for several potential confounders. RESULTS: A total of 120/360 (33.3%) leukaemia mothers and 1...

  13. Are cultural dimensions relevant for explaining cross-national differences in antibiotic use in Europe?

    NARCIS (Netherlands)

    Deschepper, Reginald; Grigoryan, Larissa; Lundborg, Cecilia Stalsby; Hofstede, Geert; Cohen, Joachim; Van Der Kelen, Greta; Deliens, Luc; Haaijer-Ruskamp, Flora M.

    2008-01-01

    Background: Antibiotics are widely-used medicines for which a more prudent use has been advocated to minimize development of resistance. There are considerable cross-national differences that can only partially be explained by epidemiological difference and variations in health care structure. The a

  14. Differences in outpatient antibiotic use between a Spanish region and a Nordic country

    DEFF Research Database (Denmark)

    Malo-Fumanal, Sara; Rabanaque-Hernández, María José; Feja-Solana, Cristina;

    2014-01-01

    Antibiotic use and misuse are linked to pathogen resistance and, as such, both constitute a public health issue with local, national, and global dimensions. Early studies have shown striking variations in the use of these drugs between Nordic and Mediterranean countries. The aim of the present st...

  15. Knowledge and Attitudes towards Antibiotic Use and Resistance - A Latent Class Analysis of a Swedish Population-Based Sample

    Science.gov (United States)

    Rosales-Klintz, Senia; Tegmark Wisell, Karin; Stålsby Lundborg, Cecilia

    2016-01-01

    Background In 2006, a study investigating knowledge and attitudes regarding antibiotic use and resistance in Sweden, indicated high level of knowledge but also areas in need of improvement. Objective (i) To provide an update on the knowledge and attitudes to antibiotic use and resistance of the Swedish population, and (ii) to identify which groups within the population are in particular need of improved knowledge or attitudes. Methods A questionnaire was sent by post in 2013 to 2,500 randomly-selected individuals aged 18–74, living in Sweden. Latent class analyses were conducted to group respondents based on their responses. The association between socio-demographic characteristics and the probability of belonging to each latent class was assessed. Results The response rate was 57%. Ninety-four per cent of the responders knew that bacteria could become resistant to antibiotics and the majority answered correctly to the questions regarding antibiotic resistance development. The respondents expressed confidence in doctors who decided not to prescribe antibiotics. Three latent classes related to ‘knowledge regarding antibiotic use and resistance’, two regarding ‘attitudes towards antibiotic accessibility and infection prevention’ and three regarding ‘attitudes towards antibiotic use and effects’ were revealed. Men, younger and more educated people were more knowledgeable but males had a less restrictive attitude. Respondents with high levels of knowledge on antibiotics were more likely to have appropriate restrictive attitudes to antibiotics. Conclusion Knowledge on antibiotic use and resistance is maintained high and has improved in Sweden compared to 2006. People with lower education and elderly are especially in need of improved knowledge about antibiotic use and resistance. PMID:27096751

  16. Antibiotic use in rural China: a cross-sectional survey of knowledge, attitudes and self-reported practices among caregivers in Shandong province

    OpenAIRE

    Ding, Lilu; Sun, Qiang; Sun, Weishuai; Du, Yihui; Li, Yue; Bian, Xuefeng; He, Guiqin; Bai, Huidong; Dyar, Oliver J.

    2015-01-01

    Background To improve antibiotic use globally, we must deepen our understanding of the public’s knowledge, attitudes and practices (KAP) concerning antibiotics. Children are frequent users of antibiotics, and their caregivers play important roles in determining how antibiotics are used. The purpose of this study was to describe caregivers’ KAP in a rural province in eastern China, and to identify socio-demographic factors associated with inappropriate antibiotic use. Methods A cross-sectional...

  17. Antibiotic and anti-inflammatory use and the risk of prostate cancer

    Directory of Open Access Journals (Sweden)

    Bent Stephen

    2009-04-01

    Full Text Available Abstract Background Prostate inflammation or infection may increase the risk of prostate cancer. Antibiotics and non-steroidal anti-inflammatory drugs (NSAIDs are used to treat prostatitis and urinary tract infections (UTIs. The objective of our study was to assess whether their use decreases the risk of prostate cancer. Methods We conducted a case-control study among men with incident prostate cancer (N = 65 cases and without prostate cancer (N = 195 controls at the San Francisco Veteran Affairs medical center (VAMC between June 1996 and June 2006. Cases were all patients who had prostate biopsies positive for cancer. We matched controls to cases on age group and race at a 3:1 ratio, and each matched pair was given an identical index date. Total antibiotic, aspirin, and NSAID use (number of prescriptions was computed for each participant by drug type and was restricted to a fill date at least 1 year before the index date. Logistic regression was used for analysis. We adjusted for the matching variables (age group and race and potential confounders (years of VAMC enrollment and number of clinic visits. Results Neither total antibiotic use nor total anti-inflammatory use reduces the risk of prostate cancer (P > 0.05. Conclusion Our analysis did not reveal a relation between use of antibiotics, aspirin, or NSAIDs and the risk of prostate cancer.

  18. Potential therapeutic uses of mecamylamine and its stereoisomers.

    Science.gov (United States)

    Nickell, Justin R; Grinevich, Vladimir P; Siripurapu, Kiran B; Smith, Andrew M; Dwoskin, Linda P

    2013-07-01

    Mecamylamine (3-methylaminoisocamphane hydrochloride) is a nicotinic parasympathetic ganglionic blocker, originally utilized as a therapeutic agent to treat hypertension. Mecamylamine administration produces several deleterious side effects at therapeutically relevant doses. As such, mecamylamine's use as an antihypertensive agent was phased out, except in severe hypertension. Mecamylamine easily traverses the blood-brain barrier to reach the central nervous system (CNS), where it acts as a nicotinic acetylcholine receptor (nAChR) antagonist, inhibiting all known nAChR subtypes. Since nAChRs play a major role in numerous physiological and pathological processes, it is not surprising that mecamylamine has been evaluated for its potential therapeutic effects in a wide variety of CNS disorders, including addiction. Importantly, mecamylamine produces its therapeutic effects on the CNS at doses 3-fold lower than those used to treat hypertension, which diminishes the probability of peripheral side effects. This review focuses on the pharmacological properties of mecamylamine, the differential effects of its stereoisomers, S(+)- and R(-)-mecamylamine, and the potential for effectiveness in treating CNS disorders, including nicotine and alcohol addiction, mood disorders, cognitive impairment and attention deficit hyperactivity disorder.

  19. Urinary Escherichia coli antimicrobial susceptibility profiles and their relationship with community antibiotic use in Tasmania, Australia.

    Science.gov (United States)

    Meumann, Ella M; Mitchell, Brett G; McGregor, Alistair; McBryde, Emma; Cooley, Louise

    2015-10-01

    This study assessed urinary Escherichia coli antibiotic susceptibility patterns in Tasmania, Australia, and examined their association with community antibiotic use. The susceptibility profiles of all urinary E. coli isolates collected in Tasmania between January 2010 and December 2012 were included. The amount of Pharmaceutical Benefits Scheme (PBS)-subsidised use of amoxicillin, amoxicillin/clavulanic acid (AMC), cefalexin, norfloxacin, ciprofloxacin and trimethoprim was retrieved (at the Tasmanian population level) and the number of defined daily doses per 1000 population per day in Tasmania for these antibiotics was calculated for each month during the study period. Antimicrobial susceptibility data were assessed for changes over time in the 3-year study period. Antimicrobial use and susceptibility data were assessed for seasonal differences and lag in resistance following antibiotic use. Excluding duplicates, 28145 E. coli isolates were included. Resistance levels were low; 35% of isolates were non-susceptible to amoxicillin, 14% were non-susceptible to trimethoprim and <5% were non-susceptible to AMC, cefalexin, gentamicin and norfloxacin. Amoxicillin use increased by 35% during winter/spring compared with summer/autumn, and AMC use increased by 21%. No seasonal variation in quinolone use or resistance was detected. The low levels of antimicrobial resistance identified may relate to Tasmania's isolated geographical location. Significant seasonal variation in amoxicillin and AMC use is likely to be due to increased use of these antibiotics for treatment of respiratory tract infections in winter. Quinolone use is restricted by the PBS in Australia, which is the likely explanation for the low levels of quinolone use and resistance identified. PMID:26187365

  20. Aerosolized Antibiotics.

    Science.gov (United States)

    Restrepo, Marcos I; Keyt, Holly; Reyes, Luis F

    2015-06-01

    Administration of medications via aerosolization is potentially an ideal strategy to treat airway diseases. This delivery method ensures high concentrations of the medication in the targeted tissues, the airways, with generally lower systemic absorption and systemic adverse effects. Aerosolized antibiotics have been tested as treatment for bacterial infections in patients with cystic fibrosis (CF), non-CF bronchiectasis (NCFB), and ventilator-associated pneumonia (VAP). The most successful application of this to date is treatment of infections in patients with CF. It has been hypothesized that similar success would be seen in NCFB and in difficult-to-treat hospital-acquired infections such as VAP. This review summarizes the available evidence supporting the use of aerosolized antibiotics and addresses the specific considerations that clinicians should recognize when prescribing an aerosolized antibiotic for patients with CF, NCFB, and VAP.

  1. Multi-bacteria multi-antibiotic testing using surface enhanced Raman spectroscopy (SERS) for urinary tract infection (UTI) diagnosis

    Science.gov (United States)

    Hadjigeorgiou, Katerina; Kastanos, Evdokia; Pitris, Costas

    2013-06-01

    The inappropriate use of antibiotics leads to antibiotic resistance, which is a major health care problem. The current method for determination of bacterial susceptibility to antibiotics requires overnight cultures. However most of the infections cannot wait for the results to receive treatment, so physicians administer general spectrum antibiotics. This results in ineffective treatments and aggravates the rising problem of antibiotic resistance. In this work, a rapid method for diagnosis and antibiogram for a bacterial infection was developed using Surface Enhanced Raman Spectroscopy (SERS) with silver nanoparticles. The advantages of this novel method include its rapidness and efficiency which will potentially allow doctors to prescribe the most appropriate antibiotic for an infection. SERS spectra of three species of gram negative bacteria, Escherichia coli, Proteus spp., and Klebsiella spp. were obtained after 0 and 4 hour exposure to the seven different antibiotics. Bacterial strains were diluted in order to reach the concentration of (2x105 cfu/ml), cells/ml which is equivalent to the minimum concentration found in urine samples from UTIs. Even though the concentration of bacteria was low, species classification was achieved with 94% accuracy using spectra obtained at 0 hours. Sensitivity or resistance to antibiotics was predicted with 81%-100% accuracy from spectra obtained after 4 hours of exposure to the different antibiotics. This technique can be applied directly to urine samples, and with the enhancement provided by SERS, this method has the potential to be developed into a rapid method for same day UTI diagnosis and antibiogram.

  2. Impact of PCR for respiratory viruses on antibiotic use : Theory and practice

    NARCIS (Netherlands)

    van de Pol, Alma C.; Wolfs, Tom F. W.; Tacke, Carline E. A.; Uiterwaal, Cuno S. P.; Forster, Johannes; van Loon, Anton M.; Kimpen, Jan L. L.; Rossen, John W. A.; Jansen, Nicolaas J. G.

    2011-01-01

    RATIONALE FOR THE STUDY: Real-time polymerase chain reaction (PCR) for respiratory viruses is more sensitive, yet more expensive, than conventionally used direct immunofluorescence (DIF). We determined the impact of real-time PCR, additional to DIF, on antibiotic prescription in ventilated children

  3. Comparison of three microbial screening methods for antibiotics using routine monitoring samples

    NARCIS (Netherlands)

    Pikkemaat, M.G.; Rapallini, M.; Oostra, S.; Elferink, J.W.A.

    2009-01-01

    Monitoring large numbers of slaughter animals for the presence of antimicrobial residues is preferably carried out using microbiological screening methods, because of their high cost-effectiveness. An evaluation of the Nouws antibiotic test (NAT) was performed on routine monitoring samples and the p

  4. Use of antibiotics in childhood and risk of Type 1 diabetes

    DEFF Research Database (Denmark)

    Mikkelsen, K H; Knop, F K; Vilsbøll, T;

    2016-01-01

    AIMS: To investigate whether the use of antibiotics from infancy to adolescence influences the risk of Type 1 diabetes. METHODS: We conducted a population-based case-control study, including all Type 1 diabetes cases in Denmark among children born between 1997 and 2012 (n=1578). Odds ratios...

  5. Evaluation of the use of dry cow antibiotics in low somatic cell count cows

    NARCIS (Netherlands)

    Scherpenzeel, C. G M; Den Uijl, I. E M; Van Schaik, G.; Olde Riekerink, R. G M; Keurentjes, J. M.; Lam, T. J G M

    2014-01-01

    The goal of dry cow therapy (DCT) is to reduce the prevalence of intramammary infections (IMI) by eliminating existing IMI at drying off and preventing new IMI from occurring during the dry period. Due to public health concerns, however, preventive use of antibiotics has become questionable. This st

  6. Quality of antibiotic use for lower respiratory tract infections at hospitals: (how) can we measure it?

    NARCIS (Netherlands)

    Schouten, J.A.; Hulscher, M.E.J.L.; Wollersheim, H.C.H.; Braspenning, J.C.C.; Kullberg, B.J.; Meer, J.W.M. van der; Grol, R.P.T.M.

    2005-01-01

    BACKGROUND: To assess and improve the quality of antibiotic use in patients with community-acquired pneumonia (CAP) and acute exacerbation of chronic bronchitis or chronic obstructive pulmonary disease (AECB), a valid set of quality indicators is required. This set should also be applicable in pract

  7. Seasonal and temporal variation in release of antibiotics in hospital wastewater: estimation using continuous and grab sampling.

    Directory of Open Access Journals (Sweden)

    Vishal Diwan

    Full Text Available The presence of antibiotics in the environment and their subsequent impact on resistance development has raised concerns globally. Hospitals are a major source of antibiotics released into the environment. To reduce these residues, research to improve knowledge of the dynamics of antibiotic release from hospitals is essential. Therefore, we undertook a study to estimate seasonal and temporal variation in antibiotic release from two hospitals in India over a period of two years. For this, 6 sampling sessions of 24 hours each were conducted in the three prominent seasons of India, at all wastewater outlets of the two hospitals, using continuous and grab sampling methods. An in-house wastewater sampler was designed for continuous sampling. Eight antibiotics from four major antibiotic groups were selected for the study. To understand the temporal pattern of antibiotic release, each of the 24-hour sessions were divided in three sub-sampling sessions of 8 hours each. Solid phase extraction followed by liquid chromatography/tandem mass spectrometry (LC-MS/MS was used to determine the antibiotic residues. Six of the eight antibiotics studied were detected in the wastewater samples. Both continuous and grab sampling methods indicated that the highest quantities of fluoroquinolones were released in winter followed by the rainy season and the summer. No temporal pattern in antibiotic release was detected. In general, in a common timeframe, continuous sampling showed less concentration of antibiotics in wastewater as compared to grab sampling. It is suggested that continuous sampling should be the method of choice as grab sampling gives erroneous results, it being indicative of the quantities of antibiotics present in wastewater only at the time of sampling. Based on our studies, calculations indicate that from hospitals in India, an estimated 89, 1 and 25 ng/L/day of fluroquinolones, metronidazole and sulfamethoxazole respectively, might be getting

  8. Using Therapeutic Toys to Facilitate Venipuncture Procedure in Preschool Children.

    Science.gov (United States)

    da Silva, José Ronaldo Soares; Pizzoli, Lourdes Margareth Leite; Amorim, Amanda Regina do Prado; Pinheiros, Fernanda Tais; Romanini, Giovanna Chippari; da Silva, Jack Gomes; Joanete, Shirley; Alves, Silvana S M

    2016-01-01

    Intravenous access procedures in children are considered to be one of the most stressful because it is invasive, and the use of needles generates anxiety, insecurity, and fear. Playful strategies using dolls and even the materials used for venipuncture can assist children in understanding, accepting, and coping with the procedure. Field research was developed on the applicability of the therapeutic toy in the preparation of preschool children for venipuncture procedure based on the protocol developed by Martins, Ribeiro, Borba, and Silva (2001) and Kiche and Almeida (2009). The study was done in a private hospital in Greater São Paulo, Brazil, with 10 children ages 3 to 6 years. Data were gathered through observation and questionnaires completed by the children's adult guardians. Before the activity, the children showed fearful facial expressions, used monosyllabic responses, and avoided looking at the health care professional. After the strategy of using therapeutic toy dolls and puppets, 40% of the children calmly accepted the venipuncture procedure, and 100% showed a change to their initial negative reaction, became more communicative and cooperative, and participated and interacted with researchers, even after the end of the activity and procedure. The strategy of therapeutic toys helps make an unfamiliar environment, strangers, and a procedure characterized as painful and difficult less stressful. Pediatric nurses are in a good position to use this resource to offer more humanized care to children. PMID:27254974

  9. Therapeutic drug monitoring of tamoxifen using LC-MS/MS.

    Science.gov (United States)

    Tchu, Simone M; Lynch, Kara L; Wu, Alan H B

    2012-01-01

    Tamoxifen is a selective estrogen receptor modulator (SERM) that is used widely in the treatment of estrogen receptor positive breast cancer (ER+). Therapeutic monitoring of tamoxifen, and its metabolites N-desmethyltamoxifen (NDTam) and 4-hydroxy-N-desmethyltamoxifen (endoxifen), may be clinically useful for guiding treatment decisions. Two significant barriers to tamoxifen efficacy are: (1) variability in conversion of tamoxifen into the potent antiestrogenic metabolite, endoxifen, and (2) poor compliance and adherence to tamoxifen therapy. Therapeutic monitoring can be used to address both of these issues. Low levels of endoxifen indicate either poor compliance or poor metabolism of tamoxifen. Low tamoxifen levels would suggest poor compliance while a low ratio of endoxifen to NDTam would be indicative of poor metabolism. Solid phase extraction of patient serum followed by liquid chromatography tandem mass spectrometry (LC-MS/MS) detection enables rapid, accurate, detection of tamoxifen, N-desmethyltamoxifen, and endoxifen. PMID:22767121

  10. Outpatient Antibiotic Use and Prevalence of Antibiotic-Resistant Pneumococci in France and Germany: A Sociocultural Perspective

    OpenAIRE

    Harbarth, Stephan; Albrich, Werner; Brun-Buisson, Christian

    2002-01-01

    The prevalence of penicillin-nonsusceptible pneumococci is sharply divided between France (43%) and Germany (7%). These differences may be explained on different levels: antibiotic- prescribing practices for respiratory tract infections; patient-demand factors and health-belief differences; social determinants, including differing child-care practices; and differences in regulatory practices. Understanding these determinants is crucial for the success of possible interventions. Finally, we em...

  11. In vitro prevention of Pseudomonas aeruginosa early biofilm formation with antibiotics used in cystic fibrosis patients.

    Science.gov (United States)

    Fernández-Olmos, Ana; García-Castillo, María; Maiz, Luis; Lamas, Adelaida; Baquero, Fernando; Cantón, Rafael

    2012-08-01

    The ability of antibiotics used in bronchopulmonary infections in cystic fibrosis (CF) patients to prevent Pseudomonas aeruginosa early biofilm formation was studied using a biofilm microtitre assay with 57 non-mucoid P. aeruginosa isolates (44 first colonisers and 13 recovered during the initial intermittent colonisation stage) obtained from 35 CF patients. Minimum biofilm inhibitory concentrations (BICs) of levofloxacin, ciprofloxacin, imipenem, ceftazidime, tobramycin, colistin and azithromycin were determined by placing a peg lid with a formed biofilm onto microplates containing antibiotics. A modification of this protocol consisting of antibiotic challenge during biofilm formation was implemented in order to determine the biofilm prevention concentration (BPC), i.e. the minimum concentration able to prevent biofilm formation. The lowest BPCs were for fluoroquinolones, tobramycin and colistin and the highest for ceftazidime and imipenem. The former antibiotics had BPCs identical to or only slightly higher than their minimum inhibitory concentrations (MICs) determined by standard Clinical and Laboratory Standards Institute (CLSI) microdilution and were also active on formed biofilms as reflected by their low BIC values. In contrast, ceftazidime and imipenem were less effective for prevention of biofilm formation and on formed biofilms. In conclusion, the new BPC parameter determined in non-mucoid P. aeruginosa isolates recovered during early colonisation stages in CF patients supports early aggressive antimicrobial treatment guidelines in first P. aeruginosa-colonised CF patients. PMID:22727530

  12. Management of Antibiotic Residues from Agricultural Sources: Use of Composting to Reduce Chlortetracycline Residues in Beef Manure from Treated Animals

    Science.gov (United States)

    Chlortetracycline (CTC) is one of only ten antibiotics licensed in the U.S.A. for use as a growth promoter for livestock. The widespread use of CTC may contribute to development of antibiotic-resistant bacteria. The objective of this study was to determine the effect of composting on the fate of C...

  13. The economics of using prophylactic antibiotic-loaded bone cement in total knee replacement.

    Science.gov (United States)

    Gutowski, C J; Zmistowski, B M; Clyde, C T; Parvizi, J

    2014-01-01

    The rate of peri-prosthetic infection following total joint replacement continues to rise, and attempts to curb this trend have included the use of antibiotic-loaded bone cement at the time of primary surgery. We have investigated the clinical- and cost-effectiveness of the use of antibiotic-loaded cement for primary total knee replacement (TKR) by comparing the rate of infection in 3048 TKRs performed without loaded cement over a three-year period versus the incidence of infection after 4830 TKRs performed with tobramycin-loaded cement over a later period of time of a similar duration. In order to adjust for confounding factors, the rate of infection in 3347 and 4702 uncemented total hip replacements (THR) performed during the same time periods, respectively, was also examined. There were no significant differences in the characteristics of the patients in the different cohorts. The absolute rate of infection increased when antibiotic-loaded cement was used in TKR. However, this rate of increase was less than the rate of increase in infection following uncemented THR during the same period. If the rise in the rate of infection observed in THR were extrapolated to the TKR cohort, 18 additional cases of infection would have been expected to occur in the cohort receiving antibiotic-loaded cement, compared with the number observed. Depending on the type of antibiotic-loaded cement that is used, its cost in all primary TKRs ranges between USD $2112.72 and USD $112 606.67 per case of infection that is prevented.

  14. The Influence of a Continuing Medical Education Campaign on New Strategies to Improve Appropriate Use of Antibiotics

    Directory of Open Access Journals (Sweden)

    Brenda A. Bucklin

    2015-01-01

    Full Text Available Introduction. Widespread use of antibiotics has led to drug-resistant bacteria and reports of drug-resistant infections. A continuing medical education (CME campaign was used to improve antibiotic use among primary care providers. Methods. The Office of CME and Professional Development at the University of Colorado School of Medicine produces a semiannual, week-long course for primary care providers. A 2-year multifaceted CME campaign consisted of course content on antibiotic use, a practice audit, and two surveys to measure perceptions of the problem of antibiotic overuse, potential barriers to achieving appropriate use, and strategies to overcome barriers. Results. The overall response rate in the 2nd part of the campaign was 68.4%. Sixty-six percent of respondents had implemented at least one strategy to reduce antibiotic overuse. The rate was significantly higher among those who had attended previous reviews (81.0% compared with those who had attended neither (54%, p=0.0002. However, there was no “dose effect” on the rate of implementing a new strategy. Conclusions. Overuse of antibiotic therapy has important public health implications. Results suggest that mixed interactive and didactic CME program was effective in increasing awareness of antibiotic overuse and strategies for reducing antibiotic administration.

  15. Bombarding Cancer: Biolistic Delivery of therapeutics using Porous Si Carriers

    Science.gov (United States)

    Zilony, Neta; Tzur-Balter, Adi; Segal, Ester; Shefi, Orit

    2013-08-01

    A new paradigm for an effective delivery of therapeutics into cancer cells is presented. Degradable porous silicon carriers, which are tailored to carry and release a model anti-cancer drug, are biolistically bombarded into in-vitro cancerous targets. We demonstrate the ability to launch these highly porous microparticles by a pneumatic capillary gene gun, which is conventionally used to deliver cargos by heavy metal carriers. By optimizing the gun parameters e.g., the accelerating gas pressure, we have successfully delivered the porous carriers, to reach deep targets and to cross a skin barrier in a highly spatial resolution. Our study reveals significant cytotoxicity towards the target human breast carcinoma cells following the delivery of drug-loaded carriers, while administrating empty particles results in no effect on cell viability. The unique combination of biolistics with the temporal control of payload release from porous carriers presents a powerful and non-conventional platform for designing new therapeutic strategies.

  16. Knowledge and perceptions on antibiotic use and resistance among high school students and teachers in New Delhi, India: A qualitative study

    Science.gov (United States)

    Kotwani, Anita; Wattal, Chand; Joshi, P. C.; Holloway, Kathleen

    2016-01-01

    Objective: To explore the perceptions and knowledge of school teachers and students about antibiotic use, resistance, and suggestions for practical interventions for the rational use of antibiotics. Methodology: Five focus group discussions (FGDs) with high school students (Class: 9–11) and five with teachers were conducted in two private and three public schools (one teacher and one student FGD per school) in five municipal wards of Delhi. Qualitative data on antibiotic knowledge, resistance, and behaviors with respect to antibiotics use were collected. There were 4–8 persons per teacher FGD and 15–20 persons per student FGD. FGDs were analyzed using “thematic analyses.” Results: Students had poor knowledge regarding antibiotics and antibiotic resistance, while only some teachers had a basic understanding. Four broad themes needing attention emerged: definition of antibiotic and antibiotic resistance, antibiotic use behavior, doctor–patient relationship, and interventional strategies suggested to curtail the misuse of antibiotics and to spread awareness. In order to tackle these problems, both groups suggested a multipronged approach including robust public awareness campaigns also involving schools, better doctor–patient relationships, and stronger regulations. Conclusions: Although students and teachers exhibited poor knowledge about antibiotic use and resistance, they were keen to learn about these issues. School education programs and public education could be used to shape correct perceptions about antibiotic use among all stakeholders including children. This may help in the containment of antibiotic resistance and thus preservation of antibiotics for future generations.

  17. Antibiotics Quiz

    Science.gov (United States)

    ... Recommendations Pediatric Treatment Recommendations Inpatient Healthcare Professionals Community Pharmacists Continuing Education & Curriculum Opportunities Weighing in on Antibiotic Resistance Improving Prescribing Outpatient Antibiotic Stewardship Interventions That Work Systematic Reviews ...

  18. Antibiotic susceptibility of members of the Lactobacillus acidophilus group using broth microdilution and molecular identification of their resistance determinants

    NARCIS (Netherlands)

    Mayrhofer, S.; Hoek, van A.H.A.M.; Mair, C.; Huys, G.; Aarts, H.J.M.; Kneifel, W.; Domig, K.J.

    2010-01-01

    The range of antibiotic susceptibility to 13 antibiotics in 101 strains of the Lactobacillus acidophilus group was examined using the lactic acid bacteria susceptibility test medium (LSM) and broth microdilution. Additionally, microarray analysis and PCR were applied to identify resistance genes res

  19. First case of Helicobacter pylori infection resistant to seven antibiotics in Iran

    Directory of Open Access Journals (Sweden)

    Amin Talebi Bezmin Abadi

    2014-10-01

    Full Text Available Treatment of Helicobacter pylori infection with common antibiotics is typically recommended for several digestive conditions, including peptic ulcers. However, reports of resistant H. pylori isolates are increasing, and unfortunately, these do not respond to currently available therapeutic regimens. We report the case of a 31-year-old woman with two peptic ulcers in the duodenal antrum. An H. pylori strain was isolated, and tested for antibiotic resistance using agar dilution and disk diffusion. The isolated strain was found to be resistant to all seven antibiotics that were tested. Therefore, constant monitoring for antibiotic resistance should be performed prior to initiating antibiotic therapy.

  20. [Behavioral approach to facilitate appropriate use of antibiotics].

    Science.gov (United States)

    Matsushita, Osamu; Higuchi, Kazuko; Ishii, Noriko; Negayama, Kiyoshi; Taminato, Tomohiko

    2008-11-01

    Many hospitals have infection control education programs to facilitate the appropriate use of antimicrobial agents. Even with these efforts, however, it is not rare to encounter irregular prescriptions. In order to solve this discrepancy between knowledge and actual behavior, we chose an alternative approach to improve the decision making process. Recent advances in information technology have made it possible to not only instantly integrate various bacterial examination results using a computer, but to simultaneously carry out the statistical analyses at a much lower cost. We employed a client-server system to accomplish these tasks in Kagawa University Hospital. By connecting CCD camera-equipped microscopes to the system directly, image uploading has become a single-clicking job. Various microbial examination data were automatically transferred to the system once they became available in analytical devices such as BacT/ALERT 3D, VITEK, and an MIC analyzer. These data were presented to hospital doctors in well-designed web windows without delay. By removing psychological barriers to access laboratory examination data, statistics, and relevant information, more doctors seemed to independently follow scientific processes to choose antimicrobial agents. The daily behavior of hospital doctors has also been influenced by the system, e. g., pasting the microscopic images onto clinical records, or starting Gram staining in their own wards. These subtle but fundamental changes will eventually alter the way they make prescription decisions. The computer system was also useful for the infection control team to monitor and detect nosocomial infections, which has become essential to carry out its daily activities.

  1. Antibiotic Application and Emergence of Multiple Antibiotic Resistance (MAR) in Global Catfish Aquaculture.

    Science.gov (United States)

    Chuah, Li-Oon; Effarizah, M E; Goni, Abatcha Mustapha; Rusul, Gulam

    2016-06-01

    Catfish is one of the most cultivated species worldwide. Antibiotics are usually used in catfish farming as therapeutic and prophylactic agents. In the USA, only oxytetracycline, a combination of sulfadimethoxine and ormetoprim, and florfenicol are approved by the Food Drug Administration for specific fish species (e.g., catfish and salmonids) and their specific diseases. Misuse of antibiotics as prophylactic agents in disease prevention, however, is common and contributes in the development of antibiotic resistance. Various studies had reported on antibiotic residues and/or resistance in farmed species, feral fish, water column, sediments, and, in a lesser content, among farm workers. Ninety percent of the world aquaculture production is carried out in developing countries, which lack regulations and enforcement on the use of antibiotics. Hence, efforts are needed to promote the development and enforcement of such a regulatory structure. Alternatives to antibiotics such as antibacterial vaccines, bacteriophages and their lysins, and probiotics have been applied to curtail the increasing emergence of antibiotic-resistant bacteria due to the imprudent application of antibiotics in aquaculture. PMID:27038482

  2. [Immunotropic effects of probiotic complex bactistatin used simultaneously with antibiotics].

    Science.gov (United States)

    Vorobeĭchikov, E V; Stepanov, A V; Volkov, M Iu; Vasilenko, A Zh; Ponomarenko, V M; Sinitsa, A V

    2008-01-01

    The immunotropic effects of the probiotic complex Bactistatin (the complex contains metabolites of Bacillus subtilis) used simultaneously with oral doxycycline during different periods of time (1, 5, 10 and 20 days) were estimated. The dynamics of the changes in the nonspecific immunity factors under the effect of the above mentioned products or their combination (bactistatin + doxycycline) during the treatment of different duration was demonstrated. It was found that the oral administration of the metabolic probiotic bactistatin to experimental animals during 1-10 days increased the activity of the nonspecific resistance factors. The immunotropic effects of the product were evident at the level of the cells of the blood phagocytic system and the processes related to synthesis of such enzymes as lysozyme and myeloperoxidase and their release into the blood stream. Comparatively rapid increase of the functional activity of the factors was registered even after a single administration of the product. When the combination of the products (bactistatin + doxycycline) was administered to the animals during a fixed period of time (10 days) significant activation of the nonspecific immunity factors was observed. In perspective the findings will allow to optimize the basic regimens of antibacterial therapy and urgent (postcontact) prevention of infectious diseases. PMID:18942386

  3. The early use of appropriate prophylactic antibiotics in susceptible women for the prevention of preterm birth of infectious etiology

    DEFF Research Database (Denmark)

    Joergensen, Jan Stener; Weile, Louise Katrine Kjær; Lamont, Ronald F

    2014-01-01

    /meta-analyses have been conducted but none has simultaneously addressed the optimal choice of agent, patient and timing of intervention. We conclude that inappropriate antibiotics used in inappropriate women at inappropriately late gestations do not reduce preterm birth. Conversely, a focused systematic review...... of preterm birth so it is logical to consider the use of antibiotics for the prevention of preterm birth. AREAS COVERED: Infection and antibiotics in the etiology, prediction and prevention of preterm birth. EXPERT OPINION: Antibiotics for the prevention of preterm birth have addressed different risk groups......, diagnostic methods, degrees of abnormal flora, antibiotic dose regimens, routes of administration, host susceptibilities, host response, gestational age at time of treatment, outcome parameters and definitions of success and outcomes. To address this confusion, a number of systematic reviews...

  4. Using wildlife activity and antibiotic resistance analysis to model bacterial water quality in coastal ponds

    OpenAIRE

    Pullaro, Thomas C.; Pan, Wei; Chiovarou, Erica D.; Daugomah, James W.; Shea, Norman R.; Siewicki, Thomas C.

    2009-01-01

    Models that help predict fecal coliform bacteria (FCB) levels in environmental waters can be important tools for resource managers. In this study, we used animal activity along with antibiotic resistance analysis (ARA), land cover, and other variables to build models that predict bacteria levels in coastal ponds that discharge into an estuary. Photographic wildlife monitoring was used to estimate terrestrial and aquatic wildlife activity prior to sampling. Increased duck activity was an impor...

  5. Appropriate empirical antibiotic use and 30-d mortality in cirrhotic patients with bacteremia

    Science.gov (United States)

    Park, Hyun; Jang, Ki Jun; Jang, Won; Park, Sang Hoon; Park, Ji Young; Jeon, Tae Joo; Oh, Tae Hoon; Shin, Won Chang; Choi, Won-Choong; Sinn, Dong Hyun

    2015-01-01

    AIM: To analyze whether prompt and appropriate empirical antibiotic (AEA) use is associated with mortality in cirrhotic patients with bacteremia. METHODS: A total of 102 episodes of bacteremia in 72 patients with cirrhosis were analyzed. AEA was defined as a using or starting an antibiotic appropriate to the isolated pathogen at the time of bacteremia. The primary endpoint was 30-d mortality. RESULTS: The mortality rate at 30 d was 30.4% (31/102 episodes). Use of AEA was associated with better survival at 30 d (76.5% vs 46.9%, P = 0.05), and inappropriate empirical antibiotic (IEA) use was an independent factor associated with increased mortality (OR = 3.24; 95%CI: 1.50-7.00; P = 0.003, adjusted for age, sex, Child-Pugh Class, gastrointestinal bleeding, presence of septic shock). IEA use was more frequent when the isolated pathogen was a multiresistant pathogen, and when infection was healthcare-related or hospital-acquired. CONCLUSION: AEA use was associated with increased survival of cirrhotic patients who developed bacteremia. Strategies for AEA use, tailored according to the local epidemiological patterns, are needed to improve survival of cirrhotic patients with bacteremia. PMID:25834324

  6. Hygromycin B and apramycin antibiotic resistance cassettes for use in Campylobacter jejuni.

    Directory of Open Access Journals (Sweden)

    Andrew Cameron

    Full Text Available Campylobacter jejuni genetic manipulation is restricted by the limited number of antibiotic resistance cassettes available for use in this diarrheal pathogen. In this study, two antibiotic resistance cassettes were developed, encoding for hygromycin B and apramycin resistance, for use in mutagenesis or for selection of gene expression and complementation constructs in C. jejuni. First, the marker genes were successfully modified to allow for insertional mutagenesis or deletion of a gene-of-interest, and were bracketed with restriction sites for the facilitation of site-specific cloning. These hygromycin B and apramycin markers are encoded by plasmids pAC1H and pAC1A, respectively. We also modified an insertional gene-delivery vector to create pRRH and pRRA, containing the hygromycin B and apramycin resistance genes, and 3 unique restriction sites for the directional introduction of genes into the conserved multi-copy rRNA gene clusters of the C. jejuni chromosome. We determined the effective antibiotic concentrations required for selection, and established that no harmful effects or fitness costs were associated with carrying hygromycin B or apramycin resistance under standard C. jejuni laboratory conditions. Using these markers, the arylsulfatase reporter gene astA was deleted, and the ability to genetically complement the astA deletion using pRRH and pRRA for astA gene insertion was demonstrated. Furthermore, the relative levels of expression from the endogenous astA promoter were compared to that of polycistronic mRNA expression from the constitutive promoter upstream of the resistance gene. The development of additional antibiotic resistance cassettes for use in Campylobacter will enable multiple gene deletion and expression combinations as well as more in-depth study of multi-gene systems important for the survival and pathogenesis of this important bacterium.

  7. A clinical observation of early short-term use of potent antibiotics in severely burned patients

    Institute of Scientific and Technical Information of China (English)

    RONG Xin-zhou; ZHANG Wen-zhen; REN Jia-liang; ZHOU Wei-ming

    2001-01-01

    Objective: To evaluate the effect of early and short-term use of potent antibiotics following extensive severe burn injury. Methods: Seventeen severely burned patients hospitalized in the same period (Nov.,1998 to Oct., 2000) wer esame treatment in Group 2 (n=8) was discontinued until day 15 postburn. The survival rate, blood bacterial culture, body temperature and white blood cell and platelet counts were compared between the 2 groups. Results: All the 17 patients survived and all blood bacterial cultures were negative. No significant difference of body temperature and white blood cell and platelet counts between the 2 groups was observed (P>0.05). Conclusion: Early use of high-potency antibiotics at short treatment course after extensive severe burn is effective to prevent infection and reduce the cost.

  8. Prophylactic antibiotics for variceal hemorrhage: Clostridium difficile infection still can be a risk

    Institute of Scientific and Technical Information of China (English)

    Naohiro Okano; Kentaro Iwata

    2011-01-01

    Bron et al presented a retrospective study regarding the prophylactic use of antibiotics for variceal hemorrhage. Antibiotics appeared to improve the survival rate of patients without increasing clostridium difficile infection (CDI). We argue against the conclusion of the authors and consider that this result may be simply due to concurrent use of metronidazole, a therapeutic agent against CDI.

  9. Systemic Antibiotic Use During Pregnancy and Childhood Cancer in the Offspring

    DEFF Research Database (Denmark)

    Momen, Natalie; Olsen, Jørn; Gissler, Mika;

    to the child’s birth, from 1995 to 2008. Each cancer case, aged 0 to 14 years (n=1,157, including 475 leukemia, 153 central and sympathetic nervous system tumors, and 80 renal tumors), was matched by birthdate and sex with three population-based controls (n=3,471). Conditional logistic regression was used...... antibiotics. We plan to investigate these further with the addition of data from the Swedish national registers and the California Childhood Leukemia Study....

  10. APPROPRIATE USE OF ANTIBIOTICS FOR THE MANAGEMENT OF SEPSIS IN NEONATES

    OpenAIRE

    Samiya Nazeer Khan* and Siby Joseph

    2012-01-01

    Neonatal sepsis is associated with increased mortality and morbidity including neurodevelopmental impairment and prolongation of hospital stay. Clinical features of sepsis are non-specific in neonates and a high index of suspicion is required for timely diagnosis. Antibiotics are a very important group of drugs for the sick neonate and have undoubtedly played a role in their improved survival. But they come with a set of risks like other drugs used in critical care which must be carefully con...

  11. Possible Therapeutic Use of Loperamide for Symptoms of Lactose Intolerance

    OpenAIRE

    Szilagyi, Andrew; Torchinsky, Alick; Colacone, Antoinnette

    2000-01-01

    OBJECTIVES: To examine a potential practical therapeutic use of loperamide (Lo) to decrease the symptoms of lactose intolerance.SUBJECTS AND METHODS:  Nineteen (eight men, 11 women) healthy lactose maldigesters (18 of 19 with symptoms) underwent a 25 g lactose challenge on five separate days. Breath hydrogen was measured, areas under the curve (AUC) were calculated for 4 h, and 4 and 12 h symptom scores were recorded. After establishing baseline measurements, test doses of 4 mg, 8 mg and 12 m...

  12. Use of antibiotics in animal agriculture and the fate of antibiotic residues and resistance genes in the environment after land application of swine manure

    International Nuclear Information System (INIS)

    Full text: Two swine confinement facilities, designated sites A and C were the focus of study. The antibiotic regimens at both sites included chlortetracycline and tylosin. Hog manure at these sites was treated in open, unlined lagoons before being applied as fertilizer to onsite (site A) and offsite (Site C) farm fields. Sites differed in their sub-surface geology, and each site was outfitted with a network of groundwater sampling wells for the monitoring of chemical contaminants, antibiotic residues, bacterial indicators of faecal contamination, and antibiotic resistance genes. Sterile containers were used to collect water from waste lagoons and wells once in 2000, and twice in 2001 and 2002. Additionally, the presence of antibiotic resistance genes was investigated from soil samples collected from 2005 to 2007 from seven different fields that were amended with manure. DNA was extracted from water and soil samples. Detection of antibiotic resistance genes was accomplished by PCR using primers that have been described elsewhere. These primer sets targeted three major groups of antibiotic resistance genes: 1) four classes of genes (tet(M), tet(O), tet(Q), tet(W)) conferring resistance to tetracycline by means of ribosomal protection proteins; 2) three classes of genes (tet(C), tet(H), tet(Z)) conferring resistance to tetracycline by means of efflux pump proteins; 3) eight RNA methylase genes (tlr(B), tlr(D), erm(A), erm(B), erm(C), erm(F), erm(G), erm(Q)) conferring resistance to macrolide antibiotics, including tylosin and erythromycin, as well as to the lincosamide antibiotics and Streptogramin-B. The RNA methylases tlr(B) and tlr(D) have been found in tylosin-producing strains of soil bacteria, while the other six erm genes come from a diversity of pathogenic, human commensal, and environmental bacteria. These genes were selected as targets based on preliminary surveys of lagoon and groundwater and upon the antibiotic usage of the study sites. Presence

  13. Antibiotic use and resistance: perceptions and ethical challenges among doctors, pharmacists and the public in Vellore, South India.

    Science.gov (United States)

    Chandy, Sujith J; Mathai, Elizabeth; Thomas, Kurien; Faruqui, Atiya Rehman; Holloway, Kathleen; Lundborg, Cecilia Stalsby

    2013-01-01

    Inappropriate antibiotic use and resistance are major public health challenges. Interventional strategies require ascertaining the perceptions of major stakeholders and documenting the challenges to changing practice. Towards this aim, a qualitative study was conducted in Vellore, South India, using focus group discussions among doctors, pharmacists and public. There were eight groups with six to eight participants each. The themes explored were: understanding of infections, antibiotics and resistance; practices and pressure driving antibiotic use; and strategies for appropriate use. Data were transcribed, analysed, verified and a summary prepared with salient features and quotations. It was found that the public had minimal awareness of resistance, antibiotics and infections. They wanted symptomatic relief. Doctors reported prescribing antibiotics for perceived patient expectations and quick recovery. Business concerns contributed to antibiotics sales among pharmacists. Pharmaceutical industry incentives and healthcare provider competition were the main ethical challenges. Suggested interventional strategies by the participants included creating public awareness, better healthcare provider communication, improved diagnostic support, strict implementation of guidelines, continuing education, and strengthening of regulations. Perceived patient benefit, unrestricted autonomy and business-cum-industry pressures are promoting inappropriate use of antibiotics. Strategies improving responsible use will help preserve their effectiveness, and provide distributive justice and benefit for future generations.

  14. Antibiotic use and resistance: perceptions and ethical challenges among doctors, pharmacists and the public in Vellore, South India.

    Science.gov (United States)

    Chandy, Sujith J; Mathai, Elizabeth; Thomas, Kurien; Faruqui, Atiya Rehman; Holloway, Kathleen; Lundborg, Cecilia Stalsby

    2013-01-01

    Inappropriate antibiotic use and resistance are major public health challenges. Interventional strategies require ascertaining the perceptions of major stakeholders and documenting the challenges to changing practice. Towards this aim, a qualitative study was conducted in Vellore, South India, using focus group discussions among doctors, pharmacists and public. There were eight groups with six to eight participants each. The themes explored were: understanding of infections, antibiotics and resistance; practices and pressure driving antibiotic use; and strategies for appropriate use. Data were transcribed, analysed, verified and a summary prepared with salient features and quotations. It was found that the public had minimal awareness of resistance, antibiotics and infections. They wanted symptomatic relief. Doctors reported prescribing antibiotics for perceived patient expectations and quick recovery. Business concerns contributed to antibiotics sales among pharmacists. Pharmaceutical industry incentives and healthcare provider competition were the main ethical challenges. Suggested interventional strategies by the participants included creating public awareness, better healthcare provider communication, improved diagnostic support, strict implementation of guidelines, continuing education, and strengthening of regulations. Perceived patient benefit, unrestricted autonomy and business-cum-industry pressures are promoting inappropriate use of antibiotics. Strategies improving responsible use will help preserve their effectiveness, and provide distributive justice and benefit for future generations. PMID:23439193

  15. Evaluating antibiotic stewardship programs in patients with bacteremia using administrative data

    DEFF Research Database (Denmark)

    Boel, J; Søgaard, M; Andreasen, V;

    2015-01-01

    of treatment, and computed adjusted hazard ratios (HRs) and 95 % confidence intervals (CIs) for 30-day mortality and post-discharge readmission by regimen and appropriateness of treatment. In total, 945 (47.1 %) were treated by the old regimen and 1,063 (52.9 %) by the new. The median length of stay (8 days...... treatment. We categorized 2,008 adult patients diagnosed with bacteremia between 2010 and 2012 according to whether they received cephalosporins or fluoroquinolones (old regimen) or not (new regimen). We used administrative data to extract individual level data on mortality, readmission, and appropriateness......When introducing new antibiotic guidelines for empirical treatment of bacteremia, it is imperative to evaluate the performance of the new guideline. We examined the utility of administrative data to evaluate the effect of new antibiotic guidelines and the prognostic impact of appropriate empirical...

  16. Encapsulation of Cancer Therapeutic Agent Dacarbazine Using Nanostructured Lipid Carrier.

    Science.gov (United States)

    Almoussalam, Musallam; Zhu, Huijun

    2016-01-01

    The only formula of dacarbazine (Dac) in clinical use is intravenous infusion, presenting a poor therapeutic profile due to the low dispersity of the drug in aqueous solution. To overcome this, a nanostructured lipid carrier (NLC) consisting of glyceryl palmitostearate and isopropyl myristate was developed to encapsulate Dac. NLCs with controlled size were achieved using high shear dispersion (HSD) following solidification of oil-in-water emulsion. The synthesis parameters, including surfactant concentration, the speed and time of HSD were optimized to achieve the smallest NLC with size, polydispersion index and zeta potential of 155 ± 10 nm, 0.2 ± 0.01, and -43.4 ± 2 mV, respectively. The optimal parameters were also employed for Dac-loaded NLC preparation. The resultant NLC loaded with Dac possessed size, polydispersion index and zeta potential of 190 ± 10 nm, 0.2 ± 0.01, and -43.5 ± 1.2 mV, respectively. The drug encapsulation efficiency and drug loading reached 98% and 14%, respectively. This is the first report on encapsulation of Dac using NLC, implying that NLC could be a new potential candidate as drug carrier to improve the therapeutic profile of Dac. PMID:27168058

  17. Changing use of surgical antibiotic prophylaxis in Thika Hospital, Kenya: a quality improvement intervention with an interrupted time series design.

    Directory of Open Access Journals (Sweden)

    Alexander M Aiken

    Full Text Available INTRODUCTION: In low-income countries, Surgical Site Infection (SSI is a common form of hospital-acquired infection. Antibiotic prophylaxis is an effective method of preventing these infections, if given immediately before the start of surgery. Although several studies in Africa have compared pre-operative versus post-operative prophylaxis, there are no studies describing the implementation of policies to improve prescribing of surgical antibiotic prophylaxis in African hospitals. METHODS: We conducted SSI surveillance at a typical Government hospital in Kenya over a 16 month period between August 2010 and December 2011, using standard definitions of SSI and the extent of contamination of surgical wounds. As an intervention, we developed a hospital policy that advised pre-operative antibiotic prophylaxis and discouraged extended post-operative antibiotics use. We measured process, outcome and balancing effects of this intervention in using an interrupted time series design. RESULTS: From a starting point of near-exclusive post-operative antibiotic use, after policy introduction in February 2011 there was rapid adoption of the use of pre-operative antibiotic prophylaxis (60% of operations at 1 week; 98% at 6 weeks and a substantial decrease in the use of post-operative antibiotics (40% of operations at 1 week; 10% at 6 weeks in Clean and Clean-Contaminated surgery. There was no immediate step-change in risk of SSI, but overall, there appeared to be a moderate reduction in the risk of superficial SSI across all levels of wound contamination. There were marked reductions in the costs associated with antibiotic use, the number of intravenous injections performed and nursing time spent administering these. CONCLUSION: Implementation of a locally developed policy regarding surgical antibiotic prophylaxis is an achievable quality improvement target for hospitals in low-income countries, and can lead to substantial benefits for individual patients and

  18. Use of antibiotics among outpatients%门诊抗菌药物应用分析

    Institute of Scientific and Technical Information of China (English)

    蒋正立; 朱萍

    2012-01-01

    OBJECTIVE To investigate the antibiotic usage among outpatients in our hospital and provide reference for rational clinical use. METHODS The antibiotic usage was analyzed by amount ranking and frequency in our hospital from 2008 to 2010. RESULTS The sale amount of antibiotics was increased and DDDs were decreased year by year in 3 years. The antibiotic with highest sale amount and DDDs were penicillins. Amoxicillin/clavulanate potassium had in average the highest sale amount in the single drug sale, and ampicillin/sulbactam had in average the highest DDDs. CONCLUSION The use of antimicrobial agents in our hospital is basically reasonable.%目的 了解医院门诊抗菌药物应用情况,为临床合理用药提供参考.方法 采用金额排序法和频度分析法,对2008-2010年抗菌药物使用情况进行统计分析.结果 近3年抗菌药物销售金额呈逐年增长,用药频度呈逐年递减,销售金额和用药频度均排在首位的是青霉素类,单品种药物平均销售金额排在首位的是阿莫西林/克拉维酸、平均DDDs排在首位的是氨苄西林/舒巴坦.结论 调查该医院抗菌药物使用基本合理.

  19. The agricultural use of water treatment plant sludge: pathogens and antibiotic resistance

    Directory of Open Access Journals (Sweden)

    Ignacio Nadal Rocamora

    2015-12-01

    Full Text Available The use of water treatment plant sludge to restore degraded soils is customary agricultural practice, but it could be dangerous from the point of view of both health and the environment. A transient increase of either pathogenic or indicator microbial populations, whose persistence in time is variable and attributed to the characteristics of the soil (types of materials in the soil, any amendments (origin and treatments it has undergone or the weather (humidity and temperature mainly, has often been detected in soils treated with this kind of waste. Given their origin, water treatment plant sludges could lead to the transmission of a pathogens and b antibiotic-resistant microorganisms to human beings through the food chain and cause the spreading of antibiotic resistances as a result of their increase and persistence in the soil for variable periods of time. However, Spanish legislation regulating the use of sludges in the farming industry is based on a very restricted microbiological criterion. Thus, we believe better parameters should be established to appropriately inform of the state of health of soils treated with water treatment plant sludge, including aspects which are not presently assessed such as antibiotic resistance.

  20. Therapeutic drug monitoring of amoxicillin and cloxacillin

    Institute of Scientific and Technical Information of China (English)

    OTRIBUT; PTATTEVIN; MVERDIER; YLETULZO; CMICELET; HALLAIN; DBENTURE-FERRER

    2004-01-01

    AIM: Beta-lactams (BL) are broad-spectrum antibiotics currently used in number of infectious diseases and some infections need high dose of antibiotics. BL studied here are eliminated rather quickly by the kidney. A renal insufficiency involves an increase in BL concentrations. Therapeutic drug monitoring could help in adapting the target concentration. METHODS: We developed a rapid (less than 20 min), sensitive, and specific HPLC method

  1. A history of the therapeutic use of liquorice in Europe.

    Science.gov (United States)

    Fiore, Cristina; Eisenhut, Michael; Ragazzi, Eugenio; Zanchin, Giorgio; Armanini, Decio

    2005-07-14

    Liquorice root has been used in Europe since prehistoric times, and is well documented in written form starting with the ancient Greeks. In this review we compare the independent development of medical uses of this botanical drug in several ancient cultures, attempting to show the rationality of specific indications across different ethnic groups with different cultural backgrounds. Identical specific indications in different cultures highlight universally reproducible therapeutic effects that are beyond those of a mere placebo. In the first part of the review, historical sources dealing with liquorice (Scythian, Greek, Roman, and from the Middle Ages in Germany, Italy, Spain, England) have been considered. In the second part, the historical records of diseases treated with liquorice have been presented. Finally, a comparison between traditional use in and outside Europe, with the most important recent scientific studies concerning its use, is presented. PMID:15978760

  2. Pancreatic islet-cell viability, functionality and oxidative status remain unaffected at pharmacological concentrations of commonly used antibiotics in vitro

    Indian Academy of Sciences (India)

    Yogita Shewade; Suraj Tirth; R R Bhonde

    2001-09-01

    Environmental factors such as diet, physical activity, drugs, pollution and life style play an important role in the progression and/or precipitation of diseases like diabetes, hypertension, obesity and cardiovascular disorders. Indiscriminate use of antibiotics to combat infectious diseases is one of the commonest forms of misuse of drugs. Antibiotics seem to have a correlation with diabetes and pancreatic function. There are controversial reports about the effect of antibiotics on the pancreatic islets; some suggesting their harmless action, some depicting a beneficial role and others indicating deleterious effect. Moreover, use of antibiotics is mandatory during islet isolation and cultivation to reduce incidences of microbial contamination. It is likely that antibiotic treatment may adversely affect islet viability and its functioning leading to failure of islet transplantation. The present in vitro study was undertaken to examine the effect of commonly used antibiotics such as gentamycin, penicillin, streptomycin, tetracycline, neomycin, erythromycin and chloramphenicol on islet viability, its functioning and induction of oxidative stress if any. The viability and insulin production data showed that none of the antibiotics used in the present study affect the viability and the functioning of the islets at their pharmacological concentrations. Free radical levels measured in terms of melonyldialdehyde (MDA), nitric oxide (NO) and reduced glutathione (GSH) reveal that except for a marginal increase in lipid peroxidation with tetracycline and slight increase in NO levels with streptomycin, none of these antibiotics affect the oxidative status of the cells. Antioxidant enzymes such as superoxide dismutase and catalase remain unaffected after this treatment. Our results reveal the innocuous nature of the antibiotics used at pharmacological concentrations, suggesting their safety whenever prescribed to combat infections and also during islet isolation procedures.

  3. Antibiotic resistances in Listeria monocytogenes and Salmonella enterica isolated from foods with animal origin

    OpenAIRE

    Baltasar Balsalobre Hernández; Joaquín Hernández-Godoy

    2004-01-01

    Extensive use of antibiotics in both human and animal health and in cattle production has generated resistant microorganisms to common antibiotics. Resistances spread caused by human and animal therapeutic is well known, but we know poorly frecuency of resistant bacteria in foods with animal origin and destinated to human consumers. In this paper, sensitivity to nineteen antibiotics was investigated in Listeria monocytogenes and Salmonella enterica strains isolated from foods with animal orig...

  4. Effective Phages as Green Antimicrobial Agents Against Antibiotic-Resistant Hospital Escherichia coli

    OpenAIRE

    Rahmani, Rana; Zarrini, Gholamreza; Sheikhzadeh, Farzam; Aghamohammadzadeh, Naser

    2015-01-01

    Background: Bacteriophages are viruses that attack bacteria and lead to their lysis in an efficient and highly specific manner. These natural enemies of bacteria were used as therapeutic agents before the advent of antibiotics. Currently, with the rapid spread of multi-drug resistant bacteria, phage therapy can be an effective alternative treatment for antibiotic resistant bacteria. Objectives: This study evaluated the effectiveness of bacteriophages in removing antibiotic-resistant clinical ...

  5. A cross-sectional study on knowledge, attitude, and behavior related to antibiotic use among undergraduate medical students in a tertiary care medical college, Kashmir

    Directory of Open Access Journals (Sweden)

    Shakeel Ahmad Mir

    2015-12-01

    Conclusions: There is an urgent need to improve education on antibiotic use in medical curricula. Furthermore, strict policies must be enforced to regulate dispensing of antibiotics. [Int J Basic Clin Pharmacol 2015; 4(6.000: 1156-1162

  6. Challenges for the therapeutic use of pluripotent stem derived cells

    Directory of Open Access Journals (Sweden)

    Magda eForsberg

    2012-02-01

    Full Text Available Human embryonic stem cells (hESC and induced pluripotent stem cells (hiPSC are an attractive cell source for regenerative medicine. These cells can be expanded to vast numbers and can be differentiated to many cell types to generate pluripotent stem cells (PSC derived therapeutic cells. These cells are desired for cell transplantations. Cell replacement is promising, but it has many challenges. The challenge of introduction of exogenous cells in a recipient requires addressing several different topics; the immunological response and possible rejection, cleanliness, exclusion of tumor formation and functionality of the PSC derived therapeutic cells. Immunological rejection can be addressed with immunomodulation of the cells and the recipient. Cleanliness can be optimized using good manufacturing practice (GMP quality systems. Tumor formation requires the removal of any PSC remaining after differentiation. At last, the functionality of the cells must be tested in in-vitro and in animal models. After addressing these challenges, precise strategies are developed to monitor the status of the cells at different times and in case of undesired results, corresponding counteracting strategies must exist before any clinical attempt.

  7. Enhancing cancer therapeutics using size-optimized magnetic fluid hyperthermia

    Science.gov (United States)

    Khandhar, Amit P.; Ferguson, R. Matthew; Simon, Julian A.; Krishnan, Kannan M.

    2012-04-01

    Magnetic fluid hyperthermia (MFH) employs heat dissipation from magnetic nanoparticles to elicit a therapeutic outcome in tumor sites, which results in either cell death (>42 °C) or damage (Fe3O4) nanoparticles (MNPs) synthesized in organic solvents and subsequently transferred to aqueous phase using a biocompatible amphiphilic polymer. Monodisperse MNPs, ˜16 nm diameter, show maximum heating efficiency, or specific loss power (watts/g Fe3O4) in a 373 kHz alternating magnetic field. Our in vitro results, for 15 min of heating, show that only 40% of cells survive for a relatively low dose (490 μg Fe/ml) of these size-optimized MNPs, compared to 80% and 90% survival fraction for 12 and 13 nm MNPs at 600 μg Fe/ml. The significant decrease in cell viability due to MNP-induced hyperthermia from only size-optimized nanoparticles demonstrates the central idea of tailoring size for a specific frequency in order to intrinsically improve the therapeutic potency of MFH by optimizing both dose and time of application.

  8. Enhancing cancer therapeutics using size-optimized magnetic fluid hyperthermia.

    Science.gov (United States)

    Khandhar, Amit P; Ferguson, R Matthew; Simon, Julian A; Krishnan, Kannan M

    2012-04-01

    Magnetic fluid hyperthermia (MFH) employs heat dissipation from magnetic nanoparticles to elicit a therapeutic outcome in tumor sites, which results in either cell death (>42 °C) or damage (monodisperse magnetite (Fe(3)O(4)) nanoparticles (MNPs) synthesized in organic solvents and subsequently transferred to aqueous phase using a biocompatible amphiphilic polymer. Monodisperse MNPs, ∼16 nm diameter, show maximum heating efficiency, or specific loss power (watts/g Fe(3)O(4)) in a 373 kHz alternating magnetic field. Our in vitro results, for 15 min of heating, show that only 40% of cells survive for a relatively low dose (490 μg Fe/ml) of these size-optimized MNPs, compared to 80% and 90% survival fraction for 12 and 13 nm MNPs at 600 μg Fe/ml. The significant decrease in cell viability due to MNP-induced hyperthermia from only size-optimized nanoparticles demonstrates the central idea of tailoring size for a specific frequency in order to intrinsically improve the therapeutic potency of MFH by optimizing both dose and time of application. PMID:22393267

  9. Monitoring Therapeutic Treatments against Burkholderia Infections Using Imaging Techniques

    Directory of Open Access Journals (Sweden)

    Tiffany M. Mott

    2013-05-01

    Full Text Available Burkholderia mallei, the etiologic agent of glanders, are Category B select agents with biothreat potential, and yet effective therapeutic treatments are lacking. In this study, we showed that CpG administration increased survival, demonstrating protection in the murine glanders model. Bacterial recovery from infected lungs, liver and spleen was significantly reduced in CpG-treated animals as compared with non-treated mice. Reciprocally, lungs of CpG-treated infected animals were infiltrated with higher levels of neutrophils and inflammatory monocytes, as compared to control animals. Employing the B. mallei bioluminescent strain CSM001 and the Neutrophil-Specific Fluorescent Imaging Agent, bacterial dissemination and neutrophil trafficking were monitored in real-time using multimodal in vivo whole body imaging techniques. CpG-treatment increased recruitment of neutrophils to the lungs and reduced bioluminescent bacteria, correlating with decreased bacterial burden and increased protection against acute murine glanders. Our results indicate that protection of CpG-treated animals was associated with recruitment of neutrophils prior to infection and demonstrated, for the first time, simultaneous real time in vivo imaging of neutrophils and bacteria. This study provides experimental evidence supporting the importance of incorporating optimized in vivo imaging methods to monitor disease progression and to evaluate the efficacy of therapeutic treatment during bacterial infections.

  10. Surveillance of antibiotic and analgesic use in the Oral Surgery Department of the University Dentistry Clinical Center of Kosovo

    Science.gov (United States)

    Haliti, Naim R; Haliti, Fehim R; Koçani, Ferit K; Gashi, Ali A; Mrasori, Shefqet I; Hyseni, Valon I; Bytyqi, Samir I; Krasniqi, Lumnije L; Murtezani, Ardiana F; Krasniqi, Shaip L

    2015-01-01

    Background Because Kosovo has no reliable information on antimicrobial and analgesic use in dental practice, the survey reported here evaluated the antibiotic and analgesic prescriptions in the Oral Surgery Department of the University Dentistry Clinical Center of Kosovo (UDCCK). Methods The data of 2,442 registered patients for a 1-year period were screened and analyzed concerning antibiotic and analgesic use as per standards of rational prescription. Results Dentistry doctors prescribed antibiotics significantly more often than analgesics. Antibiotics were prescribed in 8.11% of all cases, while only 1.35% of total prescriptions were for analgesics. The total consumption of antibiotic drugs in the UDCCK was 4.53 Defined Daily Doses [DDD]/1,000 inhabitants/day, compared with only 0.216 DDD/1,000 inhabitants/day for analgesics. From a total number of 117 patients, 32 patients received combinations of two antibiotics. Conclusion Pharmacotherapy analysis showed that the prescription rates of antibiotics and analgesics in the UDCCK are not rational in terms of the qualitative aspects of treatment. For the qualitative improvement of prescription of these drug groups, we recommend the implementation of treatment guidelines following rational standards. PMID:26491336

  11. Effects of Antibiotic Use on the Microbiota of the Gut and Associated Alterations of Immunity and Metabolism

    Directory of Open Access Journals (Sweden)

    M. Pilar Francino

    2013-11-01

    Full Text Available The excessively widespread use of antibiotics has created many threats. A well-known problem is the increasing bacterial resistance to antibiotics, which has clearly become a worldwide challenge to the effective control of infections by many pathogens. But, beyond affecting the pathogenic agents for which it is intended, antibiotic treatment also affects the mutualistic communities of microbes that inhabit the human body. As they inhibit susceptible organisms and select for resistant ones, antibiotics can have strong immediate effects on the composition of these communities, such as the proliferation of resistant opportunists that can cause accute disease. Furthermore, antibiotic-induced microbiota alterations are also likely to have more insidious effects on long-term health. In the case of the gut microbiota, this community interacts with many crucial aspects of human biology, including the regulation of immune and metabolic homeostasis, in the gut and beyond. It follows that antibiotic treatments bear the risk of altering these basic equilibria. Here, we review the growing literature on the effects of antibiotic use on gut microbiota composition and function, and their consequences for immunity, metabolism, and health.

  12. Targeted localized use of therapeutic antibodies: a review of non-systemic, topical and oral applications.

    Science.gov (United States)

    Jones, Russell G A; Martino, Angela

    2016-01-01

    gangrenosum, antibiotic resistant bacterial infections or ulcerated wounds. Diseases confined to the gastrointestinal tract can be targeted directly by applying antibody via the injection-free peroral route. The gastrointestinal tract is unusual in that its natural immuno-tolerant nature ensures the long-term safety of repeatedly ingesting heterologous antiserum or antibody materials. Without the stringent regulatory, purity and clean room requirements of manufacturing parenteral (injectable) antibodies, production costs are minimal, with the potential for more direct low-cost targeting of gastrointestinal diseases, especially with those caused by problematic antibiotic resistant or toxigenic bacteria (e.g. Clostridium difficile, Helicobacter pylori), viruses (e.g. rotavirus, norovirus) or inflammatory bowel disease (e.g. ulcerative colitis, Crohn's disease). Use of the oral route has previously been hindered by excessive antibody digestion within the gastrointestinal tract; however, this limitation may be overcome by intelligently applying one or more strategies (i.e. decoy proteins, masking therapeutic antibody cleavage sites, pH modulation, enzyme inhibition or encapsulation). These aspects are additionally discussed in this review and novel insights also provided. With the development of new applications via local injections, topical and peroral routes, it is envisaged that an extended range of ailments will increasingly fall within the clinical scope of therapeutic antibodies further expanding this market.

  13. A REVIEW ON THERAPEUTIC USES OF PEDALIUM MUREX LINN

    Directory of Open Access Journals (Sweden)

    A. Elumalai

    2011-06-01

    Full Text Available Traditional system of medicinal consists of large number of plants with various medicinal and pharmacological importances and hence represents a priceless tank of new bioactive molecules. Pedalium murex is a small herb distributed in tropical Africa, Ceylon, India and Mexico. It is commonly found in Deccan and some parts of Ceylon and Gujarat and in its costal areas of Southern India. It is commonly called Gokhru (Yaanai Nerinji a member of family Pedaliaceae. The plant is sweet, cooling, mucilaginous, diuretic and inflammatory and used to treat digestive, carminative, tonic, spasmodic affections, amenorrhoea, and vitiated conditions of pita, inflammation and general debility. This review will be helpful to create interest towards Pedalium murex and may be useful in developing new formulations with more therapeutic and economical value.

  14. A Community Intervention to Decrease Antibiotics Used for Self-Medication Among Latino Adults

    OpenAIRE

    Mainous, Arch G.; Diaz, Vanessa A.; Carnemolla, Mark

    2009-01-01

    PURPOSE Recent evidence in Latino communities indicates substantial self-medication with antibiotics obtained without a prescription (WORx). We implemented and evaluated a culturally sensitive educational intervention to decrease antibiotic self-medication.

  15. A platform for the discovery of new macrolide antibiotics

    Science.gov (United States)

    Seiple, Ian B.; Zhang, Ziyang; Jakubec, Pavol; Langlois-Mercier, Audrey; Wright, Peter M.; Hog, Daniel T.; Yabu, Kazuo; Allu, Senkara Rao; Fukuzaki, Takehiro; Carlsen, Peter N.; Kitamura, Yoshiaki; Zhou, Xiang; Condakes, Matthew L.; Szczypiński, Filip T.; Green, William D.; Myers, Andrew G.

    2016-05-01

    The chemical modification of structurally complex fermentation products, a process known as semisynthesis, has been an important tool in the discovery and manufacture of antibiotics for the treatment of various infectious diseases. However, many of the therapeutics obtained in this way are no longer effective, because bacterial resistance to these compounds has developed. Here we present a practical, fully synthetic route to macrolide antibiotics by the convergent assembly of simple chemical building blocks, enabling the synthesis of diverse structures not accessible by traditional semisynthetic approaches. More than 300 new macrolide antibiotic candidates, as well as the clinical candidate solithromycin, have been synthesized using our convergent approach. Evaluation of these compounds against a panel of pathogenic bacteria revealed that the majority of these structures had antibiotic activity, some efficacious against strains resistant to macrolides in current use. The chemistry we describe here provides a platform for the discovery of new macrolide antibiotics and may also serve as the basis for their manufacture.

  16. Bacteriophage Procurement for Therapeutic Purposes.

    Science.gov (United States)

    Weber-Dąbrowska, Beata; Jończyk-Matysiak, Ewa; Żaczek, Maciej; Łobocka, Małgorzata; Łusiak-Szelachowska, Marzanna; Górski, Andrzej

    2016-01-01

    Bacteriophages (phages), discovered 100 years ago, are able to infect and destroy only bacterial cells. In the current crisis of antibiotic efficacy, phage therapy is considered as a supplementary or even alternative therapeutic approach. Evolution of multidrug-resistant and pandrug-resistant bacterial strains poses a real threat, so it is extremely important to have the possibility to isolate new phages for therapeutic purposes. Our phage laboratory and therapy center has extensive experience with phage isolation, characterization, and therapeutic application. In this article we present current progress in bacteriophages isolation and use for therapeutic purposes, our experience in this field and its practical implications for phage therapy. We attempt to summarize the state of the art: properties of phages, the methods for their isolation, criteria of phage selection for therapeutic purposes and limitations of their use. Perspectives for the use of genetically engineered phages to specifically target bacterial virulence-associated genes are also briefly presented. PMID:27570518

  17. A point prevalence survey of antibiotic use in four acute-care teaching hospitals utilizing the European Surveillance of Antimicrobial Consumption (ESAC) audit tool.

    Science.gov (United States)

    Aldeyab, M A; Kearney, M P; McElnay, J C; Magee, F A; Conlon, G; MacIntyre, J; McCullagh, B; Ferguson, C; Friel, A; Gormley, C; McElroy, S; Boyce, T; McCorry, A; Muller, A; Goossens, H; Scott, M G

    2012-09-01

    The objective of this research was to assess current patterns of hospital antibiotic prescribing in Northern Ireland and to determine targets for improving the quality of antibiotic prescribing. A point prevalence survey was conducted in four acute teaching hospitals. The most commonly used antibiotics were combinations of penicillins including β-lactamase inhibitors (33·6%), metronidazole (9·1%), and macrolides (8·1%). The indication for treatment was recorded in 84·3% of the prescribing episodes. A small fraction (3·9%) of the surgical prophylactic antibiotic prescriptions was for >24 h. The results showed that overall 52·4% of the prescribed antibiotics were in compliance with the hospital antibiotic guidelines. The findings identified the following indicators as targets for quality improvement: indication recorded in patient notes, the duration of surgical prophylaxis and compliance with hospital antibiotic guidelines. The results strongly suggest that antibiotic use could be improved by taking steps to address the identified targets for quality improvement.

  18. 3 Certain Shell Hospital Inpatient Antibiotic Uses are Analysed%某三甲医院住院病人抗生素利用分析

    Institute of Scientific and Technical Information of China (English)

    刘伟卿

    2002-01-01

    Objective We appraise the application condition of 3 certain shell hospital antibiotics. Methods According to medicine, we use research method. As the 280 certain courtyard regular inpatients of May 2001 use the condition of antibiotic,investigate. With the survey that DDD studies as medicine use, we worth. Is judgement doctor with DUI reasonable use the standard of medicine? Results 185 examples are used antibiotic, take 66.07%. With penicillins, Quinolones and Aminoglycosides use count frequently highest. Before locating in, 5 antibiotics are in proper order. Penicillin G, Clindamycin,Amikacin, Sodium Cefotaxime, and Ciprofloxacin. Conclusions The most antibiotic DUI ≤ 1, whole, the application ofantibiotic is reasonable.

  19. Antibodies: an alternative for antibiotics?

    Science.gov (United States)

    Berghman, L R; Abi-Ghanem, D; Waghela, S D; Ricke, S C

    2005-04-01

    In 1967, the success of vaccination programs, combined with the seemingly unstoppable triumph of antibiotics, prompted the US Surgeon General to declare that "it was time to close the books on infectious diseases." We now know that the prediction was overly optimistic and that the fight against infectious diseases is here to stay. During the last 20 yr, infectious diseases have indeed made a staggering comeback for a variety of reasons, including resistance against existing antibiotics. As a consequence, several alternatives to antibiotics are currently being considered or reconsidered. Passive immunization (i.e., the administration of more or less pathogen-specific antibodies to the patient) prior to or after exposure to the disease-causing agent is one of those alternative strategies that was almost entirely abandoned with the introduction of chemical antibiotics but that is now gaining interest again. This review will discuss the early successes and limitations of passive immunization, formerly referred to as "serum therapy," the current use of antibody administration for prophylaxis or treatment of infectious diseases in agriculture, and, finally, recent developments in the field of antibody engineering and "molecular farming" of antibodies in various expression systems. Especially the potential of producing therapeutic antibodies in crops that are routine dietary components of farm animals, such as corn and soy beans, seems to hold promise for future application in the fight against infectious diseases. PMID:15844826

  20. Targeting angiogenesis-dependent calcified neoplasms using combined polymer therapeutics.

    Directory of Open Access Journals (Sweden)

    Ehud Segal

    Full Text Available BACKGROUND: There is an immense clinical need for novel therapeutics for the treatment of angiogenesis-dependent calcified neoplasms such as osteosarcomas and bone metastases. We developed a new therapeutic strategy to target bone metastases and calcified neoplasms using combined polymer-bound angiogenesis inhibitors. Using an advanced "living polymerization" technique, the reversible addition-fragmentation chain transfer (RAFT, we conjugated the aminobisphosphonate alendronate (ALN, and the potent anti-angiogenic agent TNP-470 with N-(2-hydroxypropylmethacrylamide (HPMA copolymer through a Glycine-Glycine-Proline-Norleucine linker, cleaved by cathepsin K, a cysteine protease overexpressed at resorption sites in bone tissues. In this approach, dual targeting is achieved. Passive accumulation is possible due to the increase in molecular weight following polymer conjugation of the drugs, thus extravasating from the tumor leaky vessels and not from normal healthy vessels. Active targeting to the calcified tissues is achieved by ALN's affinity to bone mineral. METHODS AND FINDING: The anti-angiogenic and antitumor potency of HPMA copolymer-ALN-TNP-470 conjugate was evaluated both in vitro and in vivo. We show that free and conjugated ALN-TNP-470 have synergistic anti-angiogenic and antitumor activity by inhibiting proliferation, migration and capillary-like tube formation of endothelial and human osteosarcoma cells in vitro. Evaluation of anti-angiogenic, antitumor activity and body distribution of HPMA copolymer-ALN-TNP-470 conjugate was performed on severe combined immunodeficiency (SCID male mice inoculated with mCherry-labeled MG-63-Ras human osteosarcoma and by modified Miles permeability assay. Our targeted bi-specific conjugate reduced VEGF-induced vascular hyperpermeability by 92% and remarkably inhibited osteosarcoma growth in mice by 96%. CONCLUSIONS: This is the first report to describe a new concept of a narrowly-dispersed combined

  1. Understanding variation in quality of antibiotic use for community-acquired pneumonia: Effect of patient, professional and hospital factors

    OpenAIRE

    Schouten, Jeroen; Hulscher, Marlies; Kullberg, Bart Jan; Cox, Angela; Gyssens, Inge; Van Der Meer, Jos,; Grol, Richard

    2005-01-01

    textabstractObjectives: To develop effective and targeted interventions to improve care for patients with community-acquired pneumonia (CAP), insight is needed into the factors that influence the quality of antibiotic use. Therefore, we measured the performance of nine quality indicators and studied determinants of variation in the quality of antibiotic use. Patients and methods: Data on 498 prospectively included patients with CAP from eight medium-sized Dutch hospitals were extracted from t...

  2. Strategies to Minimize Antibiotic Resistance

    Directory of Open Access Journals (Sweden)

    Sang Hee Lee

    2013-09-01

    Full Text Available Antibiotic resistance can be reduced by using antibiotics prudently based on guidelines of antimicrobial stewardship programs (ASPs and various data such as pharmacokinetic (PK and pharmacodynamic (PD properties of antibiotics, diagnostic testing, antimicrobial susceptibility testing (AST, clinical response, and effects on the microbiota, as well as by new antibiotic developments. The controlled use of antibiotics in food animals is another cornerstone among efforts to reduce antibiotic resistance. All major resistance-control strategies recommend education for patients, children (e.g., through schools and day care, the public, and relevant healthcare professionals (e.g., primary-care physicians, pharmacists, and medical students regarding unique features of bacterial infections and antibiotics, prudent antibiotic prescribing as a positive construct, and personal hygiene (e.g., handwashing. The problem of antibiotic resistance can be minimized only by concerted efforts of all members of society for ensuring the continued efficiency of antibiotics.

  3. Validation and Application of a Dried Blood Spot Assay for Biofilm-Active Antibiotics Commonly Used for Treatment of Prosthetic Implant Infections.

    Science.gov (United States)

    Knippenberg, Ben; Page-Sharp, Madhu; Salman, Sam; Clark, Ben; Dyer, John; Batty, Kevin T; Davis, Timothy M E; Manning, Laurens

    2016-08-01

    Dried blood spot (DBS) antibiotic assays can facilitate pharmacokinetic (PK)/pharmacodynamic (PD) studies in situations where venous blood sampling is logistically difficult. We sought to develop, validate, and apply a DBS assay for rifampin (RIF), fusidic acid (FUS), and ciprofloxacin (CIP). These antibiotics are considered active against organisms in biofilms and are therefore commonly used for the treatment of infections associated with prosthetic implants. A liquid chromatography-mass spectroscopy DBS assay was developed and validated, including red cell partitioning and thermal stability for each drug and the rifampin metabolite desacetyl rifampin (Des-RIF). Plasma and DBS concentrations in 10 healthy adults were compared, and the concentration-time profiles were incorporated into population PK models. The limits of quantification for RIF, Des-RIF, CIP, and FUS in DBS were 15 μg/liter, 14 μg/liter, 25 μg/liter, and 153 μg/liter, respectively. Adjusting for hematocrit, red cell partitioning, and relative recovery, DBS-predicted plasma concentrations were comparable to measured plasma concentrations for each antibiotic (r > 0.95; P < 0.0001), and Bland-Altman plots showed no significant bias. The final population PK estimates of clearance, volume of distribution, and time above threshold MICs for measured and DBS-predicted plasma concentrations were comparable. These drugs were stable in DBSs for at least 10 days at room temperature and 1 month at 4°C. The present DBS antibiotic assays are robust and can be used as surrogates for plasma concentrations to provide valid PK and PK/PD data in a variety of clinical situations, including therapeutic drug monitoring or studies of implant infections.

  4. Coping With Hypertension Using Safer Herbal Medicine ? A Therapeutic Review

    Directory of Open Access Journals (Sweden)

    Lakshmi.T

    2011-06-01

    Full Text Available Hypertension (HT is a major modifiable risk factor for cardiovascular disease, and if treated can significantly reduce cardiovascular disease risk. Herbal medicines are in great demand in the developed as well as developing countries for primary healthcare because of their wide biological and medicinal activities, higher safety margins and lesser cost. our article reviews the efficacy of some of valuable herbs like Allium sativum, Centella asiatica, Ginkgo biloba, Crataegus oxycantha, Crataegus monogyna, Passiflora Edulis, Hibiscus sabdariffa, Elaeocarpus ganitrus, Hypericum perforatum, Achillea millefolium. They have a history of human use and their Anti hypertensive properties have been evaluated preclinically and clinically. The present literature emphasizes on causes for hypertension, its signs, symptoms, preventive measures as well as its safer options of treatments. Available data suggests that the extracts of most of these herbs or compounds derived from them may provide a safe and effective adjunctive therapeutic approach for the treatment of hypertension

  5. Clinical score and rapid antigen detection test to guide antibiotic use for sore throats: randomised controlled trial of PRISM (primary care streptococcal management)

    OpenAIRE

    P. Little; Hobbs, F D R; Moore, M.; Mant, D; Williamson, I.; McNulty, C; Cheng, Y.E.; Leydon, G; McManus, R; Kelly, J; Barnett, J; Glasziou, P.; Mullee, M

    2013-01-01

    OBJECTIVE: To determine the effect of clinical scores that predict streptococcal infection or rapid streptococcal antigen detection tests compared with delayed antibiotic prescribing. DESIGN: Open adaptive pragmatic parallel group randomised controlled trial. SETTING: Primary care in United Kingdom. PATIENTS: Patients aged ?3 with acute sore throat. INTERVENTION: An internet programme randomised patients to targeted antibiotic use according to: delayed antibiotics (the compara...

  6. Strategic alliance between the infectious diseases specialist and intensive care unit physician for change in antibiotic use.

    Science.gov (United States)

    Curcio, D; Belloni, R

    2005-02-01

    There is a general consensus that antimicrobial use in intensive care units (ICU) is greater than that in general wards. By implementing a strategy of systematic infectious disease consultations in agreement with the ICU chief, we have modified the antibiotic prescription habits of the ICU physician. A reduction was observed in the use of selected antibiotics (third-generation cephalosporins, vancomycin, carbapenems and piperacillin-tazobactam), with a significant reduction in the length of hospital stay for ICU patients and lower antibiotic costs without negative impact on patient mortality. Leadership by the infectious diseases consultant in combination with commitment by ICU physicians is a simple and effective method to change antibiotic prescription habits in the ICU. PMID:15828447

  7. Status Report from the Scientific Panel on Antibiotic Use in Dermatology of the American Acne and Rosacea Society

    Science.gov (United States)

    Rosen, Ted; Thiboutot, Diane; Webster, Guy F.; Gallo, Richard L.; Leyden, James J.; Walker, Clay; Zhanel, George; Eichenfield, Lawrence

    2016-01-01

    In this third article of the three-part series, management of skin and soft tissue infections is reviewed with emphasis on new information on methicillin-resistant Staphylococcus aureus. Due to changes in the evolution of methicillin-resistant Staphylococcus aureus clones, previous distinctions between healthcare-acquired methicillin-resistant Staphylococcus aureus and community-acquired methicillin-resistant Staphylococcus aureus are currently much less clinically relevant. Many nosocomial cases of methicillin-resistant Staphylococcus aureus infection are now caused by community-acquired methicillin-resistant Staphylococcus aureus, with changing patterns of antibiotic susceptibility and resistance. Also reviewed are clinical scenarios where antibiotics may not be needed and suggestions for optimal use of antibiotic therapy for dermatologie conditions, including recommendations on perioperative antibiotic use. PMID:27386047

  8. Lactobacillus rhamnosus GG Intake Modifies Preschool Children's Intestinal Microbiota, Alleviates Penicillin-Associated Changes, and Reduces Antibiotic Use.

    Directory of Open Access Journals (Sweden)

    Katri Korpela

    Full Text Available Antibiotic use is considered among the most severe causes of disturbance to children's developing intestinal microbiota, and frequently causes adverse gastrointestinal effects ranging from mild and transient diarrhoea to life-threatening infections. Probiotics are commonly advocated to help in preventing antibiotic-associated gastrointestinal symptoms. However, it is currently unknown whether probiotics alleviate the antibiotic-associated changes in children's microbiota. Furthermore, it is not known how long-term probiotic consumption influences the developing microbiota of children. We analysed the influence of long-term Lactobacillus rhamnosus GG intake on preschool children's antibiotic use, and antibiotic-associated gastrointestinal complaints in a double blind, randomized placebo-controlled trial with 231 children aged 2-7. In addition, we analysed the effect of L. rhanmosus GG on the intestinal microbiota in a subset of 88 children. The results show that long-term L. rhamnosus GG supplementation has an influence on the composition of the intestinal microbiota in children, causing an increase in the abundance of Prevotella, Lactococcus, and Ruminococcus, and a decrease in Escherichia. The treatment appeared to prevent some of the changes in the microbiota associated with penicillin use, but not those associated with macrolide use. The treatment, however, did reduce the frequency of gastrointestinal complaints after a macrolide course. Finally, the treatment appeared to prevent certain bacterial infections for up to 3 years after the trial, as indicated by reduced antibiotic use.ClinicalTrials.gov NCT01014676.

  9. PHYSIOLOGICAL REGULATION OF PROTEASE AND ANTIBIOTICS IN PENICILLIUM SP. USING SUBMERGED AND SOLID STATE FERMENTATION TECHNIQUES

    Directory of Open Access Journals (Sweden)

    HAIDER M. HAMZAH

    2009-03-01

    Full Text Available A fungal strain belonging to the genus Penicillium was isolated from soil sample and has been diagnosed as Penicillium sp. according to its morphological characteristics of the colonies on solid media and also microscopical examination of the fungal parts. Antibiotics, protease activity and pH values were determined after cultivation of the fungus using submerged fermentation (SF and solid state fermentation (SSF. The two different patterns of fermentation processes seem to influence the physiological behavior of the fungus differently. Experiments were made using nutrient broth medium (N.B for SF and wheat bran in SSF. The pH values were adjacent to 5.5. Wheat bran was enriched with fish scales and egg shale in a ratio of (1:2:0.005 w/w and the mixture was moistened by adding (30 ml whey solution. After 7 days of incubation, the pH value of SF was increased to 8.0 at 30ºC. The SF was appeared efficient for antibiotics production. Using well diffusion technique the extracted antibiotics solution was active against some pathogenic bacteria such as Staphylococcus aureus, E. coli, Proteus sp., Salmonella sp., Pseudomonas aeruginosa and Streptococcus sp. In SSF relative proteases concentrations were found to be highly reactive than SF. This was proved by the appearance of the zone (20 mm and 32 mm due to the hydrolysis of milk and blood proteins respectively using pH 5.5 at 30ºC for 24 hrs. The activity of proteases was (10.4 U/ml.

  10. Therapeutic approaches for treating hemophilia A using embryonic stem cells.

    Science.gov (United States)

    Kasuda, Shogo; Tatsumi, Kohei; Sakurai, Yoshihiko; Shima, Midori; Hatake, Katsuhiko

    2016-06-01

    Hemophilia A is an X-linked rescessive bleeding disorder that results from F8 gene aberrations. Previously, we established embryonic stem (ES) cells (tet-226aa/N6-Ainv18) that secrete human factor VIII (hFVIII) by introducing the human F8 gene in mouse Ainv18 ES cells. Here, we explored the potential of cell transplantation therapy for hemophilia A using the ES cells. Transplant tet-226aa/N6-Ainv18 ES cells were injected into the spleens of severe combined immunodeficiency (SCID) mice, carbon tetrachloride (CCl4)-pretreated wild-type mice, and CCl4-pretreated hemophilia A mice. F8 expression was induced by doxycycline in drinking water, and hFVIII-antigen production was assessed in all cell transplantation experiments. Injecting the ES cells into SCID mice resulted in an enhanced expression of the hFVIII antigen; however, teratoma generation was confirmed in the spleen. Transplantation of ES cells into wild-type mice after CCl4-induced liver injury facilitated survival and engraftment of transplanted cells without teratoma formation, resulting in hFVIII production in the plasma. Although CCl4 was lethal to most hemophilia A mice, therapeutic levels of FVIII activity, as well as the hFVIII antigen, were detected in surviving hemophilia A mice after cell transplantation. Immunolocalization results for hFVIII suggested that transplanted ES cells might be engrafted at the periportal area in the liver. Although the development of a safer induction method for liver regeneration is required, our results suggested the potential for developing an effective ES-cell transplantation therapeutic model for treating hemophilia A in the future. PMID:27131224

  11. Therapeutic approaches for treating hemophilia A using embryonic stem cells.

    Science.gov (United States)

    Kasuda, Shogo; Tatsumi, Kohei; Sakurai, Yoshihiko; Shima, Midori; Hatake, Katsuhiko

    2016-06-01

    Hemophilia A is an X-linked rescessive bleeding disorder that results from F8 gene aberrations. Previously, we established embryonic stem (ES) cells (tet-226aa/N6-Ainv18) that secrete human factor VIII (hFVIII) by introducing the human F8 gene in mouse Ainv18 ES cells. Here, we explored the potential of cell transplantation therapy for hemophilia A using the ES cells. Transplant tet-226aa/N6-Ainv18 ES cells were injected into the spleens of severe combined immunodeficiency (SCID) mice, carbon tetrachloride (CCl4)-pretreated wild-type mice, and CCl4-pretreated hemophilia A mice. F8 expression was induced by doxycycline in drinking water, and hFVIII-antigen production was assessed in all cell transplantation experiments. Injecting the ES cells into SCID mice resulted in an enhanced expression of the hFVIII antigen; however, teratoma generation was confirmed in the spleen. Transplantation of ES cells into wild-type mice after CCl4-induced liver injury facilitated survival and engraftment of transplanted cells without teratoma formation, resulting in hFVIII production in the plasma. Although CCl4 was lethal to most hemophilia A mice, therapeutic levels of FVIII activity, as well as the hFVIII antigen, were detected in surviving hemophilia A mice after cell transplantation. Immunolocalization results for hFVIII suggested that transplanted ES cells might be engrafted at the periportal area in the liver. Although the development of a safer induction method for liver regeneration is required, our results suggested the potential for developing an effective ES-cell transplantation therapeutic model for treating hemophilia A in the future.

  12. Pharmacy sales data versus ward stock accounting for the surveillance of broad-spectrum antibiotic use in hospitals

    Directory of Open Access Journals (Sweden)

    Haug Jon B

    2011-12-01

    Full Text Available Abstract Background Antibiotic consumption in hospitals is commonly measured using the accumulated amount of drugs delivered from the pharmacy to ward held stocks. The reliability of this method, particularly the impact of the length of the registration periods, has not been evaluated and such evaluation was aim of the study. Methods During 26 weeks, we performed a weekly ward stock count of use of broad-spectrum antibiotics - that is second- and third-generation cephalosporins, carbapenems, and quinolones - in five hospital wards and compared the data with corresponding pharmacy sales figures during the same period. Defined daily doses (DDDs for antibiotics were used as measurement units (WHO ATC/DDD classification. Consumption figures obtained with the two methods for different registration intervals were compared by use of intraclass correlation analysis and Bland-Altman statistics. Results Broad-spectrum antibiotics accounted for a quarter to one-fifth of all systemic antibiotics (ATC group J01 used in the hospital and varied between wards, from 12.8 DDDs per 100 bed days in a urological ward to 24.5 DDDs in a pulmonary diseases ward. For the entire study period of 26 weeks, the pharmacy and ward defined daily doses figures for all broad-spectrum antibiotics differed only by 0.2%; however, for single wards deviations varied from -4.3% to 6.9%. The intraclass correlation coefficient, pharmacy versus ward data, increased from 0.78 to 0.94 for parenteral broad-spectrum antibiotics with increasing registration periods (1-4 weeks, whereas the corresponding figures for oral broad-spectrum antibiotics (ciprofloxacin were from 0.46 to 0.74. For all broad-spectrum antibiotics and for parenteral antibiotics, limits of agreement between the two methods showed, according to Bland-Altman statistics, a deviation of ± 5% or less from average mean DDDs at 3- and 4-weeks registration intervals. Corresponding deviation for oral antibiotics was ± 21% at a 4

  13. Strategies to enhance rational use of antibiotics in hospital: a guideline by the German Society for Infectious Diseases

    OpenAIRE

    de With, K.; Allerberger, F.; Amann, S.; Apfalter, P.; Brodt, Hans Reinhard; Eckmanns, Tim; Fellhauer, M.; Geiss, H. K.; Janata, O.; Krause, R; Lemmen, S; Meyer, Elisabeth; Mittermayer, H.; Porsche, U.; Presterl, E.

    2016-01-01

    Introduction: In the time of increasing resistance and paucity of new drug development there is a growing need for strategies to enhance rational use of antibiotics in German and Austrian hospitals. An evidence-based guideline on recommendations for implementation of antibiotic stewardship (ABS) programmes was developed by the German Society for Infectious Diseases in association with the following societies, associations and institutions: German Society of Hospital Pharmacists, German Soc...

  14. Characterization of silver nanoparticles synthesized using Urtica dioica Linn. leaves and their synergistic effects with antibiotics

    Directory of Open Access Journals (Sweden)

    Kumari Jyoti

    2016-07-01

    Full Text Available In continuation of the efforts for synthesizing silver nanoparticles (AgNPs by green chemistry route, here we report a facile bottom-up ‘green’ route for the synthesis of AgNPs using aqueous leaves extract of Urtica dioica (Linn.. The synthesized AgNPs were characterized by UV-vis spectroscopy, X-ray diffraction (XRD, Fourier transform-infrared spectroscopy (FTIR, Zeta-sizer and Zeta-potential, Scanning electron microscopy (SEM, Energy dispersive X-ray (EDX spectroscopy, Transmission electron microscopy (TEM and Selected area electron diffraction (SAED. The results obtained from various characterizations revealed that AgNPs were in the size range of 20–30 nm and crystallized in face-centered-cubic structure. The antibacterial activity against Gram-positive (Bacillus cereus, Bacillus subtilis, Staphylococcus aureus and Staphylococcus epidermidis and Gram-negative (Escherichia coli, Klebsiella pneumoniae, Serratia marcescens and Salmonella typhimurium bacterial pathogens was demonstrated by synthesized nanoparticles. Further, synergistic effects of AgNPs with various antibiotics were evaluated against above mentioned bacterial pathogens. The results showed that AgNPs in combination with antibiotics have better antibacterial effect as compared with AgNPs alone and hence can be used in the treatment of infectious diseases caused by bacteria. The maximum effect, with a 17.8 fold increase in inhibition zone, was observed for amoxicillin with AgNPs against S. marcescens proving the synergistic role of AgNPs. Therefore, it may be used to augment the activities of antibiotics.

  15. [Use of the protoplast fusion and regeneration method for screening antibiotic producers among inactive strains of Streptomyces].

    Science.gov (United States)

    Malanicheva, I A; Koz'mian, L I; Belova, A Iu; Dudnik, Iu V

    1993-06-01

    Intraspecies fusion of protoplasts of two strains of Streptomyces fradiae, i.e native protoplasts of an inactive strain INA 00708 and heat inactivated protoplasts of a neomycin-producing strain ATCC 10745, and regeneration of the protoplasts of the inactive strain INA 00708 resulted in formation of clones producing neomycin and clones synthesizing antibiotics of an unknown nature differing from neomycin. All the active clones were unstable and lost their antibiotic activity in subcultures. Regeneration of the protoplasts of 4 different inactive strains of Streptomyces sp. also resulted in formation of active clones which were unstable and lost their capacity for the antibiotic synthesis after the first subculture. The data in principal indicate to the possible use of protoplast fusion and regeneration in screening of cultures producing new antibiotics among inactive strains of streptomycetes. However, the efficiency of such procedures is low since the experiments are labor-consuming and the resulting active clones are genetically unstable. PMID:8166572

  16. Ribosomal Antibiotics: Contemporary Challenges

    Directory of Open Access Journals (Sweden)

    Tamar Auerbach-Nevo

    2016-06-01

    Full Text Available Most ribosomal antibiotics obstruct distinct ribosomal functions. In selected cases, in addition to paralyzing vital ribosomal tasks, some ribosomal antibiotics are involved in cellular regulation. Owing to the global rapid increase in the appearance of multi-drug resistance in pathogenic bacterial strains, and to the extremely slow progress in developing new antibiotics worldwide, it seems that, in addition to the traditional attempts at improving current antibiotics and the intensive screening for additional natural compounds, this field should undergo substantial conceptual revision. Here, we highlight several contemporary issues, including challenging the common preference of broad-range antibiotics; the marginal attention to alterations in the microbiome population resulting from antibiotics usage, and the insufficient awareness of ecological and environmental aspects of antibiotics usage. We also highlight recent advances in the identification of species-specific structural motifs that may be exploited for the design and the creation of novel, environmental friendly, degradable, antibiotic types, with a better distinction between pathogens and useful bacterial species in the microbiome. Thus, these studies are leading towards the design of “pathogen-specific antibiotics,” in contrast to the current preference of broad range antibiotics, partially because it requires significant efforts in speeding up the discovery of the unique species motifs as well as the clinical pathogen identification.

  17. Ribosomal Antibiotics: Contemporary Challenges.

    Science.gov (United States)

    Auerbach-Nevo, Tamar; Baram, David; Bashan, Anat; Belousoff, Matthew; Breiner, Elinor; Davidovich, Chen; Cimicata, Giuseppe; Eyal, Zohar; Halfon, Yehuda; Krupkin, Miri; Matzov, Donna; Metz, Markus; Rufayda, Mruwat; Peretz, Moshe; Pick, Ophir; Pyetan, Erez; Rozenberg, Haim; Shalev-Benami, Moran; Wekselman, Itai; Zarivach, Raz; Zimmerman, Ella; Assis, Nofar; Bloch, Joel; Israeli, Hadar; Kalaora, Rinat; Lim, Lisha; Sade-Falk, Ofir; Shapira, Tal; Taha-Salaime, Leena; Tang, Hua; Yonath, Ada

    2016-01-01

    Most ribosomal antibiotics obstruct distinct ribosomal functions. In selected cases, in addition to paralyzing vital ribosomal tasks, some ribosomal antibiotics are involved in cellular regulation. Owing to the global rapid increase in the appearance of multi-drug resistance in pathogenic bacterial strains, and to the extremely slow progress in developing new antibiotics worldwide, it seems that, in addition to the traditional attempts at improving current antibiotics and the intensive screening for additional natural compounds, this field should undergo substantial conceptual revision. Here, we highlight several contemporary issues, including challenging the common preference of broad-range antibiotics; the marginal attention to alterations in the microbiome population resulting from antibiotics usage, and the insufficient awareness of ecological and environmental aspects of antibiotics usage. We also highlight recent advances in the identification of species-specific structural motifs that may be exploited for the design and the creation of novel, environmental friendly, degradable, antibiotic types, with a better distinction between pathogens and useful bacterial species in the microbiome. Thus, these studies are leading towards the design of "pathogen-specific antibiotics," in contrast to the current preference of broad range antibiotics, partially because it requires significant efforts in speeding up the discovery of the unique species motifs as well as the clinical pathogen identification. PMID:27367739

  18. The Local Treatment of Burns With Antibiotics

    OpenAIRE

    Napoli, B.; D’Arpa, N.; Masellis, A.; Masellis, M.

    2005-01-01

    After presenting an analysis of the principal antiseptics used for the local treatment of burns, highlighting their toxicity and the limitations of their antibacterial effectiveness, we describe the therapeutic protocol used in our burns centre (where antibacterial treatment consists exclusively of antibiotics for both local and systemic use). We review the data regarding actual and predicted mortality, and mortality due to septicaemia during the years 2000-2003.

  19. Use of antibiotics within the IMCI guidelines in outpatient settings in Papua New Guinean children: an observational and effectiveness study.

    Directory of Open Access Journals (Sweden)

    Nicolas Senn

    Full Text Available There is a need to investigate the effectiveness and appropriateness of antibiotics prescription within the Integrated Management of Childhood Illness (IMCI strategy in the context of routine outpatient clinics.Making use of a passive case detection system established for a malaria prevention trial in outpatient clinics in Papua New Guinea, the appropriateness and effectiveness of the use of antibiotics within the IMCI was assessed in 1605 young children. Main outcomes were prescription of antibiotics and re-attendances within 14 days for mild pneumonia, mild diarrhoea and uncomplicated malaria whether they were managed with or without antibiotics (proxy of effectiveness. Appropriateness was assessed for both mild and severe cases, while effectiveness was assessed only for mild diseases.A total of 6975 illness episodes out of 8944 fulfilled inclusion criteria (no previous attendance <14 days+full medical records. Clinical incidence rates (episodes/child/year; 95% CI were 0.85 (0.81-0.90 for pneumonia, 0.62 (0.58-0.66 for malaria and 0.72 (0.65-0.93 for diarrhoea. Fifty three percent of 6975 sick children were treated with antibiotics, 11% were not treated with antibiotics when they should have been and in 29% antibiotics were prescribed when they should not have been. Re-attendance rates within 14 days following clinical diagnosis of mild pneumonia were 9% (126/1401 when managed with antibiotics compared to 8% (56/701 when managed without (adjusted Hazard Ratio (aHR = 1.00 (0.57-1.76, p = 0.98. Rates for mild diarrhoea were 8% (73/874 and 9% (79/866 respectively (aHR = 0.8 (0.42-1.57, p = 0.53.Non-adherence to IMCI recommendations for prescription of antibiotics is common in routine settings in Papua New Guinea. Although recommended, the use of antibiotics in young children with mild pneumonia as defined by IMCI criteria did not impact on their outcome. Better tools and new strategies for the identification of bacterial

  20. Probiotics to Prevent the Need for, and Augment the Use of, Antibiotics

    Directory of Open Access Journals (Sweden)

    Gregor Reid

    2006-01-01

    Full Text Available Although humans and microbes are inseparable, our knowledge and understanding of the majority of microbes that help keep us alive and well is in desperate need of further investigation. Of the organisms that influence humans before birth and inhabit various niches from birth to old age, we know little about their identity, origin, metabolic properties, attributes and mechanisms of interactions with the host and surrounding microbes. The use of probiotics ("live microorganisms which when administered in adequate amounts confer a health benefit on the host" has re-emerged as a means to restore and boost the beneficial microbes in our bodies. The timing of resurgent interest in this ancient field coincides with the need to augment or replace antibiotics whose side effects are unwelcome and whose efficacy is diminishing due to drug resistance. Evidence that probiotic strains can act as adjuncts to antibiotic therapy by reducing adverse effects, improving antibiotic function and enhancing mucosal immunity is mounting. It is to our discredit that basic research on microbial ecology has been stalled in Canada for the past 20 years. If supported, research into indigenous and probiotic microbes will form an important part of future research that sheds light on health, disease and a basic understanding of life itself. In some cases, probiotics will be the difference between a good quality of life and a bad one, or perhaps even life over death. Improvements in clinical studies, manufacturing and regulatory standards must coincide with this progress to ensure that physicians and consumers have reliable, proven products for safe and efficacious use.

  1. Surgical site infection and pattern of antibiotic use in a tertiary care hospital in Peshawar

    International Nuclear Information System (INIS)

    Surgical site infection (SSI) is most common complication following surgical procedures. The objective of the study was to collect information on SSI regarding the most frequent pathogen in cases operated in casualty of Lady Read ing Hospital (LRH) Peshawar, and sensitivity of the isolated pathogens to different antibiotics used. Methods: The study was carried out at surgical 'B' unit (SBU) LRH from Jan 1, 2009 till Dec 31, 2009. A total of 100 patients who developed SSI after being operated for peritonitis following traumatic gut perforations, perforated appendix and enteric perforation. The patients included presented to casualty, operated in casualty OT and were shifted to the SBU, LRH. Children and patients operated on the elective list were excluded. Data was collected on specially designed proforma. Demographic details, details of SSI, culture/sensitivity reports and antibiotic used for prophylaxis and after C/S report were recorded. Results: Out of a total of 100, 72 had superficial, 20 had organ/space and 8 had deep SSI. Organisms were isolated in 77 cases (77%). E. coli being most common pathogen (46%), followed by Pseudomonas (23%), mixed growth of Staph. Aureus or MRSA (13%), MRSA (5%) and Staph aureus (4%) in descending order. No growth was reported in 23% of cases. Conclusion: E.coli was the most common organism involved in SSI in SBU LRH. The incidence of infection with MRSA in our unit is high. Combination of antibiotics like pipreacillin/Tazobactam, Cefoperazone/Sulbactam, were most effective against the isolated organisms, except MRSA where Linezolid, vancomycin and Tiecoplanin were effective. (author)

  2. Antibiotic use for upper respiratory tract infections in children: A cross-sectional survey of knowledge, attitudes, and practices (KAP of parents in Greece

    Directory of Open Access Journals (Sweden)

    Theodoridou Maria N

    2011-07-01

    Full Text Available Abstract Background Upper respiratory tract infections (URTIs are common in children. The cause of URTIs is usually viral, but parents' attitudes often contribute to inappropriate prescription of antibiotics, promoting antibiotic resistance. The objective of this study was to document and analyse parental beliefs on antibiotic use for children with URTIs in Greece, a country with high levels of antibiotic use and antibiotic resistance. Methods A knowledge-attitude-practice questionnaire was developed and distributed to Greek parents caring for children who were 5-6 years old, between January and July of the same school year. The sample of the study contained parents from all geographic areas of Greece. Results The majority of Greek parents (80% believed that UTRIs are mostly self-limited, although 74% of them expected to receive antibiotics when such a diagnosis was given. Earache was the most common reason for which parents expected antibiotics (45%. Greek parents rarely gave antibiotics to their children without medical advice (10% and most (88% believed that unnecessary antibiotic use drives antibiotic resistance and they were happy to receive symptomatic therapy if instructed by their physician. Almost 70% of parents confused antibiotics with other medicines used for symptomatic therapy for a child with URTI. Conclusion Greek parents have a trusted relationship with their paediatrician and rarely give antibiotics without medical advice, indicating that parents contribute less than expected to antibiotic misuse. Parents also appreciate the benign course of most URTIs and the fact that unnecessary antibiotic use is harmful. More time needs to be invested in educating mostly physicians on the potential benefit from reducing antibiotic prescribing for children with URTI.

  3. Status Report from the Scientific Panel on Antibiotic Use in Dermatology of the American Acne and Rosacea Society: Part 3: Current Perspectives on Skin and Soft Tissue Infections with Emphasis on Methicillin-resistant Staphylococcus aureus, Commonly Encountered Scenarios when Antibiotic Use May Not Be Needed, and Concluding Remarks on Rational Use of Antibiotics in Dermatology.

    Science.gov (United States)

    Del Rosso, James Q; Rosen, Ted; Thiboutot, Diane; Webster, Guy F; Gallo, Richard L; Leyden, James J; Walker, Clay; Zhanel, George; Eichenfield, Lawrence

    2016-06-01

    In this third article of the three-part series, management of skin and soft tissue infections is reviewed with emphasis on new information on methicillin-resistant Staphylococcus aureus. Due to changes in the evolution of methicillin-resistant Staphylococcus aureus clones, previous distinctions between healthcare-acquired methicillin-resistant Staphylococcus aureus and community-acquired methicillin-resistant Staphylococcus aureus are currently much less clinically relevant. Many nosocomial cases of methicillin-resistant Staphylococcus aureus infection are now caused by community-acquired methicillin-resistant Staphylococcus aureus, with changing patterns of antibiotic susceptibility and resistance. Also reviewed are clinical scenarios where antibiotics may not be needed and suggestions for optimal use of antibiotic therapy for dermatologie conditions, including recommendations on perioperative antibiotic use. PMID:27386047

  4. Review article: antibiotics and probiotics in inflammatory bowel disease.

    Science.gov (United States)

    Kruis, W

    2004-10-01

    Treatment with antibiotics in inflammatory bowel disease has a long tradition and is widely used. The indications for antibiotic therapy are wide ranging, from specific situations such as abscesses or fistulae, to patients with severe disease (as an unspecific 'protective' measure), and to address the hypothesis that the enteric flora as a whole, or specific microorganisms such as mycobacteria, are involved in the pathogenesis of inflammatory bowel disease. The best-studied single antibiotic compound is metronidazole. However, overall, the scientific basis for the use of antibiotics is limited, which may reflect a lack of interest from sponsors within the pharmaceutical industry. Despite this weak evidence base, antibiotics are a globally established therapeutic tool in inflammatory bowel disease. Growing evidence from human and animal studies points towards a pivotal pathogenetic role of intestinal bacteria in inflammatory bowel disease. In view of these experimental findings, clinical trials have been undertaken to elucidate the therapeutic effects of probiotics in inflammatory bowel disease. Probiotics are viable nonpathogenic microorganisms which confer health benefits to the host by improving the microbial balance of the indigenous microflora. So far, of the many candidates, one specific strain (Escherichia coli Nissle 1917) and a mixture of eight different bacteria have demonstrated convincing therapeutic efficacy in controlled studies. Maintenance therapy in ulcerative colitis and prevention therapy, as well as the treatment of pouchitis, have emerged as areas in which probiotic therapy offers a valid therapeutic alternative to current treatments. Further investigations may detect additional clinically effective probiotics and other clinical indications.

  5. COAGULASE POSITIVE STAPHYLOCOCCI RESISTANCE TO BETALACTAM ANTIBIOTICS: USING IODOMETRIC AND ACIDOMETRIC ASSAY – 1999

    Directory of Open Access Journals (Sweden)

    A TAVAKOLI

    2002-12-01

    Full Text Available Introduction. It is very important to know the resistant bacteria to common used antibiotics in our community. Staphylococcus coagulase positive was the main cause of infection in infectious disease. This study was done to demonstrate the pattern of resistance to batalactamase antibiotics among staphiococci. Methods. During a period of five month, 38 coagulase positive staphylococcus isolates were identified from various clinical specimens from 600 patients at the AI-Zahra university hospital (affiliated to IUMSHS. Results. Betalactamase production assays using rapid acidometric and iodometric tests showed that 78.9 percent and 73.6 percent of isolates were positive, respectively. The differnce in determination rate between acidometric and iodometric tests was not statistically significant. Moreover the acidometric test was cheaper and more easy to perform than iodometric test. In vitro sensitivity testing using the disc diffusion method showed that all of isolates were resistant to carbenicillin, ampicillin and amoxicillin, while 7.9 percent and 13.2 percent were resistant to cefazolin and cephalexin, respectively. Discussion. We recommend use of cefazolin, cephalexin and oxacillin for treatment of patients with staphylococcus infections.

  6. Therapeutic use of stem cells for cardiovascular disease.

    Science.gov (United States)

    Faiella, Whitney; Atoui, Rony

    2016-12-01

    Stem cell treatments are a desirable therapeutic option to regenerate myocardium and improve cardiac function after myocardial infarction. Several different types of cells have been explored, each with their own benefits and limitations. Induced pluripotent stem cells possess an embryonic-like state and therefore have a high proliferative capacity, but they also pose a risk of teratoma formation. Mesenchymal stem cells have been investigated from both bone marrow and adipose tissue. Their immunomodulatory characteristics may permit the use of allogeneic cells as universal donor cells in the future. Lastly, studies have consistently shown that cardiac stem cells are better able to express markers of cardiogenesis compared to other cell types, as well improve cardiac function. The ideal source of stem cells depends on multiple factors such as the ease of extraction/isolation, effectiveness of engraftment, ability to differentiate into cardiac lineages and effect on cardiac function. Although multiple studies highlight the benefits and limitations of each cell type and reinforce the successful potential use of these cells to regenerate damaged myocardium, more studies are needed to directly compare cells from various sources. It is interesting to note that research using stem cell therapies is also expanding to treat other cardiovascular diseases including non-ischemic cardiomyopathies. PMID:27539581

  7. The Quality of Liquid Fermented Products for Alternative Use of Antibiotics for Animal Raising

    International Nuclear Information System (INIS)

    The chemical properties of liquid fermented products (LFP) as probiotics substance for alternative uses of antibiotic were studied. The LFP of 235 were sampling from markets and farmers during 2005-2006. The total count of bacteria, fungi, lactic acid bacteria (LAB), Actinomyces and coliform bacteria were conducted. Chemical analysis of LFP showed medium nitrogen (0.01- 0.55%), maximum sugar contents (0.02 - 19.40%), high lactic acid contents (0.34 - 13.01%) and low pH (2.9-5.0). LFPs were free from fecal coliform and Escherichia coil (Ec); but in LAB (1.0 - 1.25x107 cfu/ml) and high Actinomyces (1.0 - 7.5 x 106 cfu/ml). LFPs inhibited Staphylococcus aureus (Sa), Samonella typhimurium (STM), Escherichia coil (Ec) and Ec 0157 at maximum yield by using Minimal Inhibition Concentration (MIC). But Pseudomonas aeruginosa (Pa) could medium inhibited. Therefore LFP samples are suitable as probiotics for alternative use of antibiotic for animal raising.

  8. Antibiotic-Free Selection in Biotherapeutics: Now and Forever

    Directory of Open Access Journals (Sweden)

    Charlotte Mignon

    2015-04-01

    Full Text Available The continuously improving sophistication of molecular engineering techniques gives access to novel classes of bio-therapeutics and new challenges for their production in full respect of the strengthening regulations. Among these biologic agents are DNA based vaccines or gene therapy products and to a lesser extent genetically engineered live vaccines or delivery vehicles. The use of antibiotic-based selection, frequently associated with genetic manipulation of microorganism is currently undergoing a profound metamorphosis with the implementation and diversification of alternative selection means. This short review will present examples of alternatives to antibiotic selection and their context of application to highlight their ineluctable invasion of the bio-therapeutic world.

  9. Beyond Antibiotics?

    Directory of Open Access Journals (Sweden)

    LE Nicolle

    2006-01-01

    Full Text Available The AMMI Canada meeting in March 2006 hosted a symposium exploring the potential alternatives to antibiotics for the prevention and treatment of infection. Four papers summarizing talks from that session are published in this issue of the Journal (1-4. These reviews address the scientific underpinnings for a number of proposed concepts, and summarize the current status of clinical use. The approaches - probiotics, bacteriophage therapy, and manipulation of innate immunity - are all intriguing but are still removed from immediate practical applications.

  10. How to optimize the evaluation and use of antibiotics in neonates.

    Science.gov (United States)

    van den Anker, Johannes N

    2014-03-01

    Early and late-onset neonatal sepsis has specific pathogen distribution and infection rates in neonates with different gestational and postnatal ages. Despite the fact that early-onset sepsis is relatively rare (choice of antibacterial agents and dosing regimens used in NICUs across the world. Therefore, a more rational approach in the neonatal use of antibiotics is needed because of two major reasons: the emergence of multi-resistant bacteria in NICUs, and short- and long-term side effects of frequently used antibacterial agents in the neonatal population. This paper will focus on the optimal use of aminoglycosides (both used in early and late onset sepsis) and vancomycin (primarily used in late onset infections) in NICUs, and will underscore the need for specialists in neonatal medicine and pediatric pharmacology to work closely together to reach the most effective and safe way of using medicines in the NICU. PMID:24709446

  11. Off-label abuse of antibiotics by bacteria.

    Science.gov (United States)

    Viswanathan, V K

    2014-01-01

    Antibiotics and antibiotic resistance made news on several fronts in the past year. Many public health organizations, including the CDC, used terms such as "crisis", "catastrophic consequences", and "nightmare scenario" to highlight the rapid emergence and spread of antibiotic resistance. A report from the Pew Commission on Industrial Farm Animal Production, on the fifth anniversary of the publication of its landmark 2008 report, noted that state and federal legislative efforts to limit non-therapeutic use of antibiotics in animal production were thwarted by drug and food animal industries. In its lobbying disclosures, the Farm Bureau stated that such efforts to limit use of animal antibiotics were "based on emotion and no credible peer reviewed science." Meanwhile, there have been inexorable advances in our understanding of the molecular mechanisms by which antibiotics induce diversity and resistance in bacteria. This article reviews one study that probed the role of the bacterial general stress response in sub-inhibitory antibiotic-induced mutagenesis and antibiotic resistance. PMID:24637595

  12. Antibiotics in otorhinolaryngology practice

    Directory of Open Access Journals (Sweden)

    Stefan-Mikić Sandra

    2002-01-01

    Full Text Available Introduction This study investigated utilization of antibacterial agents at the Ear, Nose and Throat Department of the Outpatient Service of the Health Center Novi Sad - Liman and at the Ear, Nose and Throat Clinic of the Clinical Center Novi Sad, in the period February - March 2001. Material and methods All antibacterial agents were classified as group J, regarding Anatomic-Therapeutic-Chemical Classification. Data on drug utilization were presented in Defined Daily Doses (DDD. Patients who were under observation were all treated with antibiotics. Results In regard to prescribed treatment in the Ear, Nose and Throat Department of the Outpatient Service of the Health Center Novi Sad - Liman, most outpatients were treated with macrolide antibiotics - in 26.21%; combination of penicillin and beta-lactamase inhibitors in 20.83% and pyranosides in 16.12%. At the Ear, Nose and Throat Clinic of the Clinical Center Novi Sad, macrolides and lincosamines were most frequently used - in 20.46%; cephalosporins in 19.87% and penicillins susceptible to beta-lactamase in 18.85%. It is extremely positive and in agreement with current pharmacotherapeutic principles that in both institutions peroral ampicillins have not been prescribed. Aminoglycosides have been prescribed in less than 1% of patients of the Ear, Nose and Throat Department of the Outpatient Service of the Health Center Novi Sad - Liman, whereas they were much more frequently prescribed at the Ear, Nose and Throat Clinic of the Clinical Center Novi Sad - in 11.25%. Although there is a positive postantibiotic effect in regard to these antibiotics and it is recommended to use them once a day, in both examined institutions aminoglycosides were given twice a day. In regard to bacterial identification it was done in 80.76% of patients of the Ear, Nose and Throat Department of the Outpatient Service of the Health Center Novi Sad - Liman, while in the Ear, Nose and Throat Clinic of the Clinical Center

  13. Use of Capsaicin to Treat Pain: Mechanistic and Therapeutic Considerations

    Directory of Open Access Journals (Sweden)

    Man-Kyo Chung

    2016-11-01

    Full Text Available Capsaicin is the pungent ingredient of chili peppers and is approved as a topical treatment of neuropathic pain. The analgesia lasts for several months after a single treatment. Capsaicin selectively activates TRPV1, a Ca2+-permeable cationic ion channel that is enriched in the terminals of certain nociceptors. Activation is followed by a prolonged decreased response to noxious stimuli. Interest also exists in the use of injectable capsaicin as a treatment for focal pain conditions, such as arthritis and other musculoskeletal conditions. Recently injection of capsaicin showed therapeutic efficacy in patients with Morton’s neuroma, a painful foot condition associated with compression of one of the digital nerves. The relief of pain was associated with no change in tactile sensibility. Though injection evokes short term pain, the brief systemic exposure and potential to establish long term analgesia without other sensory changes creates an attractive clinical profile. Short-term and long-term effects arise from both functional and structural changes in nociceptive terminals. In this review, we discuss how local administration of capsaicin may induce ablation of nociceptive terminals and the clinical implications.

  14. Therapeutic uses of anti-interleukin-6 receptor antibody.

    Science.gov (United States)

    Kang, Sujin; Tanaka, Toshio; Kishimoto, Tadamitsu

    2015-01-01

    Cytokine-targeted therapy has generated a paradigm shift in the treatment of several immune-mediated diseases. Interleukin-6 (IL-6), which was initially identified as B-cell stimulatory factor 2, is a prototypical cytokine with wide-ranging biological effects on immune cells such as B and T cells, on hepatocytes, hematopoietic cells, vascular endothelial cells and on many others. IL-6 is thus crucially involved in the regulation of immune responses, hematopoiesis and inflammation. When infections and tissue injuries occur, IL-6 is promptly synthesized and performs a protective role in host defense against such stresses and traumas. However, excessive production of IL-6 during this emergent process induces potentially fatal complications, including systemic inflammatory response syndrome (SIRS), and dysregulated, persistently high expression of IL-6 causes the onset or development of various chronic immune-mediated disorders. For these reasons, IL-6 blockade was expected to become a novel therapeutic strategy for various diseases characterized by IL-6 overproduction. Indeed, worldwide clinical trials of tocilizumab, a humanized anti-IL-6 receptor monoclonal antibody, have successfully proved its outstanding efficacy against rheumatoid arthritis, juvenile idiopathic arthritis and Castleman disease, leading to the approval of tocilizumab for the treatment of these diseases. Moreover, various reports regarding off-label use of tocilizumab strongly suggest that it will be widely applicable for acute, severe complications such as SIRS and cytokine-release syndrome and other refractory chronic immune-mediated diseases. PMID:25142313

  15. Therapeutic drug monitoring of antiepileptic drugs by use of saliva.

    Science.gov (United States)

    Patsalos, Philip N; Berry, Dave J

    2013-02-01

    Blood (serum/plasma) antiepileptic drug (AED) therapeutic drug monitoring (TDM) has proven to be an invaluable surrogate marker for individualizing and optimizing the drug management of patients with epilepsy. Since 1989, there has been an exponential increase in AEDs with 23 currently licensed for clinical use, and recently, there has been renewed and extensive interest in the use of saliva as an alternative matrix for AED TDM. The advantages of saliva include the fact that for many AEDs it reflects the free (pharmacologically active) concentration in serum; it is readily sampled, can be sampled repetitively, and sampling is noninvasive; does not require the expertise of a phlebotomist; and is preferred by many patients, particularly children and the elderly. For each AED, this review summarizes the key pharmacokinetic characteristics relevant to the practice of TDM, discusses the use of other biological matrices with particular emphasis on saliva and the evidence that saliva concentration reflects those in serum. Also discussed are the indications for salivary AED TDM, the key factors to consider when saliva sampling is to be undertaken, and finally, a practical protocol is described so as to enable AED TDM to be applied optimally and effectively in the clinical setting. Overall, there is compelling evidence that salivary TDM can be usefully applied so as to optimize the treatment of epilepsy with carbamazepine, clobazam, ethosuximide, gabapentin, lacosamide, lamotrigine, levetiracetam, oxcarbazepine, phenobarbital, phenytoin, primidone, topiramate, and zonisamide. Salivary TDM of valproic acid is probably not helpful, whereas for clonazepam, eslicarbazepine acetate, felbamate, pregabalin, retigabine, rufinamide, stiripentol, tiagabine, and vigabatrin, the data are sparse or nonexistent. PMID:23288091

  16. The Pharmacological Properties and Therapeutic Use of Apomorphine

    Directory of Open Access Journals (Sweden)

    Samo Ribarič

    2012-05-01

    Full Text Available Apomorphine (APO is an aporphine derivative used in human and veterinary medicine. APO activates D1, D2S, D2L, D3, D4, and D5 receptors (and is thus classified as a non-selective dopamine agonist, serotonin receptors (5HT1A, 5HT2A, 5HT2B, and 5HT2C, and α-adrenergic receptors (α1B, α1D, α2A, α2B, and α2C. In veterinary medicine, APO is used to induce vomiting in dogs, an important early treatment for some common orally ingested poisons (e.g., anti-freeze or insecticides. In human medicine, it has been used in a variety of treatments ranging from the treatment of addiction (i.e., to heroin, alcohol or cigarettes, for treatment of erectile dysfunction in males and hypoactive sexual desire disorder in females to the treatment of patients with Parkinson's disease (PD. Currently, APO is used in patients with advanced PD, for the treatment of persistent and disabling motor fluctuations which do not respond to levodopa or other dopamine agonists, either on its own or in combination with deep brain stimulation. Recently, a new and potentially important therapeutic role for APO in the treatment of Alzheimer’s disease has been suggested; APO seems to stimulate Ab catabolism in an animal model and cell culture, thus reducing the rate of Ab oligomerisation and consequent neural cell death.

  17. Photocatalytic decomposition behavior and reaction pathway of sulfamethazine antibiotic using TiO2.

    Science.gov (United States)

    Fukahori, Shuji; Fujiwara, Taku

    2015-07-01

    The photocatalytic degradation of sulfanethazine (SMT), one of the sulfonamide antibiotics, in aqueous solution by TiO2 was investigated. The time courses of SMT concentration, the amount of non-purgeable organic carbon, and the concentrations of ions such as SO4(2-), NH4(+), and NO3(-) formed during the photocatalytic reaction were measured and the structures of seven intermediates formed with the disappearance of SMT were also estimated by LC/MS/MS analyses. In addition to that of SMT, the decomposition behaviors of model compounds sulfanilic acid (SA) and 4-amino-2, 6-dimethylpyrimidine (ADMP) were investigated using the TiO2/UV system. The observed photocatalytic degradation behaviors of SMT, SA, and ADMP gave new insight into the degradation pathway of SMT. Especially, the formation of p-aminophenol during SMT decomposition, which until now has not been reported in previous studies concerning the photocatalytic decomposition of SMT and other sulfonamide antibiotics. These results indicate the existence of a novel photocatalytic degradation pathway for sulfonamides. The direct substitution of the sulfonamide group with a hydroxyl group is suggested.

  18. An Invitation to between-Session Change: The Use of Therapeutic Letters in Couples and Family Counseling

    Science.gov (United States)

    Kindsvatter, Aaron; Nelson, Jill R.; Desmond, Kimberly J.

    2009-01-01

    Therapeutic letters (i.e., brief therapeutic messages that are sent to clients between counseling sessions) have been used since the days of Freud and have been shown to have beneficial therapeutic impacts. This article describes the use of therapeutic letters in couples and family counseling. The use of three types of therapeutic letter (letters…

  19. [Programs for optimizing the use of antibiotics (PROA) in Spanish hospitals: GEIH-SEIMC, SEFH and SEMPSPH consensus document].

    Science.gov (United States)

    Rodríguez-Baño, Jesús; Paño-Pardo, José Ramón; Alvarez-Rocha, Luis; Asensio, Angel; Calbo, Esther; Cercenado, Emilia; Cisneros, José Miguel; Cobo, Javier; Delgado, Olga; Garnacho-Montero, José; Grau, Santiago; Horcajada, Juan Pablo; Hornero, Ana; Murillas-Angoiti, Javier; Oliver, Antonio; Padilla, Belén; Pasquau, Juan; Pujol, Miquel; Ruiz-Garbajosa, Patricia; San Juan, Rafael; Sierra, Rafael

    2012-01-01

    The antimicrobial agents are unique drugs for several reasons. First, their efficacy is higher than other drugs in terms of reduction of morbidity and mortality. Also, antibiotics are the only group of drugs associated with ecological effects, because their administration may contribute to the emergence and spread of microbial resistance. Finally, they are used by almost all medical specialties. Appropriate use of antimicrobials is very complex because of the important advances in the management of infectious diseases and the spread of antibiotic resistance. Thus, the implementation of programs for optimizing the use of antibiotics in hospitals (called PROA in this document) is necessary. This consensus document defines the objectives of the PROA (namely, to improve the clinical results of patients with infections, to minimise the adverse events associated to the use of antimicrobials including the emergence and spread of antibiotic resistance, and to ensure the use of the most cost-efficacious treatments), and provides recommendations for the implementation of these programs in Spanish hospitals. The key aspects of the recommendations are as follows. Multidisciplinary antibiotic teams should be formed, under the auspices of the Infection Committees. The PROA need to be considered as part of institutional programs and the strategic objectives of the hospital. The PROA should include specific objectives based on measurable indicators, and activities aimed at improving the use of antimicrobials, mainly through educational activities and interventions based more on training activities directed to prescribers than just on restrictive measures.

  20. Cuban experience with the therapeutic use of adult stem cells

    International Nuclear Information System (INIS)

    The basic and clinical researches carried out during past years on the stem cells and its therapeutic possibilities are at present times, one of the most interesting subjects of the contemporaneous medicine. There are advances in the study and application of adult stem cells showing remarkable advantages on the embryonic ones, since its handling is more simple, economic and they are obtained from the own subject to be treated. For the introduction in Cuba of the regenerative cellular therapy in the Institute of Hematology and Immunology the cellular sources selected were the adult stem cells derived from bone marrow and the mobilized ones to the peripheral blood. To make easy the expansion of treatment to other hospital centers, authors standardized a technique for the mobilization of the hematopoietic stem cells to peripheral blood using a granulocyte colony-stimulating factor (Filgrastim, of national production) developing a simple, economic and more tolerable method for patients. In this way, the cellular therapy has been expanded to 6 Cuban provinces and until April, 2009 562 cases with autologous adult stem cells transplant have been treated, from which the 81.7% to correspond to patients presenting with Angiology diseases with a significant reduction of major amputations. Also, the results have been very promising in the bone lesions and periodontal processes among other diseases treated. The results obtained until now may be considered as a new achievement of revolutionary science and of our national health systems and of science and technique. The method used is an economic and feasible procedure for the institutions with scarce resources

  1. Radiation dosimetry in developing a radioactive stent for therapeutic use

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Eun Hee; Kim, Jang Hee; Chung, Wee Sup; Woo, Kwang Sun [Korea Cancer Center Hospital , Seoul (Korea, Republic of)

    1997-09-01

    Research Goal: A new radioation therapy protocol of the esophageal carcinoma has been proposed. A metal stent coated with beta-emitting radioisotope would be inserted into the lesion of malignant esophageal obstruction and irradiate it. In this study, dose to the esophageal wall is estimated to suggest the selection of radioisotope, total activity, and the activity distribution pattern over the stent. Result: Dose distribution of the esophageal wall is determined by the energy spectrum of beta particles emitted from the radioisotope used in the stent activation. The endpoint energy of the beta spectrum corresponds to a range in liquid water, which determines the depth into the esophageal wall where the dose is significant. With a stent of constant areal activity density, dose to the esophageal wall increases with an increasing stent height until reaching a saturation value. Dose is maximum at the esophageal wall surface. The degree of dose decreasing as the target moves into the esophageal wall varies among different radioisotopes. However, dose decreases by similar degree among different radioisotopes as the target moves from the stent central height toward the stent end. For a stent of 2 cm in diameter, more than 4 cm in heigh, and 10 {mu}Ci/cm{sup 2} in activity, dose at the esophageal wall surface and at the stent central height is {approx}70 Gy, {approx}60 Gy, {approx}50 Gy, {approx}50 Gy, {approx}25 Gy, and {approx}15 Gy for {sup 90}Y, {sup 188}Re, {sup 166}Ho, {sup 32}P, {sup 186}Re, and {sup 192}Ir, respectively. Applications: Dose estimates provided in this study and the experimental results from the researchers at Yonsei University, who applied the radioactive stent to animals, will be used to analyze the relationship between the stent design and the corresponding therapeutic effect. This helps utilizing the new protocol of treating the esophageal carcinoma. 37 refs., 18 tabs., 27 figs. (author)

  2. Descriptive Study on Parents’ Knowledge, Attitudes and Practices on Antibiotic Use and Misuse in Children with Upper Respiratory Tract Infections in Cyprus

    Directory of Open Access Journals (Sweden)

    Christos Hadjichristodoulou

    2011-08-01

    Full Text Available Upper respiratory tract infections (URTIs are common in children and represent a significant cause of antibiotic abuse which contributes to the development of antibiotic resistance. A survey was conducted in Cyprus in 2006 to assess parents’ and pediatricians’ Knowledge, Attitude and Practices (KAP concerning the role of antibiotics in children with URTIs. A school-based stratified geographic clustering sampling was used and a pre-tested KAP questionnaire was distributed. A different questionnaire was distributed to paediatricians. Demographic factors associated with antibiotic misuse were identified by backward logistic regression analysis. The parental overall response rate was 69.3%. Parents (N = 1,462 follow pediatricians advice and rarely administer antibiotics acquired over the counter. Although a third expects an antibiotic prescription for URTI symptoms, most deny pressuring their doctors. Low parental education was the most important independent risk factor positively related to antibiotic misuse (OR = 2.88, 95%CI 2.02 to 4.12, p < 0.001. Pediatricians (N = 33 denied prescribing antibiotics after parental pressure but admit that parents ask for antibiotics and believe they expect antibiotic prescriptions even when not needed. In conclusion, Cypriotic parents trust their primary care providers. Although it appears that antibiotic misuse is not driven by parental pressure, the pediatricians’ view differs.

  3. The use of anthrax and orthopox therapeutic antibodies from human origin in biodefense

    International Nuclear Information System (INIS)

    It is impossible to protect whole nations from the effects of bioterrorism by preventive vaccination; there are too many possible agents, costs would be exorbitantly high, and the health risks associated with complex mass vaccination programs would be unacceptable. Adequate protection, however, could be provided via a combination of rapid detection and diagnosis and the treatment of those exposed with drugs which would be beneficial in all stages of disease. Monoclonal antibodies, preferably from human origin to prevent severe complications, which neutralize or block the pathological effects of biological agents, are the optimal candidates to be deployed in case of biological warfare or a bioterrorist event. The human body is one of the better and most suitably equipped places for the generation of monoclonal antibodies which are to be used effectively in humans for treatment. Such antibodies will be of optimal physiological specificity, affinity, and pharmacological properties. In addition, the chances on severe adverse effects and cross-reactivity with human tissues will be slim. Therefore the human immune response is used by the Dutch company IQ Therapeutics, a spin-off of the Groningen University, as a basis for selecting the antibodies. People, immunised against or infected with the agent in question, donate blood cells voluntarily, which are used to generate fully human monoclonal antibodies. In this way effective therapeutics against the protective antigen (PA) and lethal factor (LF) toxin components of Bacillus anthracis are developed and currently antibodies against orthopox viruses are generated as well from donors, which have been immunized with vaccinia. Other projects are the development of therapeutic antibodies for MRSA (antibiotics resistant Staphylococcus aureus) and Enterococcus spp. Both human antibodies against the anthrax toxin components are efficacious in vitro and in pre- and post-exposure settings in mice and rabbits. The anti-LF antibody

  4. Use of antibiotics in upper respiratory infections on patients under 16 years old in private ambulatory medicine

    Directory of Open Access Journals (Sweden)

    Peláez-Ballestas Ingris

    2003-01-01

    Full Text Available OBJECTIVE: To assess antibiotic use for upper respiratory infections (URI treatment on patients under 16 years-old who are beneficiaries of a pre-paid health care scheme. MATERIAL AND METHODS: A database containing the record of all the medical prescriptions for URI treatment, from May 1997 to April 1998 was analyzed. Patients were under 16 years old and had been diagnosed with common colds, pharyngitis, bronchitis, sinusitis, otitis, and other unspecified upper respiratory tract infections. Three hundred and fifty-one physicians of seven different specialties who attended 25 300 beneficiaries wrote such prescriptions. RESULTS: A total of 30 889 assorted medications were prescribed to 5 533 patients with the above diagnoses. Antibiotics were prescribed for 77.5% of all diagnoses, ranging from 58% for pharyngitis to 91% for laryngitis. The most frequently used antibiotics were: penicillin, cephalosporins, and macrolides. CONCLUSIONS: This study presents the information of antibiotics prescription practices for URI in a pre-paid health plan in Mexico. These findings may be used to support specific campaigns for rational use of antibiotics among children attended at private ambulatory health care practices.

  5. Predictive properties and therapeutical use of gasotransmitters : A renal perspective

    NARCIS (Netherlands)

    Frenay, Anne-Roos Sophie

    2015-01-01

    In this thesis, we explored the predictive properties of gasotransmitters on graft survival and all-cause mortality in renal transplant recipients. To provide further evidence for the involvement of gasotransmitters in renal and cardiovascular damage we tested their therapeutical potential in experi

  6. Effects of probiotics and antibiotics on the intestinal homeostasis in a computer controlled model of the large intestine.

    NARCIS (Netherlands)

    Rehman, A.; Heinsen, F.A.; Koenen, M.E.; Venema, K.; Knecht, H.; Hellmig, S.; Schreiber, S.; Ott, S.J. de

    2012-01-01

    Background: Antibiotic associated diarrhea and Clostridium difficile infection are frequent complications of broad spectrum antibiotic therapy. Probiotic bacteria are used as therapeutic and preventive agents in these disorders, but the exact functional mechanisms and the mode of action are poorly u

  7. Antibiotic Resistance Pattern Of Bacterial Pathogens Isolated From Poultry Manure Used To Fertilize Fish Ponds In New Bussa, Nigeria

    Directory of Open Access Journals (Sweden)

    Funso Omojowo

    2013-02-01

    Full Text Available This study was carried out to isolate and identify antibiotic resistant bacteria from poultry manure usually used for pond fertilization. Poultry manure from 120 Chickens in National Institute for Freshwater Fisheries Research (NIFFR integrated fish farms, New-Bussa, Nigeria was collected. Five bacterial pathogens; Salmonella typhi, Escherichia coli, Shigella dysenteriae, Staphylococcus aureus and Aeromonas hydrophila were isolated. Antibiotic susceptibility testing carried out using the disk diffusion technique. Antibiotics used were; ofloxacin, amoxicillin, tetracycline, ampicillin, erythromycin, gentamicin, nalidixic acid and chloramphenicol. All the isolated organisms were 100% sensitive to ofloxacin. The multiple resistance pattern revealed that 100% were resistant to tetracycline, 84.34% resistant to ampicillin, 76.68% resistant to amoxicillin, 66% resistant to chloramphenicol, 66% resistant to gentamicin, 29% resistant to erythromycin, 28.34% resistant to nalidixic acid. The risk posed by untreated poultry manure used in fish pond fertilization and the public health implications of these results were discussed.

  8. Beliefs about the use of nonprescribed antibiotics among people in Yogyakarta City, Indonesia: a qualitative study based on the theory of planned behavior.

    Science.gov (United States)

    Widayati, Aris; Suryawati, Sri; de Crespigny, Charlotte; Hiller, Janet E

    2015-03-01

    Although antibiotics are prescription-only medicine in Indonesia, they can be purchased without prescription. This qualitative study elicited beliefs about nonprescribed antibiotics use informed by the theory of planned behavior to develop a questionnaire for an expanded theory of planned behavior survey. Twenty-five (N = 25) adults with experience of using nonprescribed antibiotics were interviewed. Content analysis was applied. Participants reported that the use of nonprescribed antibiotics was advantageous in term of saving time and money and of reducing the number of medicines that need to be purchased, in contrast to a perception of what occurs with medical prescriptions. Potential adverse effects, poor health outcomes, and antimicrobial resistance were the perceived disadvantages. Facilitators of such use were the availability of over-the-counter antibiotics and successful experience in using antibiotics. Medication for children was the perceived barrier to such use. Family members and friends, especially those with health education background, approved of such use.

  9. Antibiotics and probiotics in treatment of inflammatory bowel disease

    Institute of Scientific and Technical Information of China (English)

    Paolo Gionchetti; Fernando Rizzello; Karen M Lammers; Claudia Morselli; Lucia Sollazzi; Samuel Davies; Rosy Tambasco; Carlo Calabrese; Massimo Campieri

    2006-01-01

    Many experimental and clinical observations suggest that intestinal microflora plays a potential role in the pathogenesis of inflammatory bowel disease (IBD).Manipulation of the luminal content using antibiotics or probiotics represents a potentially effective therapeutic option. The available studies do not support the use of antibiotics in ulcerative colitis (UC). Antibiotics are effective in treating septic complications of Crohn's disease (CD) but their use as a primary therapy is more controversial, although this approach is frequently and successfully adopted in clinical practice.There is evidence that probiotic therapy may be effective in the prevention and treatment of mild to moderate UC. In contrast, a lack of successful study data at present precludes the widespread use of probiotics in the treatment of CD.Both antibiotics and probiotics appear to play a beneficial role in the treatment and prevention of pouchitis and further trials are warranted to fully quantify their clinical efficacy.

  10. Using Enzymes to Improve Antibiotic Effectiveness on "Staphylococcus Epidermidis" Biofilm Removal

    Science.gov (United States)

    Candal, Carmen

    2012-01-01

    The effectiveness of five different enzymes as treatments against Staphylococcus biofilm growth was measured in the presence of antibiotics and alone. Protease was the least effective enzyme in biofilm removal with all antibiotics, and pectinase was the most effective with dicloxacillin and clindamycin. Also, dicloxacillin was the most effective…

  11. Screening currency notes for microbial pathogens and antibiotic resistance genes using a shotgun metagenomic approach.

    Directory of Open Access Journals (Sweden)

    Saakshi Jalali

    Full Text Available Fomites are a well-known source of microbial infections and previous studies have provided insights into the sojourning microbiome of fomites from various sources. Paper currency notes are one of the most commonly exchanged objects and its potential to transmit pathogenic organisms has been well recognized. Approaches to identify the microbiome associated with paper currency notes have been largely limited to culture dependent approaches. Subsequent studies portrayed the use of 16S ribosomal RNA based approaches which provided insights into the taxonomical distribution of the microbiome. However, recent techniques including shotgun sequencing provides resolution at gene level and enable estimation of their copy numbers in the metagenome. We investigated the microbiome of Indian paper currency notes using a shotgun metagenome sequencing approach. Metagenomic DNA isolated from samples of frequently circulated denominations of Indian currency notes were sequenced using Illumina Hiseq sequencer. Analysis of the data revealed presence of species belonging to both eukaryotic and prokaryotic genera. The taxonomic distribution at kingdom level revealed contigs mapping to eukaryota (70%, bacteria (9%, viruses and archae (~1%. We identified 78 pathogens including Staphylococcus aureus, Corynebacterium glutamicum, Enterococcus faecalis, and 75 cellulose degrading organisms including Acidothermus cellulolyticus, Cellulomonas flavigena and Ruminococcus albus. Additionally, 78 antibiotic resistance genes were identified and 18 of these were found in all the samples. Furthermore, six out of 78 pathogens harbored at least one of the 18 common antibiotic resistance genes. To the best of our knowledge, this is the first report of shotgun metagenome sequence dataset of paper currency notes, which can be useful for future applications including as bio-surveillance of exchangeable fomites for infectious agents.

  12. Screening currency notes for microbial pathogens and antibiotic resistance genes using a shotgun metagenomic approach.

    Science.gov (United States)

    Jalali, Saakshi; Kohli, Samantha; Latka, Chitra; Bhatia, Sugandha; Vellarikal, Shamsudheen Karuthedath; Sivasubbu, Sridhar; Scaria, Vinod; Ramachandran, Srinivasan

    2015-01-01

    Fomites are a well-known source of microbial infections and previous studies have provided insights into the sojourning microbiome of fomites from various sources. Paper currency notes are one of the most commonly exchanged objects and its potential to transmit pathogenic organisms has been well recognized. Approaches to identify the microbiome associated with paper currency notes have been largely limited to culture dependent approaches. Subsequent studies portrayed the use of 16S ribosomal RNA based approaches which provided insights into the taxonomical distribution of the microbiome. However, recent techniques including shotgun sequencing provides resolution at gene level and enable estimation of their copy numbers in the metagenome. We investigated the microbiome of Indian paper currency notes using a shotgun metagenome sequencing approach. Metagenomic DNA isolated from samples of frequently circulated denominations of Indian currency notes were sequenced using Illumina Hiseq sequencer. Analysis of the data revealed presence of species belonging to both eukaryotic and prokaryotic genera. The taxonomic distribution at kingdom level revealed contigs mapping to eukaryota (70%), bacteria (9%), viruses and archae (~1%). We identified 78 pathogens including Staphylococcus aureus, Corynebacterium glutamicum, Enterococcus faecalis, and 75 cellulose degrading organisms including Acidothermus cellulolyticus, Cellulomonas flavigena and Ruminococcus albus. Additionally, 78 antibiotic resistance genes were identified and 18 of these were found in all the samples. Furthermore, six out of 78 pathogens harbored at least one of the 18 common antibiotic resistance genes. To the best of our knowledge, this is the first report of shotgun metagenome sequence dataset of paper currency notes, which can be useful for future applications including as bio-surveillance of exchangeable fomites for infectious agents.

  13. Autophagy as a target for therapeutic uses of multifunctional peptides.

    Science.gov (United States)

    Muciño, Gabriel; Castro-Obregón, Susana; Hernandez-Pando, Rogelio; Del Rio, Gabriel

    2016-04-01

    The emergence of complex diseases is promoting a change from one-target to multitarget drugs and peptides are ideal molecules to fulfill this polypharmacologic role. Here we review current status in the design of polypharmacological peptides aimed to treat complex diseases, focusing on tuberculosis. In this sense, combining multiple activities in single molecules is a two-sided sword, as both positive and negative side effects might arise. These polypharmacologic compounds may be directed to regulate autophagy, a catabolic process that enables cells to eliminate intracellular microbes (xenophagy), such as Mycobacterium tuberculosis (MBT). Here we review some strategies to control MBT infection and propose that a peptide combining both antimicrobial and pro-autophagic activities would have a greater potential to limit MBT infection. This endeavor may complement the knowledge gained in understanding the mechanism of action of antibiotics and may lead to the design of better polypharmacological peptides to treat complex diseases such as tuberculosis. PMID:26968336

  14. Risk of resistance related to antibiotic use before admission in patients with community-acquired bacteraemia

    DEFF Research Database (Denmark)

    Pedersen, Gitte; Schønheyder, Henrik Carl; Steffensen, Flemming Hald;

    1999-01-01

    admission and to 37% during the 6 months. The most frequently prescribed antibiotics within 30 days were ampicillin (28%), penicillin G (27%), sulphonamides and/or trimethoprim (16%) and macrolides (14%). The most frequent blood isolates were Escherichia coli (33%), other Enterobacteriaceae 8......%), Streptococcus pneumoniae (23%) Staphylococcus aureus (10%). Of the 575 isolates of E. coli, 425 (74%), 432 (75%) and 518 (90%) were susceptible to ampicillin, sulphonamides and trimethoprim, respectively. Previous antibiotic prescriptions were strongly associated with resistance to ampicillin, sulphonamides...... and trimethoprim in E. coli. The association was less pronounced for S. aureus and enteric rods other than E. coli. Antibiotic prescriptions within the last 3 months predicted antibiotic resistance, and this should be taken into account when selecting empirical antibiotic therapy of severe community...

  15. Use of web services for computerized medical decision support, including infection control and antibiotic management, in the intensive care unit.

    Science.gov (United States)

    Steurbaut, Kristof; Van Hoecke, Sofie; Colpaert, Kirsten; Lamont, Kristof; Taveirne, Kristof; Depuydt, Pieter; Benoit, Dominique; Decruyenaere, Johan; De Turck, Filip

    2010-01-01

    The increasing complexity of procedures in the intensive care unit (ICU) requires complex software services, to reduce improper use of antibiotics and inappropriate therapies, and to offer earlier and more accurate detection of infections and antibiotic resistance. We investigated whether web-based software can facilitate the computerization of complex medical processes in the ICU. The COSARA application contains the following modules: Infection overview, Thorax, Microbiology, Antibiotic therapy overview, Admission cause with comorbidity and admission diagnosis, Infection linking and registration, and Feedback. After the implementation and test phase, the COSARA software was installed on a physician's office PC and then on the bedside PCs of the patients. Initial evaluation indicated that the services had been integrated easily into the daily clinical workflow of the medical staff. The use of a service oriented architecture with web service technology for the development of advanced decision support in the ICU offers several advantages over classical software design approaches. PMID:20086264

  16. [Use of Autobac system in the study of the bacteriostatic effect of combinations of antibiotics (author's transl)].

    Science.gov (United States)

    Darbas, H; Boyer, G; Cavadore, D

    1980-01-01

    After determining the LSI80 (light scattering index 80) concentration X and Y of two antibiotics for a given bacteria by an automated light scatter photometric method, we use the same process to test the bacteriostatic effect of all the combinations between the values 2X, X, X/2, X/4, X/8 and 2Y, Y, Y/2, Y/4, Y/8. The results read on the light scatter photometer are interpreted: --approximatealy by means of a simplified schematic diagram; --more precisely by drawing three curves: we begin with two inhibiton curves in order to determine the LSI50 concentrations (CLSI50) of each antibiotic, isolted and in the presence of defined concentrations of the complementary antibiotic; then from these CLSI50 we draw the bacteriostatic effect curve of the combination. When the LSI50 effect of the combination occurs with less than 50% of the CLSI50 of each isolated antibiotic, the combination is synergistic. It is antagonist if the bacteriostase is obtained with more than 100% of the CLSI50 of each isolated antibiotic. The intermediate percentages determine the indifferent effects. The additive effects come to an equilateral hyperbola passing through the points 50%-50%, 25%-75%. The Autobac system allows inoculum standardization, very simplified handlihg and automatic reading. It takes only 9 h to handle the complete process, including the determinations of the CLSI80 and the study of the combination. There is a high correlation between the results obtained and those given by the Patte and Chabbert "carre method".

  17. A study of antibiotic prescribing

    DEFF Research Database (Denmark)

    Jaruseviciene, L.; Radzeviciene-Jurgute, R.; Jurgutis, A.;

    2012-01-01

    Background. Globally, general practitioners (GPs) write more than 90% of all antibiotic prescriptions. This study examines the experiences of Lithuanian and Russian GPs in antibiotic prescription for upper respiratory tract infections, including their perceptions of when it is not indicated...... to ensure correct antibiotic use. Further, GPs should be supported in enhancing their communication skills about antibiotic use with their patients and encouraged to implement a shared decision-making model in their practices. © Versita Sp. z o.o....

  18. Therapeutic Angiogenesis Using Local Perivascular and Pericardial Delivery.

    Science.gov (United States)

    Laham; Post; Sellke; Simons

    2000-08-01

    Therapeutic angiogenesis is a potential new treatment strategy that promises to grow new blood vessels to the ischemic myocardium in patients with ischemic heart disease. Despite its investigation in more than 550 patients with ischemic heart disease, the concept of clinical therapeutic angiogenesis remains a theoretic one with more questions than answers. This is due in part to a poor understanding of the fundamental mechanisms of adult collateralization and growth factor-induced angiogenesis, a poor understanding of the relative importance of large epicardial feeding collaterals versus intramyocardial neovascularization, and limited data concerning the best angiogenic cytokine, the best delivery modality, and the need for sustained exposure to that cytokine. This article discusses the available data on local perivascular delivery and pericardial delivery as they pertain to therapeutic angiogenesis. These delivery strategies have several characteristics that may make them ideal as adjuncts for coronary artery bypass surgery (local perivascular delivery) or in noninstrumented pericardium (pericardial delivery). They also have the theoretic advantage of affecting epicardial vessels and potentially promoting epicardial feeding collaterals.

  19. Investigating the Antibiotic Resistance Problem.

    Science.gov (United States)

    Lawson, Michael; Lawson, Amy L.

    1998-01-01

    Seeks to give teachers useful information on the extent of the problem of antibiotic-resistant bacteria, mechanisms bacteria use to resist antibiotics, the causes of the emergence of antibiotic-resistant organisms, and practices that can prevent or reverse this trend. Contains 19 references. (DDR)

  20. Monitoring the Use of Antibiotics by the ATC/DDD Method and DU 90%: Observational Studies in Community Health Service Centers in North Gorontalo District

    Directory of Open Access Journals (Sweden)

    Sarini Pani

    2015-12-01

    Full Text Available Irrational use of antibiotics may lead to increase morbidity and mortality. Monitoring of antibiotics was required to support government programs, especially The Department of Health stating the use of antibiotics for non-respiratory diseases pneumonia was less than 20%. The evaluation of antibiotics use in this research applied ATC / DDD methods and DU 90%. The antibiotic used for non-pneumonia ARI were 9 types and the antibiotics contained DU 90% were three types namely amoxicillin 500 mg (2,723 DDD/1000 patients-year, ciprofloxacin (0,378 DDD/1000 patients-day and cefadroxil (0,202 DDD/1000 patients-day. Quantitative data analysis using the ATC / DDD indicated that the most used antibiotic was amoxicillin (500 mg 2723 DDD / 1000 patients-day and the least was amoxicillin (125 mg / 5 ml 1.5 DDD / 1000 patients-day. The effects of short-term use of antibiotic prescribing in primary medical care could increase the resistance. Qualitative studies were needed to determine the pattern of irrational antibiotic use in community health service center and to develop the intervention model.

  1. Bone grafting and one-stage revision of THR - biological reconstruction and effective antimicrobial treatment using antibiotic impregnated allograft bone.

    Science.gov (United States)

    Winkler, Heinz

    2012-01-01

    Infection of a total hip replacement (THR) is considered one of the most serious complications in orthopaedic surgery. Problems derive from the presence of biofilms with inherent resistance to usual antibiotic treatment and bone defects resulting from infection induced osteolysis. Discussions on the choice of treatment mainly focus on the chance of eradicating the infection in either one or more stages. The advantages of only one operation with regard to patients' satisfaction, functional results and economical burden are evident. However, the fear of re-infection usually leads surgeons to multiple stage procedures, mostly using antibiotic loaded spacers in the interval. Spacers have no effect on biofilms and are associated with a high rate of complications such as breakage or dislocation. Cemented revisions show several disadvantages like reduction of biomechanical properties through added antibiotics, inferior long term results, difficulties of removal in case of recurrence etc. Uncemented implants appear more advantageous but are at risk of becoming colonised by remaining biofilm fragments. To overcome this risk higher local concentrations of antibiotics are needed. Allograft bone may be impregnated with high loads of antibiotics using special incubation techniques, resulting in an antibiotic bone compound (ABC). ABC provides local concentrations exceeding those of cement by more than a 100-fold and efficient release is prolonged for several weeks. At the same time it is likely to restore bone stock, which is usually compromised after removal of an infected endoprosthesis. Based on these considerations new protocols for one-stage exchange of infected THR have been established. Bone voids may be filled with ABC, uncemented implants may be fixed in original healthy bone. Recent studies indicate an overall success rate of more than 90% with one operation, without any adverse side effects. Incorporation of allografts appears as after grafting with unimpregnated bone

  2. The future of antibiotics.

    Science.gov (United States)

    Spellberg, Brad

    2014-01-01

    Antibiotic resistance continues to spread even as society is experiencing a market failure of new antibiotic research and development (R&D). Scientific, economic, and regulatory barriers all contribute to the antibiotic market failure. Scientific solutions to rekindle R&D include finding new screening strategies to identify novel antibiotic scaffolds and transforming the way we think about treating infections, such that the goal is to disarm the pathogen without killing it or modulate the host response to the organism without targeting the organism for destruction. Future economic strategies are likely to focus on 'push' incentives offered by public-private partnerships as well as increasing pricing by focusing development on areas of high unmet need. Such strategies can also help protect new antibiotics from overuse after marketing. Regulatory reform is needed to re-establish feasible and meaningful traditional antibiotic pathways, to create novel limited-use pathways that focus on highly resistant infections, and to harmonize regulatory standards across nations. We need new antibiotics with which to treat our patients. But we also need to protect those new antibiotics from misuse when they become available. If we want to break the cycle of resistance and change the current landscape, disruptive approaches that challenge long-standing dogma will be needed. PMID:25043962

  3. Design of a 2D MRI compatible robot for performing prostate cancer treatment using therapeutic ultrasound

    OpenAIRE

    Yiallouras, Christos

    2015-01-01

    Therapeutic ultrasound is a promising treatment method for many common cancers, including prostate cancer. Magnetic resonance image (MRI) guidance of therapeutic ultrasound permits targeting and monitoring of therapy. In this thesis a prototype MRI compatible positioning device for the treatment of prostate cancer using therapeutic ultrasound is presented. The accuracy, MRI compatibility and functionality of the positioning device was evaluated in in vitro experiments (using gel phantoms and ...

  4. Metagenomics and antibiotics.

    Science.gov (United States)

    Garmendia, L; Hernandez, A; Sanchez, M B; Martinez, J L

    2012-07-01

    Most of the bacterial species that form part of the biosphere have never been cultivated. In this situation, a comprehensive study of bacterial communities requires the utilization of non-culture-based methods, which have been named metagenomics. In this paper we review the use of different metagenomic techniques for understanding the effect of antibiotics on microbial communities, to synthesize new antimicrobial compounds and to analyse the distribution of antibiotic resistance genes in different ecosystems. These techniques include functional metagenomics, which serves to find new antibiotics or new antibiotic resistance genes, and descriptive metagenomics, which serves to analyse changes in the composition of the microbiota and to track the presence and abundance of already known antibiotic resistance genes in different ecosystems.

  5. College Students, Shared Decision Making, and the Appropriate Use of Antibiotics for Respiratory Tract Infections: A Systematic Literature Review

    Science.gov (United States)

    Blyer, Kristina; Hulton, Linda

    2016-01-01

    Objective: This systematic review examines shared decision making to promote the appropriate use of antibiotics for college students with respiratory tract infections. Participants/Methods: CINAL, Cochrane, PubMed, EBSCO, and PsycNET were searched in October 2014 using the following criteria: English language, human subjects, peer-reviewed, shared…

  6. "The Bug Investigators": Assessment of a School Teaching Resource to Improve Hygiene and Prudent Use of Antibiotics

    Science.gov (United States)

    McNulty, Cliodna A. M.; Bowen, Jo; Gelb, David; Charlett, Andre

    2007-01-01

    Purpose: The aim of this study is to measure the effectiveness of the "Bug Investigators" pack in improving children's knowledge about micro-organisms, hygiene and antibiotics when it is used within the National Curriculum in junior schools. Design/methodology/approach: Teaching, using the "Bug Investigators" pack, was given by Gloucestershire…

  7. [GnRH analogs in gynecology. Possibilities for therapeutic use].

    Science.gov (United States)

    Niesert, S

    1990-09-10

    Gonadotropin releasing hormone (GnRH) agonists are synthetic peptide analogues of the natural gonadotropin releasing hormone with a stronger and more prolonged effect than the natural GnRH. Repeated administration of GnRH agonists induces pituitary desensitization followed by a decrease in gonadotropin secretion and estradiol synthesis. Thus reversible hypogonadotropic hypogonadism is produced. Consequently, estrogen-dependent diseases can be treated successfully with GnRH analogues. The therapeutic results obtained in patients with endometriosis, leiomyoma, pubertas praecox, and metastatic breast cancer are discussed. Furthermore the contraceptive properties of GnRH analogues, and combination treatment with HMG to induce ovulation is reviewed. PMID:2262188

  8. Combining physical and virtual contexts through augmented reality: design and evaluation of a prototype using a drug box as a marker for antibiotic training.

    Science.gov (United States)

    Nifakos, Sokratis; Tomson, Tanja; Zary, Nabil

    2014-01-01

    Introduction. Antimicrobial resistance is a global health issue. Studies have shown that improved antibiotic prescription education among healthcare professionals reduces mistakes during the antibiotic prescription process. The aim of this study was to investigate novel educational approaches that through the use of Augmented Reality technology could make use of the real physical context and thereby enrich the educational process of antibiotics prescription. The objective is to investigate which type of information related to antibiotics could be used in an augmented reality application for antibiotics education. Methods. This study followed the Design-Based Research Methodology composed of the following main steps: problem analysis, investigation of information that should be visualized for the training session, and finally the involvement of the end users the development and evaluation processes of the prototype. Results. Two of the most important aspects in the antibiotic prescription process, to represent in an augmented reality application, are the antibiotic guidelines and the side effects. Moreover, this study showed how this information could be visualized from a mobile device using an Augmented Reality scanner and antibiotic drug boxes as markers. Discussion. In this study we investigated the usage of objects from a real physical context such as drug boxes and how they could be used as educational resources. The logical next steps are to examine how this approach of combining physical and virtual contexts through Augmented Reality applications could contribute to the improvement of competencies among healthcare professionals and its impact on the decrease of antibiotics resistance.

  9. Combining physical and virtual contexts through augmented reality: design and evaluation of a prototype using a drug box as a marker for antibiotic training

    Directory of Open Access Journals (Sweden)

    Sokratis Nifakos

    2014-12-01

    Full Text Available Introduction. Antimicrobial resistance is a global health issue. Studies have shown that improved antibiotic prescription education among healthcare professionals reduces mistakes during the antibiotic prescription process. The aim of this study was to investigate novel educational approaches that through the use of Augmented Reality technology could make use of the real physical context and thereby enrich the educational process of antibiotics prescription. The objective is to investigate which type of information related to antibiotics could be used in an augmented reality application for antibiotics education. Methods. This study followed the Design-Based Research Methodology composed of the following main steps: problem analysis, investigation of information that should be visualized for the training session, and finally the involvement of the end users the development and evaluation processes of the prototype. Results. Two of the most important aspects in the antibiotic prescription process, to represent in an augmented reality application, are the antibiotic guidelines and the side effects. Moreover, this study showed how this information could be visualized from a mobile device using an Augmented Reality scanner and antibiotic drug boxes as markers. Discussion. In this study we investigated the usage of objects from a real physical context such as drug boxes and how they could be used as educational resources. The logical next steps are to examine how this approach of combining physical and virtual contexts through Augmented Reality applications could contribute to the improvement of competencies among healthcare professionals and its impact on the decrease of antibiotics resistance.

  10. Guidelines to rational use of antibiotics in acute upper respiratory tract infections in Chinese children

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    @@Acute respiratory tract infections (ARTIs) is the most common disease afflicting Chinese children and ranks first in numbers of outpatients, hospitalization and fatality rate. ARTI is also the most frequent reason that antibiotics are prescribed.

  11. Therapeutic Assessment in Psychological Triage Using the PAI.

    Science.gov (United States)

    Brown, Joshua D; Morey, Leslie C

    2016-01-01

    This case illustrates the utility of incorporating therapeutic assessment in a triage context that typically involves a focus on gathering information. A man referred to our clinic by a local mental health center was seen by our assessment team for a triage that includes the administration of a single psychological test, the Personality Assessment Inventory (PAI). Although this triage must rapidly gather information to determine client suitability and treatment assignment, we still attempt to work with clients to collaboratively develop goals for this assessment that include addressing questions that are central concerns for the clients. In this case, the test results suggested a severe disorder that accounted for many phenomena that he had been experiencing but had apparently been reluctant to share. The information gathered led to a referral to a different treatment program that could provide pharmacological and more intensive forms of treatment. However, the collaborative bond formed between the assessor and the client during this triage was sufficiently strong that it was our assessor to whom the client turned in a subsequent crisis precipitated by a symptomatic exacerbation. This case illustrates complementary information gathering and therapeutic goals of assessment even in the context of a brief assessment. PMID:26730992

  12. Therapeutic treatment of Alzheimer's disease using metal complexing agents.

    Science.gov (United States)

    Price, Katherine A; Crouch, Peter J; White, Anthony R

    2007-11-01

    Alzheimer's disease (AD) is a progressive neurodegenerative disorder characterized by deposition of extracellular amyloid plaques, formation of intracellular neurofibrillary tangles and neuronal dysfunction in the brain. A growing body of evidence indicates a central role for biometals such as copper in many critical aspects of AD. The amyloid beta (Abeta) peptide and its parental molecule, the amyloid precursor protein (APP) both modulate Cu and Zn metabolism in the brain. Therefore, aberrant changes to APP or Abeta metabolism could potentially alter biometal homoestasis in AD, leading to increased free radical production and neuronal oxidative stress. Modulation of metal bioavailability in the brain has been proposed as a potential therapeutic strategy for treatment of AD patients. The lipid permeable metal complexing agent, clioquinol (CQ), has shown promising results in animal models of AD and in small clinical trials involving AD patients. Moreover, a new generation of metal-ligand based therapeutics is currently under development. Patents now cover the generation of novel metal ligand structures designed to modulate metal binding to Abeta and quench metal-mediated free radical generation. However, the mechanism by which CQ and other metal complexing agents slows cognitive decline in AD animal models and patients is unknown. Increasing evidence suggests that ligand-mediated redistribution of metals at a cellular level in the brain may be important. Further research will be necessary to fully understand the complex pathways associated with efficacious metal-based pharmaceuticals for treatment of AD.

  13. Effectiveness of Interventions in Reducing Antibiotic Use for Upper Respiratory Infections in Ambulatory Care Practices

    OpenAIRE

    Vinnard, Christopher; Linkin, Darren R.; Localio, A. Russell; Leonard, Charles E; Teal, Valerie L.; Fishman, Neil O.; Hennessy, Sean

    2013-01-01

    The objective was to evaluate the effect of separate interventions on antimicrobial prescribing for uncomplicated upper respiratory tract infections. The authors conducted a quasi-experimental pre-post study with concurrent control groups for each intervention. Academic detailing led to a significant reduction in unnecessary antibiotic prescribing. However, there was no significant change in antibiotic prescribing in response to educational mailings to providers or to provider involvement in ...

  14. Use and misuse of antibiotics in the neonatal intensive care unit.

    Science.gov (United States)

    Tzialla, C; Borghesi, A; Perotti, G F; Garofoli, F; Manzoni, P; Stronati, M

    2012-10-01

    Severe infections represent the main cause of neonatal mortality accounting for more than one million neonatal deaths worldwide every year. Antibiotics are the most commonly prescribed medications in neonatal intensive care units (NICUs) and in industrialized countries about 1% of neonates are exposed to antibiotic therapy. Signs and symptoms of sepsis are nonspecific, and empiric antimicrobial therapy is promptly initiated after obtaining appropriate cultures in order to prevent deleterious consequences. However, many preterm infants who do not have infection receive antimicrobial agents during hospital stay and antibiotic treatment in the setting of negative cultures can have serious adverse effects like: promotion of bacterial antibiotic resistance, alteration of gut colonization, increase risk of Candida colonization and subsequent invasive candidiasis, increase risk of death, necrotizing enterocolitis and late-onset sepsis. Appropriate choice of antimicrobial agents and optimal duration of therapy in neonates with suspected or culture-proven sepsis is essential in order to prevent serious consequences. Moreover the establishment of an antibiotic stewardship programme in the NICUs is the best way of ensuring neonatal infections remain treatable while efforts are made for the developing of optimal antibiotic prescribing.

  15. Use and misuse of antibiotics in the neonatal intensive care unit.

    Science.gov (United States)

    Tzialla, C; Borghesi, A; Perotti, G F; Garofoli, F; Manzoni, P; Stronati, M

    2012-10-01

    Severe infections represent the main cause of neonatal mortality accounting for more than one million neonatal deaths worldwide every year. Antibiotics are the most commonly prescribed medications in neonatal intensive care units (NICUs) and in industrialized countries about 1% of neonates are exposed to antibiotic therapy. Signs and symptoms of sepsis are nonspecific, and empiric antimicrobial therapy is promptly initiated after obtaining appropriate cultures in order to prevent deleterious consequences. However, many preterm infants who do not have infection receive antimicrobial agents during hospital stay and antibiotic treatment in the setting of negative cultures can have serious adverse effects like: promotion of bacterial antibiotic resistance, alteration of gut colonization, increase risk of Candida colonization and subsequent invasive candidiasis, increase risk of death, necrotizing enterocolitis and late-onset sepsis. Appropriate choice of antimicrobial agents and optimal duration of therapy in neonates with suspected or culture-proven sepsis is essential in order to prevent serious consequences. Moreover the establishment of an antibiotic stewardship programme in the NICUs is the best way of ensuring neonatal infections remain treatable while efforts are made for the developing of optimal antibiotic prescribing. PMID:22958010

  16. Studies on the purification, characterization and structure of antibiotics from centipede using RI labelled compound

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Key Seung; Lee, Sang Min; Choi, Jin Sung; Hong, Sa Weon [Hanyang University, Seoul (Korea, Republic of)

    1997-07-01

    The substance which has antibiotic properties was extracted by diethyl ether and purified from a centipede S. subspinipes by the silicic acid and high S column chromatography. This antibiotics named {sup C}entipedin{sup h}as exhibited a significant antibiotic activity against a variety of microorganism, such as Gram{sup +}, Gram{sup -}, fungi etc. In connection with the antibiotic property, it was confirmed that its inhibitory effect on the growth of Staphylococcus aureus was related with the transcriptional level of DNA and RNA polymerase. The centipedin was measured quantitatively by GC methods and molecular weight was confirmed as 162 Da by mass-spec. Also, molecular formular was identified to C{sub 9}O{sub 3}H{sub 6} by the method of UV, IR and NMR. Antibiotics from centipede did not exhibit any significant cytotoxicity against cancer cell lines, such as HL-60 cell and myeloma cell. It was confirmed that centipedin antibiotics was biosynthesized from {sup 14}C-acetate in vivo experiment. 12 refs., 23 figs. (author)

  17. Genetic improvement through selective breeding: Part of an integrated strategy to reduce disease loss and Antibiotic use

    Science.gov (United States)

    Bacterial cold water disease (BCWD) is a frequent cause of elevated mortality in rainbow trout, and outbreaks often require the use of antibiotic treatment. Since antimicrobial resistance is of concern, additional control methods are desirable. Family-based selective breeding offers new opportuniti...

  18. Maternal use of antibiotics and the risk of childhood febrile seizures: a Danish population-based cohort.

    Directory of Open Access Journals (Sweden)

    Jessica E Miller

    Full Text Available OBJECTIVE: In a large population-based cohort in Denmark to examine if maternal use of antibiotics during pregnancy, as a marker of infection, increases the risk of febrile seizures in childhood in a large population-based cohort in Denmark. METHODS: All live-born singletons born in Denmark between January 1, 1996 and September 25, 2004 and who were alive on the 90(th day of life were identified from the Danish National Birth Registry. Diagnoses of febrile seizures were obtained from the Danish National Hospital Register and maternal use of antibiotics was obtained from the National Register of Medicinal Product Statistics. Hazard ratios (HR and 95% confidence intervals (95% CI were estimated by Cox proportional hazard regression models. RESULTS: We followed 551,518 singletons for up to 5 years and identified a total of 21,779 children with a diagnosis of febrile seizures. Slightly increased hazard ratios were observed among most exposure groups when compared to the unexposed group, ex. HR 1.08 95% CI: 1.05-1.11 for use of any systemic antibiotic during pregnancy. CONCLUSION: We found weak associations between the use of pharmacologically different antibiotics during pregnancy and febrile seizures in early childhood which may indicate that some infections, or causes or effects of infections, during pregnancy could affect the fetal brain and induce susceptibility to febrile seizures.

  19. Infectious diseases and the use of antibiotics in outpatients at the emergency department of the University Hospital of Leon, Nicaragua

    NARCIS (Netherlands)

    den Engelsen, C.; van der Werf, C.; Matute, A. J.; Delgado, E.; Schurink, C. A. M.; Hoepelman, A. I. M.

    2009-01-01

    Background: In order to develop guidelines for the use of antimicrobial agents, it is necessary to obtain detailed information on the prevalence of infectious diseases and antibiotic usage. Methods: A retrospective study was conducted among outpatients with acute infections visiting the emergency de

  20. Potential use of Bacillus thuringiensis bacteriocins to control antibiotic-resistant bacteria associated with mastitis in dairy goats.

    Science.gov (United States)

    Gutiérrez-Chávez, A J; Martínez-Ortega, E A; Valencia-Posadas, M; León-Galván, M F; de la Fuente-Salcido, N M; Bideshi, D K; Barboza-Corona, J E

    2016-01-01

    Mastitis caused by microbial infections in dairy goats reduces milk yield, modifies milk composition, and potentially contributes to morbidity in herds and consumers of dairy products. Microorganisms associated with mastitis in dairy goats are commonly controlled with antibiotics, but it is known that continued use of these chemical agents promotes antibiotic resistance among bacterial populations. Recently, it has been shown that bacteriocins of Bacillus thuringiensis inhibit growth of food-borne pathogens and also bacteria associated with bovine mastitis. However, there is no report on their ability to inhibit microorganisms linked to mastitis in dairy goats. In this study, using 16S rDNA and ITS regions of rDNA, we identified nine bacterial isolates and an encapsulated yeast associated with mastitis in dairy goats. Enterococcus durans, Brevibacillus sp., and Staphylococcus epidermidis 2 were resistant to, respectively, 75, ~67, ~42, and ~42 % of the antibiotics screened. In addition, 60 % of the bacterial isolates were resistant to penicillin, ampicillin, vancomycin, and dicloxacillin. Importantly, 60 % of the isolates were inhibited by the bacteriocins, but S. epidermidis 1, Enterobacter sp., Escherichia vulneris, and Cryptococcus neoformans were not susceptible to these antimicrobial peptides. Using Brevibacillus sp. and Staphylococcus chromogenes as indicator bacteria, we show that peptides of ~10 kDa that correspond to the molecular mass of bacteriocins used in this study are responsible for the inhibitory activity. Our results demonstrate that multiple antibiotic-resistant bacteria associated with subclinical mastitis in dairy goats from Guanajuato, Mexico, are susceptible to bacteriocins produced by B. thuringiensis.

  1. Lactobacillus rhamnosus GG Intake Modifies Preschool Children's Intestinal Microbiota, Alleviates Penicillin-Associated Changes, and Reduces Antibiotic Use

    NARCIS (Netherlands)

    Korpela, Katri; Salonen, Anne; Virta, Lauri J.; Kumpu, Minna; Kekkonen, Riina A.; Vos, De Willem M.

    2016-01-01

    Antibiotic use is considered among the most severe causes of disturbance to children's developing intestinal microbiota, and frequently causes adverse gastrointestinal effects ranging from mild and transient diarrhoea to life- Threatening infections. Probiotics are commonly advocated to help in p

  2. The routine use of antibiotics to promote animal growth does little to benefit protein undernutrition in the developing world

    DEFF Research Database (Denmark)

    Collignon, P.; Wegener, Henrik Caspar; Braam, P.;

    2005-01-01

    these countries. Poultry and pork production are unlikely to decrease by more than 2%. Average daily protein supply would decrease by no more than 0.1 g per person (or 0.2% of total protein intake). Eliminating the routine use of in-feed antibiotics will improve human and animal health, by reducing the...

  3. Potential use of Bacillus thuringiensis bacteriocins to control antibiotic-resistant bacteria associated with mastitis in dairy goats.

    Science.gov (United States)

    Gutiérrez-Chávez, A J; Martínez-Ortega, E A; Valencia-Posadas, M; León-Galván, M F; de la Fuente-Salcido, N M; Bideshi, D K; Barboza-Corona, J E

    2016-01-01

    Mastitis caused by microbial infections in dairy goats reduces milk yield, modifies milk composition, and potentially contributes to morbidity in herds and consumers of dairy products. Microorganisms associated with mastitis in dairy goats are commonly controlled with antibiotics, but it is known that continued use of these chemical agents promotes antibiotic resistance among bacterial populations. Recently, it has been shown that bacteriocins of Bacillus thuringiensis inhibit growth of food-borne pathogens and also bacteria associated with bovine mastitis. However, there is no report on their ability to inhibit microorganisms linked to mastitis in dairy goats. In this study, using 16S rDNA and ITS regions of rDNA, we identified nine bacterial isolates and an encapsulated yeast associated with mastitis in dairy goats. Enterococcus durans, Brevibacillus sp., and Staphylococcus epidermidis 2 were resistant to, respectively, 75, ~67, ~42, and ~42 % of the antibiotics screened. In addition, 60 % of the bacterial isolates were resistant to penicillin, ampicillin, vancomycin, and dicloxacillin. Importantly, 60 % of the isolates were inhibited by the bacteriocins, but S. epidermidis 1, Enterobacter sp., Escherichia vulneris, and Cryptococcus neoformans were not susceptible to these antimicrobial peptides. Using Brevibacillus sp. and Staphylococcus chromogenes as indicator bacteria, we show that peptides of ~10 kDa that correspond to the molecular mass of bacteriocins used in this study are responsible for the inhibitory activity. Our results demonstrate that multiple antibiotic-resistant bacteria associated with subclinical mastitis in dairy goats from Guanajuato, Mexico, are susceptible to bacteriocins produced by B. thuringiensis. PMID:26022411

  4. Public Knowledge and Attitudes Regarding the Use of Antibiotics and Resistance: Findings from a Cross-Sectional Study Among Palestinian Adults.

    Science.gov (United States)

    Abu Taha, A; Abu-Zaydeh, A H; Ardah, R A; Al-Jabi, S W; Sweileh, W M; Awang, R; Zyoud, S H

    2016-09-01

    Antibiotics are considered to be among the most commonly sold drug classes in Palestine. Resistance to antibiotics has increased for reasons relating to the use and misuse of antibiotics. The aim of this study was to evaluate the knowledge, and attitudes regarding antibiotic use and awareness about resistance among adults visiting the emergency departments at hospitals in North Palestine. A self-administered cross-sectional questionnaire survey involving participants aged 18 or over was conducted from June 2012 to February 2013. Adults who visited the emergency departments at hospitals in North Palestine were included. Demographic characteristics, knowledge and attitudes towards antibiotic use were included in the questionnaire. Poor and good knowledge were defined as a total knowledge score of 0-7 and 8-15 of 15 questions, respectively. Attitude scores of 0-3 and 4-7 of 7 questions were considered poor and good, respectively. A total of 375 questionnaires were included in the study. A response rate of 83.3% was attained. About 55.0% of the participants had a good knowledge and 56.5% had a good attitude towards rational antibiotic use. A significant positive correlation was shown between participants' knowledge scores and participants' attitude scores towards antibiotic use (R = 0.344, P = 0.001. Participants with a high family income were more likely to be aware of appropriate antibiotic use than participants with a low family income (P-value attitude towards rational antibiotic use than those with a lower education level (P-value attitude gaps in antibiotic use. These findings will help health policymakers in Palestine to implement intervention programmes to rationalize antibiotic use. Continuing medical education, professional development and training workshops for healthcare professionals regarding rational use of antibiotics and health risks associated with the spread of antibiotic resistance are needed. In addition, minimizing non-prescription use of

  5. Multiclass determination and confirmation of antibiotic residues in honey using LC-MS/MS.

    Science.gov (United States)

    Lopez, Mayda I; Pettis, Jeffery S; Smith, I Barton; Chu, Pak-Sin

    2008-03-12

    A multiclass method has been developed for the determination and confirmation in honey of tetracyclines (chlortetracycline, doxycycline, oxytetracycline, and tetracycline), fluoroquinolones (ciprofloxacin, danofloxacin, difloxacin, enrofloxacin, and sarafloxacin), macrolides (tylosin), lincosamides (lincomycin), aminoglycosides (streptomycin), sulfonamides (sulfathiazole), phenicols (chloramphenicol), and fumagillin residues using liquid chromatography tandem mass spectrometry (LC-MS/MS). Erythromycin (a macrolide) and monensin (an ionophore) can be detected and confirmed but not quantitated. Honey samples (approximately 2 g) are dissolved in 10 mL of water and centrifuged. An aliquot of the supernatant is used to determine streptomycin. The remaining supernatant is filtered through a fine-mesh nylon fabric and cleaned up by solid phase extraction. After solvent evaporation and sample reconstitution, 15 antibiotics are assayed by LC-MS/MS using electrospray ionization (ESI) in positive ion mode. Afterward, chloramphenicol is assayed using ESI in negative ion mode. The method has been validated at the low part per billion levels for most of the drugs with accuracies between 65 and 104% and coefficients of variation less than 17%. The evaluation of matrix effects caused by honey of different floral origin is presented. PMID:18257525

  6. Levothyroxine: therapeutic use and regulatory issues related to bioequivalence.

    Science.gov (United States)

    Wartofsky, Leonard

    2002-06-01

    Levothyroxine is the overwhelming choice of clinicians for the treatment of hypothyroidism and for the suppression of goitre and thyroid nodules in selected cases. The monitoring of serum levels of thyroid stimulating hormone is necessary for appropriate dosage adjustment of levothyroxine. Levothyroxine has a narrow therapeutic index: both underdosage (subclinical hypothyroidism) and excessive dosage (subclinical hyperthyroidism) are associated with adverse symptoms and pathophysiological effects and are to be avoided. The consequent necessity for careful titration of doses has had an impact on the issue of switchability, or bioequivalence, of the various marketed levothyroxine products. In this article, the basis for concern about currently accepted standards of the FDA for pharmacological bioequivalence are examined in the context of levothyroxine. The history and status of the recent request by the FDA for a new drug application for all levothyroxine products, and its impact on the market leader Synthroid, is also discussed.

  7. [Evolution in the antibiotic susceptibility and resistance].

    Science.gov (United States)

    Stefani, S

    2009-07-01

    Over the last decade the proliferation of antibiotic-resistant pathogens has been a growing problem, especially in some geographic areas, making useless most of the classical antibiotic therapies. The rapid emergence of resistant bacteria is the result of different factors as the intrinsic microbial complexity, the growing attitude to travel of humans, animals and goods, the use of antibiotics outside hospitals, and the lack of precise therapeutic chooses for high risk group of patients. The antibiotic-resistance becomes certainly a serious problem when a resistant pathogen, and often multi-resistant today, is present in an infective site. In fact in a recent estimate of the Centre for Disease Control and Prevention (CDC) about 90.000 deaths per year in the USA are attributable to bacterial infections and in particular to resistant pathogens. It appears clear that the clinic relevance of this problem is the decimation of the sensible germs of the normal flora that leads to the upper hand of the only resistant bacteria. The antibiotic therapy, in fact, select the resistance and each bacteria has developed a particular strategy to survive: mutations of the genetic content or acquisition of resistance genes from the external. Among the Gram positive bacteria, besides methicillin resistant Staphyloccocus aureus, there are other pathogens such as coagulase-negative staphylococci (CoNS), Enterococcus faecium and Enterococcus faecalis, some species of streptococci and multiresistant Corynebacterium. The CoNS, eg. S. epidermidis, S. hominis and S. haemolyticus, are recognized as new important nosocomial pathogens and are not only responsible of invasive infections but have become in few years resistant to oxacillin (more than 60%) and multiresistant. The unsuspected fragility of glycopeptides, which for 40 years have been the most important treatment against infections due to Gram-positive bacteria, has posed the need for new antimicrobial molecules. Among the therapeutic

  8. Understanding Antibiotic Use in Minya District, Egypt: Physician and Pharmacist Prescribing and the Factors Influencing Their Practices

    OpenAIRE

    Dooling, Kathleen L.; Amr Kandeel; Hicks, Lauri A.; Waleed El-Shoubary; Khaled Fawzi; Yasser Kandeel; Ahmad Etman; Anna Leena Lohiniva; Maha Talaat

    2014-01-01

    Overuse of antibiotics has contributed to the emergence of antibiotic-resistant bacteria globally. In Egypt, patients can purchase antibiotics without a prescription, and we hypothesized frequent inappropriate antibiotic prescribing and dispensing. We interviewed physicians (n = 236) and pharmacists (n = 483) and conducted focus groups in Minya, Egypt, to assess attitudes and practices regarding antibiotic prescribing for outpatient acute respiratory infections (ARI). Antibiotics were reporte...

  9. Occurrence of Antibiotics and Emerging Contaminants in Dairy Farming

    Science.gov (United States)

    Watanabe, N.; Harter, T.; Bergamaschi, B.

    2007-12-01

    Intense animal husbandry is of growing concern as a potential contamination source of a variety of emerging contaminants including pathogens, naturally occurring and synthetic steroid hormones, and various pharmaceuticals, particularly antibiotics. For example, more than twenty million pounds of antibiotics are sold for use in animal husbandry with 95% going towards therapeutic use. Here, we focus on the application and potential environmental occurrence of pharmaceuticals and disinfectants on dairies. Recommended drug applications are available from national databases. Statistical data on actual usage, however, are not available. We complement national data with interviews and dairy visits for further evaluation of drug and chemical usage (not including pesticides used on crops and fertilizer) and an overall assessment of the potential antibiotics output in dairy waste. We find that aminoglycosides, tetracyclines, and coccidiostats make up much of the total mass of antibiotics used. On dairies using the ionophoric antibiotic monensin as feed additive, monensin makes up a large fraction of the total antibiotics use (by mass). Other chemicals of potential concern include disinfectants used to prevent mastitis, detergents used in the milking parlor, footbath reagents to prevent and treat lameness, and insecticides used to control flies and mites.

  10. A proposal to limit otoscopy to reduce unnecessary use of antibiotics: a call for research.

    Science.gov (United States)

    Spiro, David M; Welker, Melissa A; Arnold, Donald H; Meckler, Garth D

    2011-02-01

    Acute otitis media (AOM) is the most common bacterial infection in childhood, accounting for more than 10 million prescriptions written in the USA alone. Otoscopy is the only method to diagnose AOM, is difficult to perform in young children and has been found to be inaccurate. Otoscopy has certain risks, the most common of which are child discomfort, trauma to the external ear canal and parental anxiety. Current guidelines emphasize the importance of making an accurate diagnosis of AOM, which includes the presence of fever, otalgia or both. We propose a new strategy to limit the use of otoscopy to circumstances in which the pretest probability of AOM is high. We suggest indications for mandatory otoscopy and a flow chart outlining a proposal for limiting otoscopy in the management of AOM. Clinical research evaluating the rational use of otoscopy is encouraged to evaluate outcomes and acceptance of this proposal. Limiting otoscopy to clinical conditions in which the likelihood of AOM is high may reduce unnecessary pain and anxiety associated with the procedure, reduce rates of misdiagnosis and support the more judicious use of antibiotics.

  11. Removal and degradation of β-lactam antibiotics in water using didodecyldimethylammonium bromide-modified montmorillonite organoclay.

    Science.gov (United States)

    Saitoh, Tohru; Shibayama, Takayoshi

    2016-11-01

    β-Lactam antibiotics including penicillin G, nafcillin, cefazolin, cefotaxime, and oxacilline in water were rapidly removed and degraded by using didodecyldimethylammonium bromide (DDAB)-montmorillonite (MT) organoclay. Removal of antibiotics increased with increasing the amount of organoclay added and the amount of DDAB sorbed on MT. Extents of organoclay sorption of antibiotics were represented by the binding constants to DDAB molecules and correlated to the aqueous-octanol distribution coefficients. The degradation rate of β-lactam antibiotics was found to significantly increase by the organoclay sorption. Even under the mild conditions (25°C and pH 7), penicillin G (m/z=335) nearly completely (>98%) degraded into penicilloic acid (m/z=353) missing β-lactam ring within 2h. The first-order reaction rate of the primary degradation increased with increasing in temperature. The activation energy estimated from the Arrhenius plot was 49kJmol(-1) and lower than the value (83.5kJmol(-1)) in water, strongly suggesting catalytic activity of DDAB-MT organoclay. The applicability to wastewater treatment was demonstrated by using secondary effluents of municipal sewage treatment plants and synthesized hospital wastewaters. PMID:27339949

  12. Environmental pollution by antibiotics and by antibiotic resistance determinants

    International Nuclear Information System (INIS)

    Antibiotics are among the most successful drugs used for human therapy. However, since they can challenge microbial populations, they must be considered as important pollutants as well. Besides being used for human therapy, antibiotics are extensively used for animal farming and for agricultural purposes. Residues from human environments and from farms may contain antibiotics and antibiotic resistance genes that can contaminate natural environments. The clearest consequence of antibiotic release in natural environments is the selection of resistant bacteria. The same resistance genes found at clinical settings are currently disseminated among pristine ecosystems without any record of antibiotic contamination. Nevertheless, the effect of antibiotics on the biosphere is wider than this and can impact the structure and activity of environmental microbiota. Along the article, we review the impact that pollution by antibiotics or by antibiotic resistance genes may have for both human health and for the evolution of environmental microbial populations. - The article reviews the current knowledge on the effects that pollution by antibiotics and antibiotic resistance genes may have for the microbiosphere.

  13. Environmental pollution by antibiotics and by antibiotic resistance determinants

    Energy Technology Data Exchange (ETDEWEB)

    Martinez, Jose Luis, E-mail: jlmtnez@cnb.csic.e [Departamento de Biotecnologia Microbiana, Centro Nacional de Biotecnologia, Consejo Superior de Investigaciones Cientificas, Darwin 3, Cantoblanco, 28049 Madrid, and CIBERESP (Spain)

    2009-11-15

    Antibiotics are among the most successful drugs used for human therapy. However, since they can challenge microbial populations, they must be considered as important pollutants as well. Besides being used for human therapy, antibiotics are extensively used for animal farming and for agricultural purposes. Residues from human environments and from farms may contain antibiotics and antibiotic resistance genes that can contaminate natural environments. The clearest consequence of antibiotic release in natural environments is the selection of resistant bacteria. The same resistance genes found at clinical settings are currently disseminated among pristine ecosystems without any record of antibiotic contamination. Nevertheless, the effect of antibiotics on the biosphere is wider than this and can impact the structure and activity of environmental microbiota. Along the article, we review the impact that pollution by antibiotics or by antibiotic resistance genes may have for both human health and for the evolution of environmental microbial populations. - The article reviews the current knowledge on the effects that pollution by antibiotics and antibiotic resistance genes may have for the microbiosphere.

  14. Changes in patterns of antibiotic use in Chinese public hospitals (2005-2012) and a benchmark comparison with Sweden in 2012

    NARCIS (Netherlands)

    Sun, Jing; Shen, Xiao; Li, Meng; He, Liu; Guo, Shuyan; Skoog, Gunilla; Grape, Malin; Cars, Otto; Dong, Siping

    2015-01-01

    Changes in patterns of antibiotic use in Chinese hospitals before and after intensive nationwide interventions are reported and compared with Chinese national targets and antibiotic use in Swedish hospitals. Chinese data were collected quarterly and yearly from selected patient prescriptions/medical

  15. Background antibiotic resistance patterns in antibiotic-free pastured poultry production

    Science.gov (United States)

    Antibiotic resistance (AR) is a significant public health issue, and agroecosystems are often viewed as major environmental sources of antibiotic resistant foodborne pathogens. While the use of antibiotics in agroecosystems can potentially increase AR, appropriate background resistance levels in th...

  16. Phytocompounds and modulatory effects of Anacardium microcarpum (cajui on antibiotic drugs used in clinical infections

    Directory of Open Access Journals (Sweden)

    Barbosa-Filho VM

    2015-11-01

    Full Text Available Valter M Barbosa-Filho,1,2 Emily P Waczuk,2 Nadghia F Leite,3 Irwin RA Menezes,1 José GM da Costa,1 Sírleis R Lacerda,1 Isaac A Adedara,2 Henrique Douglas Melo Coutinho,4 Thais Posser,5 Jean P Kamdem2,6 1Departamento de Ciências Biológicas, Centro de Ciências Biológicas e da Saúde (CCBS, Universidade Regional do Cariri (URCA, Crato, CE, Brazil; 2Programa de Pós-Graduação em Bioquímica Toxicológica, Departamento de Bioquímica e Biologia Molecular, Universidade Federal de Santa Maria, Santa Maria, RS, Brazil; 3Departamento de Química Biológica, Centro de Ciências Biológicas e da Saúde (CCBS, 4Laboratory of Microbiology and Molecular Biology, Universidade Regional do Cariri (URCA, Crato, CE, Brazil; 5Campus São Gabriel, Universidade Federal do Pampa, São Gabriel, RS, Brazil; 6Departamento de Bioquímica, Instituto de Ciências Básica da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil Background: The challenge of antibiotic resistance and the emergence of new infections have generated considerable interest in the exploration of natural products from plant origins as combination therapy. In this context, crude ethanolic extract (CEE, ethyl acetate fraction (EAF, and methanolic fraction (MF from Anacardium microcarpum were tested alone or in combination with antibiotics (amikacin, gentamicin, ciprofloxacin, and imipenem against Escherichia coli, Pseudomonas aeruginosa, and Staphylococcus aureus. Methods: Antibiotic resistance-modifying activity was performed using the microdilution method by determining the minimal inhibitory concentration (MIC. In addition, phytochemical prospecting analyses of tested samples were carried out. Results: Our results indicated that all the extracts showed low antibacterial activity against multidrug-resistant strains (MIC =512 µg/mL. However, addition of CEE, EAF, and MF to the growth medium at the subinhibitory concentration (MIC/8=64 µg/mL significantly modulated

  17. Lysostaphin: use of a recombinant bactericidal enzyme as a mastitis therapeutic.

    Science.gov (United States)

    Oldham, E R; Daley, M J

    1991-12-01

    A recombinant mucolytic protein, lysostaphin, was evaluated as a potential intramammary therapeutic for Staphylococcus aureus mastitis in dairy cattle. Lysostaphin, a product of Staphylococcus simulans, enzymatically degrades the cell wall of Staphylococcus aureus and is bactericidal. Thirty Holstein-Freisian dairy cattle in their first lactation were infected with Staphylococcus aureus (Newbould 305, ATCC 29740) in all quarters. Infections were established and monitored for somatic cell counts and Staphylococcus aureus colony-forming units 3 wk prior to subsequent treatment. Infected animals were injected through the teat canal with a single dose of recombinant lysostaphin (dose response 1 to 500 mg) or after three successive p.m. milkings with 100 mg of recombinant lysostaphin in 60 ml of sterile phosphate-buffered saline. Animals were considered cured if the milk remained free of Staphylococcus aureus for a total of 28 milkings after last treatment. Kinetic analysis of immunologically active recombinant lysostaphin demonstrated that a minimum bactericidal concentration was maintained in the milk for up to 36 to 48 h after a single infusion of 100 mg of recombinant lysostaphin. The cure rate of quarters receiving recombinant lysostaphin (100 mg in sterile phosphate-buffered saline, administered over three consecutive p.m. milkings) was 20% compared with 29% for sodium cephapirin in saline and 57% for a commercial antibiotic formulation, respectively. An improved formulation of recombinant lysostaphin may prove to be an effective alternative to antibiotic therapy for bovine mastitis.

  18. August 2014 Phoenix pulmonary journal club: the use of macrolide antibiotics in chronic respiratory disease

    Directory of Open Access Journals (Sweden)

    Robbins RA

    2014-08-01

    Full Text Available No abstract available. Article truncated after 150 words. This month's journal club reviewed the role of macrolide antibiotics in chronic respiratory disease. Macrolide usage was suggested from observational studies in Japan in diffuse panbroncholitis, a disorder associated with chronic respiratory infection, usually Pseudomonas aeruginosa (1. Clinical improvement was noted despite doses of antibiotics well below the minimal inhibitory concentration (MIC of the antibiotic. This suggested the antibiotic was likely working by an anti-inflammatory effect. These observations were extended to cystic fibrosis (CF where prophylactic macrolide therapy in CF patients infected with Pseudomonas has become standard therapy (2. More recently, low dose macrolide therapy has been applied to non-CF lung diseases such as chronic obstructive pulmonary disease (COPD, bronchiectasis and asthma. Time did not permit a review of all studies so a representative sample was discussed. In patients with COPD, the four randomized, placebo-controlled trials reviewed all suggested that chronic therapy with macrolide antibiotics reduced COPD exacerbations (3-5. This ...

  19. An audit on the knowledge, beliefs and attitudes about the uses and side-effects of antibiotics among outpatients attending 2 teaching hospitals in Jordan.

    Science.gov (United States)

    Alzoubi, K; Al-Azzam, S; Alhusban, A; Mukattash, T; Al-Zubaidy, S; Alomari, N; Khader, Y

    2013-05-01

    This study aimedto assess general knowledge, beliefs and attitudes of people towards the use of antibiotics. Individuals referring to the outpatient pharmacies of 2 major teaching hospitals in the north of Jordan completed a self-administered, validated questionnaire. A total of 1091 individuals (56.8% males) participated in the study. Of these, 20.1% of the participants stated that antibiotics were used for bacterial infections, while 18.3% thought they were used for viral infections and 43.6% for mixed bacterial/viral infections. The average knowledge score of the participants about antibiotic uses and side-effects was low. Middle-aged participants and those with an education beyond high school had significantly higher knowledge scores about antibiotics use. Almost 75% of the participants disagreed that antibiotics could be given without a prescription.

  20. Do we need new antibiotics?

    Science.gov (United States)

    Rolain, J-M; Abat, C; Jimeno, M-T; Fournier, P-E; Raoult, D

    2016-05-01

    For several years, alarmist articles both in mass media and in the scientific community have reported an increase in antibiotic resistance, even citing an inability to treat patients infected with multidrug-resistant bacteria (MDR) responsible for high mortality worldwide. In this review we summarize and discuss the key points associated with the reality of (i) the existence of pandrug-resistant bacteria, (ii) the increase of resistance worldwide, (iii) the link between resistance and death, and (iv) the need to develop new antibiotics. Data on antibiotic resistance in Europe for the main bacteria associated with invasive infections apparently demonstrate that apart from Klebsiella pneumoniae, which is resistant to carbapenems in three countries (Romania, Italy and Greece), the level of resistance to three or more classes of antibiotics (defined as MDR phenotype) has remained low and stable over the last 5 years and that therapeutic options exist both for reference antibiotics and for old antibiotics. The clinical outcome of patients infected by MDR bacteria remains controversial and death rates attributable to MDR bacteria versus non-MDR bacteria are still debated. The arsenal of antibiotics currently available (including 'old antibiotics') suffices for facing the waves of emergence of new bacterial resistance and should be considered as a World Heritage. This heritage should be managed in a non-profit model with international regulatory approval. PMID:27021418

  1. Turmeric (Curcuma Longa Linn.) Supplementation as an Alternative to Antibiotics in Poultry Diets

    OpenAIRE

    Nanung Danar Dono

    2013-01-01

    Antibiotics have been used in non-therapeutic fashion as growth promoter for about 50 years in many parts of the world. It has been proven that supplementation of antibiotics in the diets reduces morbidity and mortality, as well as improve feed efficiency and overall growth performance of broiler chickens. However, the routine use of these antimicrobial growth promoters (AGPs) is being curtailed in view of threat to public health occurring through microflora that are developing resistance to ...

  2. Electrochemical Detection of Fluoroquinolone Antibiotics in Milk Using a Magneto Immunosensor

    Directory of Open Access Journals (Sweden)

    Daniel G. Pinacho

    2014-08-01

    Full Text Available An amperometric magneto-immunosensor (AMIS for the detection of residues of fluoroquinolone antibiotics in milk samples is described for the first time. The immunosensor presented combines magnetic beads biomodified with an antibody with a broad recognition profile of fluoroquinolones, a haptenized enzyme and a magnetic graphite–epoxy composite (m-GEC electrode. After the immunochemical reaction with specific enzyme tracer, the antibody biomodified magnetic beads are easily captured by an electrode made of graphite-epoxy composite containing a magnet, which also acts as transducer for the electrochemical detection. In spite of the complexity of milk, the use of magnetic beads allows elimination of potential interferences caused by the matrix components; hence the AMIS could perform quantitative measurements, directly in these samples, without any additional sample cleanup or extraction step. The immunosensor is able to detect up to seven different fluoroquinolones far below the MRLs defined by the UE for milk; for example ciprofloxacin is detected directly in milk with an IC50 of 0.74 µg/L and a LOD of 0.009 µg/L. This strategy offers great promise for rapid, simple, cost-effective, and on-site analysis fluoroquinolones in complex samples.

  3. Antibiotic toxicity and absorption in zebrafish using liquid chromatography-tandem mass spectrometry.

    Directory of Open Access Journals (Sweden)

    Fan Zhang

    Full Text Available Evaluation of drug toxicity is necessary for drug safety, but in vivo drug absorption is varied; therefore, a rapid, sensitive and reliable method for measuring drugs is needed. Zebrafish are acceptable drug toxicity screening models; we used these animals with a liquid chromatography-tandem mass spectrometry (LC-MS/MS method in a multiple reaction monitoring mode to quantify drug uptake in zebrafish to better estimate drug toxicity. Analytes were recovered from zebrafish homogenate by collecting supernatant. Measurements were confirmed for drugs in the range of 10-1,000 ng/mL. Four antibiotics with different polarities were tested to explore any correlation of drug polarity, absorption, and toxicity. Zebrafish at 3 days post-fertilization (dpf absorbed more drug than those at 6 h post-fertilization (hpf, and different developmental periods appeared to be differentially sensitive to the same compound. By observing abnormal embryos and LD50 values, zebrafish embryos at 6 hpf were considered to be suitable for evaluating embryotoxicity. Also, larvae at 3 dpf were adapted to measure acute drug toxicity in adult mammals. Thus, we can exploit zebrafish to study drug toxicity and can reliably quantify drug uptake with LC-MS/MS. This approach will be helpful for future studies of toxicology in zebrafish.

  4. Determining the use of prophylactic antibiotics in breast cancer surgeries: a survey of practice

    Directory of Open Access Journals (Sweden)

    Acuna Sergio A

    2012-08-01

    Full Text Available Abstract Background Prophylactic antibiotics (PAs are beneficial to breast cancer patients undergoing surgery because they prevent surgical site infection (SSI, but limited information regarding their use has been published. This study aims to determine the use of PAs prior to breast cancer surgery amongst breast surgeons in Colombia. Methods An online survey was distributed amongst the breast surgeon members of the Colombian Association of Mastology, the only breast surgery society of Colombia. The scope of the questions included demographics, clinical practice characteristics, PA prescription characteristics, and the use of PAs in common breast surgical procedures. Results The survey was distributed amongst eighty-eight breast surgeons of whom forty-seven responded (response rate: 53.4%. Forty surgeons (85.1% reported using PAs prior to surgery of which >60% used PAs during mastectomy, axillary lymph node dissection, and/or breast reconstruction. Surgeons reported they targeted the use of PAs in cases in which patients had any of the following SSI risk factors: diabetes mellitus, drains in situ, obesity, and neoadjuvant therapy. The distribution of the self-reported PA dosing regimens was as follows: single pre-operative fixed-dose (27.7%, single preoperative dose followed by a second dose if the surgery was prolonged (44.7%, single preoperative dose followed by one or more postoperative doses for >24 hours (10.6%, and single preoperative weight-adjusted dose (2.1%. Conclusion Although this group of breast surgeons is aware of the importance of PAs in breast cancer surgery there is a discrepancy in how they use it, specifically with regards to prescription and timeliness of drug administration. Our findings call for targeted quality-improvement initiatives, such as standardized national guidelines, which can provide sufficient evidence for all stakeholders and therefore facilitate best practice medicine for breast cancer surgery.

  5. Efficacy of antineoplastic treatment is associated with the use of antibiotics that modulate intestinal microbiota.

    Science.gov (United States)

    Pflug, Natali; Kluth, Sandra; Vehreschild, Jörg J; Bahlo, Jasmin; Tacke, Daniela; Biehl, Lena; Eichhorst, Barbara; Fischer, Kirsten; Cramer, Paula; Fink, Anna-Maria; von Bergwelt-Baildon, Michael; Stilgenbauer, Stephan; Hallek, Michael; Cornely, Oliver A; Vehreschild, Maria J G T

    2016-06-01

    Reduced anticancer efficacy of cyclophosphamide and platinum salts has been reported in animals treated with anti-Gram-positive antibiotics. These effects were related to translocation of Gram-positive bacteria during mucositis with subsequent induction of cytotoxic oxygen reactive species and tumor invasion by pathogenic Th17 cells. To assess these hypotheses in a clinical setting, we identified patients receiving cyclophosphamide for chronic lymphocytic leukemia (CLL) and cisplatin for relapsed lymphoma. Data originated from the CLL8 trial (NCT00281918) and the Cologne Cohort of Neutropenic Patients (NCT01821456). Relevant antibiotics were defined as compounds with primary activity against Gram-positive bacteria. We evaluated their impact on response, progression-free survival (PFS) and overall survival (OS) by Kaplan-Meier methodology and Cox proportional hazards regression analysis. Among 800 available CLL patients, those receiving anti-Gram-positive antibiotics (n = 45/800) achieved a significantly lower overall response rate (OR 74.3% vs. 90.2%, p = 0.007). Patients with anti-Gram-positive antibiotics progressed significantly earlier, had a reduced OS (median PFS 14.1 vs. 44.1 mo, p administration of anti-Gram-positive antibiotic treatment was independently associated with reduced PFS (Hazard ratio (HR) 2.090, p = 0.001) and OS (HR 2.966, p HR 2.237, p = 0.012) and OS (HR 7.831, p < 0.001). Our data supports a potential negative impact of anti-Gram-positive antibiotics on the anticancer activity of cyclophosphamide and cisplatin in a clinical setting. PMID:27471619

  6. Using cognitive behavioural therapy with complex cases: using the therapeutic relationship to change core beliefs.

    Science.gov (United States)

    Binnie, James

    2012-07-01

    Cognitive Behavioural Therapy (CBT) is often perceived as a manualised, symptom focused, surface level approach. This article aims to reflect on working with complex clinical presentations and explore how third wave CBT can be effectively integrated into standard cognitive behavioural interventions. To achieve these aims, a case study of a CBT assessment and treatment is presented. The interventions used are described in detail. The focus changes from the more traditional symptom-led interventions to third wave approaches based on the therapeutic relationship. When the focus was redirected towards the therapeutic relationship then real change occurred, quickly and powerfully. Reflections on the process are discussed and the overall approach used was evaluated with an action plan developed to enhance future clinical practice. It is hoped that this study can help CBT be viewed as a comprehensive form of psychotherapy.

  7. Relationship between level of antibiotic use and resistance among Escherichia coli isolates from integrated multi-site cohorts of humans and swine

    Science.gov (United States)

    The objective of this longitudinal ecological study was to examine the relationship between the prevalence of antibiotic-resistant (AR) commensal E. coli isolates from both monthly human wastewater and composite swine fecal samples, and the concurrent aggregated monthly antibiotic use recorded withi...

  8. Encouraging good antimicrobial prescribing practice: A review of antibiotic prescribing policies used in the South East Region of England

    Directory of Open Access Journals (Sweden)

    Mayon White Richard T

    2001-05-01

    Full Text Available Abstract Background Good prescribing practice has an important part to play in the fight against antimicrobial resistance. Whilst it was perceived that most hospitals and Health Authorities possessed an antibiotic policy, a review of antibiotic policies was conducted to gain an understanding of the extent, quality and usefulness of these policies. Methods Letters were sent to pharmacists in hospitals and health authorities in across the South East region of the National Health Service Executive (NHSE requesting antibiotic policies. data were extracted from the policies to assess four areas; antibiotic specific, condition specific, patient specific issues and underpinning evidence. Results Of a possible 41 hospital trusts and 14 health authorities, 33 trusts and 9 health authorities (HAs provided policies. Both trust and HA policies had a median publication date of 1998 (trust range 1993-99, HA 1994-99. Eleven policies were undated. The majority of policies had no supporting references for the statements made. All policies provided some details on specific antibiotics. Gentamicin and ciprofloxacin were the preferred aminoglycoside and quinolone respectively with cephalosporins being represented by cefuroxime or cefotaxime in trusts and cephradine or cephalexin in HAs. 26 trusts provided advice on surgical prophylaxis, 17 had meningococcal prophylaxis policies and 11 covered methicillin resistant Staphylococcus aureus (MRSA. There was little information for certain groups such as neonates or children, the pregnant or the elderly. Conclusion There was considerable variation in content and quality across policies, a clear lack of an evidence base and a need to revise policies in line with current recommendations.

  9. Antibiotic use among patients with febrile illness in a low malaria endemicity setting in Uganda

    DEFF Research Database (Denmark)

    Batwala, Vincent; Magnussen, Pascal; Nuwaha, Fred

    2011-01-01

    randomized to each diagnostic arm (diagnostic method in a defined group of patients). All 52,116 outpatients (presumptive 16,971; microscopy 17,508; and RDT 17,638) aged 5 months to ninety five years presenting with fever (by statement or measured) were included. Information from outpatients and laboratory...... patients who tested negative for malaria, 7809 (61.4%) were prescribed antibiotics in the RDT and 3749 (39.3%) in the microscopy arm. Overall the prescription of antibiotics was more common for children less than five years of age 5,388 (63%) compared to those five years and above 16798 (38...

  10. Use of Antibiotic Resistance Analysis To Identify Nonpoint Sources of Fecal Pollution

    OpenAIRE

    Wiggins, B A; Andrews, R. W.; Conway, R. A.; Corr, C. L.; Dobratz, E. J.; Dougherty, D. P.; Eppard, J. R.; Knupp, S. R.; Limjoco, M. C.; Mettenburg, J. M.; Rinehardt, J. M.; Sonsino, J.; Torrijos, R. L.; Zimmerman, M.E.

    1999-01-01

    A study was conducted to determine the reliability and repeatability of antibiotic resistance analysis as a method of identifying the sources of fecal pollution in surface water and groundwater. Four large sets of isolates of fecal streptococci (from 2,635 to 5,990 isolates per set) were obtained from 236 samples of human sewage and septage, cattle and poultry feces, and pristine waters. The patterns of resistance of the isolates to each of four concentrations of up to nine antibiotics were a...

  11. [Antibiotics to treat streptococcal pharyngitis in Swiss children: is it still useful?].

    Science.gov (United States)

    Verolet, Charlotte M; Posfay-Barbe, Klara M

    2016-02-17

    Group A Streptococcus (GAS) pharyngitis is a common pediatric infectious disease in school-aged children. After the detection of the bacteria in the pharynx, treatment with 10 days of antibiotics is recommended in Switzerland. The rationale to treat is based on studies from the 1950s, when the epidemiology of GAS strain was very different and the incidence of acute rheumatic fever significantly higher than today in developed countries. This article explores the current national recommendations, as well as the benefits of antibiotic treatment in the management of this infection. A reevaluation, as in other countries, of the management and treatment of GAS pharyngitis in Switzerland is considered. PMID:27039456

  12. High throughput LSPR and SERS analysis of aminoglycoside antibiotics.

    Science.gov (United States)

    McKeating, Kristy S; Couture, Maxime; Dinel, Marie-Pier; Garneau-Tsodikova, Sylvie; Masson, Jean-Francois

    2016-08-15

    Aminoglycoside antibiotics are used in the treatment of infections caused by Gram-negative bacteria, and are often dispensed only in severe cases due to their adverse side effects. Patients undergoing treatment with these antibiotics are therefore commonly subjected to therapeutic drug monitoring (TDM) to ensure a safe and effective personalised dosage. The ability to detect these antibiotics in a rapid and sensitive manner in human fluids is therefore of the utmost importance in order to provide effective monitoring of these drugs, which could potentially allow for a more widespread use of this class of antibiotics. Herein, we report on the detection of various aminoglycosides, by exploiting their ability to aggregate gold nanoparticles. The number and position of the amino groups of aminoglycoside antibiotics controlled the aggregation process. We investigated the complementary techniques of surface enhanced Raman spectroscopy (SERS) and localized surface plasmon resonance (LSPR) for dual detection of these aminoglycoside antibiotics and performed an in-depth study of the feasibility of carrying out TDM of tobramycin using a platform amenable to high throughput analysis. Herein, we also demonstrate dual detection of tobramycin using both LSPR and SERS in a single platform and within the clinically relevant concentration range needed for TDM of this particular aminoglycoside. Additionally we provide evidence that tobramycin can be detected in spiked human serum using only functionalised nanoparticles and SERS analysis. PMID:27412506

  13. Effectiveness of Nalidixic Acid and Commonly Used Antibiotics Against Pathogens of Urinary System

    Directory of Open Access Journals (Sweden)

    Keramettin Yanik

    2016-01-01

    Full Text Available Aim: Medicines for treatment Urinary tractinfections in common population are ineffective due to long usage and developing resistance. Nowadays quinolones are first choise for empiric treatment this infections. Nalidixic acid is first used quinolone type antimicrobial in this group. Because of developing resistance and side effects new quinolones have found treatment instead of nalidixic acid. For urinary system infections. In our study we aimed to compare resistance to nalidixic acid, fosfomycin and other frequently used oral antimicrobials. Material and Method: We studied 314 urine specimens from Medical Faculty Hospital%u2019s various clinic in microbiology laboratory. After 24 hours incubation the bacteria%u2019s media that cultured were examined. Bacteria were identified with conventional and automatic systems (Vitec® 2 Compact - bioMérieux, France. Antibiotic suseptibility tested were made with Cirby-Bauer method and evaluateda eccording to Clinical Laboratory Standards Institute standards. Results: 241 (79,8% E.coli, 53 (16,9% Klebsiella spp. 11 (3,5% Proteus spp. and 9 Enterobacter spp. bacteria were identified from urine samples.. All strains resistant rate belong to Enterobacteriaceae to nalidixic acid, trimethoprim-sulfamethoxazole, cefuroxime, ciprofloxacin, norfloxacin, nitrofurantoin and fosfomycin were given 42.3% 41.4 %, 32.8 %, 28.6%, 31.5 %, 14.6% 8.5 % respectively. Mostly isolated bacterial from urine was E.coli with high potency to fosfomycin with 2.9% resistance rate was followed by nitrofurantion (resistance rate 6,9%, Cefuroxime, ciprofloxacin, norfloxacin, trimethoprim-sulfamethoxazole, nalidixic acid resistance rate were 6.2%, 30.2%, %32.3, %35.3, %46.4, %46.8 in order. Discussion: As result resistance to nalidixic acide not decreased despite not being in use for a long time and were determined that fosfomycin more susceptible fortreatment urinary tract infections.

  14. Antibiotic Resistance

    DEFF Research Database (Denmark)

    Munck, Christian

    morbidity and mortality as well as an increase in the cost of treatment. Understanding how bacteria respond to antibiotic exposure gives the foundations for a rational approach to counteract antimicrobial resistance. In the work presented in this thesis, I explore the two fundamental sources...... of antimicrobial resistance: (1) adaptive mutations and (2) horizontal acquisition of resistance genes from antibiotic gene reservoirs. By studying the geno- and phenotypic changes of E. coli in response to single and drug-pair exposures, I uncover the evolutionary trajectories leading to adaptive resistance. I...... to rationally design drug combinations that limit the evolution of antibiotic resistance due to counteracting evolutionary trajectories. My results highlight that an in-depth knowledge about the genetic responses to the individual antimicrobial compounds enables the prediction of responses to drug combinations...

  15. [Prophylactic antibiotics in neurosurgery].

    Science.gov (United States)

    Iacob, G; Iacob, Simona; Cojocaru, Inimioara

    2007-01-01

    Because of a low risk of infection (around 2-3%), prophylactic use of antibiotics in neurosurgery is a controversial issue. Some neurosurgeons consider that there are strong arguments against the use of antimicrobials (promotion of antibiotic-resistant strains of bacteria, superinfection and adverse drug reactions) and meticulous aseptic techniques could be more usefully than prophylactic antibiotics. On the other hand, despite of being rare, the consequences of a neurosurgical infection can be dramatic and may result in a rapid death, caused by meningitis, cerebritis, abscess formation or sepsis. Clinical studies emphasized that the most important factors influencing the choice of antibiotic prophylaxis in neurosurgery is the patient's immune status, virulence of the pathogens and the type of surgery ("clean contaminated"--procedure that crosses the cranial sinuses, "clean non-implant"--procedure that does not cross the cranial sinuses, CSF shunt surgery, skull fracture). Prophylaxis has become the standard of care for contaminated and clean-contaminated surgery, also for surgery involving insertion of artificial devices. The antibiotic (first/second generation of cephalosporins or vancomycin in allergic patients) should recover only the cutaneous possibly contaminating flora (S. aureus, S. epidermidis) and should be administrated 30' before the surgical incision, intravenously in a single dose. Most studies pointed that identification of the risk factors for infections, correct asepsis and minimal prophylactic antibiotic regimen, help neurosurgeons to improve patient care and to decrease mortality without selecting resistant bacteria. PMID:18293694

  16. [Analysis of antibiotic usage].

    Science.gov (United States)

    Balpataki, R; Balogh, J; Zelkó, R; Vincze, Z

    2001-01-01

    Economic analysis is founded on the assumption that resources are limited and that should be used in a way that maximizes the benefits gained. Pharmacoeconomics extends these assumptions to drug treatment. Therefore, a full pharmacoeconomic analysis must consider two or more alternative treatments and should be founded on measurement of incremental cost, incremental efficacy, and the value of successful outcome. Antibiotic policy based only on administrative restrictions is failed, instead of it disease formularies and infectologist consultation system are needed. Equally important are various programmes that encourage the cost-conscious use of the antibiotics chosen. Some of the methods evaluated in the literature include: streamlining from combination therapy to a single agent, early switching from parenteral to oral therapy, initiating treatment with oral agents, administering parenteral antibiotic at home from outset of therapy, and antibiotic streamlining programmes that are partnered with infectious disease physicians. The solution is the rational and adequate use of antibiotics, based on the modern theory and practice of antibiotic policy and infection control, that cannot be carried out without the activities of experts in this field. PMID:11769090

  17. Stability of aztreonam in a portable pump reservoir used for home intravenous antibiotic treatment (HIVAT)

    NARCIS (Netherlands)

    Vinks, A A; Touw, D J; van Rossen, R C; Heijerman, H G; Bakker, W

    1996-01-01

    The stability of the monocyclic beta-lactam antibiotic aztreonam in portable pump reservoirs was studied during storage at temperatures of -20 degrees C and +5 degrees C and during drug delivery at 37 degrees C. Three 100-ml drug reservoirs and three glass containers containing 60 mg/ml aztreonam we

  18. Use of antibiotics in rural and urban regions in the Netherlands : an observational drug utilization study

    NARCIS (Netherlands)

    de Jong, Josta; Bos, Jens H. J.; de Vries, Tjalling W.; de Jong-van den Berg, Lolkje T. W.

    2014-01-01

    Background: Large livestock farms might increase the infection risk for the nearby human population because of an increased risk for disease outbreaks and because antibiotic-resistant bacteria are more likely to be present. We hypothesized that populations residing in rural areas have more contact w

  19. Vertebral endplate (modic) changes and the treatment of back pain using antibiotics

    DEFF Research Database (Denmark)

    Manniche, Claus

    2014-01-01

    Vertebral end-plate changes/modic changes are the MRI-image of inflammatory vertebral endplate damage, most often related to general disc degeneration. However, in a subgroup of patients disc infection may be the causal factor. In patients with prolonged back pain, the prevalence of modic changes......'. Most commonly, Propionibacterium acnes is involved. Long-term antibiotics may be effective....

  20. Antibiotic use among dutch pregnant woman and the development of toddler asthma : The influence of confounding

    NARCIS (Netherlands)

    Mulder, Bianca; Pouwels, Koen B.; Schuiling-Veninga, Nynke C.M.; Bos, Jens; De Vries, Tjalling W.; Jick, Susan S.; Hak, Eelko

    2014-01-01

    Background: Recent studies have reported an increased risk of asthma in children after prenatal exposure to antibiotics, notably during third trimester due to altered vaginal bacterial flora. Associations could have been influenced by unmeasured confounders. Objectives: To assess the association bet

  1. Antibiotic use during pregnancy and asthma in preschool children : the influence of confounding

    NARCIS (Netherlands)

    Mulder, B; Pouwels, K B; Schuiling-Veninga, C C M; Bos, Jens; De Vries, T. W.; Jick, S S; Hak, E

    2016-01-01

    BACKGROUND: A recent study suggested that early-life intestinal microbiota may play an important role in the development of childhood asthma,indicating that antibiotics taken during early life or in late pregnancy may be associated with childhood asthma. OBJECTIVE: This study aims to assess the asso

  2. Effect of ethnomedicinal plants used in folklore medicine in Jordan as antibiotic resistant inhibitors on Escherichia coli

    Directory of Open Access Journals (Sweden)

    Aburjai Talal A

    2010-02-01

    Full Text Available Abstract Background Escherichia coli occurs naturally in the human gut; however, certain strains that can cause infections, are becoming resistant to antibiotics. Multidrug-resistant E. coli that produce extended-spectrum β lactamases (ESBLs, such as the CTX-M enzymes, have emerged within the community setting as an important cause of urinary tract infections (UTIs and bloodstream infections may be associated with these community-onsets. This is the first report testing the antibiotic resistance-modifying activity of nineteen Jordanian plants against multidrug-resistant E. coli. Methods The susceptibility of bacterial isolates to antibiotics was tested by determining their minimum inhibitory concentrations (MICs using a broth microdilution method. Nineteen Jordanian plant extracts (Capparis spinosa L., Artemisia herba-alba Asso, Echinops polyceras Boiss., Gundelia tournefortii L, Varthemia iphionoides Boiss. & Blanche, Eruca sativa Mill., Euphorbia macroclada L., Hypericum trequetrifolium Turra, Achillea santolina L., Mentha longifolia Host, Origanum syriacum L., Phlomis brachydo(Boiss. Zohary, Teucrium polium L., Anagyris foetida L., Trigonella foenum-graecum L., Thea sinensis L., Hibiscus sabdariffa L., Lepidium sativum L., Pimpinella anisum L. were combined with antibiotics, from different classes, and the inhibitory effect of the combinations was estimated. Results Methanolic extracts of the plant materials enhanced the inhibitory effects of chloramphenicol, neomycin, doxycycline, cephalexin and nalidixic acid against both the standard strain and to a lesser extent the resistant strain of E. coli. Two edible plant extracts (Gundelia tournefortii L. and Pimpinella anisum L. generally enhanced activity against resistant strain. Some of the plant extracts like Origanum syriacum L.(Labiateae, Trigonella foenum- graecum L.(Leguminosae, Euphorbia macroclada (Euphorbiaceae and Hibiscus sabdariffa (Malvaceae did not enhance the activity of

  3. Salinomycin, a polyether ionophoric antibiotic, inhibits adipogenesis

    International Nuclear Information System (INIS)

    Highlights: ► Salinomycin inhibits preadipocyte differentiation into adipocytes. ► Salinomycin inhibits transcriptional regulation of adipogenesis. ► Pharmacological effects of salinomycin suggest toxicity in cancer therapy. -- Abstract: The polyether ionophoric antibiotics including monensin, salinomycin, and narasin, are widely used in veterinary medicine and as food additives and growth promoters in animal husbandry including poultry farming. Their effects on human health, however, are not fully understood. Recent studies showed that salinomycin is a cancer stem cell inhibitor. Since poultry consumption has risen sharply in the last three decades, we asked whether the consumption of meat tainted with growth promoting antibiotics might have effects on adipose cells. We showed in this report that the ionophoric antibiotics inhibit the differentiation of preadipocytes into adipocytes. The block of differentiation is not due to the induction of apoptosis nor the inhibition of cell proliferation. In addition, salinomycin also suppresses the transcriptional activity of the CCAAT/enhancer binding proteins and the peroxisome proliferator-activated receptor γ. These results suggest that the ionophoric antibiotics can be exploited as novel anti-obesity therapeutics and as pharmacological probes for the study of adipose biology. Further, the pharmacological effects of salinomycin could be a harbinger of its toxicity on the adipose tissue and other susceptible target cells in cancer therapy.

  4. Salinomycin, a polyether ionophoric antibiotic, inhibits adipogenesis

    Energy Technology Data Exchange (ETDEWEB)

    Szkudlarek-Mikho, Maria; Saunders, Rudel A. [Department of Medicine, Biochemistry and Cancer Biology, Center for Diabetes and Endocrine Research, College of Medicine, University of Toledo, Toledo, OH 43614 (United States); Yap, Sook Fan [Faculty of Medicine and Health Sciences, Department of Pre-Clinical Sciences, University of Tunku Abdul Rahman (Malaysia); Ngeow, Yun Fong [Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603 (Malaysia); Chin, Khew-Voon, E-mail: khew-voon.chin@utoledo.edu [Department of Medicine, Biochemistry and Cancer Biology, Center for Diabetes and Endocrine Research, College of Medicine, University of Toledo, Toledo, OH 43614 (United States)

    2012-11-30

    Highlights: Black-Right-Pointing-Pointer Salinomycin inhibits preadipocyte differentiation into adipocytes. Black-Right-Pointing-Pointer Salinomycin inhibits transcriptional regulation of adipogenesis. Black-Right-Pointing-Pointer Pharmacological effects of salinomycin suggest toxicity in cancer therapy. -- Abstract: The polyether ionophoric antibiotics including monensin, salinomycin, and narasin, are widely used in veterinary medicine and as food additives and growth promoters in animal husbandry including poultry farming. Their effects on human health, however, are not fully understood. Recent studies showed that salinomycin is a cancer stem cell inhibitor. Since poultry consumption has risen sharply in the last three decades, we asked whether the consumption of meat tainted with growth promoting antibiotics might have effects on adipose cells. We showed in this report that the ionophoric antibiotics inhibit the differentiation of preadipocytes into adipocytes. The block of differentiation is not due to the induction of apoptosis nor the inhibition of cell proliferation. In addition, salinomycin also suppresses the transcriptional activity of the CCAAT/enhancer binding proteins and the peroxisome proliferator-activated receptor {gamma}. These results suggest that the ionophoric antibiotics can be exploited as novel anti-obesity therapeutics and as pharmacological probes for the study of adipose biology. Further, the pharmacological effects of salinomycin could be a harbinger of its toxicity on the adipose tissue and other susceptible target cells in cancer therapy.

  5. New antibiotic agents for bloodstream infections.

    Science.gov (United States)

    Vergidis, Paschalis I; Falagas, Matthew E

    2008-11-01

    Infections due to multidrug-resistant pathogens have shown a dramatic worldwide increase in prevalence. Bloodstream infections (BSIs) represent an important cause of morbidity and mortality in hospitalised patients. Research in the field led to the introduction of several novel antibiotic agents in the fight against bacterial pathogens. New antibiotics used against Gram-positive bacteria, mainly meticillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci, include daptomycin, linezolid, quinupristin/dalfopristin and semisynthetic lipoglycopeptides. Among the Gram-negative bacteria, extended-spectrum beta-lactamase-producing Enterobacteriaceae as well as highly resistant Pseudomonas and Acinetobacter isolates are of particular concern. Doripenem is a recently approved carbapenem. Polymyxins are reconsidered as valuable therapeutic options for Gram-negative infections. Tigecycline, a glycylcycline, and ceftobiprole, a novel cephalosporin under investigation, have activity both against Gram-positive and Gram-negative organisms. In addition to the above agents, alternative treatment approaches that require further investigation have also been introduced into clinical practice. These include antibiotic lock therapy and continuous intravenous administration of antibiotics. In this article, we review the above treatment options for BSIs based on current clinical evidence. Comparative trials specifically focusing on patients with bacteraemia were generally not performed; however, a proportion of patients from the reported studies did have bacteraemia. PMID:18723329

  6. Evaluation of resistance of commonly used antibiotics on clinical case of Staphylococcus capitis from Assir region, Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Nazar M Abdalla

    2011-01-01

    Full Text Available Staphylococcus capitis is a coagulase-negative species (CoNS of Staphylococcus. It causes antimicrobial resistance for nosocomial infections as well as for community-acquired infections. This case report involves a 51-year-old, married Saudi patient. He got admitted to the male medical ward of Aseer Central Hospital, with severe chest infection. Clinical examination, X-ray, and laboratory investigations were performed which involved bactech, culture media, antibiotic sensitivity test using disk diffusion [minimum inhibitory concentration (MIC] and molecular [polymerase chain reaction (PCR] for detection of CoNS of Staphylococcus species and detection of the mecA gene. Laboratory data were recorded in special formats and analyzed by statistical computer program (SPSS. Results showed the resistance of isolated S. capitis to many commonly used antibiotics.

  7. The Use of Therapeutic Rituals in Substance Abuse Treatment

    OpenAIRE

    Thomas, Becky L.

    2001-01-01

    This study explored the use of rituals in substance abuse counseling. Data were obtained from a total of 25 mental health workers in the substance abuse field from the northern region of Utah. Four research questions were asked about rituals and their use in substance abuse counseling: (I) Are addictions therapists using rituals? (2) How did therapists determine when to use rituals? (3) What types of rituals do they use? and (4) How do therapists assess ritual effectiveness? Results indicated...

  8. Therapeutic Uses and Pharmacological Properties of Garlic, Shallot, and Their Biologically Active Compounds

    Directory of Open Access Journals (Sweden)

    Peyman Mikaili

    2013-10-01

    Garlic and shallots are safe and rich sources of biologically active compounds with low toxicity. Further studies are needed to confirm the safety and quality of the plants to be used by clinicians as therapeutic agents.

  9. A Comprehensive Insight into Tetracycline Resistant Bacteria and Antibiotic Resistance Genes in Activated Sludge Using Next-Generation Sequencing

    OpenAIRE

    Kailong Huang; Junying Tang; Xu-Xiang Zhang; Ke Xu; Hongqiang Ren

    2014-01-01

    In order to comprehensively investigate tetracycline resistance in activated sludge of sewage treatment plants, 454 pyrosequencing and Illumina high-throughput sequencing were used to detect potential tetracycline resistant bacteria (TRB) and antibiotic resistance genes (ARGs) in sludge cultured with different concentrations of tetracycline. Pyrosequencing of 16S rRNA gene revealed that tetracycline treatment greatly affected the bacterial community structure of the sludge. Nine genera cons...

  10. Use of Staby® technology for development and production of DNA vaccines free of antibiotic resistance gene

    OpenAIRE

    Reschner; Scohy, S.; Vandermeulen, G.; Daukandt, M.; Jacques, C; Michel, B; Nauwynck, Hans; Xhonneux, F.; Preat, V; Vanderplasschen, Alain; Szpirer, C

    2013-01-01

    The appearance of new viruses and the cost of developing certain vaccines require that new vaccination strategies now have to be developed. DNA vaccination seems to be a particularly promising method. For this application, plasmid DNA is injected into the subject (man or animal). This plasmid DNA encodes an antigen that will be expressed by the cells of the subject. In addition to the antigen, the plasmid also encodes a resistance to an antibiotic, which is used during the construction and pr...

  11. Evaluation of the functional state of the small intestine of patients using antibiotics for treatment of out-hospital pneumonia

    OpenAIRE

    Y. M. Vahrushev; N. N. Shulyateva

    2015-01-01

    Processes of hydrolysis and absorbtion in small intestine were assessed with 60 of patients using amoxicillin/ clavulanate for treatment of out-hospital pneumonia. It is established that when carrying out an antibiotikoterapiya band digestion and absorption at the kept parietal digestion is broken. Further analysis of the factors presented will allow to work out practical recommendations on prevention of side effects of antibiotics usage in small intestine.

  12. Antibiotic administration and the development of obesity in children.

    Science.gov (United States)

    Principi, Nicola; Esposito, Susanna

    2016-03-01

    Antibiotics are the most common prescription drugs administered at the paediatric age, however their administration can cause unwanted problems. Among these issues, antibiotic-induced gut microbiota dysbiosis has appeared as an emerging issue and has been associated with obesity. This problem is particularly relevant in children because they are frequently treated with antibiotics. Early development of obesity increases the risk of adult obesity, which is associated with the emergence of very severe clinical problems. Dysbiosis induced in the first periods of life can have the most relevant practical consequences because a decrease in the number of microbes and their substitution with other microbes dramatically modifies the development of the immune system as well as glucose and lipid metabolism. Unfortunately, not all of the mechanisms that could explain the relationship between gut microbiota modification and the development of obesity have been defined. Consequently, no definitive therapeutic approach has been elucidated. Probiotics and prebiotics could play a role in treating microbial dysbiosis because the addition of specific bacterial strains has been associated with normal weight and has been demonstrated to be useful in clinical conditions other than obesity that are caused by microbiota disruption. Considering that antibiotics are commonly prescribed and that obesity is increasing in paediatric patients, further studies specifically designed to evaluate how to disrupt the relationship between antibiotics and dysbiosis are urgently needed. Presently, paediatricians have to consider dysbiosis to be a new and serious reason for the judicious use of antibiotics in clinical practice.

  13. The use of antibiotics and disinfectants in the freshwater prawn (Macrobrachium rosenbergii farms of north and south 24 Parganas districts of West Bengal

    Directory of Open Access Journals (Sweden)

    Monjit Paul

    2011-01-01

    Full Text Available The freshwater prawn (Macrobrachium rosenbergii farms and hatcheries of north and south 24 Parganas districts in West Bengal were surveyed for the details of antibiotics and disinfectants used for controlling the prawn diseases and pathogens. During the survey, 4antibiotics and four 4disinfectants were found to be used commonly by the farmers during a 12-month period of study. The chemicals used in the culture systems as antibiotics or disinfectants for the culture water, tanks, other utensils, and others have serious health hazards for both the cultured prawns and human beings. The study also indicates no herbal medicines, and probiotics are being used in prawn farms.

  14. ENZYMATIC ACTIVITY AND ANTIBIOTIC RESISTANCE PROFILE OF LACTOBACILLUS PARACASEI SSP. PARACASEI-1 ISOLATED FROM REGIONAL YOGURTS OF BANGLADESH

    Directory of Open Access Journals (Sweden)

    Ummay Honi

    2013-12-01

    Full Text Available Lactobacillus paracasei ssp. paracasei-1 was identified from traditional yogurts of Khulna region, Bangladesh and its enzyme and antibiotic resistance profiles were determined. A commercially available API Zym kit was employed to determine the activities of 19 different enzymes. We found that L. paracasei ssp. paracasei-1 showed strong activities for several enzymes, viz. leucine arylamidase, valine arylamidase, napthol-AS-BI-phosphohydrolase, β-galactosidase, α –Glucosidase, N-Acetyl- β- glucosaminidase while activities for other enzymes were absent. Antibiotic resistance profile was assessed by minimum inhibitory concentration (MIC test for 61 major antibiotics and 4 antifungal agents obtained from commercial sources in MRS Agar media. The strain generally showed resistance to gram negative spectrum antibiotic while it showed susceptibility towards β-lactam antibiotic to gram positive spectrum antibiotic. The findings provide the therapeutic basis of using L. paracasei ssp. paracasei-1 in finished food products.

  15. Optimized removal of antibiotic drugs from aqueous solutions using single, double and multi-walled carbon nanotubes.

    Science.gov (United States)

    Ncibi, Mohamed Chaker; Sillanpää, Mika

    2015-11-15

    In this study, experiments were carried out to investigate the use of as-synthesized single-walled (SWCNT), double-walled (DWCNT) and multi-walled carbon nanotubes (MWCNT) agglomerates for the removal of two antibiotics, Oxytetracycline (OXY) and Ciprofloxacin (CIP) from aqueous solution. The variations of key operating parameters on the removal process were assessed in order to find out the optimum conditions. It includes exposure time, solution pH, temperature, ultrasound assistance and desorption assays. The experimental results revealed that a moderate increase in adsorption was registered between pH 3 and 7 for both antibiotics. The application of ultrasound helped enhancing the removal capacities of OXY for all tested CNTs. For the case of MWCNTs, 1h of ultrasonication increased the adsorption capacity by 44.6%. As for CIP, the ultrasonic treatment did not enhance the overall adsorption, especially for the case of DWCNTS. The Brouers-Sotolongo equation was the best fitting isotherm model. The highest removal capacities were registered using SWCNTS for both antibiotics (724 mg/g for CIP and 554 mg/g for OXY). In addition, ethanol was the solvent that induced the highest desorption percent for the case of CIP (52% for MWCNTs). However, the desorption of OXY was negligible for all solvents (maximum 3.3% for DWCNTs using ethanol). PMID:26024613

  16. Polycyclic peptide therapeutics.

    Science.gov (United States)

    Baeriswyl, Vanessa; Heinis, Christian

    2013-03-01

    Owing to their excellent binding properties, high stability, and low off-target toxicity, polycyclic peptides are an attractive molecule format for the development of therapeutics. Currently, only a handful of polycyclic peptides are used in the clinic; examples include the antibiotic vancomycin, the anticancer drugs actinomycin D and romidepsin, and the analgesic agent ziconotide. All clinically used polycyclic peptide drugs are derived from natural sources, such as soil bacteria in the case of vancomycin, actinomycin D and romidepsin, or the venom of a fish-hunting coil snail in the case of ziconotide. Unfortunately, nature provides peptide macrocyclic ligands for only a small fraction of therapeutic targets. For the generation of ligands of targets of choice, researchers have inserted artificial binding sites into natural polycyclic peptide scaffolds, such as cystine knot proteins, using rational design or directed evolution approaches. More recently, large combinatorial libraries of genetically encoded bicyclic peptides have been generated de novo and screened by phage display. In this Minireview, the properties of existing polycyclic peptide drugs are discussed and related to their interesting molecular architectures. Furthermore, technologies that allow the development of unnatural polycyclic peptide ligands are discussed. Recent application of these technologies has generated promising results, suggesting that polycyclic peptide therapeutics could potentially be developed for a broad range of diseases. PMID:23355488

  17. Effect of Special Rectification Activities of Antibiotics on The Antibiotic Use among The Inpatients%抗菌药物专项整治活动对住院患者抗菌药物应用的影响

    Institute of Scientific and Technical Information of China (English)

    王娟; 陈耀升; 冯玉凤; 王军慈

    2015-01-01

    OBJECTIVE:To investigate the effect of the special antibiotic rectification activities on antibiotic use in the inpatients and evaluate the clinical antibiotic use after policy implementation so as to provide reference for carrying out special rectification.METHODS:Retrospectively, the antibiotic use in the inpatients in our hospital from 2010 to 2014 was analyzed with consumption amount, antibiotic use density ( AUD) , rate of antibiotic use, defined daily cost ( DDC) , medication frequency ( DDDs ) , rate of preventive antibiotic use in patients undergoing type Ⅰ incision operation and rate of pathogen test as the key monitoring indicators, with inpatient antibiotic use before and after the special rectification activities evaluated.RESULTS:Over the 5 years, the rate of antibiotic use, the AUD, the DDC and other indicators showed downward trend, with the number of antibacterial drugs available down from 50 varieties (78 specifications) to 34 varieties (53 specifications), the proportion of antibiotic consumption sum in total drug consumption sum down from 27.7%to 11.3%, the rate of antibiotic use down from 89.5% to 52.1%, AUD down from 69.5 DDD/(100 person per day) to 36.2 DDD/(100 person per day) , rate of pathogen test up year by year and rate of prophylactic antibiotic use in patients undergoing typeⅠincision operation down from 85.6%to 29.7%.The rate of rational antibiotic use in terms of drug varieties in prophylactic use, delivery time and course of treatment etc was up from 11.6% to 82.5%.The choice of prophylactic antibiotic in variety and the drug delivery time were significantly improved with the special rectification activities; however, the course of treatment needs to be standardized.CONCLUSIONS:Special rectification activities on antibiotic use significantly improved the rationality in clinical antibiotic use, however, the limitations of drug varieties of antibiotics, screening of drug resistance and the importance of pathogen test of different

  18. Is the GAIN Act a turning point in new antibiotic discovery?

    Science.gov (United States)

    Brown, Eric D

    2013-03-01

    The United States GAIN (Generating Antibiotic Incentives Now) Act is a call to action for new antibiotic discovery and development that arises from a ground swell of concern over declining activity in this therapeutic area in the pharmaceutical sector. The GAIN Act aims to provide economic incentives for antibiotic drug discovery in the form of market exclusivity and accelerated drug approval processes. The legislation comes on the heels of nearly two decades of failure using the tools of modern drug discovery to find new antibiotic drugs. The lessons of failure are examined herein as are the prospects for a renewed effort in antibiotic drug discovery and development stimulated by new investments in both the public and private sector.

  19. C-reactive protein testing in patients with acute rhinosinusitis leads to a reduction in antibiotic use

    DEFF Research Database (Denmark)

    Llor, Carl; Bjerrum, Lars; Arranz, Javier;

    2012-01-01

    in the partial intervention group (PIG) underwent all the above intervention except for the workshop and they did not have access to CRP. Multilevel logistic regression analysis was performed considering the prescription of antibiotics as the dependent variable. RESULTS: Two hundred and ten physicians were...... an intervention. Two types of intervention were considered: full intervention group (FIG) consisting in individual feedback based on results from the first registry, courses in rational antibiotic prescribing, guidelines, patient information leaflets, workshops on rapid tests and use of the CRP test. GPs...... assigned to FIG and 71 to PIG. In 2009, 59 new physicians were included as a control group. Two hundred and sixty-seven GPs visited contacts with rhinosinusitis (78.5%) registering a total of 836 cases. In the group of GPs with access to CRP rapid test, 207 patients with rhinosinusitis (75.3%) were tested...

  20. Differences in antibiotic use and knowledge between adolescent and adult mothers in Ecuador [v2; ref status: indexed, http://f1000r.es/1c4

    Directory of Open Access Journals (Sweden)

    Arturo Quizhpe P

    2013-07-01

    Full Text Available Objectives: To investigate the differences in antibiotic use and knowledge between adolescent and adult mothers of children under the age of 5 years in Ecuador. Methods: A cross sectional study was performed in four health centers and hospitals. Mothers of children under five years, seeking medical attention their child's upper respiratory tract infection (URI, were included. The data was collected through interviews, using a structured questionnaire. The questionnaire covered the topics knowledge of antibiotic treatment, risk and resistance.  Results: 777 mothers were included in the study, of which 15.8% were adolescent and 84.1% adult mothers. There were significant differences in the social and economic characteristics of the mothers (p ≤ 0.05, with adolescent mothers being more likely to have an incomplete high school education and lack of basic services in their home. Significant differences between these groups were found in adherence to treatment, knowledge about risks associated with antibiotic use, and having heard of antibiotic resistance. Among the adult mothers, 83.5% reported correct adherence, 28.5% were knowledgeable about risks associated with antibiotic use, and 29.3% had heard of antibiotic resistance. Among the adolescent mothers, these numbers were 75.4%, 15.0%, and 19.8%, respectively. Conclusions: To develop successful interventions, it is crucial to understand the factors causing differences in antibiotic use and knowledge between mothers.

  1. Therapeutic Uses of Oral History Techniques in Medicine.

    Science.gov (United States)

    Harris, Raymond; Harris, Sara

    1981-01-01

    Use of the oral history technique in clinical medicine supplies significant additional data that illuminate the psychological, social, and spiritual background of healthy or ailing aging patients. Describes some practical applications of oral history techniques in clinical medical practice and discusses their usefulness for gerontological…

  2. Hypnotherapy: A Useful Adjunctive Therapeutic Modality in Hansen's Disease.

    Science.gov (United States)

    Abdul Latheef, En; Riyaz, Najeeba

    2014-03-01

    Hypnotherapy is a useful adjunctive psychotherapeutic procedure used in various conditions such as pain disorders, atopic dermatitis, and alopecia areata. However, it is less utilized in the field of dermatology. Only limited data exist on its role in the management of various skin diseases. There is dearth of literature on the role of hypnotherapy in Hansen's disease (HD). We report two cases of HD, one with very resistant neuralgia and the other with recurrent erythema nodosum leprosum (ENL). Both the patients were assessed using hospital anxiety and depression scale, dermatology life quality index and the neuralgia was assessed using the visual analog scale. Three sessions of hypnotherapy were given to both the patients. There was dramatic improvement in the incidence of ENL and neuralgia and we could rapidly reduce the dose of drugs used for both conditions. PMID:24700936

  3. Monitoring of biogenic amines and drugs of various therapeutic groups in urine samples with use of HPLC.

    Science.gov (United States)

    Baranowska, Irena; Płonka, Joanna

    2016-04-01

    A high-performance liquid chromatography method for simultaneous separation and determination of biogenic amines [dopamine, epinephrine, serotonin and its six metabolites (normetanephrine, metanephrine, 3,4-dihydroxyphenylacetic acid, 4-hydroxy-3-methoxyphenylglycol, homovanilic acid and 5-hydroxyindoloacetic acid)] with drugs from different therapeutically groups [analgesics (paracetamol, metamizol), diuretics (furosemide) and antibiotics (cefazolin, fluconazole)] was developed. A chromatographic column with pre-column with octadecylsilane phase (C18e ) and two detectors - diode array serial connected and fluorescence - was used. Gradient elution of mixture of acetate buffer (pH 4.66) and methanol as a mobile phase was applied. The limit of detection (LOD) of 8-10 ng/mL and limit of quantitation (LOQ) of 24-30 ng/mL for biogenic amines, as well as the LOD of 50-100 ng/mL and the LOQ of 150-300 ng/mL for drugs, were determined. The applied sample preparation method allowed recoveries of 93% for the biogenic amines and 92% for the drugs to be achieved. The developed procedure has been applied to simultaneous determination of the examined compounds in urine samples and could be used in clinical analysis. PMID:26362402

  4. Antibiotic prevention of postcataract endophthalmitis

    DEFF Research Database (Denmark)

    Kessel, Line; Flesner, Per; Andresen, Jens;

    2015-01-01

    Endophthalmitis is one of the most feared complications after cataract surgery. The aim of this systematic review was to evaluate the effect of intracameral and topical antibiotics on the prevention of endophthalmitis after cataract surgery. A systematic literature review in the MEDLINE, CINAHL......, Cochrane Library and EMBASE databases revealed one randomized trial and 17 observational studies concerning the prophylactic effect of intracameral antibiotic administration on the rate of endophthalmitis after cataract surgery. The effect of topical antibiotics on endophthalmitis rate was reported by one...... with the use of intracameral antibiotic administration of cefazolin, cefuroxime and moxifloxacin, whereas no effect was found with the use of topical antibiotics or intracameral vancomycin. Endophthalmitis occurred on average in one of 2855 surgeries when intracameral antibiotics were used compared to one...

  5. [Therapeutic use of stem cells. II. Adult stem cells].

    Science.gov (United States)

    Uzan, Georges

    2004-09-30

    Many degenerative diseases are not curable by means of classical medicine. The long term objective of cell therapy is to treat the patients with their own stem cells that could be either purified from the diseased organ or from "reservoirs" of stem cells such as that constituted by the bone marrow. The existence of stem cells in the organs or reservoirs is now established in vitro and in some cases, in animal models. Numbers of technical problems linked to the scarcity of these cells still delay the clinical use of purified stem cells. However, clinical protocols using heterogeneous cell populations have already started to treat a growing number of diseases. In some case, autologous cells can be used, as it is the case for bone marrow transplantation in blood diseases. Mesenchymal cells, also purified from the bone marrow are currently used in orthopaedic diseases. Because these cells reveal a broad differentiation potential, active research programs explore their possible use for treatment of other diseases. Bone marrow also contains vascular stem cells that could be active in reappearing defective vessels responsible for ischaemic diseases. Indeed, clinical trials in which bone marrow cells are injected in the cardiac muscle of patients with myocardial infarction or in the leg muscle (gastrocnemius) of patients with hind limb ischaemia have already started. Artificial skin prepared from skin biopsies is used for the reconstitution of the derma of severely burned patients. Clinical trials have also started, using allogenic cells. The patients must be treated by immunosuppressive drugs. Neurodegenerative diseases such as Parkinson have been successfully treated by intra-cerebral injection of foetal neurones. Pancreatic islets implanted in the liver have shown to re-establish a normal glycaemia in diabetic patients. However, all these clinical trials use differentiated cells or at least progenitors which display differentiation potential and lifetime much more

  6. Measurement of dose distributions using film in therapeutic electron beams

    International Nuclear Information System (INIS)

    The feasibility of using film dosimetry data as the input data for patient treatment planning was evaluated. The central-axis depth dose and the off-axis ratios obtained from film measurements in a solid phantom were compared with those of ion-chamber measurements in water. Two techniques were used to generate isodose distributions. The first technique used only the film data, i.e., the central-axis depth dose and the off-axis ratios used for the reconstruction were determined from the film optical density (corrected for film nonlinearity). In the second technique, the central-axis depth dose measured by an ion chamber in a water phantom was combined with the off-axis ratios measured using film in the ''solid water'' phantom. The resulting isodose distributions from both techniques were compared with the ion-chamber measurements in water for 7-, 12-, and 18-MeV electrons, and the second technique showed better agreement with the ion-chamber measurements than did the first technique. The differences were within a clinically acceptable range

  7. Public Knowledge and Attitudes Regarding the Use of Antibiotics and Resistance: Findings from a Cross-Sectional Study Among Palestinian Adults.

    Science.gov (United States)

    Abu Taha, A; Abu-Zaydeh, A H; Ardah, R A; Al-Jabi, S W; Sweileh, W M; Awang, R; Zyoud, S H

    2016-09-01

    Antibiotics are considered to be among the most commonly sold drug classes in Palestine. Resistance to antibiotics has increased for reasons relating to the use and misuse of antibiotics. The aim of this study was to evaluate the knowledge, and attitudes regarding antibiotic use and awareness about resistance among adults visiting the emergency departments at hospitals in North Palestine. A self-administered cross-sectional questionnaire survey involving participants aged 18 or over was conducted from June 2012 to February 2013. Adults who visited the emergency departments at hospitals in North Palestine were included. Demographic characteristics, knowledge and attitudes towards antibiotic use were included in the questionnaire. Poor and good knowledge were defined as a total knowledge score of 0-7 and 8-15 of 15 questions, respectively. Attitude scores of 0-3 and 4-7 of 7 questions were considered poor and good, respectively. A total of 375 questionnaires were included in the study. A response rate of 83.3% was attained. About 55.0% of the participants had a good knowledge and 56.5% had a good attitude towards rational antibiotic use. A significant positive correlation was shown between participants' knowledge scores and participants' attitude scores towards antibiotic use (R = 0.344, P = 0.001. Participants with a high family income were more likely to be aware of appropriate antibiotic use than participants with a low family income (P-value awareness about the health and economic hazards of antibiotic resistance are also required. PMID:26752329

  8. [Therapeutic use of fresh plasma and "virus-safe" plasma].

    Science.gov (United States)

    Seyfert, U T; Lorenz, C; Espig, J; Heinrich, H; Grund, S; Rupp, K H; Wenzel, E

    1991-01-01

    The use of plasma and factor concentrates for the treatment of coagulation disorders is well established, but many questions remain. The indications for fresh frozen plasma are still not clearly established and excessive use is rampant. The safety of all blood products has not yet been firmly established. Peer review of transfusion practice in a hospital can be achieved by a Hospital Transfusion Committee. The review and analysis of the statistical reports of the transfusion service and strategies for enhancing quality of patient care will be presented.

  9. Probiotics reduce symptoms of antibiotic use in a hospital setting: a randomized dose response study.

    Science.gov (United States)

    Ouwehand, Arthur C; DongLian, Cai; Weijian, Xu; Stewart, Morgan; Ni, Jiayi; Stewart, Tad; Miller, Larry E

    2014-01-16

    Probiotics are known to reduce antibiotic associated diarrhea (AAD) and Clostridium difficile associated diarrhea (CDAD) risk in a strain-specific manner. The aim of this study was to determine the dose-response effect of a four strain probiotic combination (HOWARU(®) Restore) on the incidence of AAD and CDAD and severity of gastrointestinal symptoms in adult in-patients requiring antibiotic therapy. Patients (n=503) were randomized among three study groups: HOWARU(®) Restore probiotic 1.70×10(10) CFU (high-dose, n=168), HOWARU(®) Restore probiotic 4.17×10(9) CFU (low-dose, n=168), or placebo (n=167). Subjects were stratified by gender, age, and duration of antibiotic treatment. Study products were administered daily up to 7 days after the final antibiotic dose. The primary endpoint of the study was the incidence of AAD. Secondary endpoints included incidence of CDAD, diarrhea duration, stools per day, bloody stools, fever, abdominal cramping, and bloating. A significant dose-response effect on AAD was observed with incidences of 12.5, 19.6, and 24.6% with high-dose, low-dose, and placebo, respectively (p=0.02). CDAD was the same in both probiotic groups (1.8%) but different from the placebo group (4.8%; p=0.04). Incidences of fever, abdominal pain, and bloating were lower with increasing probiotic dose. The number of daily liquid stools and average duration of diarrhea decreased with higher probiotic dosage. The tested four strain probiotic combination appears to lower the risk of AAD, CDAD, and gastrointestinal symptoms in a dose-dependent manner in adult in-patients.

  10. [Health economics and antibiotic therapy].

    Science.gov (United States)

    Leclercq, P; Bigdéli, M

    1995-01-01

    In the field of antibiotic therapy, particularly the methods of economic evaluation hold one's attention within the wide range of health economics' applications. Several tools allow a comparison of the outcomes of alternative strategies and thereby guide choices to the most appropriate solutions. After a brief recall of the methods classically used to evaluate health care strategy, the authors stress the importance and difficulty of fixing and applying a correct and satisfactory procedure for evaluation. An evaluation example of antibiotic therapy allows to illustrate the application of the principles confronting a field in which competition is intense and economic stakes stay large--a fact which naturally yields to seek after objective decision making criteria. The health care policies drawn by public authorities as well as the marketing strategies of the health sector trade are partly based on such evaluations. If these techniques are not intended for the practitioner in the first place, they should not be indifferent to him since they influence health authorities and thereby indirectly affect the therapeutic freedom of the physician. PMID:7481251

  11. Situation Songs - Therapeutic Intentions and Use in Music Therapy with Children

    OpenAIRE

    Agnes Kolar-Borsky; Ulla Holck

    2014-01-01

    The aim of this study was to survey the various therapeutic intentions behind the use of one particular improvisation method applied in pediatric music therapy, called the situation song (from the German term “Situationslied”- Plahl & Koch-Temming, 2008, p. 180). According to Plahl & Koch-Temming the term situation song describes an improvised song, which is sung by the therapist or/and the child and which relates to the actual occurrence and the therapeutic relationship. The presented study ...

  12. Contemporary Indications and Therapeutic Implications for Digoxin Use

    NARCIS (Netherlands)

    M.K. Mittal; P. Chockalingam; A. Chockalingam

    2011-01-01

    Heart failure (HF) is a leading cause of morbidity and mortality. Appropriate medical therapy using angiotensin converting enzyme inhibitors and beta-blockers improves outcomes in HF, whereas the role of digoxin is still not clearly defined. Digoxin is currently recommended for patients with HF who

  13. Pharmacology of tetrandrine and its therapeutic use in digestive diseases

    Institute of Scientific and Technical Information of China (English)

    Ding-Guo Li; Zhi-Rong Wang; Han-Ming Lu

    2001-01-01

    @@ INTRODUCTION Tetrandrine (Tet) is a dibenzylisoquinoline alkaloid isolatedfrom Stephania tetrandra S. Moore, a Chinese herbalmedicine. In the past decade, lots of studies demonstrated that Tet has multiple bioactivities, It is promising to use Tet as an antifibrogenetic in liver or lung fibrosis with or without portal or pulmonary hypertension, as well as an immunomodulating and anticarcinoma drug.

  14. Therapeutic manuka honey: no longer so alternative

    OpenAIRE

    Dee A Carter; Blair, Shona E.; Nural eCokcetin; Daniel eBouzo; Peter eBrooks; Schlothauer, Ralf C.; Elizabeth J. Harry

    2016-01-01

    Medicinal honey research is undergoing a substantial renaissance. From a folklore remedy largely dismissed by mainstream medicine as alternative, we now see increased interest by scientists, clinical practitioners and the general public in the therapeutic uses of honey. There are a number of drivers of this interest: first, the rise in antibiotic resistance by many bacterial pathogens has prompted interest in developing and using novel antibacterials; second, an increasing number of reliabl...

  15. Therapeutic Manuka Honey: No Longer So Alternative

    OpenAIRE

    Dee A Carter; Blair, Shona E.; Cokcetin, Nural N.; Bouzo, Daniel; Brooks, Peter; Schothauer, Ralf; Elizabeth J. Harry

    2016-01-01

    Medicinal honey research is undergoing a substantial renaissance. From a folklore remedy largely dismissed by mainstream medicine as “alternative”, we now see increased interest by scientists, clinical practitioners and the general public in the therapeutic uses of honey. There are a number of drivers of this interest: first, the rise in antibiotic resistance by many bacterial pathogens has prompted interest in developing and using novel antibacterials; second, an increasing number of reliabl...

  16. Therapeutic Uses of Stem Cells in Endocrinology- Review Article

    OpenAIRE

    Ensieh NASLI ESFAHANI; Ghavamzadeh, Ardeshir; Larijani, Bagher

    2015-01-01

    Background: Because of the ability of proliferation, regeneration, conversion to differentiated cells and tissue producing, stem cell therapy has important clinical implications for treatment of different diseases. In this chapter we discuss different kinds of stem cells that have been used in treatment of neurologic diseases, gastrointestinal diseases, heart diseases, bone disease, kidney disease, chronic wounds, graft versus heart disease, sepsis and respiratory diseases. Then we will discu...

  17. Endoscopic Therapeutic Device Using Focused Ultrasonic Small Transducer

    Science.gov (United States)

    Yasui, Akihiro; Haga, Yoichi; Chen, Jiun-Jie; Iseki, Hiroshi; Esashi, Masayoshi; Wada, Hiroshi

    In this research, an ultrasonic probe (5.5 mm in diameter), which has a concave PZT transducer at its tip, was fabricated for ultrasonic treatments such as sonoporation and sonodynamic therapy in the human body using a catheter and/or endoscope. Ultrasound has the potential to enhance cytotoxicity of drugs such as porphyrins, a process referred to as sonodynamic therapy, and also to deliver macromolecules such as plasmid DNA, a process referred to as sonoporation. The fabricated probe was then experimentally characterized by measuring the acoustic intensity distribution around the focal point, using a PVDF needle-type ultrasonic hydrophone. When the PZT transducer was driven by a 120 Volts peak-to-peak AC signal at 1.83 MHz, the ultrasound output was successfully focused at the focal point, with a peak intensity of 24.9 W/cm2 (0.87 MPa). Using the fabricated probe, cultured Chinese Hamster Ovary (CHO) cells were exposed to ultrasound (1.83 MHz, continuous wave, peak acoustic pressure of 0.5 MPa) for 2 s in the presence of microbubbles MB-3 and Green Fluorescent Protein (GFP) plasmid DNA. As a result of sonication, the expression of GFP was observed in CHO cells.

  18. Isolation of Environmental Bacteria from Surface and Drinking Water in Mafikeng, South Africa, and Characterization Using Their Antibiotic Resistance Profiles

    Directory of Open Access Journals (Sweden)

    Suma George Mulamattathil

    2014-01-01

    Full Text Available The aim of this study was to isolate and identify environmental bacteria from various raw water sources as well as the drinking water distributions system in Mafikeng, South Africa, and to determine their antibiotic resistance profiles. Water samples from five different sites (raw and drinking water were analysed for the presence of faecal indicator bacteria as well as Aeromonas and Pseudomonas species. Faecal and total coliforms were detected in summer in the treated water samples from the Modimola dam and in the mixed water samples, with Pseudomonas spp. being the most prevalent organism. The most prevalent multiple antibiotic resistance phenotype observed was KF-AP-C-E-OT-K-TM-A. All organisms tested were resistant to erythromycin, trimethoprim, and amoxicillin. All isolates were susceptible to ciprofloxacin and faecal coliforms and Pseudomonas spp. to neomycin and streptomycin. Cluster analysis based on inhibition zone diameter data suggests that the isolates had similar chemical exposure histories. Isolates were identified using gyrB, toxA, ecfX, aerA, and hylH gene fragments and gyrB, ecfX, and hylH fragments were amplified. These results demonstrate that (i the drinking water from Mafikeng contains various bacterial species and at times faecal and total coliforms. (ii The various bacteria are resistant to various classes of antibiotics.

  19. Pharmacist-managed dose adjustment feedback using therapeutic drug monitoring of vancomycin was useful for patients with methicillin-resistant Staphylococcus aureus infections: a single institution experience

    Science.gov (United States)

    Hirano, Ryuichi; Sakamoto, Yuichi; Kitazawa, Junichi; Yamamoto, Shoji; Tachibana, Naoki

    2016-01-01

    Background Vancomycin (VCM) requires dose adjustment based on therapeutic drug monitoring. At Aomori Prefectural Central Hospital, physicians carried out VCM therapeutic drug monitoring based on their experience, because pharmacists did not participate in the dose adjustment. We evaluated the impact of an Antimicrobial Stewardship Program (ASP) on attaining target VCM trough concentrations and pharmacokinetics (PK)/pharmacodynamics (PD) parameters in patients with methicillin-resistant Staphylococcus aureus (MRSA) infections. Materials and methods The ASP was introduced in April 2012. We implemented a prospective audit of prescribed VCM dosages and provided feedback based on measured VCM trough concentrations. In a retrospective pre- and postcomparison study from April 2007 to December 2011 (preimplementation) and from April 2012 to December 2014 (postimplementation), 79 patients were treated for MRSA infection with VCM, and trough concentrations were monitored (pre, n=28; post, n=51). In 65 patients (pre, n=15; post, n=50), 24-hour area under the concentration–time curve (AUC 0–24 h)/minimum inhibitory concentration (MIC) ratios were calculated. Results Pharmacist feedback, which included recommendations for changing dose or using alternative anti-MRSA antibiotics, was highly accepted during postimplementation (88%, 29/33). The number of patients with serum VCM concentrations within the therapeutic range (10–20 μg/mL) was significantly higher during postimplementation (84%, 43/51) than during preimplementation (39%, 11/28) (P400) was significantly higher during postimplementation (84%, 42/50) than during preimplementation (53%, 8/15; P=0.013). There were no significant differences in nephrotoxicity or mortality rate. Conclusion Our ASP increased the percentage of patients that attained optimal VCM trough concentrations and PK/PD parameters, which contributed to the appropriate use of VCM in patients with MRSA infections. PMID:27789965

  20. Cryopreservation of hematopoietic stem/progenitor cells for therapeutic use.

    Science.gov (United States)

    Watt, Suzanne M; Austin, Eric; Armitage, Sue

    2007-01-01

    To date, more than 25,000 hematopoietic transplants have been carried out across Europe for hematological disorders, the majority being for hematological malignancies. At least 70% of these are autologous transplants, the remaining 30% being allogeneic, which are sourced from related (70% of the allogeneic) or unrelated donors. Peripheral blood mobilized with granulocyte colony stimulating factor is the major source of stem cells for transplantation, being used in approx 95% of autologous transplants and in approx 65% of allogeneic transplants. Other cell sources used for transplantation are bone marrow and umbilical cord blood. One crucial advance in the treatment of these disorders has been the development of the ability to cryopreserve hematopoietic stem cells for future transplantation. For bone marrow and mobilized peripheral blood, the majority of cryopreserved harvests come from autologous collections that are stored prior to a planned infusion following further treatment of the patient or at the time of a subsequent relapse. Other autologous harvests are stored as backup or "rainy day" harvests, the former specifically being intended to rescue patients who develop graft failure following an allogeneic transplant or who may require this transplant at a later date. Allogeneic bone marrow and mobilized peripheral blood are less often cryopreserved than autologous harvests. This is in contrast to umbilical cord blood that may be banked for directed or sibling (related) hematopoietic stem cell transplants, for allogeneic unrelated donations, and for autologous donations. Allogeneic unrelated donations are of particular use for providing a source of hematopoietic stem cells for ethnic minorities, patients with rare human leukocyte antigen types, or where the patient urgently requires a transplant and cannot wait for the weeks to months required to prepare a bone marrow donor. There are currently more than 200,000 banked umbilical cord blood units registered with

  1. Therapeutic use of sport climbing for patients with multiple sclerosis

    Directory of Open Access Journals (Sweden)

    Ana Ožura

    2009-05-01

    Full Text Available Sport climbing is a form of exercise that requires complex and variable movement. Because of the use of the so-called "top-rope system", this is a safe activity appropriate for individuals with physical disabilities. Therefore, climbing might prove to be an effective form of therapy for patients with multiple sclerosis. Multiple sclerosis is a chronic neurological disease that may include motor and cognitive deficits as well as affective disturbances. The illness is characterized by multifocal areas of brain damage (plaques, as consequence of autoimmune inflammation. Sport climbing might be a potentially useful activity for treating spasticity, improving a person's self image and certain aspects of cognition, such as attention and executive functions, as well as for managing emotional disturbances. All of the above are areas where patients with multiple sclerosis might be in need of assistance. The article also describes the experience of a patient with multiple sclerosis who was enrolled in our climbing program. Future research is needed to evaluate the effect of climbing therapy for patients with multiple sclerosis.

  2. Application of a liquid chromatographic procedure for the analysis of penicillin antibiotics in biological fluids and pharmaceutical formulations using sodium dodecyl sulphate/propanol mobile phases and direct injection.

    Science.gov (United States)

    Rambla-Alegre, Maria; Martí-Centelles, Rosa; Esteve-Romero, Josep; Carda-Broch, Samuel

    2011-07-29

    A direct injection liquid chromatography procedure was developed for the simultaneous determination of four penicillin antibiotics (amoxicillin, ampicillin, cloxacillin and dicloxacillin) in pharmaceutical formulations and physiological fluids (urine) using hybrid micellar mobile phases. These antimicrobials are used to treat gastrointestinal and systemic infections. The four penicillins were analysed using a Zorbax C18 reversed-phase column and detected at 210 nm. These antibiotics were separated by an interpretive optimisation procedure based on the accurate description of the retention and shape of the chromatographic peaks. Antibiotics were eluted in less than 16 min with no interference by the urine protein band or endogenous compounds using the mobile phase 0.11 M sodium dodecyl sulphate-6% propanol-0.01 M NaH(2)PO(4) buffered at pH 3. The method was validated according to the Food and Drug Administration guideline, including analytical parameters such as linearity (R(2)>0.993), intra- and inter-day precisions (RSD, %: 0.1-4.4 and 1.2-5.9, respectively), and robustness for the four compounds. This method is sensitive enough for the routine analysis of penicillins at therapeutic urine levels, with limits of detection in the 1.5-15 ng mL(-1) range and limits of quantification of 50 ng mL(-1). Recoveries in a micellar medium and a spiked urine matrix were in the 92.4-108.2% and 96-110% ranges, respectively. Finally, the method was successfully applied to determine these antibiotics in urine samples and pharmaceutical formulations. PMID:21190691

  3. Simultaneous Determination of Eight β-Lactam Antibiotics, Amoxicillin, Cefazolin, Cefepime, Cefotaxime, Ceftazidime, Cloxacillin, Oxacillin, and Piperacillin, in Human Plasma by Using Ultra-High-Performance Liquid Chromatography with Ultraviolet Detection.

    Science.gov (United States)

    Legrand, Tiphaine; Vodovar, Dominique; Tournier, Nicolas; Khoudour, Nihel; Hulin, Anne

    2016-08-01

    A simple and rapid ultra-high-performance liquid chromatography (UHPLC) method using UV detection was developed for the simultaneous determination of eight β-lactam antibiotics in human plasma, including four penicillins, amoxicillin (AMX), cloxacillin (CLX), oxacillin (OXA), and piperacillin (PIP), and four cephalosporins, cefazolin (CFZ), cefepime (FEP), cefotaxime (CTX), and ceftazidime (CAZ). One hundred-microliter samples were spiked with thiopental as an internal standard, and proteins were precipitated by acetonitrile containing 0.1% formic acid. Separation was achieved on a pentafluorophenyl (PFP) column with a mobile phase composed of phosphoric acid (10 mM) and acetonitrile in gradient elution mode at a flow rate of 500 μl/min. Detection was performed at 230 nm for AMX, CLX, OXA, and PIP and 260 nm for CFZ, FEP, CTX, and CAZ. The total analysis time did not exceed 13 min. The method was found to be linear at concentrations ranging from 2 to 100 mg/liter for each compound, and all validation parameters fulfilled international requirements. Between- and within-run accuracy errors ranged from -5.2% to 11.4%, and precision was lower than 14.2%. This simple method requires small-volume samples and can easily be implemented in most clinical laboratories to promote the therapeutic drug monitoring of β-lactam antibiotics. The simultaneous determination of several antibiotics considerably reduces the time to results for clinicians, which may improve treatment efficiency, especially in critically ill patients. PMID:27216076

  4. Misuse of antibiotics reserved for hospital settings in outpatients: a prospective clinical audit in a university hospital in Southern France.

    Science.gov (United States)

    Roche, Manon; Bornet, Charléric; Monges, Philippe; Stein, Andreas; Gensollen, Sophie; Seng, Piseth

    2016-07-01

    Some antibiotics are reserved essentially for hospital settings owing to cost effectiveness and in order to fight the emerging antibiotic resistance crisis. In some cases, antibiotics reserved exclusively for use in hospitals may be prescribed in outpatients for serious infections or in the absence of a therapeutic alternative. A 30-day prospective audit of outpatient prescriptions of antibiotics reserved exclusively for use in hospitals was performed. The objective of this study was to evaluate the relevance of outpatient antibiotic prescriptions by measuring appropriateness according to guidelines. During the study period, 53 prescriptions were included, only 40% of which were appropriate. Among the 32 inappropriate prescriptions, 4 cases lacked microbial arguments, 1 case was not adequate for the infection type, 1 case involved an incorrect antibiotic dosage, 1 case involved an incorrect interval of dose administration, 3 cases had a therapeutic alternative and 22 cases were not recommended. Of the 53 prescriptions, 66% were started in hospital and 34% in outpatients. Only 25% of cases were prescribed with infectious diseases specialist (IDS) advice, 64% were based on microbiological documentation and 13% had a negative bacterial culture. Inappropriate prescriptions were usually observed in antibiotic lock therapy, skin infections, Clostridium difficile colitis, intra-abdominal infections and intravascular catheter-related infections. Outpatient prescriptions of antimicrobial drugs reserved exclusively for use in hospitals are frequently inappropriate. We recommend a real-time analysis algorithm with the involvement of an IDS for monitoring prescriptions to improve the quality of these prescriptions and possibly to prevent antibiotic resistance. PMID:27234677

  5. Treatment for infections complications of experimental acute radiation sickness with sulacillin, a combined antibiotic

    International Nuclear Information System (INIS)

    The therapeutic efficiency of sulacillin (combination of ampicillin antibiotic with beta-lactamase sulbactam inhibitor) used for prevention and treatment of infections complications of the acute radiation disease (ARD) is considered. It is shown that sulacillin antiinfections effect essentially exceeds the activity of ampicillin by treatment of irradiated mice infected with a beta-lactamase-producing strain of Kl pneumoniae. Inclusion of the sulacillin as a principal antibiotic into the ARD therapeutic scheme provides for the 66.6 % survival of dogs at LD90/45

  6. Are There Differences in Antibiotic Use Between the Recent-Immigrants from Mainland China and the Local-Born in Hong Kong?

    Science.gov (United States)

    Wun, Yuk Tsan; Lam, Tai Pong; Lam, Kwok Fai; Ho, Pak Leung; Yung, Wai Hung Raymond

    2015-08-01

    Immigrants, especially the first-generation, were thought to have different knowledge, attitudes and practice (KAP) with antibiotics. Doctors often perceived extra pressure from them to prescribe antibiotics. To test these perceptions, we studied the difference in KAP with antibiotics between the recent-immigrants from mainland China and the local-born of Hong Kong-places with significantly different healthcare and socio-economic systems. Focus groups (including one specific group of recent-immigrants) with 56 participants and territory-wide telephone questionnaire survey with 2,471 randomly selected respondents. Recent-immigrants shared similar KAP with the local-born. After adjustment for age, sex and education, the main significant difference was the new-immigrants' behaviour of acquiring antibiotics without prescription and keeping the leftover. They, like the local-born, preferred doctors who prescribed antibiotics cautiously. Immigration status could be the surrogate for age, sex and education in the KAP with antibiotics. For antibiotic use, health education and patient care could be similar between the recent-immigrants and the local-born. PMID:24969039

  7. Shift in antibiotic prescribing patterns in relation to antibiotic expenditure in paediatrics

    NARCIS (Netherlands)

    Kimpen, JLL; van Houten, M.A.

    1998-01-01

    In paediatrics, antibiotics are among the most commonly prescribed drugs. Because of an overall rise in health care costs, lack of uniformity in drug prescribing and the emergence of antibiotic resistance, monitoring and control of antibiotic use is of growing concern and strict antibiotic policies

  8. New Algorithm for Managing Childhood Illness Using Mobile Technology (ALMANACH: A Controlled Non-Inferiority Study on Clinical Outcome and Antibiotic Use in Tanzania.

    Directory of Open Access Journals (Sweden)

    Amani Flexson Shao

    Full Text Available The decline of malaria and scale-up of rapid diagnostic tests calls for a revision of IMCI. A new algorithm (ALMANACH running on mobile technology was developed based on the latest evidence. The objective was to ensure that ALMANACH was safe, while keeping a low rate of antibiotic prescription.Consecutive children aged 2-59 months with acute illness were managed using ALMANACH (2 intervention facilities, or standard practice (2 control facilities in Tanzania. Primary outcomes were proportion of children cured at day 7 and who received antibiotics on day 0.130/842 (15∙4% in ALMANACH and 241/623 (38∙7% in control arm were diagnosed with an infection in need for antibiotic, while 3∙8% and 9∙6% had malaria. 815/838 (97∙3%;96∙1-98.4% were cured at D7 using ALMANACH versus 573/623 (92∙0%;89∙8-94∙1% using standard practice (p<0∙001. Of 23 children not cured at D7 using ALMANACH, 44% had skin problems, 30% pneumonia, 26% upper respiratory infection and 13% likely viral infection at D0. Secondary hospitalization occurred for one child using ALMANACH and one who eventually died using standard practice. At D0, antibiotics were prescribed to 15∙4% (12∙9-17∙9% using ALMANACH versus 84∙3% (81∙4-87∙1% using standard practice (p<0∙001. 2∙3% (1∙3-3.3 versus 3∙2% (1∙8-4∙6% received an antibiotic secondarily.Management of children using ALMANACH improve clinical outcome and reduce antibiotic prescription by 80%. This was achieved through more accurate diagnoses and hence better identification of children in need of antibiotic treatment or not. The building on mobile technology allows easy access and rapid update of the decision chart.Pan African Clinical Trials Registry PACTR201011000262218.

  9. Perfil de prescrições e uso de antibióticos em infecções comunitárias Prescription patterns and antibiotic use in community-based infections

    Directory of Open Access Journals (Sweden)

    Fernando de Sá Del Fiol

    2010-02-01

    Full Text Available INTRODUÇÃO: O objetivo deste estudo foi conhecer os padrões de utilização de antibióticos no município de Sorocaba, avaliando o diagnóstico referido, a terapêutica empregada e sua utilização. MÉTODOS: Utilizou-se um instrumento de avaliação aplicado por 12 meses em usuários de antibióticos. Foram coletados dados de 403 usuários e referiram-se à: informações sociodemográficas e de saúde, diagnóstico e terapêutica. RESULTADOS: Encontrou-se grande utilização e a maior utilização prévia na faixa etária de 0-10 anos (pINTRODUCTION: The aim of this study was to find out about the patterns of antibiotic use in the municipality of Sorocaba, through evaluating the reported diagnosis and the therapy used. METHODS: An evaluation tool was applied among antibiotic users over a 12-month period. Sociodemographic data and information relating to health, diagnosis and therapeutics were gathered in relation to 403 users. RESULTS: Great present use and the greatest previous use was found in the 0-10 year-old age group (p < 0.05. Infections with lung involvement were the ones most mentioned (p < 0.05 and penicillins were the drugs most used, present in 45.1% of the prescriptions. The mean duration of therapy for otitis (8.9 days was below the recommendation. For sinusitis, 22% of the prescriptions did not give guidance regarding recommended use (10 days. CONCLUSIONS: The lack and/or nonuse of therapeutic protocols resulted in great differences in prescription patterns, thereby leading to therapeutic failure and recurrence of infections, which were situations frequently found in this study.

  10. Procalcitonin-guided protocol is not useful to manage antibiotic therapy in febrile neutropenia: a randomized controlled trial.

    Science.gov (United States)

    Lima, Stella Sala Soares; Nobre, Vandack; de Castro Romanelli, Roberta Maia; Clemente, Wanessa Trindade; da Silva Bittencourt, Henrique Neves; Melo, Ana Catarina Mourão; Salomão, Luciana Caetano Botelho; Serufo, José Carlos

    2016-06-01

    Febrile neutropenia (FN) requires immediate use of antibiotics (ATB), and procalcitonin (PCT) is proven to be useful in guiding antibiotic therapy in different settings. This study investigated the use of PCT as a guide for the duration of ATB in FN. A randomized controlled trial was carried out from January-December 2010. A total of 62 hematological adult patients with FN were randomized, in 1:1 ratio, into two groups: (1) PCT group: length of ATB guided by institutional protocol plus PCT dynamics, and (2) control group: duration of ATB in accordance with institutional protocol. There was no difference between groups regarding the use of ATB for the first episode of fever (HR 1.14, 95 % CI 0.66-1.95, p = 0.641), with equivalent median duration of ATB therapy (PCT group 9.0 days and control group 8.0 days, p = 0.67), and median number of days without ATB (0 days, IQR 0-2 days for both groups, p = 0.96). We observed no difference in clinical cure rate (p = 0.68), infection relapse (p = 1.0), superinfection (p = 0.85), length of hospitalization (p = 0.64), and mortality at 28 days (p = 0.39) and at 90 days (p = 0.72). Considering the cut-off of 0.5 ng/ml, PCT was correlated with bacteremia (sensitivity of 51.9 % and specificity of 76.5 %). In this randomized controlled trial, adding a PCT-guided protocol to the standard recommendations did not reduce the use of antibiotics in febrile neutropenia, although no apparent harm was caused. PCT proved to be a marker of bacteremia in this setting. PMID:27118539

  11. Beta lactam antibiotics residues in cow's milk: comparison of efficacy of three screening tests used in Bosnia and Herzegovina

    Directory of Open Access Journals (Sweden)

    Nihad Fejzic

    2014-08-01

    Full Text Available Beta lactam antibiotics are widely used in therapy of cattle, particularly for the treatment of mastitis.  Over 95% of residue testing in dairies in Bosnia and Herzegovina is for Beta lactams. The aim of this paper is to compare the efficacy of three most common screening tests for Beta lactam residues in cow’s milk in our country. The tests used in the study are SNAP β Lactam test (Idexx, Rosa Charm β Lactam test and Inhibition MRL test. Study samples included: standardized concentrations of penicillin solution (0, 2, 3, 4, 5 and 6 ppb. In addition we tested milk samples from three equal size study groups (not receiving any antibiotic therapy, treated with Beta lactams for mastitis and treated with Beta lactams for diseases other than mastitis. Sensitivity and specificity were determined for each test, using standard penicillin concentrations with threshold value set at concentration of 4 ppb (Maximum residue level – MLR. Additionally we determined proportions of presumably false negative and false positive results for each test using results of filed samples testing. Agreement of test results for each test pair was assessed through Kappa coefficients interpreted by Landis-Koch scale. Detection level of all tests was shown to be well below MRL. This alongside with effects of natural inhibitors in milk contributed to finding of positive results in untreated and treated animals after the withholding period. Screening tests for beta lactam residues are important tools for ensuring that milk for human consumption is free from antibiotics residues.

  12. Removal of antibiotics from water using sewage sludge- and waste oil sludge-derived adsorbents.

    Science.gov (United States)

    Ding, Rui; Zhang, Pengfei; Seredych, Mykola; Bandosz, Teresa J

    2012-09-01

    Sewage sludge- and waste oil sludge-derived materials were tested as adsorbents of pharmaceuticals from diluted water solutions. Simultaneous retention of eleven antibiotics plus two anticonvulsants was examined via batch adsorption experiments. Virgin and exhausted adsorbents were examined via thermal and FTIR analyses to elucidate adsorption mechanisms. Maximum adsorption capacities for the 6 materials tested ranged from 80 to 300 mg/g, comparable to the adsorption capacities of antibiotics on various activated carbons (200-400 mg/g) reported in the literature. The performance was linked to surface reactivity, polarity and porosity. A large volume of pores similar in size to the adsorbate molecules with hydrophobic carbon-based origin of pore walls was indicated as an important factor promoting the separation process. Moreover, the polar surface of an inorganic phase in the adsorbents attracted the functional groups of target molecules. The presence of reactive alkali metals promoted reaction with acidic groups, formation of salts and their precipitation in the pore system.

  13. Production parameters of the therapeutic 105Rh radionuclide using medium energy cyclotron

    Indian Academy of Sciences (India)

    Mayeen Uddin Khandaker; Kwangsoo Kim; Guinyun Kim

    2012-08-01

    Production cross-sections of the therapeutic 105Rh radionuclide from proton-induced reactions on natural palladium target were measured using stacked-foil activation technique combined with high resolution -ray spectrometry at the MC50 cyclotron of the Korea Institute of Radiological and Medical Sciences. Note that cyclotron production of the 105Rh radionuclide from natural palladium target was measured here for the first time. Results are compared with the theoretical values obtained using the model codes TALYS and ALICE-IPPE. Thick target integral yields for the investigated 105Rh radionuclide were deduced from the threshold energy to 40 MeV. Measured data of the 105Rh radionuclide are important because of its potential applications in nuclear medicine and/or therapeutic purposes. Optimal production circumstances for the therapeutic 105Rh radionuclide using a cyclotron are discussed elaborately.

  14. Antibiotic resistances in Listeria monocytogenes and Salmonella enterica isolated from foods with animal origin Resistencias a antibióticos en Listeria monocytogenes y Salmonella enterica aislados de alimentos de origen animal

    OpenAIRE

    Baltasar Balsalobre Hernández; Joaquín Hernández-Godoy

    2004-01-01

    Extensive use of antibiotics in both human and animal health and in cattle production has generated resistant microorganisms to common antibiotics. Resistances spread caused by human and animal therapeutic is well known, but we know poorly frecuency of resistant bacteria in foods with animal origin and destinated to human consumers. In this paper, sensitivity to nineteen antibiotics was investigated in Listeria monocytogenes and Salmonella enterica strains isolated from foods with animal orig...

  15. Distribution of anticancer antibiotic daunomycin in the rat heart and kidney revealed by immunocytochemistry using monoclonal antibodies

    DEFF Research Database (Denmark)

    Fujiwara, Kunio; Shin, Masashi; Hougaard, David M.;

    2007-01-01

    Two monoclonal antibodies (ADM-1-11 and 79-31 mAbs) were raised against daunomycin (DM) conjugated to bovine serum albumin via the cross-linker N-(gamma-maleimidobutyryloxy)succinimide. The monoclonal antibodies (mAbs) specifically detected DM as well as its analogs doxorubicin and epirubicin......, but did not react with other anticancer antibiotics, including pepleomycin, mitomycin C, and actinomycin D. The mAbs reacted strongly with glutaraldehyde-conjugated DM in an enzyme linked immunosorbent assay (ELISA) used as a model system for immunocytochemistry as well as in appropriately pretreated...

  16. Antibiotics in Animal Feed Contribute to Drug-Resistant Germs

    Science.gov (United States)

    ... medlineplus/news/fullstory_158316.html Antibiotics in Animal Feed Contribute to Drug-Resistant Germs: Study Individual farm ... HealthDay News) -- Use of antibiotics in farm animal feed is helping drive the worldwide increase in antibiotic- ...

  17. Antibiotic Prophylaxis in Pediatric Dentistry

    OpenAIRE

    Davydova N.V.; Suyetenkov D.Ye.; Firsova I.V.; Oleynikova N.M.

    2011-01-01

    Identify options for the indications for antibiotic prophylaxis in children's dental reception. The analysis of publications shows that the basis of current trends prevention of postoperative wound infection in pediatric surgery should be measures aimed at eliminating or reducing the influence of risk factors, as well as the use of antibiotic prophylaxis

  18. Antibiotic Prophylaxis in Pediatric Dentistry

    Directory of Open Access Journals (Sweden)

    Davydova N.V.

    2011-03-01

    Full Text Available Identify options for the indications for antibiotic prophylaxis in children's dental reception. The analysis of publications shows that the basis of current trends prevention of postoperative wound infection in pediatric surgery should be measures aimed at eliminating or reducing the influence of risk factors, as well as the use of antibiotic prophylaxis

  19. The Antibiotic Resistance Problem Revisited

    Science.gov (United States)

    Lawson, Michael A.

    2008-01-01

    The term "antibiotic" was first proposed by Vuillemin in 1889 but was first used in the current sense by Walksman in 1941. An antibiotic is defined as a "derivative produced by the metabolism of microorganisms that possess antibacterial activity at low concentrations and is not toxic to the host." In this article, the author describes how…

  20. Effect of a multi-faceted quality improvement intervention on inappropriate antibiotic use in children with non-bloody diarrhoea admitted to district hospitals in Kenya

    Directory of Open Access Journals (Sweden)

    Opondo Charles

    2011-11-01

    Full Text Available Abstract Background There are few reports of interventions to reduce the common but irrational use of antibiotics for acute non-bloody diarrhoea amongst hospitalised children in low-income settings. We undertook a secondary analysis of data from an intervention comprising training of health workers, facilitation, supervision and face-to-face feedback, to assess whether it reduced inappropriate use of antibiotics in children with non-bloody diarrhoea and no co-morbidities requiring antibiotics, compared to a partial intervention comprising didactic training and written feedback only. This outcome was not a pre-specified end-point of the main trial. Methods Repeated cross-sectional survey data from a cluster-randomised controlled trial of an intervention to improve management of common childhood illnesses in Kenya were used to describe the prevalence of inappropriate antibiotic use in a 7-day period in children aged 2-59 months with acute non-bloody diarrhoea. Logistic regression models with random effects for hospital were then used to identify patient and clinician level factors associated with inappropriate antibiotic use and to assess the effect of the intervention. Results 9, 459 admission records of children were reviewed for this outcome. Of these, 4, 232 (44.7% were diagnosed with diarrhoea, with 130 of these being bloody (dysentery therefore requiring antibiotics. 1, 160 children had non-bloody diarrhoea and no co-morbidities requiring antibiotics-these were the focus of the analysis. 750 (64.7% of them received antibiotics inappropriately, 313 of these being in the intervention hospitals vs. 437 in the controls. The adjusted logistic regression model showed the baseline-adjusted odds of inappropriate antibiotic prescription to children admitted to the intervention hospitals was 0.30 times that in the control hospitals (95%CI 0.09-1.02. Conclusion We found some evidence that the multi-faceted, sustained intervention described in this

  1. Using mindfulness meditation to teach beginning therapists therapeutic presence: a qualitative study.

    Science.gov (United States)

    McCollum, Eric E; Gehart, Diane R

    2010-07-01

    Some of the more difficult to define aspects of the therapeutic process (empathy, compassion, presence) remain some of the most important. Teaching them presents a challenge for therapist trainees and educators alike. In this study, we examine our beginning practicum students' experience of learning mindfulness meditation as a way to help them develop therapeutic presence. Through thematic analysis of their journal entries a variety of themes emerged, including the effects of meditation practice, the ability to be present, balancing being and doing modes in therapy, and the development of acceptance and compassion for themselves and for their clients. Our findings suggest that mindfulness meditation may be a useful addition to clinical training.

  2. Determination of oxytetracycline, tetracycline and chloramphenicol antibiotics in animal feeds using subcritical water extraction and high performance liquid chromatography.

    Science.gov (United States)

    Wang, Linling; Yang, Hai; Zhang, Chunwei; Mo, Yulin; Lu, Xiaohua

    2008-06-30

    A rapid analytical method for the determination of oxytetracycline (OTC), tetracycline (TC) and chloramphenicol (CAP) antibiotics in animal feeds has been developed based on subcritical water extraction (SWE) without further sample clean-up followed by high performance liquid chromatography (HPLC) with ultraviolet (UV) detection. On extracting target antibiotics from spiked samples, the efficiency of the water extraction device was evaluated in terms of pH and volume of the extractant, temperature and time of the static extraction. The best extraction conditions were obtained by using 5.5 mL of water adjusted to pH 2 with hydrochloric acid as the extractant at 100 degrees C with 5-min static extraction. After filtration, 20 microL of the aqueous extract was directly injected into the HPLC column. Recoveries between 82.1% and 90.0% with relative standard deviations ranging between 1.6% and 4.8% were achieved from spiked animal feed samples by using this method. Compared with the traditional ultrasonic extraction, this procedure was remarkably more efficient in extracting OTC, TC and CAP, simpler to perform, and there was no use of toxic organic solvents. PMID:18539174

  3. Antibiotic susceptibility of members of the Lactobacillus acidophilus group using broth microdilution and molecular identification of their resistance determinants.

    Science.gov (United States)

    Mayrhofer, Sigrid; van Hoek, Angela H A M; Mair, Christiane; Huys, Geert; Aarts, Henk J M; Kneifel, Wolfgang; Domig, Konrad J

    2010-11-15

    The range of antibiotic susceptibility to 13 antibiotics in 101 strains of the Lactobacillus acidophilus group was examined using the lactic acid bacteria susceptibility test medium (LSM) and broth microdilution. Additionally, microarray analysis and PCR were applied to identify resistance genes responsible for the displayed resistant phenotypes in a selection of strains. In general, narrow as well as broad unimodal and bimodal MIC distributions were observed for the Lactobacillus acidophilus group and the tested antimicrobial agents. Atypically resistant strains could be determined by visual inspection of the obtained MIC ranges for ampicillin, chloramphenicol, clindamycin, erythromycin, quinupristin/dalfopristin, streptomycin and tetracycline. For most of these atypically resistant strains underlying resistance determinants were found. To our knowledge erm(A) was detected in lactobacilli for the first time within this study. Data derived from this study can be used as a basis for reviewing present microbiological breakpoints for categorization of susceptible and resistant strains within the Lactobacillus acidophilus group to assess the safety of microorganisms intended for use in food and feed applications. PMID:20888656

  4. A Comprehensive Insight into Tetracycline Resistant Bacteria and Antibiotic Resistance Genes in Activated Sludge Using Next-Generation Sequencing

    Directory of Open Access Journals (Sweden)

    Kailong Huang

    2014-06-01

    Full Text Available In order to comprehensively investigate tetracycline resistance in activated sludge of sewage treatment plants, 454 pyrosequencing and Illumina high-throughput sequencing were used to detect potential tetracycline resistant bacteria (TRB and antibiotic resistance genes (ARGs in sludge cultured with different concentrations of tetracycline. Pyrosequencing of 16S rRNA gene revealed that tetracycline treatment greatly affected the bacterial community structure of the sludge. Nine genera consisting of Sulfuritalea, Armatimonas, Prosthecobacter, Hyphomicrobium, Azonexus, Longilinea, Paracoccus, Novosphingobium and Rhodobacter were identified as potential TRB in the sludge. Results of qPCR, molecular cloning and metagenomic analysis consistently indicated that tetracycline treatment could increase both the abundance and diversity of the tet genes, but decreased the occurrence and diversity of non-tetracycline ARG, especially sulfonamide resistance gene sul2. Cluster analysis showed that tetracycline treatment at subinhibitory concentrations (5 mg/L was found to pose greater effects on the bacterial community composition, which may be responsible for the variations of the ARGs abundance. This study indicated that joint use of 454 pyrosequencing and Illumina high-throughput sequencing can be effectively used to explore ARB and ARGs in the environment, and future studies should include an in-depth investigation of the relationship between microbial community, ARGs and antibiotics in sewage treatment plant (STP sludge.

  5. Developing food supplements for moderately malnourished children: Lessons learned from ready-to-use therapeutic foods

    Science.gov (United States)

    Ready-to-use therapeutic foods (RUTFs) are solid foods that were developed by changing the formulation of the existing liquid diet, F-100, recommended by the World Health Organization (WHO) for the rapid catch-up phase of the treatment of children suffering from severe acute malnutrition (SAM). The ...

  6. Using therapeutic assessment to explore emotional constriction: a creative professional in crisis

    NARCIS (Netherlands)

    J.H. Kamphuis; H. de Saeger

    2012-01-01

    A guide to conducting Collaborative/Therapeutic Assessment to promote client growth Mental health professionals are increasingly enthusiastic about and ready to use psychological test data, research, and theory in life-relevant ways to improve diagnosis, client care, and treatment outcomes. With Col

  7. The Use of Therapeutic Stories in Counseling Child and Adolescent Sexual Abuse Survivors

    Science.gov (United States)

    Kress, Victoria E.; Adamson, Nicole A.; Yensel, Jennifer

    2010-01-01

    Counselors will regularly counsel children and adolescents with histories of sexual abuse and be challenged with providing supportive and empowering interventions that serve to move the client from victim to survivor status. Therapeutic stories are a creative counseling technique that can be used when counseling child and adolescent sexual abuse…

  8. Differences in abuse potential of ADHD drugs measured by contrasting poison centre and therapeutic use data

    DEFF Research Database (Denmark)

    Jensen, Louise; Pagsberg, Anne Katrine; Dalhoff, Kim Peder

    2015-01-01

    CONTEXT: Atomoxetine (ATX) is the treatment of choice for attention deficit hyperactivity disorders with co-morbid risk of drug abuse, although its abuse potential needs to be qualified. The purpose of this study is to analyse ATX misuse in relation to therapeutic use and compare our results...

  9. Use of saliva in therapeutic drug monitoring of caffeine in preterm infants

    NARCIS (Netherlands)

    de Wildt, SN; Kerkvliet, KTM; Wezenberg, MGA; Ottink, S; Hop, WCJ; Vulto, AG; van den Anker, JN

    2001-01-01

    Caffeine is frequently used to treat apnea of prematurity in preterm infants. Because caffeine has a narrow therapeutic window, plasma concentrations are generally monitored weekly. It would be advantageous to monitor this therapy without blood sampling; saliva might offer this possibility. Paired p

  10. Methadone: The Drug and Its Therapeutic Uses In the Treatment of Addiction. Series 31, No. 1.

    Science.gov (United States)

    Gamage, James R.; Zerkin, E. Lief

    This fact sheet from the National Clearinghouse for Drug Abuse Information discusses methadone, a therapeutic drug for the treatment of narcotic addiction. It reviews the pharmacology of the drug as well as physiological and psychological effects, patterns of use, and adverse effects (toxicity and poisoning). It examines the success rates of…

  11. Antibiotic tolerance and microbial biofilms

    DEFF Research Database (Denmark)

    Folkesson, Anders

    Increased tolerance to antimicrobial agents is thought to be an important feature of microbes growing in biofilms. We study the dynamics of antibiotic action within hydrodynamic flow chamber biofilms of Escherichia coli and Pseudomonas aeruginosa using isogenic mutants and fluorescent gene...... expression reporters and we address the question of how biofilm organization affects antibiotic susceptibility. The dynamics of microbial killing is monitored by viable count determination, and confocal laser microscopy. Our work shows that the apparent increased antibiotic tolerance is due to the formation...... of antibiotic tolerant subpopulations within the biofilm. The formation of these subpopulations is highly variable and dependent on the antibiotic used, the biofilm structural organization and the induction of specific tolerance mechanisms....

  12. Antibiotic resistance in Salmonella

    NARCIS (Netherlands)

    Vo, A.T.T.

    2007-01-01

    Immediately after their introduction in the beginning of the fourties of the previous century, the agents used to combat infectious diseases caused by bacteria were regarded with suspicion, but not long thereafter antibiotics had the status of miracle drugs. For decades mankind has lived under the i

  13. Low in vitro third-body wear on total hip prostheses induced by calcium sulphate used for local antibiotic therapy

    Directory of Open Access Journals (Sweden)

    R Heuberger

    2014-10-01

    Full Text Available In case of implant associated infection, implant preservation is associated with high failure rates. Therefore, a removal or exchange of the implant is most often mandatory for treatment success. Alternatively, under certain conditions, local antibiotic delivery can be applied – preserving the implant, using for example calcium sulphate as a resorbable carrier. In this work, third-body wear on total hip prostheses caused by calcium sulphate particles was tested in a hip simulator. Inlays made of ultra-high-molecular-weight polyethylene (UHMWPE and cross-linked polyethylene (XLPE against 28 mm CoCrMo heads and 36 mm alumina pairings were tested in triplicate, both with and without calcium sulphate particles in the test liquid. Neither the alumina articulations nor the CoCrMo heads were affected by the calcium sulphate particles since calcium sulphate is a relatively soft material. The polyethylene inlays showed 39-89 % higher wear during exposure compared to references, but wear returned to normal when no more particles were added. Thus, calcium sulphate might be used as antibiotic carrier even in the presence of total hip prostheses without fearing excessive third-body wear.

  14. Low in vitro third-body wear on total hip prostheses induced by calcium sulphate used for local antibiotic therapy.

    Science.gov (United States)

    Heuberger, R; Wahl, P; Krieg, J; Gautier, E

    2014-01-01

    In case of implant associated infection, implant preservation is associated with high failure rates. Therefore, a removal or exchange of the implant is most often mandatory for treatment success. Alternatively, under certain conditions, local antibiotic delivery can be applied - preserving the implant, using for example calcium sulphate as a resorbable carrier. In this work, third-body wear on total hip prostheses caused by calcium sulphate particles was tested in a hip simulator. Inlays made of ultra-high-molecular-weight polyethylene (UHMWPE) and cross-linked polyethylene (XLPE) against 28 mm CoCrMo heads and 36 mm alumina pairings were tested in triplicate, both with and without calcium sulphate particles in the test liquid. Neither the alumina articulations nor the CoCrMo heads were affected by the calcium sulphate particles since calcium sulphate is a relatively soft material. The polyethylene inlays showed 39-89 % higher wear during exposure compared to references, but wear returned to normal when no more particles were added. Thus, calcium sulphate might be used as antibiotic carrier even in the presence of total hip prostheses without fearing excessive third-body wear. PMID:25340804

  15. Quantifying attachment and antibiotic resistance of Escherichia coli from conventional and organic swine manure

    Science.gov (United States)

    Broad spectrum antibiotics, used to treat infections in livestock, are often administered at sub-therapeutic levels in feed rations to promote growth and for prophylaxis. Previous studies have shown that bacteria preferentially attach to sediments affecting their transport in overland flow; however...

  16. The therapeutic use of endoscopic ultrasonography in pediatric patients is safe: A case series

    Directory of Open Access Journals (Sweden)

    Yi Jia

    2015-01-01

    Full Text Available Background/Aim: Despite the safety and high diagnostic yield of endoscopic ultrasound guided fine needle aspiration (EUS FNA for the evaluation of gastrointestinal diseases in adults, literature discussing the therapeutic use of EUS FNA in pediatrics remains limited. This study reports our experience with the use of EUS in children with pancreaticobiliary disorders. Patients and Methods: A retrospective study was conducted to evaluate safety, clinical utility, and impact of therapeutic EUS on the management of children (<18 years at a tertiary referral center. Data were collected from January 1, 2011, to April 30, 2014. Patient demographics, clinical characteristics, and EUS procedure data were reviewed. Continuous variables were described using the mean and standard deviation. Categorical variables were described using frequencies and percentages. Results: A total of 6 therapeutic EUS procedures were performed in 5 children (3 F/2 M. The mean age was 13 years (range 6–17 with a mean body mass index of 28.2 (range 18.5–38.8. The indications for EUS procedures were abdominal pain with chronic pancreatitis (3 and management of symptomatic pancreaticobiliary cysts/pseudocysts observed on previous imaging (3. All procedures were performed under general anesthesia. The 6 therapeutic procedures performed were celiac plexus block (3, cyst gastrostomy with stents placement (2, and cyst aspiration using EUS FNA (1. A celiac plexus block effectively relieved abdominal pain in 2 patients with chronic pancreatitis. Cyst gastrostomy successfully resulted in pseudocyst resolution in the follow up imaging of 2 patients (up to 6 months after the procedure. Cyst aspiration with EUS guided FNA resulted in cyst resolution and confirmation of the benign nature of the cyst in 1 patient. All the procedures were successfully completed with no reported complications. Conclusion: The therapeutic use of endoscopic ultrasound in the pediatric population is safe and

  17. How antibiotic resistances could change Helicobacter pylori treatment: A matter of geography?

    Science.gov (United States)

    Ierardi, Enzo; Giorgio, Floriana; Losurdo, Giuseppe; Di Leo, Alfredo; Principi, Mariabeatrice

    2013-12-01

    Therapeutic management of Helicobacter pylori (H. pylori) remains an unsolved issue. Indeed, no therapeutic regimen is able to cure the infection in all treated patients, and in many the infection persists despite the administration of several consecutive standard therapies. Although antibiotic resistance reports describe alarming results, the outcome of therapeutic regimens does not seem to parallel this scenario in most cases, since a successful performance is often reached in more than 80% of cases. However, the phenomenon of increasing antibiotic resistance is being closely studied, and the results show controversial aspects even in the same geographic area. For the continents of Europe, America, Asia, Africa, and Oceania, minimal and maximal values of resistance to the main antibiotics (clarithromycin, amoxicillin, metronidazole, and levofloxacin) feature wide ranges in different countries. The real enigma is therefore linked to the several different therapeutic regimens, which show results that often do not parallel the in vitro findings even in the same areas. A first aspect to be emphasized is that some regimens are limited by their use in very small geographic districts. Moreover, not all therapeutic trials have considered bacterial and host factors affecting the therapeutic outcome. The additional use of probiotics may help to reduce adverse events, but their therapeutic impact is doubtful. In conclusion, the "ideal therapy", paradoxically, appears to be a "utopia", despite the unprecedented volume of studies in the field and the real breakthrough in medical practice made by the discovery and treatment of H. pylori. The ample discrepancies observed in the different areas do not encourage the development of therapeutic guidelines that could be valid worldwide. On these bases, one of the main challenges for the future might be identifying a successful solution to overcome antibiotic resistances. In this context, geography must be considered a relevant

  18. Using a stem cell-based signature to guide therapeutic selection in cancer.

    Science.gov (United States)

    Shats, Igor; Gatza, Michael L; Chang, Jeffrey T; Mori, Seiichi; Wang, Jialiang; Rich, Jeremy; Nevins, Joseph R

    2011-03-01

    Given the very substantial heterogeneity of most human cancers, it is likely that most cancer therapeutics will be active in only a small fraction of any population of patients. As such, the development of new therapeutics, coupled with methods to match a therapy with the individual patient, will be critical to achieving significant gains in disease outcome. One such opportunity is the use of expression signatures to identify key oncogenic phenotypes that can serve not only as biomarkers but also as a means of identifying therapeutic compounds that might specifically target these phenotypes. Given the potential importance of targeting tumors exhibiting a stem-like phenotype, we have developed an expression signature that reflects common biological aspects of various stem-like characteristics. The consensus stemness ranking (CSR) signature is upregulated in cancer stem cell-enriched samples at advanced tumor stages and is associated with poor prognosis in multiple cancer types. Using two independent computational approaches we utilized the CSR signature to identify clinically useful compounds that could target the CSR phenotype. In vitro assays confirmed selectivity of several predicted compounds including topoisomerase inhibitors and resveratrol towards breast cancer cell lines that exhibit a high-CSR phenotype. Importantly, the CSR signature could predict clinical response of breast cancer patients to a neoadjuvant regimen that included a CSR-specific agent. Collectively, these results suggest therapeutic opportunities to target the CSR phenotype in a relevant cohort of cancer patients. PMID:21169407

  19. The bonding of anesthetics and antibiotics on the carboxymethylcellulose

    Directory of Open Access Journals (Sweden)

    Rodić-Grabovac Branka B.

    2007-01-01

    Full Text Available The preparation of biologically active material is one of the most interesting trends in the chemical modification of cellulose. The possibility of obtaining biologically active cellulosic material by sorption of procaine hydrochloride and gentamicin sulphate on CMC was investigated in this paper. The sorption of therapeutics on CMC samples with different degree of substitution was carried out in water solutions of anesthetic and antibiotic, while the desorption was done in 0.95% NaCl solution. The amount of bonded and released therapeutics was determined by UV spe-ctrophotometry. It was found that degree of substitution of car-boxymethylcellulose and concentration of chemotherapeutic water solution have significant influence on the amount of bonded anesthetic and antibiotic. The maximum amount of bonded chemotherapeutic was 72.15 mg of procaine hydrochloride and 165.49 mg of gentamicin sulphate per gram CMC. In both cases the amounts of bonded chemotherape-utics correspond to the concentration of local anesthetic and antibiotic preparation that are used in therapeutic purposes.

  20. Early Antibiotic Treatment in Acute Pancreatitis: More News

    Directory of Open Access Journals (Sweden)

    Jan J De Waele

    2006-07-01

    Full Text Available Early antibiotic treatment still remains a therapeutic challenge in the clinical management of acute pancreatitis and several papers have been published in this field [1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14]. In particular, the antibiotic of choice in preventing the infection of pancreatic necrosis seems to be imipenem [4, 9, 10, 11, 13]. Subsequently, Manes et al. [15] have reported that meropenem, an antibiotic of the same family as imipenem having considerable stability in the presence of renal dehydropeptidase-I and enhanced activity against gram-negative bacteria including Pseudomonas aeruginosa, has an efficacy similar to imipenem in terms of the incidence of pancreatic infection and extrapancreatic infections. We have previously emphasized that further studies should be carried out to specifically decide on the optimal doses of meropenem in patients with acute pancreatitis and that there is a need for studies which answer the following questions. What should the timing of early antibiotic treatment be?. What are the resistant strains selected by meropenem?. Which are the nosocomial infections and fungal superinfections resulting from this new treatment? [16, 17]. These questions are still open and the study from Manes et al. is welcome to attempt to answer some of the aforementioned questions [18]. In this study, the authors compared antibiotic prophylaxis with early antibiotic treatment started after the demonstration of pancreatic necrosis. They studied 215 consecutive patients with acute pancreatitis who were randomized to either Group A (n=108, who started antibiotic therapy (meropenem 500 mg tid at admission, or Group B (n=107, who received antibiotics after computed tomography showed necrosis. C-reactive protein was determined in all patients within 48 hours from the onset of symptoms and computed tomography was performed in both groups after at least 48 h of hospitalization; the clinical course of disease was also compared