Safe Use Of Antibiotics Research Articles

To assess the availability of antibiotics for online sale and comparison of e-pharmacies on key characteristics influencing safe and rational use of antibiotics: an exploratory analysis.

Growing antimicrobial resistance represents serious public health threat. With the increasing presence of online/e-pharmacies in India, public access to medicines has increased. Easy access coupled with lack of adequate and authentic drug information can undermine rational antibiotic use. The present study aimed at exploring the availability of antibiotics for online sale and comparing the e-pharmacies on key characteristics influencing safe and rational use of antibiotics. A cross-sectional study was conducted over a period of 3 months using the websites of 10 popular e-pharmacies in India. Availability of antibiotics for online sale was assessed in context of the National List of Essential Medicines, 2022 and WHO-AWaRe (Access, Watch, Reserve) categories. Three separate questionnaires were developed to extract and compare relevant information from e-pharmacies pertaining to their safety and authenticity (in light of the expected standards laid down in draft e-pharmacy rules, 2018), availability of drug product and consumer awareness information for promoting prudent antibiotic use. Data were summarized using descriptive statistics. Out of the 17 antibiotics studied; antibiotics belonging to all WHO-AWaRe categories i.e. Access (83.33%), Watch (88.33%) and Reserve (78%) groups were available through e-pharmacies. Wide variation exists among the e-pharmacies regarding compliance to studied parameters under three questionnaires. Increased access to Watch and Reserve groups of antibiotics can translate into antibiotic misuse. It is therefore crucial that the regulatory gaps concerning e-pharmacies are addressed urgently and consumers are educated regarding safe and rational use of antibiotics.

Tetracycline-induced gut community dysbiosis and Israeli Acute Paralysis Virus infection synergistically negatively affect honeybees

Antibiotics are frequently employed to control bacterial diseases in honeybees, but their broad-spectrum action can disrupt the delicate balance of the gut microbiome, leading to dysbiosis. This imbalance in the gut microbiota of honeybees adversely affects their physiological health and weakens their resistance to pathogens, including viruses that significantly threaten honeybee health. In this study, we investigated whether tetracycline-induced gut microbiome dysbiosis promotes the replication of Israeli acute paralysis virus (IAPV), a key virus associated with colony losses and whether IAPV infection exacerbates gut microbiome dysbiosis. Our results demonstrated that tetracycline-induced gut microbiome dysbiosis increases the susceptibility of honeybees to IAPV infection. The viral titer in worker bees with antibiotic-induced gut microbiome dysbiosis prior to IAPV inoculation was significantly higher than in those merely inoculated with IAPV. Furthermore, we observed a synergistic effect between tetracycline and IAPV on the disruption of the honeybee gut microbiome balance. The progression of IAPV replication could, in turn, exacerbate antibiotic-induced gut microbiome dysbiosis in honeybees. Our research provides novel insights into the role of the gut microbiota in host-virus interactions, emphasizing the complex interplay between antibiotic use, gut microbiome health, and viral susceptibility in honeybees. We highlight the crucial role of a balanced gut microbiota in honey bees for their immune response against pathogens and emphasize the importance of careful, safe antibiotic use in beekeeping to protect these beneficial microbes.

Examining antibiotic use in Kenya: farmers’ knowledge and practices in addressing antibiotic resistance

BackgroundAntibiotics hold the promise of mitigating the spread of livestock diseases while enhancing productivity. However, there is global concerns surrounding the improper handling and administration of antibiotics, which has led to an alarming rise in antimicrobial resistance (AMR). Kenya is currently listed as an AMR hotspot. This study assesses farmers’ knowledge and practices on antibiotics in livestock production, knowledge on AMR as well as factors influencing farmers’ knowledge of antibiotic safety and resistance, and antibiotics use.MethodsA across-sectional, quantitative survey was employed with 319 farming households in five counties in Kenya. Multivariate regression analysis was used to identify explanatory factors.ResultsAbout 80% of households use antibiotics in their livestock, and 58% administer the antibiotics themselves. The vast majority of farmers buy antibiotics without a prescription. Antibiotics are used for both therapeutic and non-therapeutic purposes, the latter mainly in form of growth promoters and feed enhancers in poultry. The withdrawal periods reported by farmers are shorter than the officially recommended periods. Although the majority of farmers reported risky antibiotic practices, most (76%) were well aware of bacterial AMR. Nineteen of 21 knowledge statements on AMR and safe use of antibiotics were answered correctly by 55–89% of respondents, indicating considerable farmer knowledge on different aspects of antibiotics risk, while certain knowledge gaps remain. Number of livestock owned was the factor most positively influencing farmers’ knowledge on AMR and safe use.ConclusionKenya has made notable progress towards creating knowledge and awareness of farming communities on the risks and requirements associated with antibiotic use in livestock. Nonetheless, farmers’ antibiotics practices continue to constitute considerable risk of further AMR development. This shows that knowledge is not enough to ensure fundamental behavioral change. There needs to be an enabling environment driven by (1) effective policy interventions and enforcement to ensure compliance with set guidelines for antibiotic use; (2) research on and deployment of alternatives, such as probiotics, vaccinations and disease prevention measures, (3) continued public awareness raising and education using multiple channels to reach farmers and, (4) strengthened cross-sector, multi-stakeholder collaboration to address the multi-dimensional complexities of AMR.

Drug Utilization and Evaluation of Antibiotics and Classifying them based on WHO AWaRe Classification

Antibiotics are the most prescribed medicaments in medical practices worldwide. Indiscriminate use of antibiotics adds to the emergence of Antibiotic resistance (ABR) leading to inefficiency of antibiotics. WHO fostered three unique classification systems - Access, Watch, and Reserve (AWaRe classification)- a tool to identify the safe use of antibiotics. The study aimed to evaluate antibiotic use in the Department of Surgery using the WHO ATC/DDD method and further classified the antibiotics based on WHO AWaRe Classification. An observational study was carried out among 305 samples in the In-Patient Department of Surgery at a teaching hospital, in Bangalore. Data was collected from the patient’s case files using a self-designed data collection form. The collected data were entered in Microsoft Excel and appropriate statistical analysis were performed. It was found that most (28.53%) of the patients belonged to the age group of 38-47 years and most of them received antibiotic therapy as prophylaxis (69%). It was found that Ceftriaxone (28.51%), Metronidazole (21.15%), and Cefixime (18.52%) were the most frequently prescribed antibiotics. The most frequently prescribed antibiotic class was Beta-lactams (65.3%), and most prescribed antibiotics belonged to the Watch Group (53%). The most utilized antibiotics were Ceftriaxone (3.32 DDD/100 bed days) followed by Cefixime (2.15 DDD/100 bed days) and Metronidazole (1.59 DDD/100 bed days). This study shows a need to prepare and implement proper policies or guidelines for prescribing antibiotics in the hospital.

Antibiotic Stewardship: A Handshaking Strategy Among Physicians and Pharmacists to Improve therapeutic Outcomes in Hematology-Oncology.

Background: Infections are highly susceptible in patients with hematological malignancies due to immune suppression, immunosuppressive therapies and disease progression. Rational use of antibiotics following Antimicrobial Stewardship (AMS) guidelines in early detection and response to infection is significant to improve patient care. Objectives: The present study was conducted to determine the impact of clinical pharmacists' interventions (PIs) on antibiotics usage in hematology-oncology set up in Karachi, Pakistan. Methodology: An observational prospective study was conducted for a period of 4 months in a well-known 75-bed teaching hospital, specializing in bone marrow transplantation in Karachi, Pakistan without a structured Antimicrobial stewardship programs (ASPs). The information was gathered from patient medical histories, laboratory, and microbiological records. Results: A total of 876 PIs (1 to 5 per patient) were implemented. Dose modifications or interval changes accounted for the major interventions (n = 190, 21.6%). The majority of all recommendations were related to antipseudomonal β-lactams, aminoglycosides, sulfamethoxazole-trimethoprim and vancomycin. Overall, 94.3% (n = 876) of the 928 PIs were accepted. Conclusion: The PIs and the high physician acceptance rate may be useful for improving the safe use of antibiotics, lowering their toxicity, lowering the need for special-vigilance medications and potentially improving patient care.

Nursing-based intervention to optimize the self-prescribed and the misuse of antibiotics among mothers of children less than 5 years

BackgroundThe fact that bacteria have no geographical boundaries has made bacterial resistance to antibiotics a worldwide issue that requires collaboration and unity to address. Aimevaluate the effect of nursing-based intervention to optimize the self-prescribed and the misuse of antibiotics among mothers of children less than 5 years. MethodsA quasi-experimental design was used to conduct this study. The study was conducted in Maternal Child Health Centers in Mansoura City & Beni-Suef City, Egypt, 100 participants were included in the study. A structured interview questionnaire was used to collect the data, which consisted of five parts; socio-demographic data, knowledge questions about antibiotics and their resistance, attitude scale towards self-prescribed antibiotics, questionnaire on safe use of antibiotics, and patterns of self-prescribed antibiotic use. Results41 % of the study group used self-prescribed antibiotics more than 6 times in the previous 6 months and 100 % of them used them to treat fever and sore throat, followed by 76 % for vomiting and diarrhea. There were significant improvements in participants' knowledge, attitudes towards self-prescribed antibiotics, and safe use of antibiotics after implementing the nursing intervention. ConclusionThe nursing-based intervention was successful in attaining its objectives in improving the total knowledge, attitudes and practices of the studied group. RecommendationHealth education about appropriate antibiotic use should be approved as a part of the preventive services obtained for the mothers.

Prospective observational study on prescription pattern of antibiotics in general ward and intensive care unit in tertiary care hospital

The prescription pattern monitoring facilitate the rational use of drugs in the population. Rational use of drug means patients receive medication appropriate to their clinical needs in closes that meet the individual requirement for an adequate period of time and at an economical price to the individual and overall to the community. Role of Right medicine in the Right manner in the Right patients must be followed while using Antibiotics. Irrational use of medicines is major problem worldwide. WHO estimates that more than half of all medicines are prescribed, dispensed or sold inappropriately and that half of all patients fail to take them correctly. The overuse, underuse or misuse of medicine result in wastage of scarce resource and widespread health hazards. Therefore, appropriate and safe use of antibiotics in healthcare system is more Important. The main objective of the study was to determine the percentage of antibiotics used in general ward and in intensive care unit and to find out most commonly Prescribed antibiotic within 72 hours in intensive care unit, the most common microorganism found in culture sensitivity test and the common route of drug administration in general ward and in intensive care unit. This is a prospective observational study. The study was conducted in tertiary care hospital in Gujarat. The duration of the study was 6 months. Total of 120 patients data was collected from the patient case sheet. Prescription of the patients are collected in designed CRF form and relevant data is analysed to obtain frequency and percentage. Out of 120 patients, majority of patients were male and most commonly used route of administered was Iv. The commonly prescribed antibiotics in general ward was ceftriaxone 28 (29.43%), metronidazole 10 (10.53%), cefoperazone + sulbactum 10 (10.53 %) and Amoxicilin + clavulanic acid 7 (7.37 %) prescribed for different condition. In Intensive care unit, commonly prescribed antibiotics was ceftriaxone 19 (18.1 %), meropenem 15 (14.29 %) and Cefoperazone + sulbactum 12 (11. 44 %). On Discharge Time most of the patients was still on antibiotics therapy.This study analysed 120 prescription and ceftriaxone, cefoperazone + sulbactum, amoxicillin + clavulanic acid, meropenem, cefadroxil ,vancomycin,cefepime + tazobactum piperacilin + tazobactum, doxycycline Cefixime are the hospital formulary. Prescription pattern studies have become a potential tool for evaluating the health care System. This study provides important baseline information on antibiotics use. This study severs to spotlight the current prescribing trends in patients. The use of a single agent and the combination of antibiotics were dependent upon the hospital formulary and protocols and policies for antibiotic use.

The impact of antimicrobial management by clinical pharmacists in obstetrics and gynecology on antimicrobial indicators, bacterial resistance and drug costs from 2011 to 2021 in China

ObjectivesThe goal of our study is to analyze the effectiveness and role of clinical pharmacists in antibiotic management through retrospective research from 2011 to 2021, depending on the current scenario of the antibiotic application in China. MethodsWe formed a team of pharmacists to carry out multifaceted intervention measures, such as forming a working group, developing a plan, establishing management rules via the pre-trial system, prescription comments, collaborating with the administrative department, implementing training and publicity, and so on. Antibiotic use was studied, bacterial drug resistance was determined, and antibiotic costs were computed. ResultsThe pharmacist intervention and rectification of inappropriate antibacterial drug orders considerably enhanced the rational use rate of antibiotics and reduced the cost of antibiotics. Antibiotic use in clean surgery decreased from 90.22% to 11.14%, the use rate of antibiotics decreased from 63.82% to 30.26%, and antibiotic use intensity decreased from 42.75DDDs to 30.04DDDs. The types, timing, and course of antibacterials used in wards were all improved to varying degrees. Bacterial drug resistance improved noticeably, with resistance of Escherichia coli to cephalosporins, ciprofloxacin and carbapenems decreased in varying degrees. The use of antibacterial drugs has decreased significantly. ConclusionsIt is feasible and effective for pharmacists in gynecology and obstetrics to control antibiotic use, which plays a positive role in promoting the safe, effective, and cost-effective use of antibiotics and serves as a valuable reference for the antibiotic management.

Evaluation of Antibiotics Used for Lower Respiratory Tract Infections in a Tertiary Care Hospital

Objective: The main objective of the study was to evaluate patterns of antibiotics prescribed for Lower respiratory tract infections (LRTIs) in a tertiary care hospital. Methodology: A prospective observational study was conducted in the pulmonology and general medicine departments of a tertiary care hospital. The data was collected from the in- patient department after considering inclusion and exclusion criteria for a period of 6 months. Antibiotics prescribed were compared with the guidelines mentioned in the European respiratory society guidelines (ERS), Indian respiratory guidelines, IDSA guidelines, and NICE guidelines to determine the appropriateness of therapy. Statistical tools like Chi-square test were applied to the data by using SPSS software. Result: A total of 284 patients diagnosed with various LRTIs, male 55% patients predominated over female patients of 45%. The majority of the patients were under age group of 61-70 years (24%), literates (71.84%), and symptoms of SOB (88.73%), Cough (69.01%), generalized weakness/body pains (54.92%), fever (50.70%), wheeze (11.26%) and chest pain (9.85%). Among all cases of LRTI, most of the patients 56.4% were diagnosed with viral pneumonia (COVID-19). Higher number of patients was treated with beta-lactam antibiotics. Inj.Piperacillin/tazobactum (38%), Tab.Cefpodoxime proxetil/Clavulanic acid (41%), Inj.Cefaperazone/Sulbactum (35%) and Inj.Amoxicillin/Clavulanic acid (23%) were frequently used. Conclusion: Lower respiratory tract infections are mostly seen in males, elder age groups and in literate patients. Present study showed that the antibiotics were used taking into consideration various clinical and diagnostic evidences like radiology, bio-markers, patient condition and severity of the disease. However the establishment of antibiotic stewardship program is necessary to ensure safe and appropriate use of antibiotics and to prevent antibiotic resistance in patients.

Developing a Tool for Auditing the Quality of Antibiotic Dispensing in Community Pharmacies: A Pilot Study

The European Centre for Disease Prevention and Control describes the community pharmacist as the gatekeeper to the quality of antibiotic use. The pharmacist has the responsibility to guard safe and effective antibiotic use; however, little is known about how this is implemented in practice. To assess the feasibility of a method to audit the quality of antibiotic dispensing in community pharmacy practice and to explore antibiotic dispensing practices in Greece, Lithuania, Poland, and Spain. The Audit Project Odense methodology to audit antibiotic dispensing practice was adapted for use in community pharmacy practice. Community pharmacists registered antibiotic dispensing on a specifically developed registration chart and were asked to provide feedback on the registration method. Altogether, twenty pharmacists were recruited in four countries. They registered a total of 409 dispenses of oral antibiotics. Generally, pharmacists were positive about the feasibility of implementing the registration chart in practice. The frequency of checking for allergies, contraindications and interactions differed largely between the four countries. Pharmacists provided little advice to patients. The pharmacists rarely contacted prescribers. This tool seems to make it possible to get a useful picture of antibiotic dispensing patterns in community pharmacies. Dispensing practice does not seem to correspond with EU guidelines according to these preliminary results.

Knowledge, Attitude, and Medication Practice on Antibiotics among a rural population in Kedah, Malaysia

Antimicrobial resistance is a global problem that will add to the healthcare system's burden and impose an increasing threat to Public Health. This study has evaluated knowledge, attitude, and medication practice on antibiotics (AB) and identified its association with socioeconomic characteristics. A cross-sectional study was conducted using an assisted self-administered questionnaire among 105 adult respondents at a selected residential area in Kedah. A student t-test, the Pearson correlation, and regression analysis were done for the analysis. Most respondents (86.7%) were aware of AB, and 42.9% had used it in the previous year. The respondents were confused about antibiotics knowledge, implying that AB kills germs (69.5%) and viruses (48.6%). Two-thirds of the respondents, 70%, had a moderate understanding of AB, but only a few can correctly recognize AB, its side effects, and the appropriate medication. More than half of the respondents, 58% and 53%, have a positive attitude toward AB and good medication practice. However, the majority are unaware that skipping one or two doses can result in ABR. Antibiotics are still misused, as more than half of the respondents did not always complete the entire course of medication. There was a weak positive correlation between knowledge and attitude scores (p<0.01). Since the respondents have had insufficient knowledge of AB, they may misuse it in the future, leading to increased microbial resistance. It is time to educate the public about the safe use of AB through periodic health education and focus group discussions.

Antibiotic Abuse and Antimicrobial Resistance in Hospital Environment: A Retrospective Observational Comparative Study

Background and Objectives: Antimicrobial resistance represents a serious problem, and it may be life-threatening in the case of severe hospital-acquired infections (HAI). Antibiotic abuse and multidrug resistance (MDR) have significantly increased this burden in the last decades. The aim of this study was to investigate the distribution and susceptibility rates of five selected bacterial species (E. coli, K. pneumoniae, P. aeruginosa, S. aureus and E. faecium) in two healthcare settings located in the Apulia region (Italy). Materials and Methods: Setting n.1 was a university hospital and setting n.2 was a research institute working on oncological patients. All the enrolled patients were diagnosed for bacterial HAI. The observation period was between August and September 2021. Clinical samples were obtained from several biological sources, in different hospital wards. Bacterial identification and susceptibility were tested by using the software VITEC 2 Single system. Results: In this study, a higher incidence of multi-drug-resistant K. pneumoniae was reported (42,2% in setting n.1 and 50% in setting n.2), with respect to the Italian 2019 statistics report (30.3%). All the isolates of E. faecium and S. aureus were susceptible to linezolid. All the bacterial isolates of P. aeruginosa and most of K. pneumoniae were susceptible to ceftazidime–avibactam. Amikacin and nitrofurantoin represented a good option for treating E. coli infections. Multidrug-resistant (MDR) P. aeruginosa, methicillin-resistant S. aureus (MRSA) and vancomycin-resistant E. faecium (VRE) had a lower incidence in the clinical setting, with respect to E. coli and K. pneumoniae. Conclusions: The data obtained in this study can support clinicians towards a rational and safe use of antibiotics for treating the infections caused by these resistant strains, to enhance the overall efficacy of the current antibiotic protocols used in the main healthcare environments.

Prevalence and Determinants of Antibiotic Self-Administration Among Adult Antibiotic Users: A Cross-Sectional Study.

IntroductionEach year, antibiotics save hundreds of thousands of lives; nonetheless, antibiotic self-administration is a major concern all over the world. This study aimed to investigate the prevalence of antibiotic self-administration among two-month adult antibiotic users as well as the factors contributing to this prevalence.Method and ParticipantsThis cross-sectional study was conducted among 295 Bangladeshi adults between May 22nd and June 15th, 2021, during the COVID-19 pandemic. Descriptive statistics included frequency distribution, while inferential statistics included the Pearson chi-square test. For data analysis, the statistical software STATA-16 was used.ResultsIn this study, the prevalence of antibiotic self-administration was 17.97%. Antibiotic self-administration was found to be significantly more prevalent among those who were unable to take antibiotic on time, incomplete doses, did not know over prescriptions may cause antibiotic resistance, and could not correctly recognize amoxicillin and azithromycin are antibiotics.ConclusionDue to the increased rate of antibiotic self-administration among adults in Bangladesh, the responsible authority should give more attention towards the factors responsible for antibiotic self-administration and revise their current policy to ensure the safe and effective use of antibiotics.

In silico QSAR modeling to predict the safe use of antibiotics during pregnancy

The use of medicines during pregnancy is a growing public health concern due to the risk of developmental toxicity. Healthcare providers heavily rely on the FDA pregnancy risk categories (A, B, C, D, and X). Antibiotics are among the most prescribed drugs during pregnancy and are often listed under category B or C. However, the risk-benefit assessment may be lacking due to challenges in the clinical toxicology studies on pregnant women, such as ethical concerns. The primary focus of this study is to generate a model that predicts the safe use of antibiotics during pregnancy by using in silico approaches. Thus, a QSAR model was created to assess the FDA pregnancy category (B or C) of antibiotics. The dataset consisted of 97 antibiotics obtained from the FDA. A total of 6420 molecular descriptors were determined via multiple software and various machine learning algorithms were utilized. The performance of the models was measured using internal and external validation. The accuracy (ACC) values of the most successful model were 83.82% for the internal and 94.11% for the external validation. Sensitivity (SE), specificity (SP), MCC, and ROC values were 0.878, 0.778, 0.68, and 0.892 for the internal validation and 0.9, 1, 0.887, and 0.936 for the external validation, respectively. Kappa statistics also indicate that there was a substantial agreement for internal validation with 0.6765 and an almost perfect agreement for external validation with 0.8811. In conclusion, our model can be used as an initial step before pre-clinical and clinical studies to predict the safe use of antibiotics in pregnancy.

Pattern of Antibiotic Use in the Perinatal Period in a Public University Hospital in Romania.

Background and Objectives: Antibiotics are the most frequently prescribed drugs in hospitals and their prescription is increased during pregnancy and labor. There are limited data about this issue, and the safe use of antibiotics in pregnancy and antibiotic resistance remains a concern. The aim of the study is to evaluate the use of antibiotics among pregnant women attending hospital for five years. Materials and Methods: Antibiotic consumption and treatment information of patients were retrospectively collected from a hospital software program and expressed as defined daily dose (DDD) according to the World Health Organization (WHO) methodology for inpatients between 2017 and 2021. We evaluated antibiotic prescription by name, classes, and Food and Drug Administration (FDA) categories. Results: Antibiotic consumption shows a decreasing trend between 2017 and 2019, but an increasing one between 2020 and 2021. Ceftriaxone was the most prescribed antibiotic in each year, followed by cefixime, amoxicillin, metronidazole, cefuroxime, ampicillin, and ciprofloxacin. We noticed that first- and fourth-generation cephalosporins were not prescribed to these patients. A very small percentage of women in this study received antibiotics such as aminoglycosides; fluoroquinolones were generally contraindicated in the perinatal period. A large percentage of prescriptions were antibiotics classified as category B by the FDA. The most common infections that occurred in the perinatal period were those of the kidney and urinary tract in a higher number than in other studies. Conclusions: Our study shows that many classes of antibiotics used in perinatal women belong to category B antibiotics, the most prescribed being cephalosporins. Because of insufficient safety evidence and the potential for teratogenic effects on the fetus, restricted use among the category C and D antibiotic classes was seen and anticipated. Improving maternal health requires the involvement of healthcare experts in risk assessment and evaluation of existing data for appropriate antibiotic selection, dose, duration of medication, and monitoring.

Spatial distribution and risk assessment of certain antibiotics in 51 urban wastewater treatment plants in the transition zone between North and South China

The release of antibiotics from WWTPs into the environment has raised increasing concern worldwide. The monitoring of antibiotics in WWTPs throughout a region is crucial for emerging pollutant management. A large-scale survey of the occurrence, distribution, and ecological risk of seven antibiotics in 51 WWTPs was conducted in Shaanxi Province, China. Norfloxacin and ofloxacin had the highest detection concentrations of 474.2 and 656.18 ng L−1, respectively. Antibiotic residues in effluents were decreased by 5.88–94.16 % after different treatment processes. In particular, A2O or mixed processes performed well in removing target antibiotic compounds simultaneously. The ecological risk posed by antibiotic compounds detected in effluents was calculated using the risk quotient (RQ). Norfloxacin, ofloxacin, tetracycline, and roxithromycin posed different levels of potential ecotoxicological risk (RQ = 0.02–7.59). Based on the sum of the RQ values of individual antibiotic compounds, each investigated WWTP showed potential ecological risk. WWTPs with high risk levels were mainly found in the central region, while those in the southern region exhibited low risk levels, and those in the northern region showed risk levels between medium and high. This comprehensive investigation provides promising results to support the safe use and control of antibiotics in the study area.

Profil Penggunaan Antibiotik yang Aman dan Rasional pada Pengobatan Penyakit Infeksi Gigi di Tempat Praktek Dokter Gigi Kota Bandung

Antibiotics should be used according to the regimen prescribed by a doctor or pharmacist to prevent resistance. Patients after an outpatient clinic may have problems with adherence to antibiotics. This study aims to understand the safe and rational use of antibiotics in the treatment of dental infectious diseases at a dentist's office in Bandung. Collecting data using a retrospective approach based on the order in which the patient took antibiotics and then classified according to the type, class, dose and duration of antibiotic administration. There are three types of antibiotics used, namely amoxicillin, cefixime, and lincomycin. The antibiotics used were in 3 groups, namely penicillins, gene-III cephalosporins, and other antibiotics. The most common dose of the antibiotic amoxicillin is 500 mg up to 3 times a day. The results showed the use of 3 antibiotics, namely amoxicillin, cefixime and lincomycin.

Antibacterial Effect of Phenolic Acids Derived from Rice Straw and in Combination with Antibiotics Against Escherichia coli.

Many studies have demonstrated that natural plant extracts have inhibitory effects on microorganisms. The purpose of this study was to investigate the inhibitory effect of phenolic acids from rice straw (PAs) on Escherichia coli and their synergistic effect in combination with antibiotics. PAs can inhibit the growth of E. coli effectively by inducing the formation of H2O2; PA-treated cells had a tenfold greater intracellular H2O2 concentration than the control group. The synergistic effect caused by the interaction of PAs and antibiotics on inhibiting the growth of E. coli was significant. This effect may be caused by a PA-induced change in the permeability of E. coli cell membrane. The treatment with PAs made the extracellular K+ concentration reached 15mg/L within 30min, while the K+ concentration in the control group was very low and did not change significantly over time. Similarly to the extracellular K+, the extracellular protein concentration exceeded 150mg/L in the PA treatment group, while it remained very low in the control group. Due to the increased cell permeability, more antibiotics can enter the cell. Hence, this study may provide a novel method of improving the safe use of antibiotics.

Environmental Scan of Parent-Facing Health Information About Antibiotics in US Children's Hospital Websites.

Nearly half of free-standing children's hospital websites contain parent-facing resources about antibiotics. Most resources have information on safe antibiotic use, antibiotic resistance, and questions to ask clinicians. Accessibility can be improved by increasing readability, available languages, and multimedia. Future research should evaluate information accuracy, actionability, and comprehension with target audiences.

The remaining unsolved problems for rational antibiotic therapy use in pediatric community-acquired pneumonia

ABSTRACT Introduction Despite availability of several official guidelines, not all the problems related to the most effective and safe use of antibiotics in children with community-acquired pneumonia (CAP) have been solved. Presently, too many children receive unneeded antibiotics or, when antibiotics are mandatory, the choice of the drug is not appropriate. Areas covered In this paper, the authors discuss the remaining unsolved problems for rational antibiotic therapy use in pediatric community-acquired pneumonia and provide their expert perspectives. Expert opinion Further improvement in pediatric CAP management could be derived from physician education on antibiotic use and a larger use, particularly in office practice, of point of care testing or new technologies (i.e. artificial intelligence) to define etiology of a lower respiratory infection. However, recommendations regarding the duration of antibiotic therapy vary largely because of the absence of reliable data on the optimal CAP treatment according to the bacterial etiology of the disease, its severity, and child characteristics. Available evidence seems to confirm that a short course of antibiotics, approximately 5 days, can be effective and lead to results not substantially different from those obtained with prolonged-course antibiotic therapy, at least in patients with mild to moderate disease.