Antibiotic treatment

Regardless of the repeated reservations raised by countless researchers with reference to the use of catheters as vascular access for haemodialysis (HD), central venous catheters (CVCs) remain irreplaceable tools of the modern dialysis delivery system as a reliable option for the clinical situations requiring instant access to circulation, for various reasons. Patients on long-term haemodialysis are therefore at a significantly high risk for catheterrelated bloodstream infections (CRBSI) and ensuing serious complications. Although early systemic antibiotic treatment should include the coverage for Staphylococcus aureus, the pathogen with most devastating consequences including bacterial endocarditis; optimal treatment of CRBSI while preserving the catheter site, remains contentious. Nonetheless, catheter exchange over a guide wire and antimicrobial-anticoagulant "locks" have shown promising results as novel access salvage techniques. Despite the fact that a number of novel...

The second most important infectious complication in hospitalized patients is pneumonia, this occupying the first place in the Intensive Care Units (ICU). Approximately 80% of the episodes of nosocomial pneumonia occur in patients with an artificial airway, which is called ventilation-associated pneumonia (VAP). VAP is the most frequent cause of mortality among nosocomial infections in the ICU, mainly if they are caused by Pseudomonas aeruginosa and Methicillin-resistant Staphylococcus aureus (MRSA). It also increases days of mechanical ventilation and length of stay in the ICU and hospital. In spite of the available diagnostic procedures, the diagnosis of VAP continues to be a clinical one. The presence of X-ray infiltrates and purulent endotracheal secretions are the essential conditions for the diagnosis. We should also evaluate the patient's condition and the risk factors for difficult-to-treat pathogens. If the VAP is early and there are no risk factors, most of the empiric...

The second most important infectious complication in hospitalized patients is pneumonia, this occupying the first place in the Intensive Care Units (ICU). Approximately 80% of the episodes of nosocomial pneumonia occur in patients with an artificial airway, which is called ventilation-associated pneumonia (VAP). VAP is the most frequent cause of mortality among nosocomial infections in the ICU, mainly if they are caused by Pseudomonas aeruginosa and Methicillin-resistant Staphylococcus aureus (MRSA). It also increases days of mechanical ventilation and length of stay in the ICU and hospital. In spite of the available diagnostic procedures, the diagnosis of VAP continues to be a clinical one. The presence of X-ray infiltrates and purulent endotracheal secretions are the essential conditions for the diagnosis. We should also evaluate the patient's condition and the risk factors for difficult-to-treat pathogens. If the VAP is early and there are no risk factors, most of the empiric...

Las guías para neumonía adquirida en la comunidad (NAC) contribuyen a ordenar el manejo de los pacientes. La NAC presenta cambios en su etiología, epidemiología y sensibilidad a antibióticos que obligan a la revisión periódica de las guías. Un comité intersociedades elaboró esta guía dividida en tópicos y basada en guías y estudios clínicos recientes. La NAC afecta anualmente al 1% de la población; la mayoría de los pacientes requiere atención ambulatoria, en otros reviste gravedad (representa la 6ª causa de muerte en Argentina). La etiología es diferente si el paciente es ambulatorio, requiere internación en sala general o en terapia intensiva, pero no hay forma segura de predecirla clínicamente. Los predictores de mala evolución son: edad, antecedentes personales y comorbilidades y hallazgos del examen físico, del laboratorio y de la radiografía de tórax. Entre 10 y 25% de los pacientes que se internan deben hacerlo en terapia intensiva para ventilación mecánica o soporte hemodiná...

Purpose The uptake of 99mTc-UBI (29–41) was evaluated at sites of bacterial infections in rabbits before and after treat-ment with ciprofloxacin. Methods Staphylococcus aureus susceptible to ciprofloxacin was used to induce a focal infection in each rabbit of group 1 (G1), group ...

In a controlled study, the effects of amitriptyline compared with that of a placebo in cats suffering from idiopathic Feline Lower Urinary Tract Disease (FLUTD) have been investigated. Thirty-six animals were selected by veterinary practitioners and treated with a placebo or 10 mg amitriptyline once daily. All animals received concomitant antibiotic treatment. A total of 24 cats were included in the final assessment of the results. The severity of symptoms before and after treatment were compared between groups and showed no significant difference. Results indicated that the 7-day course of 10 mg amitriptyline was not effective in the treatment of idiopathic FLUTD. Thus, it is considered not to be beneficial as a short-term therapy where the therapeutic results depend on peripheral effects of the drug. Long-term effects may be expected 4 or more weeks after the start of therapy and need to be further investigated.

Amoxicillin (amoxicilline)-clavulanic acid has promising activity against pathogens that cause bone infections. We present the first evaluation of the bone penetration of a beta-lactam by population pharmacokinetics and pharmacodynamic profiling via Monte Carlo simulations. Twenty uninfected patients undergoing total hip replacement received a single intravenous infusion of 2,000 mg/200 mg amoxicillin-clavulanic acid before surgery. Blood and bone specimens were collected. Bone samples were pulverized under liquid nitrogen with a cryogenic mill, including an internal standard. The drug concentrations in serum and total bone were analyzed by liquid chromatography-tandem mass spectrometry. We used NONMEM and S-ADAPT for population pharmacokinetic analysis and a target time of the non-protein-bound drug concentration above the MIC for ≥50% of the dosing interval for near-maximal bactericidal activity in serum. The median of the ratio of the area under the curve (AUC) for bone/AUC for s...

Extending the fascial incision underlying the circumbilical approach to the shape of an ‘inverted T’ permits easy delivery of the pyloric tumour for Ramstedt’s pyloromyotomy. This modification was used in 51 consecutive infants (42 male, 9 female) with a mean age of 4.7 weeks. Extension of the skin incision or conversion to the right hypochondrium approach was not necessary in

To assess the risks and benefits associated with caesarean delivery compared with vaginal delivery. Prospective cohort study within the 2005 WHO global survey on maternal and perinatal health. 410 health facilities in 24 areas in eight randomly selected Latin American countries; 123 were randomly selected and 120 participated and provided data 106,546 deliveries reported during the three month study period, with data available for 97,095 (91% coverage). Maternal, fetal, and neonatal morbidity and mortality associated with intrapartum or elective caesarean delivery, adjusted for clinical, demographic, pregnancy, and institutional characteristics. Women undergoing caesarean delivery had an increased risk of severe maternal morbidity compared with women undergoing vaginal delivery (odds ratio 2.0 (95% confidence interval 1.6 to 2.5) for intrapartum caesarean and 2.3 (1.7 to 3.1) for elective caesarean). The risk of antibiotic treatment after delivery for women having either type of cae...

Background  Children with perforated appendicitis have a relatively high risk of intra-abdominal abscesses. There is no evidence that prolonged antibiotic treatment after surgery reduces intra-abdominal abscess formation. We compared two patient groups with perforated appendicitis with different postoperative antibiotic treatment protocols. Methods  We retrospectively reviewed patients younger than age 18 years who underwent appendectomy for perforated appendicitis at two academic hospitals between January 1992 and December 2006. Perforation was diagnosed during surgery and confirmed during histopathological evaluation. Patients in hospital A received 5 days of antibiotics postoperatively, unless decided otherwise on clinical grounds. Patients in hospital B received antibiotics for 5 days, continued until serum C-reactive protein (CRP) was p < 0.05 was considered significant. Results  A total of 149 children underwent appendectomy for perforated appendicitis: 68 in hospital A, an...

A qualitative study among rural mothers' classification of the lay etiologies of childhood cough was conducted in Bohol island, the Philippines, the site of an ARI control research project which tested the effectiveness of the WHO developed acute respiratory infections standardized case management algorithm. The study aimed to look into lay models of etiology of childhood cough and the influence of these perceptions of causation on mothers' health seeking behavior and healer choices. Some 111 mothers participated in the study, 48 identified from among those whose child was admitted to hospital, while 63 were identified from volunteer health workers' list of mothers with children under five years old. Case histories and illness histories were elicited from the hospital-based sample while the community-based mothers participated in focus group discussions and in-depth interviews using hypothetical situations. Cough was attributed primarily to the folk category piang, a ...

Keywords: Azithromycin/supply and distribution; Trachoma/drug therapy; Comparative study; Randomized controlled trials; Nepal (source: MeSH). ... Mots clés: Azithromycine/ressources et distribution; Trachome/chimiothérapie; Etude comparative; Essai clinique randomisé; ...

Fecal bacteria were studied in healthy elderly volunteers (age, 63 to 90 years; n = 35) living in the local community, elderly hospitalized patients (age, 66 to 103; n = 38), and elderly hospitalized patients receiving antibiotic treatment (age, 65 to 100; n = 21). Group- and species-specific primer sets targeting 16S rRNA genes were used to quantitate intestinal bacteria by using DNA extracted from feces and real-time PCR. The principal difference between healthy elderly volunteers and both patient cohorts was a marked reduction in the Bacteroides-Prevotella group following hospitalization. Reductions in bifidobacteria, Desulfovibrio spp., Clostridium clostridiiforme , and Faecalibacterium prausnitzii were also found in the hospitalized patients. However, total 16S rRNA gene copy numbers (per gram of wet weight of feces) were generally lower in the stool samples of the two groups of hospitalized patients compared to the number in the stool samples of elderly volunteers living in th...