Review Of Antibiotic Therapy Research Articles

Epidemiology of Nosocomial Bacteremia Due to Bacteria from the “<i>Burkholderia cepacia</i> Complex” at Libreville University Hospital Center

Introduction: Burkholderia cepacia is a non-fermenting emergent bacterium common in nosocomial infections and can cause life-threatening infections whose multidrug resistance makes them a serious threat in hospitals. The aim of this study was to determine the prevalence of B. cepacia infections during nosocomial infections at Libreville University teaching hospital. Methodology: In this cross-sectional study, lasting 19 months, 412 blood cultures were analyzed. The BacT/ALERT 3D (Biomerieux, France) was used to detect the positivity of blood culture flasks and the Viteck 2 compact (Biomerieux, France) for the identification of germs and the study of their susceptibility to antibiotics. Results: Our study population consisted of 412 patients. The sex-ratio M/F was 1.06 in favor of the male gender (n = 201, 51%). The age of the patients varied between 0 and 82 years. The bacteremia of B. cepacia mainly affected children under 15 years of age with a prevalence of 7% (n = 28). The pediatric ward was more represented with a frequency of 36% (n = 10). The antibiotic sensitivity profile showed high resistance of 100% for aminoglycosides (amikacin, tobramycin, and gentamycin), tetracycline, beta-lactams (Amoxicillin, Imipenem, Ticarcillin, Cefoxitin and Cefotaxime), and ciprofloxacin. However, four molecules were active on B. cepacia (Levofloxacin 100%, Trimethoprim + sulfamethoxazole 92.3%, ceftazidime 80% and cefepime 35%). Conclusion: Ultimately, infection and multi-resistance due to Burkholderia cepacia calls for a review of hospital hygiene in the pediatric ward and a review of antibiotic therapy in young children.

Postprescription review improves in-hospital antibiotic use: A multicenter randomized controlled trial

Although review of antibiotic therapy is recommended to optimize antibiotic use, physicians do not always perform it. This trial aimed to evaluate the impact of a systematic postprescription review performed by antimicrobial stewardship program (ASP) infectious disease physicians (IDP) on the quality of in-hospital antibiotic use. A multicenter, prospective, randomized, parallel-group trial using the PROBE (Prospective Randomized Open-label Blinded Endpoint) methodology was conducted in eight surgical or medical wards of four hospitals. Two hundred forty-six patients receiving antibiotic therapy prescribed by ward physicians for less than 24 hours were randomized to receive either a systematic review by the ASP IDP at day 1 and days 3 to 4 (intervention group, n = 123) or no systematic review (usual care, n = 123). The primary outcome measure was appropriateness of antimicrobial therapy, a composite score of appropriateness of antibiotic use at days 3 to 4 and appropriate treatment duration, adjudicated by a blinded committee. Analyses were performed on an intention-to-treat basis. In the intervention group, appropriateness of antimicrobial therapy was more frequent (55/123, 44.7% vs. 35/123, 28.5%; odds ratio 2.03, 95% confidence interval 1.20–3.45). Antibiotic treatment duration was lower in the intervention group (median (interquartile range) 7 (3–9) days vs. 10 (7–12) days; p 0.003). ASP IDP counseling to change therapy was more frequent at days 3 to 4 than at day 1 (114/123; 92.7% vs. 24/123; 19.5%, p <0.001). Clinical outcome was similar between groups. This study suggests that a systematic postprescription antibiotic review performed at days 1 and 3 to 4 results in higher quality of antibiotic use and lower antibiotic duration. This trial was registered at ClinicalTrials.gov (NCT01136200).

Fatal group B streptococcal pneumonia in neonates. Effects of antibiotics.

Prophylactic penicillin has been suggested to prevent neonatal group B streptococcal infections (GBS). However, there is a concern that the antibiotics may conceal significant bacteremia if post-treatment blood cultures were used to recover the etiologic agent. To clarify this point, the autopsy records of 111 cases of fatal neonatal pneumonias is infants less than one week of age for the period 1974-1978 were reviewed. Nineteen documented cases of group B streptococcal infections were uncovered. Review of antibiotic therapy in these infants indicate that such therapy can indeed conceal the etiologic agent of pneumonia if one uses post treatment blood (or other normally sterile body fluids) cultures as the basis of diagnosis. On the other hand, review of 41 cases with morphologic evidence of pneumonia and no identifiable etiologic agent reveal that the majority of these were referral cases from outlying hospitals who received antibiotics prior to any diagnostic work-up.

A review of antibiotic therapy in patients with systemic infections

A review of antibiotic therapy in patients with systemic infections

A Review of Antibiotic Therapy in Patients with Systemic Infections

A Review of Antibiotic Therapy in Patients with Systemic Infections