No abstract available.
Antibiotic Prophylaxis

Background: Antibiotic resistance is a popular condition, especially in hospitals. The development of multi-resistance strains of bacteria is a really interesting problem for the health branch. In Vietnam, antibiotic resistance surveillance programs are frequency performed, however, the results from them are limited. Objective: To determine the prevalence, component of bacteria species and the rate of antibiotic resistance of bacterial strains, which were isolated in the hospital. Subject and methods: 446 strains of pathogenic bacteria were isolated in Hospital 103 with routine microorganism technique. Antibiogramme was conducted with improved Kirby-Bauer technique. Results and Conclusion: Among these strains isolated in Hospital 103, the majority was the gram positive Cocci with Streptococcus spp (53.14%), S.aureus (19.73%). The gram negative was modest (under 10%). All the isolated bacteria were highly resistant to antibiotics (over 50%), except Augmentin. 29.85% of S.aureus resisted with Vancomycine.
antibiotic resistance ; bacteria

Antibiotic susceptibility ; Staphylococcus aureus ; Community

OBJECTIVES

The objectives of the study were to determine the antibiotic consumption of restricted antibiotics and to correlate this with resistance rate.

A retrospective review of pharmacy dispensing records was conducted in the adult internal medicine wards of a tertiary level teaching hospital in the Philippines between March 2019 to February 2020. Antibiotic consumption was determined using Defined Daily Dose (DDD) per 1000 patient-days (PD). Correlations between antibiotic consumption and antibiotic resistance of restricted antibiotics were done. Outcomes were compared between Ward 1 (with the presence of a unit-dose pharmacist) and Ward 3 (without a unit-dose pharmacist).

Both wards showed decreasing trends of piperacillin-tazobactam consumption and increasing trends of ceftazidime consumption from quarter 1 to quarter 4. It was observed that levofloxacin was the most prescribed fluoroquinolone with the highest consumption recorded from March to May 2019 in Ward 3 of 350.2 DDD/1000 PD as compared with ciprofloxacin which has the highest consumption (23.3 DDD/1000 PD) during the period June to August 2019 in Ward 1. Antibiotic resistance of Acinetobacter baumannii against ciprofloxacin, levofloxacin, and piperacillin-tazobactam were statistically significantly different between the wards. In Ward 1, ciprofloxacin consumption was strongly positively correlated with Escherichia coli resistance (r = 0.90). In Ward 3, a significantly moderately positive association was observed for ceftazidime consumption and A. baumannii resistance (r = 0.61), positive correlation between piperacillin-tazobactam and E. coli resistance (r = 0.65), and a strong positive correlation in Ward 3 between levofloxacin and Pseudomonas aeruginosa resistance (r = 0.71).

The restriction and pre-authorization strategy of the AMS program has greatly contributed to the decrease in the consumption of almost all restricted antibiotics. This strategy has been helpful in minimizing unnecessary antibiotic use associated with inappropriate drug therapy. The success of the AMS program has been based on the collective efforts of the AMS team with the implementation of hospital policies, such as the AMS program, across the different sites in the hospital in order to achieve optimum patient health outcomes. It was noted that the resistance rates of A. baumannii against ciprofloxacin, levofloxacin, and piperacillin-tazobactam were higher in Ward 3 compared to Ward 1 which makes infections very difficult to treat which may result to prolonged hospital stay, increased health-care costs and increased mortality rate. This study has supported the involvement of pharmacists in the AMS team by conducting auditing activities that promote safe compliance of restricted antibiotic use among patients. Pharmacists can greatly participate on either prospective or retrospective review of antibiotic utilization and analyze trends of antibiotic consumption data to provide feedback to prescribing physicians on prescribing patterns and possible correlation with occurrence of antibiotic resistance.

We present a case of a 50-year-old man with chronic kidney disease (CKD) presenting with acute diarrhea and fever. He was admitted a month prior for COVID-19, where he received antibiotics for radiographic findings of pneumonia and elevated procalcitonin. In the emergency department, his stool sample tested positive for Clostridioides difficile antigen and toxin. He was given oral vancomycin and intravenous metronidazole for fulminant C. difficile infection and was discharged with resolution of symptoms. This case documents a potential risk associated with routine antibiotic use during the pandemic and the pitfalls in interpreting procalcitonin, especially in patients with COVID-19 and CKD.
COVID-19 ; Clostridioides difficile ; antibiotic-associated colitis

Anti-Bacterial Agents ; therapeutic use ; Antibiotic Prophylaxis ; Humans ; Intraoperative Care

Introduction: Septic shock is the most common type of shock encountered by internists and is the most common cause of death in non-coronary intensive care units. In the 2012 Surviving Sepsis Campaign, one recommendation is antibiotic administration within three hours from sepsis recognition. Several large-scale studies challenged this recommendation with contrasting results. The researchers aim to determine the impact of early antibiotic therapy (EAT) on mortality and outcome of patients and to determine institutional compliance to current sepsis recommendations. Methods: This retrospective single center study included septic patients at the emergency room from February 2013 to January 2015 and were grouped into the EAT group (lesser than or equal to three hours) and control group (more than three hours) antibiotic initiation from sepsis recognition). Primary outcomes are in-hospital mortality, time-to-antibiotics and extraction of blood culture prior to antibiotics. Secondary outcomes include length of hospital stay, use of vasopressors and mechanical ventilation and development of sepsis-related complications. Results: Two-hundred sixty-one patients were included with 53.26% overall mortality rate. The overall mean timeto-antibiotics is 355.1 minutes and time-to-blood culture is 434.64 minutes. Mean time-to-antibiotics were 115 and 556 minutes in the EAT and control group respectively. Mortality was significantly higher in the control group (43.7% vs. 61.3%, p=0.006). For the sepsis related complications, development of acute kidney injury (p=0.033) was higher in the EAT group and acute respiratory failure (p=0.009) was significantly increased in the control group. Conclusion Antibiotic administration within three hours from sepsis recognition significantly reduced in-hospital mortality. Timing of antibiotics and collection of blood cultures were delayed compared to current recommendations. Among the sepsis-related complications, prolonged time-to-antibiotics (>3 hours) is associated with risk of developing acute respiratory failure and subsequent need for mechanical ventilation.
Early antibiotic therapy ; Shock, Septic ; Sepsis ; Systemic Inflammatory Response Syndrome

This study aims to examine the risk of bacterial and fungal transmission through frequent or repeated usage of the same water pipe by different smokers in public café shops. A total of 110 samples were extracted from different parts of used shisha apparatuses. These samples were collected from different cafes in seven cities in the UAE in the time period between Nov. 2016 and Feb. 2017. In all 110 samples, the bacterial and fungal strains were examined at Canadian university Dubai laboratories using standard protocols for culturing, isolating and identifying microorganisms. Later on, the samples were sent to Iranian hospital Dubai to examine the resistance of isolated bacteria to common antibiotics. Statistical analysis was conducted using quantitative data analysis and figures were expressed in percentage for clearer conclusion. Five bacterial strains were detected which are; Pseudomonas putida; Staphylococcus saprophyticus; Micrococcus luteus; Bacillus cereus and Providencia alcalifaciens (See table 2). One of the most important findings of the current study is the isolated bacteria Staphylococcus saprophyticus which showed methicillin resistance. Shisha smoking is a public health issue and could be a carrier of pathogens for smokers. There is a need for further assessments to address the impact of the sharp increase of Shisha smoking among specific populations especially in the Gulf countries (GCC) and among the female segment of society.
Shisha apparatus ; Pathogens ; Antibiotic sensitivity ; Carrier of Pathogen ; Public Health

Background and Objective: Antibiotic prophylaxis is used to prevent bacterial infections and rebleeding in cirrhosis patients with upper gastrointestinal bleeding (UGIB). However, the effects of various antibiotics on patients with UGIB are still being considered. This study aims to evaluate the effect of antibiotic prophylaxis on cirrhosis patients with UGIB. Methods: The studies were searched through databases of PubMed, ScienceDirect, Wiley Online Library, and CENTRAL from 2013 to 2023. We used Revman 5.4 to perform a meta-analysis. I2 statistics measured the heterogeneity test. The odds ratio (OR) and 95% confidence interval (CI) were used to assess the effect of antibiotic prophylaxis. Results: Twelve studies involving 14,825 cirrhosis patients were included in this study. Based on the meta-analysis, antibiotic prophylaxis significantly lowered the bacterial infection rate (OR: 0.29, 95%CI: 0.10 to 0.84, P = 0.02), and the incidence of serious adverse events (SAE) (OR: 0.50, 95%CI: 0.28 to 0.88, P = 0.02) in cirrhosis patients with UGIB. Conclusions Administration of antibiotics demonstrated a significant reduction in bacterial infection rates and SAEs. Broad-spectrum non-absorbable antibiotics can be used in cirrhosis patients with UGIB. The appropriate use of antibiotics is important to prevent resistance.
Antibiotic ; Anti-Bacterial Agents ; prophylaxis ; prevention & ; control ; Cirrhosis ; Fibrosis

The present study has been performed to evaluate 20 cardiopathy children and 20 healthy children's oral micorbes at the point of antimicrobial susceptibilities for antimicrobial prophylaxis to prevent bacterial endocarditis. The results were as follows: 1. Both groups had similar oral microbes. 2. The antimicrobial susceptibility of S. viridans were: Penicillin< Oxacillin< Ampicillin< Cephalothin< Erythromycin< Clindamycin< Gentamicin< Ciprofloxacin< Vancomycin=Imipenem. The cardiopathy group was slightly lower antimicrobial susceptibility rates than healthy group. 3. The antimicrobial susceptibility of Neisseriaceae were: Clindamycin< Erythromycin< Vancomycin< Penicillin< Gentamicin< Cephalothin< Ciprofloxacin< Imipenem. The antibiotics of bacterial endocarditis antibiotic prophylaxis regimens for dental procedures according to the American Heart Association were generally lower antimicrobial susceptibilities, so they were considered inadequate for the first selective antibiotics and Imipemem was best suitable antimicrobials. Conclusively, when choose antimicrobials for treatment or antimicrobial prophylaxsis for bacterial endocarditis, surveillant culture must be performed to evaluated personal antimicrobial susceptibilities of intraoral microbes for proper antimicrobial choice for dental procedures.
American Heart Association ; Anti-Bacterial Agents ; Antibiotic Prophylaxis ; Child* ; Endocarditis* ; Endocarditis, Bacterial ; Humans ; Imipenem ; Neisseriaceae