Antibiotic Therapy For Treatment Research Articles

The Deltacron conundrum: Its origin and potential health risks.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), since its outbreak in December 2019, has been capable of continuing the pandemic by mutating itself into different variants. Mass vaccinations, antibiotic treatment therapy, herd immunity, and preventive measures have reduced the disease's severity from the emerging variants. However, the virus is undergoing recombination among the current two variants: Delta and Omicron, resulting in a new variant, informally known as "Deltacron,"which was controversial as it might be a product of lab contamination between Omicron and Delta samples. However, the proclamation was proved wrong, and the experts are putting more effort into better understanding the variant's epidemiological characteristics to control potential outbreaks. This review has discussed the potential mutations in the novel variant and prospective risk factors and therapeutic options in the context of this new variant. This study could be used as a guide for implementing appropriate controls in a sudden outbreak of this new variant.

Asymptomatic bacteriuria and pyelonephritis during pregnancy

The most common extragenital pathology during pregnancy is urinary tract infection (UTI) of various localization. In some cases, untreated UTI can contribute to the development of obstetric, urological, and perinatal pathologies. Factors predisposing to the UTI manifestation may include increased progesterone, delayed peristalsis, urine retention in the ureters, uterine growth, bladder displacement, and increased residual urine volume. Asymptomatic bacteriuria (ASB) during pregnancy can increase the risk of pyelonephritis and subsequent maternal and fetal complications. Pregnant women should be screened for ASB at least once at the beginning of pregnancy (aft er 14 weeks). E.coli is the dominant uropathogen in 70 – 95% of UTI cases in pregnant women. The main treatment for ABT and pyelonephritis in pregnancy (PiP) is antibiotic therapy (ABT), which is prescribed empirically in most cases. There is currently no consensus on the choice of ABT and the duration of treatment for UTI in pregnant women. In the case of ineff ective drug therapy of PiP, it is necessary to raise the issue of the upper urinary tract drainage promptly.

Comparative analysis of medications for antibiotic therapy of chronic obstructive pulmonary disease in the pharmaceutical market of Ukraine and France

The aim of the work – comparative analysis of the assortment of registered medicines for antibiotic therapy of chronic obstructive pulmonary disease (COPD) in the domestic market and similar segment of the French market. Materials and methods. The study of drug assortment in Ukraine was carried out according to the State Register of Medicines of Ukraine , employing the directory of medicines Compendium online , Anatomical Therapeutic Chemical Classification , web-resource Tabletki.UA . Database Base de donnees publique des medicaments was consulted while studying the pharmaceutical market in France. The following methods were used: information search, marketing analysis, graphical, comparative and logical methods. Results . A comparative analysis of medicines employed in Ukraine and France for antibiotic therapy of chronic obstructive pulmonary disease (COPD) was performed. Conclusions . Pharmaceutical markets of drugs for antibiotic therapy of COPD in Ukraine and France are analyzed. As of January 2020, there are 43 brand names (BN) of medicines with 73 available range items registered in Ukraine, and 87 BN medicines with 150 available range items registered in France. The analysis of drugs assortment showed that foreign drugs predominate in Ukraine and France, their share is 84 % and 55 %, respectively. Among the drug-importing countries, the leaders in Ukraine are India and Germany, and in France they are Spain, England and Germany. The share of domestic drugs in Ukraine and France is lower – 16 % and 45 %, respectively. The leaders among domestic manufacturers in Ukraine are Yuria-Pharm LLC and Astrapharm LLC , in France they are Sanofi Winthrop Industrie , Mylan S.A.S. , Delpharm Tours , Delpharm Lille S.A.S. and Panpharma . In the two countries, the majority of drugs for COPD antibiotic therapy treatment is manufactured as powders for solutions and injections, and as tablets; their share in Ukraine is 41 % and 33 %, in France – 19 % and 59 %, respectively. Monocomponent drugs prevail in Ukraine and France. Since the Ukrainian pharmaceutical market, in comparison with the French drug market, is significantly dominated by foreign drugs, it is important to develop new domestic drugs that would be used in COPD treatment.

Study protocol for daiobotanpito combined with antibiotic therapy for treatment of acute diverticulitis: a study protocol for a randomized controlled trial

BackgroundColonic diverticular disease has been increasing in prevalence due to the rapidly aging global population, but standard treatment has not changed dramatically in recent years. Daiobotanpito (DBT; Da Huang Mu Dan Tang in Chinese) has been used in medical treatment of acute abdominal abscesses, such as appendicitis or diverticulitis in traditional Japanese (Kampo) medicine for many years, based on more than 3000 years of experience. Prior to this study, a retrospective open-label trial was conducted to compare patients with acute diverticulitis who received oral DBT combined with intravenous antibiotics with those who received intravenous antibiotic alone; it showed a positive effect of DBT on acute diverticulitis. We aim to investigate whether moderate to severe acute diverticulitis shows greater improvement with intravenous antibiotics plus orally administered DBT compared with intravenous antibiotics plus placebo.MethodsThis is a two-group, randomized, double-blind, placebo-controlled, multi-center trial, which is designed to evaluate the efficacy and safety of DBT in patients with moderate to severe diverticulitis treated with intravenous antibiotics. Eligible participants will be randomized to either a treatment group receiving a 10-day oral DBT regimen plus conventional therapy or a control group receiving a 10-day placebo regimen plus conventional therapy. The primary outcome will be success in treating diverticulitis: the success rate will be defined as elimination of abdominal pain within 4 days in all patients, and in patients with fever (body temperature ≧ 37.5 °C) on inclusion into this study, fever relief with reduction in body temperature to < 37.5 °C within 3 days. Secondary endpoints will include the number of hospitalization days, changes in inflammatory response (C-reactive protein (CRP), white blood cell (WBC) and neutrophil counts), fever type, number of days before beginning food intake, recurrence rate (observation for 1 year after registration), and adverse event expression rate. Assessments will be performed at baseline and on the day of discharge. The recurrence rate will be recorded at 1 year after registration.DiscussionThis study is expected to provide evidence to support the clinical benefits of DBT in the treatment of acute diverticulitis. It may also provide evidence on the efficacy and safety of DBT in the recurrence of acute diverticulitis.Trial registrationUMIN-CTR: UMIN000027381. Registered on 27 April 2017.https://upload.umin.ac.jp/cgi-bin/ctr/ctr_view_reg.cgi?recptno=R000031377, and changed to jRCTs041180063, registered on 30 July 2019; as a result of the revision of the domestic law in 2018 in Japan.

Prevalence of Antibiotic-Resistant Bacteria Isolated From Infant Stools Aged Less Than 2 Years after Antibiotic Therapy Treatment

65 stool samples were analyzed for insulation, identification and multiresistant bacteria becoming from infant aged less than two years of the pediatric ward of Khalil Amrane Hospital-Bejaia. The study of antibiotic administration by type, revealed that amoxicillin was the most commonly administered antibiotic with a rate of (33.33%) followed by gentamicin at (20.43%) and ampicillin at (17.20%). As well, the distribution of antibiotics administered by family and group revealed the predominance of B-Lactamines with a percentage of (72.04%) of which the group of penicillins of group A is predominant (50.54%). The identifications and antibiotic susceptibility tests of the various isolated pathogenic strains were carried out. From all samples, 35 bacterial isolates were identified by macroscopic, microscopic observations, and physiological and biochemical tests. According to which it can be seen clearly that the most frequent species isolated was Clostridium perfringens with 12 (34.28%) isolates. Followed, by Escherichia coli with 11 (31.43%) isolates. Enterobacter sp were represented by 8 (22.86%) isolates. The least frequent species was Staphylococcus aureus with 4 (11.83%) isolates. Furthermore, antibiogram method showed that all bacteria tested were multiresistant to 1 to 6 antibiotics.

Impact of Postnatal Antibiotics and Parenteral Nutrition on the Gut Microbiota in Preterm Infants During Early Life.

The early-life gut microbiota, which is critically important for the long-term health of infants, is normally sensitive to perturbations, especially in preterm infants. However, how the gut microbiota develops and what key factors affect the preterm gut microbiota remain largely unknown. We hypothesized that preterm microbial dysbiosis exists from the beginning after birth, and microbial alteration is associated with parenteral nutrition and antibiotic therapy interventions. Fecal samples were collected from fifty-one preterm and fifty full-term vaginally delivered (FTVD) infants at 7 time points for 90days after birth. The microbial profiles of 558 fecal DNA samples were analyzed by sequencing their 16S ribosomal RNA amplicons. A random-effects generalized least square regression was used to identify factors that influence the bacterial composition over time. The altered gut microbiota in preterm infants existed from the meconium, having significantly lower levels of Escherichia-Shigella than those in FTVD infants. The developmental trajectories of 7 predominant bacterial groups successfully fitted with exponential/linear function curves (R2 , 0.921-0.993) in both groups. By day 90, depleted levels of Bacteroides and Parabacteroides and an overabundance of Peptoclostridium were characteristic of the preterm group. The prolonged use of antibiotics and parenteral nutrition had significant adverse effects on the Lactobacillus and Bifidobacterium levels in preterm infants. Moreover, gestational age, sex, and birth weight were factors impacting specific genera in preterm infants. The early-life microbial composition and functions were markedly different in preterm infants, being associated with the prolonged use of postnatal antibiotics and parenteral nutrition.

Rational antibiotic therapy in treatment of bacterial tonsillitis in children

On the part of tonsillitis every second child suffers, and chronization of the infectious process leads to a number of complications from the organs and systems. Peritonsillar abscesses, tonsillitis sepsis, arthritis, vasculitis, rheumatism and heart disease all of these are the consequence of defective tonsillitis. There fore, the approach to the treatment of inflammations of palatine tonsils should be comprehensive and based on the results of continuous monitoring of microbial flora with a clear definition of the spectrum of its sensitivity to antibacterial agents. Purpose — improvement of antibiotic therapy of acute bacterial tonsillitis in children, based on the results of antibioticograms. The bacteriological method was used for the study, the seeds were culled quantitatively on 5% blood meat peptone agar and dense Saburo agar. Determination of the sensitivity of isolated microorganisms' cultures to antibacterial preparations was carried out by disc diffusion method. The examined contingent was made up of 75 children aged 1 to 17 years old who were on treatment with a diagnosis of acute tonsillitis in VRCCIH. Gr. (+) bacterial microflora was represented by coca flora with a high density of colonization: S.pyogenes (in 100% of children) — (4.16±0.07) Ig CFU/ml, S.salivarius (at 24.0%) — (2.96±0.12) Ig CFU / ml, S.epidermidis (62.6%) — (2.27±0.09) Ig CFU / ml, S.aureus (91.0%) — (3.38±0.11) Ig CFU / ml and Enterococcus spp. (42.6%) — (4.17±0.32) Ig CFU / ml. Among the microbial flora of Gr. (–), K.pneumoniae (in 65.3% of patients) with colonization ability (4.61±0.43) Ig CFU /ml, P.aeruginosa (in 20.0%) — (5,53±0.13) Ig CFU/ml, Alcaligenes spp. (24.0%) — (4.71±0.25) Ig CFU/ml, E.coli (at 65.3%) — (5,13±0.22) Ig CFU/ml, E.coli (69.3%) — (4.35±0.15) Ig CFU/ml. The isolated microflora was characterized by a low spectrum of sensitivity to antibacterial agents. So, S.pyogenes and Enterococcus spp. were sensitive to ceftriaxone (83.5% and 89.9% respectively), and S.aureus to oxacillin (84.0%), whereas S.pyogenes was resistant to 92.3%. Resistant S.aureus and Enterococcus spp. to the reserve cefepime (96.2% and 58.6% respectively) to which P.aeruginosa and Alcaligenes spp. were sensitive (79.3% and 78.2% respectively). Resistant to the latter were up to azithromycin in 95.1% and 91.3% of cases. E.coli, E.coli and K.pneumoniae were almost equally resistant to clarithromycin, showing high susceptibility to reserve vancomycin. Thus, in a microbiological study all children in the smears showed β-hemolytic streptococcus represented by S.pyogenes with high colonization density (4.16±0.07) Ig CFC / ml and in 91.0% of children S.aureus was isolated from colonization capacity (3.38 ± 0.11) Ig CFU / ml. Bacteria of the genus Alkaligenes were sown in 18 diseased children (24.0%), and 15 children (20.0%) isolated Pseudomonas aeruginosa. Conditionally pathogenic E.coli, E.cloacae and K.pneumoniae cultivated in more than 60.0% of cases and were characterized by high pathogenic activity. According to the results of the antibioticograms S.pyogenes and Enterococcus spp. were sensitive to ceftriaxone and resistant to cefepime. Gr.( –) flora, on the contrary, reacted to the reserve cefepimum, while exhibiting high resistance to the macrolide.

Dual effect biodegradable ciprofloxacin loaded implantable matrices for osteomyelitis: controlled release and osteointegration

Ciprofloxacin biodegradable implantable matrices (CPX-IMs) of tailored porous surfaces were fabricated by hot melt injection molding of poly-l-lactic acid (PLLA) followed by coating with PLLA/sodium chloride. CPX-IDs were designed to have a non-porous coat (NPC) or a porous coat of small pore size (SPC; 150–250 µm) or a large pore size (LPC; 250–350 µm). CPX-IMs surface pore size was confirmed by scanning electron microscope. The hardness of NPC, LPC, and SPC CPX-IMs were 58 ± 2.8, 53 ± 1.9, and 50 ± 2.1 N, respectively. The measured porosity values were 41.2 ± 1.53, 65.2 ± 1.1, and 60.7 ± 1.2%, respectively. Differential scanning calorimetry was employed to study the compatibility of ingredients, the effect of injection molding on polymer properties, and implants degradation. Coating of CPX-IMs prolonged drug release to reach a value of 90% release in 40 days. Antibacterial activity tests showed sufficiency of CPX to inhibit pathogens known to cause osteomyelitis. The in vivo study showed tissue compatibilities of the inserted matrices in tested rats with no sign of infection throughout the experiment period. SPC and LPC CPX-IMs demonstrated a better osteointegration, cell adhesion, and infiltration of different types of bone cells within implants structure compared to the non-porous matrix. Furthermore, LPC CPX-IMs showed a superior bone cell attachment and osteointegration relative to SPC CPX-IMs. Findings of this study confirmed the impact of porosity and pore sizes on cell proliferation and fracture healing concurrently with the sustained local antibiotic therapy for treatment or prevention of osteomyelitis.

Hongteng decoction combined with antibiotic therapy for treatment of periappendiceal abscess: Therapeutic effect and possible immune mechanism

Hongteng decoction combined with antibiotic therapy for treatment of periappendiceal abscess: Therapeutic effect and possible immune mechanism

Improvement of semen parameters after antibiotic therapy in asymptomatic infertile men infected with Mycoplasma genitalium.

To elucidate the association between asymptomatic infections caused by Mycoplasma genitalium and male infertility, and evaluate the role of antibiotic therapy in treatment of this failure. A total of 165 infertile males having abnormal semen parameters (study group) and 165 healthy fertile men (control group) were included. Semen samples were taken from all participants and after analyzing for semen parameters, undergone real-time PCR, microbial culture, and reactive oxygen species (ROS), as well as total antioxidant capacity (TAC) assays. Infected individuals of study group were treated with antibiotic. One month after the treatment completion, second semen samples were taken and subjected to all the tests mentioned. The data were analyzed using SPSS statistical software, version 22.0. The frequency of M. genitalium was significantly higher in the infertile men compared with the fertile ones (9.7% vs. 1.2%; p=0.001). Mean cycle threshold (C t) value was lower in infected infertile than infected fertile men (p<0.001). All semen parameters, except volume, pH, and viscosity, were improved (p<0.05), most of which reached their normal range; leukocytes in seminal fluid decreased (p=0.02), the level of TAC was elevated (p=0.002), and ROS level as well as ROS/TAC ratio reduced after antibiotic treatment (p=0.03). Wives of seven infected infertile men (43.8%) became pregnant 4months after the treatment completion. Asymptomatic infection caused by M. genitalium is correlated with male infertility and antibiotic therapy can improve the semen quality and be used to treat male infertility.

Role of Suppressive Oral Antibiotics in Orthopedic Hardware Infections for Those Not Undergoing Two-Stage Replacement Surgery.

Background. The use of suppressive antibiotics in treatment of orthopedic hardware infections (OHIs), including spinal hardware infections, prosthetic joint infections, and infections of internal fixation devices, is controversial. Methods. Over a 4-year period at 2 academic medical centers, patients with OHI who were treated with debridement and retention of hardware components, with single-stage exchange, or without surgery were studied to determine whether use of oral antibiotics for at least 6 months after diagnosis impacts successful treatment of the infection at 1 year after diagnosis. Results. Of 89 patients in the study, 42 (47.2%) were free of clinical infection 1 year after initial diagnosis. Suppressive antibiotics used for at least 6 months after diagnosis was not associated with being free of clinical infection (adjusted odds ratio [aOR], 5.29; 95% confidence interval [CI], .74-37.80), but being on suppressive antibiotics at least 3 months after diagnosis was associated with being free of clinical infection (OR, 3.50; 95% CI, 1.30-9.43). Causative organisms impacted the likelihood of success; patients with methicillin-resistant Staphylococcus aureus as well as with Gram-negative rods were both less likely to have achieved clinical success at 1 year after surgery (aOR = 0.018, 95% CI = .0017-.19 and aOR = 0.20, 95% CI = .039-.99, respectively). Conclusions. Oral suppressive antibiotic therapy in treatment of OHI with retention of hardware for 3 months, but not 6 months, postdiagnosis increases the likelihood of treatment success. The organisms implicated in the infection directly impact the likelihood of treatment success.

Pyogenic Liver Abscess: Prospective Evaluation Of USG Guided Percutaneous Therapeutic Aspiration

Background: Pyogenic liver abscess (PLA) has been a condition of high mortality, improving over recent decades with combined antibiotic and percutaneous drainage Percutaneous drainage is currently the treatment of choice in liver abscess. Percutaneous needle aspiration(PNA) as an alternative to continuous percutaneous catheter drainage in combination with systemic antibiotics for the treatment of PLA has never been popular. AimsO 15 female; most common age range 40-50 years; mean age 44.34 years) with PLAs (mean diameter 6.52±1.8 cm; range 4.8- 9cm) underwent PNA with ultrasound (USG) guidance and antibiotic therapy. Complete pus removal from each abscess was attempted with 18 gauge thin-walled trocar needles with USG guidance. If necessary, PNA was repeated every 3 day. Results: The percentage of abscesses requiring one, two, three and more sessions of aspiration was 50%, 30%, 18% and 2% respectively. The success rate was unrelated to the largest size or number of abscess in the patient. Cure (normalization of clinical and laboratory parameters and resolution of hepatic lesions) was achieved in all patients (100%).. Patients were hospitalized for 7-22 days (mean11±4.56days) No patient needed imaging-guided percutaneous catheter drainage or open surgical. Neither complications nor deaths ensued. Recurrence of PLA was not observed in any patient during follow-up (6-12) months Conclusions: USG-guided PNA with antibiotic therapy in treatment for PLA is a safe, effective & low-cost procedure. It should be considered as a first line alternative to catheter drainage. Our data suggest that a trial of percutaneous needle aspiration should always be undertaken before catheter drainage or surgery.

OralSaccharomyces boulardiicombined with conventional antibiotic therapy for treatment of secondary diarrhea in neonates

Oral<i>Saccharomyces boulardii</i>combined with conventional antibiotic therapy for treatment of secondary diarrhea in neonates

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

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.

Рациональная антибиотикотерапия в лечении воспалительных заболеваний глаза бактериальной этиологии в педиатрической практике

Рациональная антибиотикотерапия в лечении воспалительных заболеваний глаза бактериальной этиологии в педиатрической практике

New paradigms of urinary tract infections: Implications for patient management

Urinary tract infections (UTIs) represent one of the most commonly acquired diseases among the general population as well as hospital in-patients, yet remain difficult to effectively and consistently treat. High rates of recurrence, anatomic abnormalities, and functional disturbances of the urinary tract all contribute to the difficulty in management of these infections. However, recent advances reveal important molecular and genetic factors that contribute to bacterial invasion and persistence in the urinary tract, particularly for the most common causative agent, uropathogenic Escherichia coli. Recent studies using animal models of experimental UTIs have recently provided mechanistic insight into the clinical observations that question the effectiveness of antibiotic therapy in treatment. Ultimately, continuing research will be necessary to identify the best targets for effective treatment of this costly and widespread infectious disease.

Comparison of antibiotic-only and antibiotic-steroid combination treatment in corneal ulcer patients: double-blinded randomized clinical trial

Objective: To determine the benefit of early addition of corticosteroids to antibiotics in the treatment of corneal ulcers. Design: Randomized clinical trial. Participants: Thirty eyes of 30 patients, over the age of 12 years, with bacterial corneal ulcer confirmed by culture. Methods: Patients were randomized before enrollment; 15 were treated with gatifloxacin (Zymar) and a masked placebo and the other 15 were treated with gatifloxacin and masked dexamethasone 0.1% (Maxidex). Primary outcome was residual ulcer size at 10 weeks based on digital photographs. Secondary outcomes included residual ulcer area by clinician estimate, visual acuity, VF-14 score, and time to healing. Results: All subjects (n = 30) demonstrated a reduction in ulcer size over the study period. There was no significant difference between the 2 groups in terms of the primary outcome. There was a significant difference between the 2 groups in 1 of the secondary outcomes. The mean residual ulcer size compared with the baseline by clinician estimate (slit-lamp) was −0.789 mm 2 for the antibiotic-only group and −4.206 mm 2 for the antibiotic-steroid group ( p = 0.05). Among the other secondary outcomes there were no significant differences between the 2 groups. Conclusions: No benefit was demonstrated in our primary outcome for using steroids in combination with antibiotic therapy in treatment of corneal ulcers. This study suggests that the early addition of steroids to the antibiotic treatment of corneal ulcers does not seem to be harmful when employed in a closely monitored clinical setting.

Short vs. Long Course of Antibiotics for Pediatric Septic Arthritis

Controversy exists about the optimal duration of antibiotic therapy for treatment of septic arthritis in children and about the role of surgical

GASTRIC MALT LYMPHOMA AND HELYCOBACTER PYLORI INFECTION

Introduction: Gastric MALT lymphoma accounts aproximately 7% of all gastric tumors. Women are mostly affected by this disease (mean age 60 years). The aim of this study was to determine the incidence of gastric MALT lymphoma in the Endoscopy Unit of the Department of Gastroenterology Of University Clinical Center Tuzla, the degree of histological malignancy and correlation with the Helycobacter pylori infection and then to evaluate the effectiveness of triple-antibiotic therapy (protonic pump inhibitors and antacides) in treatment of these cases. Patients and methods: All the patiens in the study were performed with gastroscopy and mucosal tissue biopsy in the Endoscopy Unit of the Department of Gastroenterology of UKC Tuzla. PHD and IHH analysis of the given material were performed in the Patology Department of UKC Tuzla. The blood analyses on H. Pylori were done in the Department of Microbiology of UKC Tuzla. Results: 112 patients with gastric tumors were involved in this study, 91 of whom suffered from malignant tumors, six of them had MALT lymphoma (five of them had confirmed H. pylori infection, four had histologically confirmed low-grade tumors and two was categorised as high grade malignancies). Histological lesions were classified according to the actual Ann Arbor classification. Patients with high malignancy risk underwent the operative procedures, and then were treated by polychemiotherapy (CHOP protocole, VI-VIII cikluses). All the patients with confirmed H. pylori infection were treated with antibiotics for 2-4 months, after which complete eradication was accomplished in all cases. Patients histologicaly diagnosed with low grade malignancy showed complete histological regression. In addition to that, after triple antibiotic therapy none of the patients presented with the disease transformation into another histological form. Discussion and Conclusion: The results of this study prooved high incidence in use of triple antibiotic therapy in treatment of patients who suffer from MALT lymphoma with confirmed H. pylori infection. Besides, it is very important to emphasise the fact that patients had no side-effects during polychemiotherapy which was used to treat all the patients regardless of their histological type and malignancy degree of MALT lymphoma.

A distributed environment for the integration of multiple high-performance decision support systems into clinical workflow

Current studies conclude that clinical decision support systems can help reduce serious medical errors. The importance of Causal Probabilistic Networks (CPNs) for constructing such systems is already well-known. However, the computational complexity of probabilistic inference, which results in unacceptably high response times, can hinder acceptance and integration into clinician workflow. This paper investigates the optimization and parallelization potential of complex CPN-based medical decision support systems and evaluates the results of implementing a parallel, high performance version of an existing decision support system concerning proper antibiotic treatment therapy. Furthermore, it discusses distributed computing techniques for making multiple high performance decision support systems available at the time and location of decision making, by exploiting computing resources residing inside, as well as outside the hospital walls optimally.