Urological infections are among the most frequent bacterial diseases and result in acorrespondingly high consumption of antibiotics with the associated known increased risk for the development of multidrug-resistant pathogens. For this reason, the measures summarized under the term antibiotic stewardship (ABS) are becoming increasingly more important for arational use of antibiotics, which are explicitly underlined in the current European and German guidelines on urological infections. Despite these clear guideline recommendations the use of antibiotics in the urological practice is often suboptimal, especially in the treatment of asymptomatic bacteriuria and the excessive use of fluoroquinolones. In this article the principles of ABS are illustrated based on the current guidelines, frequent false applications are described and practical recommendations are given for urologists when dealing with antibiotics in cases of urinary tract infections and urological interventions.

The exact cause of ulcerative colitis (UC) remains unclear but likely involves an immune response to an unidentified component of gut microbiota. The use of antibiotics in treating acute severe UC (ASUC) remains controversial. This study aimed to assess the benefits of adding antibiotics to corticosteroids for managing ASUC. This retrospective study included patients with ASUC who met the Truelove and Witts diagnostic criteria at admission and received intravenous (IV) corticosteroids, with or without adjunctive antibiotics. Key outcomes included the need for medical and surgical rescue therapy during hospitalization and UC-related re-hospitalization rates at 1 week, 3 months, and 1 year. Propensity score matching (PSM) was employed to minimize selection bias in evaluating the impact of adjunctive antibiotics on clinical outcomes. Of the 386 screened patients, 222 met the inclusion criteria: 75 (33.8%) received IV corticosteroids alone, while 147 (66.2%) received IV corticosteroids combined with antibiotics. After PSM (60 patients per group), the addition of antibiotics showed no significant effect on the need for medical rescue therapy during hospitalization, re-hospitalization, or clinical response based on the partial Mayo score after 1 week of hospitalization (68.3% vs. 60.0%; P= 0.341). Similarly, no significant differences were observed in the need for medical rescue therapy, re-hospitalization, or UC-related surgery rates at 3 months or 1 year (P> 0.05). In patients with ASUC, treatment outcomes did not significantly differ between those receiving IV corticosteroids alone and those receiving a combination of IV corticosteroids and antibiotics, suggesting that adjunctive antibiotic use may offer no added clinical benefits.

A review on antibiotic use in tilapia farming: Pharmacokinetics, impacts, and potential health risks.

A versatile colorimetric array sensor based on FeCu-based prussian blue analogue heterostructures for efficient discrimination of tetracycline antibiotics and rapid identification of urinary tract infection pathogens.

Association between national antimicrobial stewardship policies and antibiotic selection for uncomplicated cystitis in Japan: A 10-year database study.

From certification to action: Antimicrobial use and stewardship perceptions in Colombian dairy herds.

Interfering with the response of bacterial pathogens to host substances: An unexplored strategy to control bacterial diseases in aquaculture.

In the United States, postmenopausal women represent the largest group affected by recurrent urinary tract infections (rUTIs). Limited evidence supports long-term use of antibiotics for rUTI prophylaxis in this population. In addition to being expensive, repeated antibiotic use contributes to antimicrobial resistance, posing additional concerns for postmenopausal women who may be at higher risk for serious infection or complications from resistant infections. Topical estrogen, which directly addresses the pathophysiologic changes associated with rUTIs in this population, offers an effective and cost-efficient option for postmenopausal patients while avoiding the dangers of antimicrobial resistance.

Comment on: Use of intracameral antibiotics prophylaxis in patients with posterior capsule rupture during cataract surgery: systemic review and meta-analysis.

Antimicrobials are among the classes of pharmaceuticals most used by acute care surgeons, with many emergency general surgery conditions either related to infections or at high risk of infectious complications. As such, knowledge of proper use of antimicrobial agents, especially in this era of increasing antimicrobial resistance, is imperative for optimal outcomes. This review focuses on the advanced infectious diseases and antimicrobial utilization knowledge required to treat complicated and critically ill surgical patients. Overall concepts pertaining to antibiotics are discussed, followed by a more in-depth discussion of conditions common in emergency general surgery. Key themes include the importance of source control and accurate culture data, the frequent need for broad-spectrum, empiric antimicrobial therapy, subsequent careful de-escalation of antibiotics, and minimizing treatment duration. (J Trauma Acute Care Surg. 2026;101: 13-27. Copyright © 2026 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Association for the Surgery of Trauma.).

Machine learning in diagnostic stewardship: A technical approach in improving diagnostic accuracy, optimizing antibiotic use in false positive CSF cultures.

Efficacy and safety of a digital clinical decision support system using a C-reactive protein-based algorithm and evidence-based stopping rules to guide antibiotic therapy duration: A single-center, open-label randomized controlled trial in a tertiary care hospital.

Urinary Microbiome and Metabolome Differentiate Overactive Bladder From the Physiological State, and Reflect Recent Antibiotic Use and Treatment Response.

Fructooligosaccharides alleviate early-life antibiotic-exposed food allergy via the Indole-3-propionic acid-AhR-Nrf2 Axis: A multi-omics prospective cohort study.

Community-acquired pneumonia (CAP) remains a major global health burden, with antibacterial therapy as the primary treatment strategy. In clinical practice, plasma drug concentrations are often used to guide therapy, yet they may not reliably reflect effective pulmonary exposure, which is particularly critical for older adults, patients with comorbidities, and critically ill populations. In recent years, targeted pulmonary pharmacokinetics/pharmacodynamics (PK/PD) studies have gained increasing attention and have become an important reference for guiding precision antimicrobial therapy in clinical settings. This review provides a comprehensive overview of the pulmonary PK characteristics of key antibiotics commonly used for CAP, including macrolides, fluoroquinolones, β-lactams, tetracyclines, and the pleuromutilin agent lefamulin. Major factors influencing drug distribution in the lung are summarized. The significance of pulmonary PK/PD targets in antibiotic selection, dose adjustment, and individualized treatment is discussed, aiming to support improved clinical outcomes, rational antibiotic use, and resistance management. A deeper understanding of pulmonary PK/PD properties is essential to advance evidence-based and optimized treatment for CAP.

Antibiotic Use Among Children Before, During, and After the COVID-19 Pandemic: A Nationwide Study.

Mutation-driven mechanisms underlying antibiotic resistance of Helicobacter pylori in Asia: A systematic review and meta-analysis (2000-2024).

Pyogenic flexor tenosynovitis (PFT) is a common hand infection associated with significant morbidity. Management varies due to lack of evidence-based guidelines, typically involving surgery and antibiotics. We conducted a cohort study, comparing outcomes between different surgical methods to see if one is optimal. Retrospective data collection of patients who underwent surgery for PFT in a single tertiary plastic surgery unit between 21 August 2013 and 4 October 2023 was undertaken. Demographics, injury mechanism, operative details and antibiotic use were recorded. Cases involving cellulitis or osteomyelitis were excluded. Outcomes included length of stay, length of follow-up and post-operative complications. Multivariable regression analyses were performed, adjusting for age, diabetes and smoking status. A total of 174 patients (mean age 47.2 years [SD 18.7]) were included. PFT most commonly resulted from animal bites (23.7% of cases). There was wide variation in antibiotic prescribing practice. Open surgery was performed in 121 cases, whilst 53 underwent minimally invasive procedures. No statistically significant differences in outcomes were observed between techniques in unadjusted or adjusted analyses. Diabetes was associated with an increased likelihood of requiring further procedures on multivariable analysis. There is no evidence of differing outcomes for open or minimally invasive techniques. Diabetes may be associated with a requirement for further procedures. However, these results should be interpreted in the context of the retrospective design, missing data and potential for confounding by indication. Standardised, evidence-based management guidelines are required, with prospective multi-centre studies needed to better define optimal treatment strategies.

Prebiotics partially protect offspring from maternal antibiotic-induced obesity risk by altering maternal milk microbiota and gut colonization in Sprague-Dawley rats.

Acute bloody diarrhea (hematochezia) in children is traditionally associated with invasive bacterial infection, but its etiologic spectrum is increasingly recognized as heterogeneous. We aimed to characterize the etiologic distribution of acute bloody diarrhea in a pediatric emergency department and to compare the diagnostic yields of multiplex gastrointestinal PCR and conventional stool testing. In this prospective observational study conducted between July 2018 and July 2019, consecutive children aged 0 to 18 years presenting with visible blood in stool (hematochezia) to a tertiary pediatric emergency department were enrolled. Disease severity was assessed using the Clinical Dehydration Scale (CDS) and the modified Vesikari score. All stool samples were tested with conventional methods (culture, antigen for rotavirus/adenovirus, microscopy) and a 22-target commercial multiplex gastrointestinal PCR panel. The contribution of multiplex PCR was analyzed as a descriptive diagnostic yield rather than as a predictor in a regression model, and a multivariable logistic regression model containing clinical variables only was used to test whether clinical severity independently predicted bacterial etiology. A sensitivity analysis used a stricter culture-confirmed definition of bacterial etiology. Eighty-three children were enrolled (median age 48mo, IQR 21 to 84; 55% male). At least 1 enteropathogen was detected in 62 patients (74.7%). A bacterial pathogen was identified in 37 of 83 patients (44.6%), a viral-only infection in 14 (16.9%), a parasitic infection in 11 (13.3%), and a mixed viral-bacterial co-detection in 4 (4.8%). Of the 37 bacterial detections, 10 (27.0%) were identified by stool culture alone, 22 (59.5%) by multiplex PCR alone, 1 (2.7%) by both culture and PCR, and 4 (10.8%) by combined antigen and PCR in mixed infections. In the multivariable logistic regression model, none of CDS ≥5, fever, continuous modified Vesikari score, or recent antibiotic use was independently associated with bacterial etiology. Culture and PCR were complementary: 27.0% of bacterial pathogens were detected only by culture despite a negative bacterial PCR target. Pediatric acute bloody diarrhea is etiologically heterogeneous: fewer than half of the presentations had a bacterial etiology, and clinical severity alone did not reliably identify those with bacterial infection. Multiplex PCR expanded-but did not replace-stool culture, with more than a quarter of bacterial pathogens detected only by culture. Clinical management of children with bloody diarrhea should combine maintained clinical vigilance with comprehensive microbiological testing (stool culture plus multiplex PCR).