Antibiotics In People Research Articles

Antimicrobial resistance: A significant public health issue of both human and veterinary concern

Abstract Introduction The discovery of antibiotics and the subsequent realization that these medications are the most effective treatments for a wide range of illnesses affecting the health of humans and animals constituted a revolution in medical history. Methods A review of the literature was done, looking for pertinent studies, using an explorative review method to discuss how the widespread use of antibiotics often led to bacterial resistance and antibiotic residue in food animals, which negatively impacted humans and animals. Results The study showed that treating bacterial resistance is a therapeutic challenge for physicians and veterinary professionals. Increased treatment failure rates, the severity of disease-causing infections, the frequency of blood infections, the length of time patients were sick, and the death rate in both humans and animals are all signs that the overuse of antibiotics is becoming a catastrophe. Discussion To prevent the negative effects of antibiotics in people, animals, and the environment, especially in developing nations, this article ends by recommending that strict guidelines, laws, and regulations regarding the use of antibiotics in clinical human and veterinary medicine be implemented. Concern must be expressed about the effects of inactivity on public health, both now and in the future. We may attempt to reverse the global resistance issue by increasing the use of antibiotics and reducing the frequency of resistance genes at all levels. Ultimately, the safety of animal products depends on the proper use of antibiotics in animal husbandry under the supervision of a veterinarian.

The Association between Aminoglycoside Exposure and Ototoxicity in Children with Cystic Fibrosis

Introduction: Pulmonary exacerbations increase the requirement of aminoglycoside (AG) antibiotics in people with cystic fibrosis (pwCF). Several studies have shown that AGs have a cumulative effect on ototoxicity. We aimed to investigate the relationship between AG exposure and ototoxicity by using 3 different methods in patients with CF. Materials/Methods: The multicenter study included 121 pwCF aged between 5 and 18 years with a history of parenteral AG exposure. Standard pure-tone audiometry, extended high-frequency pure-tone audiometry (EHF-PTA), and distortion-product otoacoustic emissions (DPOAE) tests were performed. Mitochondrial mutation analysis for m1555G>A was performed in 61 patients. Results: Median age was 12.85 years and 52.1% (n = 63) were male. 18.2% (n = 22) of the patients had received parenteral AGs more than 5 courses/lifetime. Ototoxicity was detected in at least one of the tests in 56.2% (n = 68) of the patients. Only 10.7% (n = 13) of the patients had reported a symptom indicating ototoxicity. 30.3% (n = 30) of the patients had ototoxicity in the low exposure group, while it was 45.5% (n = 10) in the high exposure group according to EHF-PTA (p > 0.05). Median number of parenteral amikacin courses was significantly higher in the ototoxic group (2 [1.25–5.75] vs. 2 [1–3]; p = 0.045). No m1555A>G mutation was detected in 61 patients who screened for mitochondrial mutation analysis. Conclusion: As AG ototoxicity occurs primarily at high frequencies, EHF-PTA is important in early detecting ototoxicity. EHF-PTA and DPOAE detected ototoxicity in some patients with normal PTA results. All pwCF with a history of AG exposure should be evaluated for hearing loss since symptoms may only be noticed in the late period.

P115 A retrospective analysis of the ECFSPR to characterise the pulmonary phenotype and use of intravenous antibiotics in people with cystic fibrosis harbouring bi-allelic CFTR class 1 mutations

P115 A retrospective analysis of the ECFSPR to characterise the pulmonary phenotype and use of intravenous antibiotics in people with cystic fibrosis harbouring bi-allelic CFTR class 1 mutations

Prescribing antimicrobials effectively in Dentistry; Resources to support the role of the dentist in antimicrobial stewardship

Background The discovery of antibiotics revolutionised modern medicine and extended the average human lifespan by 23 years.1 Antimicrobial resistance threatens to reverse the progress that has been made. In 2019, there were 4.95 million deaths globally associated with drug-resistant bacterial infections.2 That figure may rise to as many as 50 million by 2050, making this an unprecedented global public health problem.3 The threat of a post-antibiotic era has prompted the publication of Ireland’s One Health National Action Plan on Antimicrobial Resistance (2021-2025).4 This National Action Plan advocates for the judicious use of antimicrobials to limit any unintended consequences and antimicrobial resistance. This is commonly known as Antimicrobial Stewardship. Antibiotic resistance is largely driven by the overuse and misuse of antibiotics in people, animals and in the environment.4 Dentists are responsible for approximately 10% of antibiotic prescribing in humans globally.5 With several international studies of dental antibiotic prescribing demonstrating that overprescribing occurs frequently5, dentists have an opportunity to contribute significantly to slowing the development and spread of antibiotic resistance by optimising prescribing. This article aims to show how dentists can support good antimicrobial stewardship in their practice.

How Phage Therapy Works, Its Advantages and Disadvantages: Mini Review

Phage therapy is a treatment method that uses bacteriophages, which are viruses that infect bacteria, to treat bacterial infections. Phages are natural adversaries, helping to restrict their proliferation in the natural environment. Phages are made up of DNA or RNA in a protein capsid and cannot multiply independently, relying on bacterial hosts to live. The use of antibiotics in people and animals is a key contributor to antimicrobial resistance (AMR), a serious public health concern in the twenty-first century. Compared to traditional antibiotic treatments, phage therapy has several advantages, including automatic dosing, low inherent toxicity, and the ability to use low doses. Phages infect bacteria, reprogramming the cell to become a phage factory, and producing new phage particles that lyse the cell and release more phages. Some phages have a temperate life cycle in which infected cells carry the phage genome indefinitely in a dormant state. Since 1919, phage treatment has been used to treat diseases such as Shigella dysenteries and has the potential to be utilized to treat antibiotic-resistant bacteria.

Adherence to inhaled antibiotics in people with cystic fibrosis: insights from a virtual patient advisory board

ABSTRACT Background Chronic airway infection by Pseudomonas aeruginosa significantly impacts the health of people with cystic fibrosis (PwCF), presenting complex treatment challenges. Research design and methods To gain insights into PwCF’s experiences, a virtual European Patient Advisory Board was convened. Board explored inhaled antibiotic usage, treatment adherence, and associated challenges. Additionally, an online survey was conducted among PwCF to further understand real-life experiences and unmet needs, particularly related to CFTR modulators. Results The Advisory Board proved instrumental in collecting valuable real-world perspectives, offering potential avenues for reshaping the care model for complex diseases like cystic fibrosis. Conclusions PwCF on CFTR modulators are questioning the necessity of continuing chronic medications and therapies. Physicians are urged to carefully consider the balance between simplifying antibiotic treatment and the risk of clinical deterioration due to bacterial infections when making treatment decisions. Furthermore, the development and global harmonization of diagnostic tools for chronic lung damage and treatment guidelines are crucial to justify the demanding routines that PwCF must endure to manage their condition. The heterogeneity in patient journeys, diagnostic challenges, treatment complexity, and issues related to adherence highlight the need for patient-centric, personalized care that emphasizes improving and maintaining treatment adherence to optimize cystic fibrosis management.

Utilization Of Antibiotics In Rural Communities Of Sub- Saharan Africa: Challenges And Resistances

In the last seven decades, antibiotics have greatly influenced the remarkable advancement in world health by becoming the standard therapy for infectious diseases. Antibiotic resistance (ABR) is a significant worldwide human health issue, having notably negative effects in low- and middle-income countries (LMICs). What were once fatal illnesses are now beaten by millions of people. But since there are only so many antibiotics available, misusing them has resulted in antibiotic resistance and decreased efficacy within a few years after the release of every lifesaving antibiotic. The WHO claims that the threat of antibiotic resistance to global health and development. The Sustainable Development Goals (SDGs) must be attained urgently through multi-sectoral approach. One of the ten leading worldwide public health hazards to civilization, according to WHO, is ABR. The major causes of the emergence of infections that are resistant to antibiotics are their improper usage and excessive use. The spread of bacteria, some of which may be antibiotic-resistant, is encouraged by a lack of safe drinking water, sanitation facilities, and effective infection control and prevention measures. Antibiotic resistance is as significant a threat to international security, food and nutrition security, and industrialization, according to the WHO, as terrorist attacks and global warming. ABR has a huge cost to the economy. Long-term disease not only increases the risk of mortality and incapacity but also lengthens hospital stay, necessitates the use of more expensive medications, and puts a strain on the finances of those affected. In the absence of powerful antibiotics, contemporary medicine's ability to cure infections, including those that arise following extensive surgeries and invasive procedures, would be compromised. Due to the lack of adequate mass surveillance, it is difficult to determine the scope of the ABR issue in LMICs, although considerable progress has been made in recent years since the WHO Global Antibiotic Resistance and Use Surveillance System (GLASS) initiative was launched in 2015. One of the main factors influencing the choice of ABR in LMICs is the widespread and frequently improper use of antibiotics in people, animals, and crops. This, combined with the insufficient control of pharmacological byproducts at the centers of manufacturing, must be quickly addressed. ABR spreads more quickly in LMICs because a number of factors including poor sanitation and hygiene insufficient exposure to sufficient health facilities, and a lack of legislation. The aim is to review to predisposing factors that influence the use of antibiotics aimed at informing policy decision on antibiotics use.

Biomarkers as point-of-care tests to guide prescription of antibiotics in people with acute respiratory infections in primary care.

Biomarkers as point-of-care tests to guide prescription of antibiotics in people with acute respiratory infections in primary care.

Inhaled antibiotics for pulmonary exacerbations in cystic fibrosis.

Cystic fibrosis is a genetic disorder in which abnormal mucus in the lungs is associated with susceptibility to persistent infection. Pulmonary exacerbations are when symptoms of infection become more severe. Antibiotics are an essential part of treatment for exacerbations and inhaled antibiotics may be used alone or in conjunction with oral antibiotics for milder exacerbations or with intravenous antibiotics for more severe infections. Inhaled antibiotics do not cause the same adverse effects as intravenous antibiotics and may prove an alternative in people with poor access to their veins. This is an update of a previously published review. To determine if treatment of pulmonary exacerbations with inhaled antibiotics in people with cystic fibrosis improves their quality of life, reduces time off school or work, and improves their long-term lung function. We searched the Cochrane Cystic Fibrosis Group's Cystic Fibrosis Trials Register. Date of the last search: 7 March 2022. We also searched ClinicalTrials.gov, the Australia and New Zealand Clinical Trials Registry and WHO ICTRP for relevant trials. Date of last search: 3 May 2022. Randomised controlled trials in people with cystic fibrosis with a pulmonary exacerbation in whom treatment with inhaled antibiotics was compared to placebo, standard treatment or another inhaled antibiotic for between one and four weeks. Two review authors independently selected eligible trials, assessed the risk of bias in each trial and extracted data. They assessed the certainty of the evidence using the GRADE criteria. Authors of the included trials were contacted for more information. Five trials with 183 participants are included in the review. Two trials (77 participants) compared inhaled antibiotics alone to intravenous antibiotics alone and three trials (106 participants) compared a combination of inhaled and intravenous antibiotics to intravenous antibiotics alone. Trials were heterogenous in design and two were only available in abstract form. Risk of bias was difficult to assess in most trials but, for four out of five trials, we judged there to be a high risk from lack of blinding and an unclear risk with regards to randomisation. Results were not fully reported and only limited data were available for analysis. One trial was a cross-over design and we only included data from the first intervention arm. Inhaled antibiotics alone versus intravenous antibiotics alone Only one trial (18 participants) reported a perceived improvement in lifestyle (quality of life) in both groups (very low-certainty evidence). Neither trial reported on time off work or school. Both trials measured lung function, but there was no difference reported between treatment groups (very low-certainty evidence). With regards to our secondary outcomes, one trial (18 participants) reported no difference in the need for additional antibiotics and the second trial (59 participants) reported on the time to next exacerbation. In neither case was a difference between treatments identified (both very low-certainty evidence). The single trial (18 participants) measuring adverse events and sputum microbiology did not observe any in either treatment group for either outcome (very low-certainty evidence). Inhaled antibiotics plus intravenous antibiotics versus intravenous antibiotics alone Inhaled antibiotics plus intravenous antibiotics may make little or no difference to quality of life compared to intravenous antibiotics alone. None of the trials reported time off work or school. All three trials measured lung function, but found no difference between groups in forced expiratory volume in one second (two trials; 44 participants; very low-certainty evidence) or vital capacity (one trial; 62 participants). None of the trials reported on the need for additional antibiotics. Inhaled plus intravenous antibiotics may make little difference to the time to next exacerbation; however, one trial (28 participants) reported on hospital admissions and found no difference between groups. There is likely no difference between groups in adverse events (very low-certainty evidence) and one trial (62 participants) reported no difference in the emergence of antibiotic-resistant organisms (very low-certainty evidence). We identified only low- or very low-certainty evidence to judge the effectiveness of inhaled antibiotics for the treatment of pulmonary exacerbations in people with cystic fibrosis. The included trials were not sufficiently powered to achieve their goals. Hence, we are unable to demonstrate whether one treatment was superior to the other or not. Further research is needed to establish whether inhaled tobramycin may be used as an alternative to intravenous tobramycin for some pulmonary exacerbations.

Antibiotic prophylaxis for corneal abrasion.

Corneal abrasion is a common disorder frequently faced by ophthalmologists, emergency physicians, and primary care physicians. Ocular antibiotics are one of the management options for corneal abrasion. A comprehensive summary and synthesis of the evidence on antibiotic prophylaxis in traumatic corneal abrasion is thus far unavailable, therefore we conducted this review to evaluate the current evidence regarding this important issue. To assess the safety and efficacy of topical antibioticprophylaxis following corneal abrasion. Our objectives were 1) to investigate the incidence of infection with antibiotics versus placebo or alternative antibiotics in people with corneal abrasion; and 2) to investigate time to clinical cure, defined as complete healing (re-epithelialization) of the epithelium, with antibiotics versus placebo or alternative antibiotics in people with corneal abrasion. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (which contains the Cochrane Eyes and Vision Trials Register; 2021, Issue 4), Ovid MEDLINE, Embase.com, PubMed, the Latin American and Caribbean Health Sciences Literature database (LILACS), ClinicalTrials.gov, and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP). We did not use any date or language restrictions in the electronic search for trials. We last searched the electronic databases on 25 April 2021. We included randomized controlled trials (RCTs) comparing antibiotic with another antibiotic or placebo in children and adults with corneal abrasion due to any cause. We used standard Cochrane methodology and assessed the certainty of the body of evidence for the prespecified outcomes using the GRADE classification. Our search of the electronic databases yielded 8661 records. We screened 7690 titles and abstracts after removal of duplicates. We retrieved 32 full-text reports for further review. We included two studies that randomized a total of 527 eyes of 527 participants in the review. One study was conducted in Denmark, and one was conducted in India. The two studies did not examine most of our prespecified primary and secondary outcomes. The first study wasaparallel-group RCT comparing chloramphenicol ocular ointment with fusidic acidocular gels (frequency was not clearly reported). This studyenrolled 153 participants older than 5 yearsof age with corneal abrasion in Denmark with a one-day follow-up duration.No participants had secondary infection in the fusidic acid group, whereas three (4.1%) participants in the chloramphenicol group had a slight reaction (risk ratio [RR] 0.15, 95% confidence interval [CI] 0.01 to 2.79; 144 participants; very low certainty evidence). Thirty-one(44.3%) participants in the fusidic acid arm and 34 (46.6%) participants in the chloramphenicol arm were cured(defined as the area of abrasion zero and no infection) at day 1(RR0.94, 95% CI0.65 to 1.34; 144 participants; very low certainty evidence).Without providing specific data, the study reported that the degree of pain was not affected by the interventions received. The most common adverse events reported were itching and discomfort of the eye, which occurred in approximately one-third of participants in each group (low certainty evidence). A secondmulticenter, two-arm RCT conducted in India enrolled 374 participants older than 5 years of age with corneal abrasion who presented within 48 hours after injury. This studyinvestigated the effect of a three-day course of either ocular ointment combinations of chloramphenicol-clotrimazole or chloramphenicol-placebo(all three times daily). At day 3,169 (100%) participants in thechloramphenicol-clotrimazole armand203 (99%) out of 205 participants in the chloramphenicol-placebo armwere cured without any complication, defined ascomplete epithelialization of the cornea without evidence of infection (RR1.01, 95% CI0.99 to 1.03; 374 participants; very low certainty evidence). Fourparticipants assigned tothe chloramphenicol-placebo armexperienced mild adverse events: two participants (1%) had mild chemosis and irritation, and two (1%) had small single sterile corneal infiltrates (low certainty evidence). Given the low to very low certainty of the available evidence, any beneficial effects of antibiotic prophylaxis in preventing ocular infection or accelerating epithelial healing following a corneal abrasion remain unclear. Moreover, the current evidence is insufficient to support any antibiotic regimen being superior to another. There is a need for a well-designed RCT assessing the efficacy and safety of ocular antibiotics in the treatment of corneal abrasion with a particular focus on high-risk populations and formulation of interventions.

What are the benefits and harms of antibiotics for people with sore throat?

What are the benefits and harms of antibiotics for people with sore throat?

Single versus combination intravenous anti-pseudomonal antibiotic therapy for people with cystic fibrosis.

The choice of antibiotic, and the use of single or combined therapy are controversial areas in the treatment of respiratory infection due to Pseudomonas aeruginosa in cystic fibrosis (CF). Advantages of combination therapy include wider range of modes of action, possible synergy and reduction of resistant organisms; advantages of monotherapy include lower cost, ease of administration and reduction of drug-related toxicity. Current evidence does not provide a clear answer and the use of intravenous antibiotic therapy in CF requires further evaluation. This is an update of a previously published review. To assess the effectiveness of single compared to combination intravenous anti-pseudomonal antibiotic therapy for treating people with CF. We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Trials Register, comprising references identified from comprehensive electronic database searches and handsearches of relevant journals and abstract books of conference proceedings. Most recent search of the Group's Trials Register: 07 October 2020. We also searched online trials registries on 16 November 2020. Randomised controlled trials (RCTs) comparing a single intravenous anti-pseudomonal antibiotic with a combination of that antibiotic plus a second anti-pseudomonal antibiotic in people with CF. Two authors independently assessed trial quality and extracted data. We assessed the certainty of the data using GRADE. We identified 59 trials, of which we includedeight trials (356 participants) comparing a single anti-pseudomonal agent to a combination of the same antibiotic and one other.There was a wide variation in the individual antibiotics used in each trial. In total, the trials included seven comparisons of a beta-lactam antibiotic (penicillin-related or third generation cephalosporin) with a beta-lactam-aminoglycoside combination and three comparisons of an aminoglycoside with a beta-lactam-aminoglycoside combination. There was considerable heterogeneity amongst these trials, leading to difficulties in performing the review and interpreting the results.These results should be interpreted cautiously. Six of the included trials were published between 1977 and 1988; these were single-centre trials with flaws in the randomisation process and small sample size. Overall, the methodological quality was poor and the certainty of the evidence ranged from low to moderate. The review did not find any differences between monotherapy and combination therapy in either the short term or in the long term for the outcomes of differentlung function measures,bacteriological outcome measures, need for additional treatment, adverse effects, quality of life or symptom scores. The results of this review are inconclusive. The review raises important methodological issues. There is a need for an RCT which needs to be well-designed in terms of adequate randomisation allocation, blinding, power and long-term follow-up. Results need to be standardised to a consistent method of reporting, in order to validate the pooling of results from multiple trials.

What are the benefits and harms of antibiotics for people with the common cold and/or acute purulent rhinitis?

What are the benefits and harms of antibiotics for people with the common cold and/or acute purulent rhinitis?

Association of Intensity of Antipseudomonal Antibiotic Therapy With Risk of Treatment-Emergent Organisms in Children With Cystic Fibrosis and Newly Acquired Pseudomonas Aeruginosa

Abstract Background While Pseudomonas aeruginosa (Pa) eradication regimens have contributed to a decline in Pa prevalence in people with cystic fibrosis (CF), this antibiotic exposure might increase the risk of acquisition of drug-resistant organisms. This study evaluated the association between antipseudomonal antibiotic exposure intensity and acquisition risk of drug-resistant organisms among children with CF and new Pa infection. Methods We utilized data from the Early Pseudomonas Infection Control Clinical Trial (EPIC CT), a randomized controlled trial comparing Pa eradication strategies in children with CF and new Pa. The exposure was the number of weeks of oral or inhaled antipseudomonal antibiotics or ever versus never treatment with intravenous antipseudomonal antibiotics during the 18 months of EPIC CT participation. Primary outcomes were risks of acquisition of several respiratory organisms during 5 years of follow-up after EPIC CT estimated using Cox proportional hazards models separately for each specific organism. Results Among 249 participants, there was no increased acquisition risk of any organism associated with greater inhaled antibiotic exposure. With each additional week of oral antibiotics, there was an increased hazard of Achromobacter xylosoxidans acquisition (HR, 1.24; 95% CI: 1.02–1.50; P = .03). Treatment with intravenous antibiotics was associated with an increased hazard of acquisition of multidrug-resistant Pa (HR, 2.47; 95% CI: 1.28–4.78; P = .01) and MRSA (HR, 1.57; 95% CI: 1.03–2.40; P = .04). Conclusions Results from this study illustrate the importance of making careful antibiotic choices to balance the benefits of antibiotics in people with CF while minimizing risk of acquisition of drug-resistant organisms.

PILOT STUDY: Assessing the knowledge, attitude and use of antibiotics in People in A commercial area; Kwame Nkrumah university community, Ghana

PILOT STUDY: Assessing the knowledge, attitude and use of antibiotics in People in A commercial area; Kwame Nkrumah university community, Ghana

Comparing the quantity and quality of randomised placebo-controlled trials of antibiotics for acute respiratory, urinary, and skin and soft tissue infections: a scoping review.

BackgroundThe management of acute respiratory infections (ARIs), urinary tract infections (UTIs), and skin and soft tissue infections (SSTIs) should be guided by high quality evidence.AimTo compare the quantity and quality of randomised placebo-controlled trials of antibiotics for ARIs, UTIs, and SSTIs.Design & settingA scoping review of the literature was performed using comprehensive search strategies.MethodPubMed and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched for published studies from inception until 17 April 2019. Randomised controlled trials (RCTs) that compared participants in primary care or in the community who had uncomplicated acute ARI, UTI, or studies, and were randomised to antibiotic or placebo (or no active treatment), were eligible for inclusion. Two groups of researchers independently screened articles for inclusion, extracted data, and assessed the quality of included studies.ResultsA total of 108 eligible studies were identified: 80 on ARI, eight on UTI, and 20 on SSTI. The quality of studies varied with unclear risk of bias (RoB) prevalent in many domains. There was a gradual improvement in the quality of trials investigating ARIs over time, which could not be assessed in SSTI and UTI studies.ConclusionThis review highlights a sparsity of trials assessing the effectiveness of antibiotics in people with UTIs and SSTIs, compared to trials targeting ARIs. This gap in the evidence needs to be addressed by conducting further high quality trials on the effects of antibiotics in patients with UTI and SSTI.

What are the benefits and harms of topical antibiotics for people with chronic suppurative otitis media?

What are the benefits and harms of topical antibiotics for people with chronic suppurative otitis media?

P353 “There’s no place like home”: formalising the provision of home IV antibiotics for people with cystic fibrosis in Northern Ireland

P353 “There’s no place like home”: formalising the provision of home IV antibiotics for people with cystic fibrosis in Northern Ireland

What are the effects of adjunct topical antibiotics for people with atopic dermatitis being treated with topical steroids?

What are the effects of adjunct topical antibiotics for people with atopic dermatitis being treated with topical steroids?

Antibiotics for trachoma.

Antibiotics for trachoma.