Antibiotic Management Research Articles

High-Risk Patients Undergoing Holmium Laser Enucleation of the Prostate Have Fewer Infections with a Longer Course of Preoperative Antibiotics.

Introduction: There are minimal data to guide antibiotic management of patients undergoing holmium laser enucleation of the prostate (HoLEP) for benign prostatic hyperplasia. Specifically, management of high-risk patients who are catheter dependent or have positive preoperative urine cultures varies widely. We aimed to evaluate the effect of preoperative antibiotic duration on infectious complications in high-risk patients undergoing HoLEP. Methods: A multi-institutional retrospective review of patients undergoing HoLEP between 2018 and 2023 at five institutions was performed. Patients were defined as high risk if they were catheter-dependent (indwelling urethral catheter, self-catheterization, or suprapubic tube) or had a positive preoperative urine culture. These patients were categorized into long course (>3 days) or short course (≤3 days) of preoperative antibiotics. The primary outcome was 30-day infectious complications defined as a positive urine culture with symptoms. A t-test or Wilcoxon rank-sum test was used for continuous variables and Fisher's exact test was used for categorical variables. Logistic regression analysis was conducted to identify associations with infectious complications. Results: Our cohort included 407 patients, of which 146 (36%) and 261 (64%) were categorized as short course and long course of preoperative antibiotics, respectively. Median preoperative antibiotic duration was 1 day (interquartile range [IQR]: 0, 3 days) and 7 days (IQR: 5, 7 days) in the short and long cohorts, respectively. Thirty-day postoperative infectious complications occurred in 11 (7.6%) patients who received a short course of antibiotics and 5 (1.9%) patients who received a long course of antibiotics (odds ratio 0.24, 95% confidence interval 0.07-0.67; p = 0.009). Variables such as age, positive urine culture, and postoperative antibiotic duration were not significantly associated with postoperative infection after propensity score weighting. Conclusion: In high-risk patients undergoing HoLEP, infectious complications were significantly lower with a long course vs short course of antibiotics. Further prospective trials are needed to identify optimal preoperative antibiotic regimens.

New Perspectives in Immunotherapy: Dendritic Cell Training for Recurrent Respiratory Tract Infections

Specific allergen immunotherapy (AIT) is the only treatment option currently available that has a disease-modifying effect which persists after treatment is stopped. Recent advancements involve using adjuvants with glycoconjugated allergens derived from Saccharomyces cerevisiae to enhance AIT by improving allergen immunogenicity and directing immune responses towards Th1 or regulatory profiles. Novel studies have also demonstrated that these glycoconjugates induce long-lasting epigenetic changes in dendritic cells (DCs), initiating a trained immunity effect that extends protection against subsequent microbial exposures in a process referred to as trained immunity. This process not only broadens the immune response to target antigens but also provides an enhanced response to subsequent microbial challenges, representing a significant breakthrough in the treatment of recurrent or multiple infections. Moreover, respiratory tract infections, among the most frequent causes of illness worldwide, often rely on antibiotics for management, despite many being of viral origin. The rampant abuse of antibiotics has led to an unstoppable growth in multidrug resistance, underscoring the urgent need for new strategies to provide an effective and safe alternative for managing recurrent respiratory tract infections (RRTIs).

Antimicrobial Resistance Patterns of Common Gram-Negative Microorganisms Isolated from Patients with Lower Respiratory Tract Infections in a Teaching Hospital in Vietnam.

This cross-sectional study investigated the antimicrobial resistance (AMR) patterns of gram-negative pathogens isolated from 4,789 hospitalized patients with lower respiratory tract infections (LRTIs). Of the collected specimens, 1,325 (27.7%) tested positive for gram-negative bacteria. Acinetobacter baumannii (38.6%), Pseudomonas aeruginosa (33.5%), Klebsiella pneumoniae (18.7%), Escherichia coli (5.6%), and Klebsiella aerogenes (3.5%) were the most prevalent isolates. AMR analysis revealed high resistance rates (79.9%-100%) of A. baumannii isolates to multiple classes of antibiotics except amikacin, trimethoprim/sulfamethoxazole, and colistin. P. aeruginosa displayed low resistance to colistin (< 10%) but high resistance to other antibiotics. K. pneumoniae displayed high resistance rates of 90.0%-100.0% to most penicillins, whereas resistance rates were notably lower for colistin (7.1%) and amikacin (16.7%). K. aerogenes exhibited high resistance to various antibiotics and sensitivity to amikacin (95.1%), ampicillin (100.0%), and colistin (100.0%). E. coli isolates exhibited resistance to ampicillin (96.9%) and maximum sensitivity to several antibiotics. Our study identified significant AMR trends and highlighted the prevalence of multidrug-resistant strains (93.6% for K. aerogenes and 69.1%-92.4% for other isolates). These findings emphasize the urgent need for appropriate antibiotic management practices to combat AMR in gram-negative pathogens associated with LRTIs.

Revolutionizing Healthcare: The Role of Artificial Intelligence in Antibiotic Stewardship and Resistance Management

Artificial intelligence (AI) has great potential to transform the way antibiotics are managed in healthcare by providing creative ways to fight antibiotic resistance and enhance patient outcomes. This paper examines the various aspects of AI's function in the management of antibiotics, including diagnosis, tailored treatment, infection surveillance, and future implications. The talk focuses on the potential advantages of AI-driven methods, such as improved diagnostic precision, customized treatment plans, and proactive monitoring of patterns of antibiotic resistance. But there are several obstacles to overcome before AI can be fully applied in the healthcare industry. These include issues with technical complexity, data accessibility and quality, clinical acceptability, regulatory concerns, and long-term financial viability. Collaboration amongst partners, financial support for infrastructure and resources, and a dedication to moral, patient-centered care are all necessary to meet these obstacles. Notwithstanding these challenges, AI-driven antibiotic management has enormous potential to revolutionize global patient outcomes, fight antibiotic resistance, and change healthcare delivery.

Advancements in Topical and Systemic Antibiotic Management for Burn Wounds: A Comprehensive Literature Review

Introduction: Antimicrobial treatment in burn patient include systemic and topical antibiotic care should be carefully deliberated to prevent the development of resistant organisms Methods: This literature review was compiled using information from numerous open access web databases. Data were compiled and analyzed. Results and Discussions: To prevent antibiotic resistance and prevent infection, the best prophylactic antibiotics for burn patients are topical antibiotics. However, for the treatment of patients with extensive burns or those with antibiotic resistance, especially antibiotics for gram-positive bacteria, systemic antibiotics can be used for treatment. Conclusion: The use of antibiotics in patients with burns can be adjusted to the patient's needs. surgeons may consider its use to prevent antibiotic resistance in patients.

Real-life impact on antimicrobial prescription of Syndromic Molecular Testing in adults hospitalized in infectious disease departments. Respiratory Syndromic Molecular Testing panel: Is it worth it?

BackgroundWhile sensitive molecular diagnostic tests enable accurate and rapid diagnosis of many respiratory viruses, their impact on antibiotic management remains uncertain.Our study aimed to evaluate the impact of respiratory syndromic molecular testing panel in real-life clinical practice. MethodRetrospective descriptive study involving consecutive hospitalized patients in an infectious disease department who had been prescribed a respiratory syndromic molecular testing panel on nasopharyngeal swab samples (FilmArray Respiratory Panel 2 plus) during hospitalization from October 1st, 2021, to February 28th, 2023. ResultsAll in all, 94 out of 210 screened patients were included in the study. Syndromic molecular testing results influenced antibiotic treatment in seven cases: discontinuation in four cases (three virus identifications), changes in two (Mycoplasma pneumoniae positive cases), and initiation in two (negative viral PCRs and one positive bacterial culture). ConclusionIn our study, respiratory syndromic molecular testing had low impact on antibiotic modification.

Variation in Systemic Antibiotic Treatment for Diabetic Foot Osteomyelitis in England and Wales: A Multi-Centre Case Review.

Background: Diabetic foot osteomyelitis (DFO) is a major complication and can lead to significant morbidity and mortality. Systemic antibiotic therapy is often initiated first line to achieve quiescence of infection. To perform a multi-centre case review of systemic antibiotic intervention to treat adults with DFO in England and Wales and compare with national guidelines 'Diabetic foot problems: prevention and management'. Methods: Eight centres from England and Wales retrospectively collated data from a minimum of five adults (aged ≥ 18 years) from electronic case records. All patients were treated with systemic antibiotics following a new diagnosis of DFO (1 June 2021-31 December 2021). Results: 40 patients (35 males and 5 females) were included; the mean age was 62.3 years (standard deviation (SD) 13.0). Patients commenced systemic oral 14 (35%) or intravenous 26 (65%) antibiotic therapy following a new diagnosis of DFO. Twenty-seven (67.5%) patients were medically or surgically managed in the 12-week period with clinical quiescence of infection. Twenty-one patients (52.5%) had no recurrence of DFO infection within 12 weeks; seventeen (42.5%) of these patients had clinical quiescence of infection with systemic antibiotics alone without surgical intervention and nine (22.5%) of these cases had no recurrence of DFO. There were no cases of major amputation or death. All centres showed significant in-centre variability in systemic antibiotic management; variability was reported in the clinical and quantity indicators specifically to antibiotic selection, single versus dual therapy, mode of delivery and duration of treatment. Conclusions: This case review identifies there is existing variation when treating adults with systemic antibiotics for DFO. Further national guidance is required to standardise service delivery and care to improve patient outcomes.

Unveiling the genetic architecture and transmission dynamics of a novel multidrug-resistant plasmid harboring blaNDM-5 in E. Coli ST167: implications for antibiotic resistance management

BackgroundThe emergence of multidrug-resistant (MDR) Escherichia coli strains poses significant challenges in clinical settings, particularly when these strains harbor New Delhi metallo-ß-lactamase (NDM) gene, which confer resistance to carbapenems, a critical class of last-resort antibiotics. This study investigates the genetic characteristics and implications of a novel blaNDM-5-carrying plasmid pNDM-5-0083 isolated from an E. coli strain GZ04-0083 from clinical specimen in Zhongshan, China.ResultsPhenotypic and genotypic evaluations confirmed that the E. coli ST167 strain GZ04-0083 is a multidrug-resistant organism, showing resistance to diverse classes of antibiotics including ß-lactams, carbapenems, fluoroquinolones, aminoglycosides, and sulfonamides, while maintaining susceptibility to monobactams. Investigations involving S1 pulsed-field gel electrophoresis, Southern blot analysis, and conjugation experiments, alongside genomic sequencing, confirmed the presence of the blaNDM-5 gene within a 146-kb IncFIB plasmid pNDM-5-0083. This evidence underscores a significant risk for the horizontal transfer of resistance genes among bacterial populations. Detailed annotations of genetic elements—such as resistance genes, transposons, and insertion sequences—and comparative BLAST analyses with other blaNDM-5-carrying plasmids, revealed a unique architectural configuration in the pNDM-5-0083. The MDR region of this plasmid shares a conserved gene arrangement (repA-IS15DIV-blaNDM-5-bleMBL-IS91-suI2-aadA2-dfrA12) with three previously reported plasmids, indicating a potential for dynamic genetic recombination and evolution within the MDR region. Additionally, the integration of virulence factors, including the iro and sit gene clusters and enolase, into its genetic architecture poses further therapeutic challenges by enhancing the strain’s pathogenicity through improved host tissue colonization, immune evasion, and increased infection severity.ConclusionsThe detailed identification and characterization of pNDM-5-0083 enhance our understanding of the mechanisms facilitating the spread of carbapenem resistance. This study illuminates the intricate interplay among various genetic elements within the novel blaNDM-5-carrying plasmid, which are crucial for the stability and mobility of resistance genes across bacterial populations. These insights highlight the urgent need for ongoing surveillance and the development of effective strategies to curb the proliferation of antibiotic resistance.

Toxin genotypes, antibiotic resistance and their correlations in Clostridioides difficile isolated from hospitals in Xi’an, China

BackgroundClostridioides difficile is the main pathogen of antimicrobial-associated diarrhoea and health care facility-associated infectious diarrhoea. This study aimed to investigate the prevalence, toxin genotypes, and antibiotic resistance of C. difficile among hospitalized patients in Xi’an, China.ResultsWe isolated and cultured 156 strains of C. difficile, representing 12.67% of the 1231 inpatient stool samples collected. Among the isolates, tcdA + B + strains were predominant, accounting for 78.2% (122/156), followed by 27 tcdA-B + strains (27/156, 17.3%) and 6 binary toxin gene-positive strains. The positive rates of three regulatory genes, tcdC, tcdR, and tcdE, were 89.1% (139/156), 96.8% (151/156), and 100%, respectively. All isolates were sensitive to metronidazole, and the resistance rates to clindamycin and cephalosporins were also high. Six strains were found to be resistant to vancomycin.ConclusionCurrently, the prevalence rate of C. difficile infection (CDI) in Xi’an is 12.67% (156/1231), with the major toxin genotype of the isolates being tcdA + tcdB + cdtA-/B-. Metronidazole and vancomycin were still effective drugs for the treatment of CDI, but we should pay attention to antibiotic management and epidemiological surveillance of CDI.

Unmasking Hidden Threats Global Spread of MBL Resistance Exposed

This study aims to establish a routine monitoring system for MBL enzymes to provide timely data to healthcare professionals and policy makers, enabling informed decision making on antibiotic use and resistance management. Using a combination of molecular biology techniques and data analysis, we monitor MBL activity in various institutional settings. The increasing prevalence of multidrug-resistant (MDR) bacteria is a significant threat to public health globally. Metallo-beta-lactamase (MBL), an enzyme that confers resistance to a wide range of beta-lactam antibiotics, is particularly concerning due to its ability to spread rapidly in healthcare and community settings. Despite the importance of this issue, systematic monitoring and understanding of MBL remains inadequate. Our findings reveal a significant, previously unreported presence of MBLs, underscoring the urgent need for targeted antibiotic stewardship programs. The implications of this study emphasize the importance of integrating enzyme monitoring into standard healthcare practices to reduce the spread of MDR bacteria. Highlights: Regular Monitoring: Essential for tracking MBL enzyme prevalence and guiding antibiotic use. Advanced Techniques: Molecular biology methods enhance MBL detection and analysis. Policy Integration: Crucial for implementing enzyme monitoring in healthcare to combat MDR bacteria spread. Keywords: MBL Enzymes, Antibiotic Resistance, Healthcare Monitoring, Molecular Biology, Stewardship Programs

Antibiotic prophylaxis for preventing surgical site infections after abdominal surgery

Surgical site infections (SSIs) pose severe burden in healthcare, specially in laparoscopic surgeries. It,s the leading cause of morbidity, mortality, and healthcare costs. The reason to improve this strategy is to enhance SAP practices for laparoscopic surgery by evaluating different antibiotics prophylaxis. Conducting a thorough examination on the basis of vast studies results in effective SAP implications to rule out laparoscopic surgeries leading to reduce SSI effort and safety of patient. Our research put great significance on customized approaches to SAP. In addition to SAP,various factors such as the kind of procedure, patient-specific risks, antimicrobial resistance and other preventive measures,such as surgical site antiseptics and glycemic control, RCS is also important in preventing SSIs. In addition to SAP, surgical techniques, postoperative care, and stewardship after administration outside the operative suite are needed. High-quality studies in diverse populations and development of standardized SAP protocols are warranted to optimize patient outcomes. To sum up this discussion , this chronological review gives esteemed awareness into improving SAP procedures for laparoscopic surgery. By amalgamating evidence-based guidelines and promoting effective antibiotic management , physicians and surgeons can contribute to reducing SSIs and ameliorate patient safety worldwide.

PREVALENCE AND ANTIBIOTIC RESISTANCE PROFILES OF BACTERIAL ISOLATED FROM BURN WOUND INFECTIONS

Burn wound infections remain a sizeable assignment, especially because of the superiority of multidrug-resistant gram-negative organisms. The objective of this take a look at was to assess the superiority of bacterial infections in burn wounds, perceive the most not unusual bacterial species, and determine their antibiotic resistance profiles. A overall of eighty samples had been amassed from burn sufferers. Bacterial cultures were performed, and the isolated bacteria were identified using standard microbiological techniques. Antibiotic susceptibility testing was conducted using the disc diffusion method. In this study, 44 samples (73.3%) tested positive for bacterial growth. Pseudomonas sp. was the most commonly isolated bacteria (56%), followed by Staphylococcus aureus (22%) and others. Antibiotic resistance profiling revealed high resistance rates among the isolated bacteria, with Rifampicin showing the highest resistance rate (80%), followed by Cefotaxime (64%) and Amoxicillin (56%). The high prevalence of multidrug-resistant gram-negative organisms in burn wound infections underscores the urgent need for effective antibiotic management strategies. These findings highlight the importance of continuous surveillance of antibiotic resistance patterns and the development of tailored treatment protocols to mitigate the morbidity and mortality associated with burn wound infections. Additionally, there is a critical need for the development of new antimicrobial agents and infection control measures to combat the growing threat of antibiotic resistance in burn care settings.

Resistance pattern of some bacterial isolates from burns and wound infection

Wound and burn infections present ongoing challenges in healthcare due to multidrug-resistant bacteria. This study aimed to identify bacteria from these infections, assess antibiotic resistance, and evaluate treatment efficacy. Samples from 86 patients were cultured and tested for antibiotic susceptibility. Imipenem showed effectiveness against Gram-negative bacteria, while ciprofloxacin was more effective against Gram-positive bacteria. Rifampicin demonstrated reduced sensitivity. Staphylococcus aureus and Enterobacteriaceae were prevalent, indicating increasing multidrug resistance. These findings emphasize the need for tailored treatment strategies to combat antibiotic resistance effectively in wound and burn infections. Highlight: Resistance Challenge: Addressing antibiotic resistance in wound and burn infections. Tailored Treatment: Importance of customized approaches for effective antibiotic management. Predominant Pathogens: Identifying prevalent bacteria to guide targeted treatment strategies. Keywoard: Wound Infections, Burn Infections, Antibiotic Resistance, Bacterial Identification, Treatment Efficacy

Outcomes Following Different Management of Mycotic Infrarenal Abdominal Aortic Aneurysms.

The objective was to present our experience on managing mycotic infrarenal abdominal aortic aneurysm (MIAAA) through a retrospective cohort study. Data of patients with MIAAA managed in our center from July 2016 to October 2022 were retrospectively analyzed. The diagnosis of MIAAA was made based on: (1) preoperative clinical signs of infection; (2) elevated serologic infection parameters; (3) para-aneurysmal infection features on enhanced computed tomography; and (4) positive blood or tissue cultures. All the patients received standard antibiotic therapy. Surgical management including endovascular aneurysm repair (EVAR), initial EVAR followed by open re-operation, and initial open surgical repair (OSR) were conducted according to disease seriosity, physical condition, and patient's will. Infection index and clinical outcome were evaluated during the follow-up time. A total of 23 patients (21 men; averaged=66.3 years, range=49-79 years) were included, with a mean follow-up time of 19.9 months (range=1-75 months). Bacteria culture from blood or tissue specimen was positive in 15 patients (Salmonella, n=8; Escherichia coli, n=3; methicillin-sensitive Staphylococcus aureus [MSSA], n=1; Klebsiella pneumoniae, n=1; Staphylococcus epidermidis, n=1; Mycobacterium tuberculosis, n=1). Seven patients received OSR as the initial surgical intervention, whereas 14 patients chose EVAR instead. The 2 conservatively managed patients (refused surgery) died within 30 days. The 7 patients who received initial OSR survived till now. Among the 14 patients who underwent initial EVAR, infection deteriorated without exception (14/14, 100%). Three of these patients refused re-operation and died within 6 months. Eleven patients received secondary surgical intervention (10 cases of aneurysm and endograft resection, thorough debridement, subclavian to bi-femoral artery bypass, or in situ aorta reconstruction; 1 case of laparoscopic debridement) and 7 survived the follow-up time. The overall mortality rate was 39.1% (9/23). The mortality rates differed greatly following different intervention methods (merely antibiotic management, 100%; initial open operation, 0%; initial EVAR without secondary operation, 100%; initial EVAR plus secondary operation, 36.4%). Open surgical repair is still the first choice for hemodynamically stable and low-risk patients. Merely EVAR is related with disastrous results, which should be reserved as a temporary alternative for patients with ruptured aneurysms, hemodynamic instability or high surgical risk, and followed by timely secondary OSR. The management of mycotic or primary-infected aortic aneurysm is challenging; treatment remains controversial. Our center has reviewed our experience over the past 6 years and found that open surgical repair is still the first choice for hemodynamically stable and low-risk patients. Merely endovascular aneurysm repair (EVAR) is related with disastrous results, which should be reserved as a temporary alternative for patients with ruptured aneurysms, hemodynamic instability or high surgical risk, and followed by timely secondary open surgical repair.

Antibiotic regimens tailored by clinical pharmacist supported by intensivist enhance rational use of antibiotics

ABSTRACT Background High antibiotics utility rates have been observed in surgical intensive care units (SICU). The present study was performed to evaluate the effect of engaging a clinical pharmacist in SICU on rational use of antibiotic treatment. Methods This retrospective quasi-experimental experiment involved 505 patients, over a period of one year, admitted to emergency department surgical/trauma ICU of a large tertiary care hospital. Before and during pharmacist participation periods of six months, 226 and 153 patients, respectively, are compared. Results Antibiotics consumption pattern changed with a decrease in total antibiotic consumption from 101.42 to 94.1 Defined Daily Dose/100 patients’ days after the clinical pharmacist participation, in addition to, a statistically significant rise (p = 0.001) in percentage of appropriateness of the prescribed antibiotic therapy from 72.1% to 86.3%. Time to control infection (days) was not statistically different (p = 0.825) in both periods. The average ICU days of stay was statistically significant longer (p = 0.046) during pharmacist attendance (4.42 ± 5.61) in comparison with period without pharmacist attendance (3.31 ± 3.66). The difference in ICU mortality rate was not statistically significance (p = 0.217). Cost per stay increased by 65% during pharmacist intervention period. Conclusions Antibiotic management with pharmacist participation as a part of multidisciplinary team with intensivist can promote rate of the appropriateness of the prescribed antibiotic therapy, lower utility of antibiotic consumption, but with a longer ICU stay, no mortality reduction, and higher expenses per stay. Trial Registry ClinicalTrials.gov: NCT04931914.

The Prevalence of Antibiotic Resistance Phenotypes and Genotypes in Multidrug-Resistant Bacterial Isolates from the Academic Hospital of Jaén, Spain.

The heterogenicity of antimicrobial resistance genes described in clinically significant bacterial isolates and their potential role in reducing the efficacy of classically effective antibiotics pose a major challenge for global healthcare, especially in infections caused by Gram-negative bacteria. We analyzed 112 multidrug-resistant (MDR) isolates from clinical samples in order to detect high resistance profiles, both phenotypically and genotypically, among four Gram-negative genera (Acinetobacter, Escherichia, Klebsiella, and Pseudomonas). We found that 9.8% of the total selected isolates were classified as extensively drug-resistant (XDR) (six isolates identified as A. baumannii and five among P. pneumoniae isolates). All other isolates were classified as MDR. Almost 100% of the isolates showed positive results for blaOXA-23 and blaNDM-1 genes among the A. baumannii samples, one resistance gene (blaCTX-M) among E. coli, and two genetic determinants (blaCTX-M and aac(6')-Ib) among Klebsiella. In contrast, P. aeruginosa showed just one high-frequency antibiotic resistance gene (dfrA), which was present in 68.42% of the isolates studied. We also describe positive associations between ampicillin and cefotaxime resistance in A. baumannii and the presence of blaVEB and blaGES genes, as well as between the aztreonam resistance phenotype and the presence of blaGES gene in E. coli. These data may be useful in achieving a better control of infection strategies and antibiotic management in clinical scenarios where these multidrug-resistant Gram-negative pathogens cause higher morbidity and mortality.

Evaluating antibiotic prophylaxis adherence: Implications for surgical site infections and wound care management

AimThis study aimed to evaluate adherence to an antibiotic prophylaxis protocol and its impact on incidence of surgical site infection (SSI). Materials and methodA prospective observational cohort study was conducted at a teaching hospital in São Paulo, Brazil, from September to November 2015. The population were adults who underwent surgery with surgical antibiotic prophylaxis. The main outcomes measured were incidence of SSI at 30-days postoperatively, protocol adherence and surgical wound complications. STROBE guidelines were followed. ResultsAmong the 527 participants recruited, a 30-day follow-up was completed by 78.7 % (n = 415). Within this cohort, 57.6 % were females aged over 60 years (36.4 %). The incidence of SSI stood at 9.4 % (n = 39), with dehiscence being the most prevalent complication at 64.1 % (n = 25), followed by increased exudate at 51.3 % (n = 20). Notably, full adherence to the antibiotic prophylaxis protocol was low at 1.7 % (n = 7). The study observed a 60 % increased risk of SSI for every protocol mistake made. Alarmingly, 17.8 % (n = 74) of participants received antibiotic treatment exceeding the stipulated protocol duration. The overall mortality rate stood at 13.5 % (n = 56), with 1 % (n = 4) of these deaths attributed to SSI. ConclusionThere is a pressing global necessity to enhance antibiotic management, as underscored by this study's revelation of low adherence to the antibiotic prophylaxis protocol. This lack of adherence correlated with a notable incidence of SSI and subsequent wound complications. Nearly 20 % of participants received prolonged antibiotic treatment. Adhering strictly to the protocol could substantially impact SSI-related outcomes and enhance global antibiotic management.

Correction to: Economics of Informed Antibiotic Management and Judicious Use Policies in Animal Agriculture

Correction to: Economics of Informed Antibiotic Management and Judicious Use Policies in Animal Agriculture

Research status and rapid detection methods of antibiotic residues in agricultural products

Antibiotics are widely utilized in agriculture for the prevention and treatment of animal diseases. How-ever, the abuse and overuse of antibiotics progressively increase the risks of antibiotic residues and antibiotic resis-tance. The bioaccumulation and biomagnification of antibiotics through food chains will negatively affect ecological safety, and finally threaten human health. There are many shortages of traditional antibiotic detection techniques, such as complex procedures, complicated operation and time consuming, and thus are difficult to meet the demand of instant, efficient and accurate on-site detection. Therefore, it is crucial to develop rapid detection techniques of antibiotics to manage the application of antibiotics in agriculture. We reviewed the utilization, and management of antibiotics in animal husbandry, residual characteristics, and potential hazards of antibiotics in agricultural products, summarized the advancements in rapid detection techniques of antibiotics in agricultural products over the past five years, compared the advantages and disadvantages of different rapid detection techniques, and prospected the future development in this area. This review would provide a valuable reference to the control and point-of-care test of antibiotics in agricultural products.

Year in Review 2023: Noteworthy Literature in Cardiothoracic Critical Care.

This article reviews noteworthy investigations and society recommendations published in 2023 relevant to the care of critically ill cardiothoracic surgical patients. We reviewed 3,214 articles to identify 18 publications that add to the existing literature across a variety of topics including resuscitation, nutrition, antibiotic management, extracorporeal membrane oxygenation (ECMO), neurologic care following cardiac arrest, coagulopathy and transfusion, steroids in pulmonary infections, and updated guidelines in the management of acute respiratory distress syndrome (ARDS).