Incidence Of Bacterial Complications Research Articles

Treatment of influenza and other acute respiratory viral infections in patients with diabetes mellitus

The study of the influenza and ARVI clinical performance, the development of patients with diabetes mellitus, evaluation of the effectiveness and safety application of antiviral therapy, carried out in the framework of routine clinical practice. 126 patients aged from 22 to 83 years (27.8% of men) with ARVI or influenza that occurred with medical care during the first 5 days of the disease (60.3% in the first 48 hours) are included. All patients suffer from diabetes, for the treatment of which oral hypoglycemic agents or insulins were constantly taken. The patients were divided into two groups: the first group received standard symptomatic treatment of ARVI; antiviral drug Kagocel. Diabetes and other acute respiratory viral infections. There is an increase in the incidence of bacterial complications - 2.2 times, an increase in the frequency of systemic antibiotics - 2.3 times. The purpose of the drug prescription led to a more rapid regression of all the symptoms of influenza and ARVI, but the most striking positive dynamics was observed in the symptoms of general weakness and headache. The prescription of Kagocel was accompanied by a 58% reduction in the number of bacterial complications and a 53% reduction in the use of antibiotics, which led to a reduction in the number of cases of the disease and an improvement in initial diseases, with an frequency increase in 1.8 times. The most significant effect achieved with early treatment and early initiation of antiviral therapy (in the first 48 hours of the disease).

Topical issues of inhaled antibacterial therapy of respiratory diseases in children

Despite the fact that acute respiratory infections have viral etiology, the frequency of antibiotic prescriptions accounts for more than 70% in outpatient practice. However, the preventive administration of systemic antibiotics does not reduce the duration of the disease and the incidence of bacterial complications. In addition, the irrational use of antibiotic therapy can lead to the development of antibiotic resistance of infectious disease pathogens. The global problem of antibiotic resistance is seen as a serious threat to public health, and therefore the systemic antibiotic restriction policy is crucial, which helps to reduce the formation of antibiotic-resistant strains of infectious agents. The possibility of using local antibacterial drugs enables optimization of antibiotic therapy and reduces the risk of the development of antibiotic resistance. The article discusses the issues of use of thiamphenicol glycinate acetylcysteinate in various diseases in children.

Antibiotic use and bacterial complications following upper respiratory tract infections: a population-based study

ObjectivesTo investigate if use of antibiotics was associated with bacterial complications following upper respiratory tract infections (URTIs).DesignEcological time-trend analysis and a prospective cohort study.SettingPrimary, outpatient specialist and inpatient care in...

Reply to Musher et al

To the Editor—We thank Musher et al [1] for their comments about our article [2] and their thorough review of their recently published study [3] that was similar to ours. We concur that the practice of medicine remains an art that is not well served by strict adherence to treatment algorithms and overreliance on any single test result without thoughtful interpretation in the proper clinical context. However, we also believe that medicine should also be guided by valid scientific data, and there is now a large body of evidence that indicates that serum biomarkers, although not perfect, are useful for patient management [4]. We wish to reemphasize that the goal of our study was to determine the incidence of bacterial infections that complicate viral respiratory infections, a highly debated issue for which there are very few data. To this end, we used standard assays to identify bacterial infection but also included elevated procalcitonin level to provide the most conservative estimate. We were not attempting to validate the serum procalcitonin level as a marker of bacterial infection, nor did we state or imply that this test should be the starting point in algorithms to withhold antibiotics. Most experts would agree that the diagnosis of bacterial respiratory infection by use of traditional microbiologic techniques is remarkably difficult and that the acquisition of good-quality sputum specimens remains very problematic. Despite Herculean efforts to do so, we successfully obtained adequate samples within 6 hours of antibiotic administration in only 51% of subjects, whereas Musher et al collected adequate samples within 18 hours of antibiotic administration from only 31%. At present, there are no sensitive and specific diagnostic tests for bacterial respiratory infection. So how do we attempt to answer this important question? Musher et al acknowledge that an elevated serum procalcitonin level is generally consistent with a bacterial infection, so we are uncertain as to why they would have concerns that we used both traditional microbiologic data and elevated procalcitonin levels for the most inclusive definition for bacterial complications of viral infection. Most would agree that the use of specific microbiologic testing alone would have significantly underestimated the problem. An important difference between our study and the study by Musher et al is that we did not limit inclusion to patients hospitalized with pneumonia. Since both the Infectious Diseases Society of America and the American Thoracic Society recommend early empirical antibiotic therapy for patients with pneumonia, the question of the incidence of bacterial complications and the usefulness of serum biomarkers in this group with viral infection may be less relevant. However, many patients hospitalized with respiratory virus infection do not have pneumonia; rather, they have other conditions, such as acute exacerbation of chronic obstructive pulmonary disease (COPD), acute exacerbation of asthma, acute bronchitis, and decompensated chronic medical conditions, such as congestive heart failure. The use of antibiotics for these syndromes is not clearly defined, yet it is nearly universal among hospitalized patients. In our previous study of COPD to which Musher et al refer, we found that the serum procalcitonin level was significantly higher in patients with COPD who had pneumonia than in those with exacerbations without pneumonia [5]. However, the procalcitonin level did not provide good discrimination between bacterial and viral nonpneumonic exacerbations. The statement that the procalcitonin level was low in 11 of 16 patients with bacterial and viral pneumonia is incorrect because these subjects had no radiographic evidence of pneumonia. Our conclusions, based on this prior study and our current study, are that serum biomarkers may not be as useful for less invasive forms of respiratory infection and that examination of sputum remains an important tool for the clinician. However, given the issues of bacterial colonization in patients with COPD, the only way to really know whether sputum findings or an elevated procalcitonin level is the best predictor of the need for antibiotics in exacerbations of COPD without pneumonia is to perform a randomized clinical trial. We believe our study provides a relatively accurate estimate of the incidence of bacterial complications of serious respiratory viral infection, given the current limitations of diagnostic testing. Because 60% of the patients in our study had no evidence of bacterial infection and 4 deaths due to Clostridium difficile infection occurred in this group, we think it is appropriate for clinicians to consider whether broad-spectrum antibiotics are needed in all patients with documented viral infection, particularly those without clear evidence of pneumonia. We stand by our concluding statement that further studies are needed to develop treatment algorithms that combine biomarkers and clinical parameters, so that antibiotics can be safely discontinued in some patients hospitalized with viral infection.

Application of Ultralow Doses of Antibodies to Interferon-γ in Complex Therapy of Bacterial Infections and Prophylaxis of Bacterial Complications

Comparative placebo-controlled clinical trials on the efficiency and safety of ultralow doses of antibodies to human IFN-gamma (anaferon pediatric formulation and anaferon) and prophylaxis of bacterial complication showed that administration of these preparations in complex therapy of bacterial infection reduced the incidence of bacterial complications of viral infections and considerably decreased the duration of the main clinical symptoms of the disease.

Early or delayed cholecystectomy in acute cholecystitis? A clinical trial

Abstract Patients with a preoperative diagnosis of acute cholecystitis were prospectively allocated to treatment with early cholecystectomy (ES) within 7 days of the onset of symptoms, or initial conservative treatment followed by delayed elective surgery (DS). Patients whose symptoms required emergency operation, patients older than 75 years and patients with pancreatitis were excluded from the trial but were followed up. During the study period 402 patients with acute cholecystitis were admitted, 101 fell into the ES group and 91 into the DS group. The conservative regimen had to be interrupted in 15 patients (13·8 per cent) because their clinical status deteriorated and 13 patients (11·9 per cent) in the DS group did not return for planned elective surgery. One patient in the DS group died. There was no difference in the frequency of intra- and postoperative complications between the 2 study groups, the incidence of bacterial complications being markedly low, especially in the ES group. The ES group had a moderate but significantly greater intraoperative blood loss. Hospital stay was almost 1 week shorter in the ES group and insurance payment for loss of working capacity was also shorter in the ES group. These results indicate that early cholecystectomy is the treatment of choice in acute cholecystitis in patients aged 75 years and under.

Postpartum resumption of cyclic ovarian function, first estrus and re-conception and their relation to energy metabolism in high-producing dairy cows

In the last few decades a continuous increase was observed in average milk production of dairy cows all over the world. Simultaneously, however, a dramatic decrease was seen in reproductive performance. This tendency is attributed to the increased incidence of bacterial complications in uterine involution, as well as to the high occurrence of ovarian malfunctions in the postpartum period. The aim of this paper is to review the physiology and pathology of the latter, really complex phenomenon. The nutritional basis of this process, that the requirements of high-producing dairy cows shift abruptly after parturition as the daily milk yield rapidly increases and the ensuing negative energy balance (NEB) will extend 10-12 weeks. In the context of the high genetic merit dairy cow, the pp NEB is the difference between the dietary intake of utilizable energy and the expenditure of energy for body mass maintenance and milk synthesis. In principle, it is a physiological phenomenon, which may, however, result in more or less severe disorders in both the metabolism and reproduction and so it may lead to great economic losses in modern dairy practice [112]. In the first 3-4 weeks after calving the NEB is highly correlated with both milk yield and the interval to first ovulation. Because the number of ovulatory estrous cycles preceding the insemination (AI) has been shown to influence the conception rate, the length of the pp interval to first ovulation provides an important parameter for assessing the effect of NEB on reproductive performance S19, 20?.