TY - JOUR. T1 - Fluconazole prophylaxis in critically ill trauma intensive care unit patients. AU - Munshi, Imtiaz. AU - Steeman, Danny. AU - Parra-Oavia, Eduarde. AU - Erbefla, Jose. AU - Siva, Rogelio. AU - Morejon, Ortando. AU - Kkton, Orlando. AU - Namias, Nicholas. PY - 1998/12/1. Y1 - 1998/12/1. N2 - Introduction: To investigate the efficacy of fluconazote as prophylaxis on the incidence of secondary fungal infections in critically ill trauma intensive care unit (TICU) patients receiving broad spectrum antibiotics and to assess the development of resistant fungal species to fluconazote Methods: Descriptive, prospective study, over 38 months, involving 328 TICU patients placed on broad spectrum antibiotics. AI patients received 200 mg/day enterai dose fluconazote for the duration of broad spectrum antibiotic usage. Pre-and post-fluconazole cultures are obtained. Results: 328 TICU patients were placed on broad spectrum antibiotics and subsequent floconazote prophylaxis. Distribution of ...
which of the following is broad spectrum antibiotic expain ampicillin chloramphenicol penicillin o78kgbqq -Chemistry - TopperLearning.com
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Antimicrobial stewardship programs (ASPs) focus on improving the utilization of broad spectrum antibiotics to decrease the incidence of multidrug-resistant Gram positive and Gram negative pathogens. Hospital admission for both medical and surgical intra-abdominal infections (IAIs) commonly results in the empiric use of broad spectrum antibiotics such as fluoroquinolones, beta-lactam beta-lactamase inhibitors, and carbapenems that can select for resistant organisms. This review will discuss the management of uncomplicated and complicated IAIs as well as highlight stewardship initiatives focusing on the proper use of broad spectrum antibiotics.
EDITOR-Roos et al showed that α haemolytic streptococci-a part of the normal flora-have a protective effect against otitis media.1 Even though the effect was modest, this finding is remarkable and should influence antibiotic policy.. Broad spectrum antibiotics impair the normal flora. In a recent epidemiological survey we found an association between the use of such antibiotics and an increased risk of recurrence of acute otitis media (broad spectrum antibiotics v phenoxymethylpenicillin: odds ratio 1.8 (95% confidence interval 1.3 to 2.6)).2 Howard et al showed that recurrences were less common among children treated with a narrow spectrum drug (penicillin or erythromycin) than among those treated with a broad spectrum antimicrobial (amoxicillin or erythromycin plus sulphonamide) (13.3% v 40.5%, P=0.0125).3. Nowadays, broad spectrum antibiotics are increasingly used to treat otitis, although the clinical picture of this disease has become milder.2 Broad spectrum drugs have not been shown to ...
Define antibiotic sensitivity test. antibiotic sensitivity test synonyms, antibiotic sensitivity test pronunciation, antibiotic sensitivity test translation, English dictionary definition of antibiotic sensitivity test. n. A substance, such as penicillin or erythromycin, produced by or derived from certain microorganisms, including fungi and bacteria, that can destroy or...
Sometimes there is a perception, not restricted to pneumonia, that the use of a broad spectrum antibiotic, a big gun, is going to be the best treatment for all patients. This perception can complicate the selection of antibiotics especially when there is limited information to support the decision, said senior author Carlos G. Grijalva, MD, MPH. To help inform those decisions, this study compared two pneumonia treatment regimens, a big gun (broad spectrum antibiotics) vs. a small gun (narrow spectrum antibiotics), and found there were no significant differences in clinical outcomes or associated costs ...
Symptoms and Treatments. Broad Spectrum Antibiotic use is the mainstay of treatment for this complication. There are many potential approaches to this therapy. For example: Antibiotics are given in 2-3 week courses followed by a 1-2 week drug holiday. Generally a few cycles of this treatment can allow for quiet periods of a few months to a few years. However, some persons may require almost continuous antibiotics.. Alternating antibiotics and increasing the antibiotic-free period will decrease the development of resistant strains of bacteria.. Note: Prolonged use of Broad Spectrum Antibiotics may be complicated by superinfection.. ...
New medication or old medications with new uses, as well as new treatment guidelines are constantly coming out. Pharmacists need to be aware of clinical controversies and stay up-to-date with the pharmacotherapy and therapeutics of all medications. Pharmacists will gain knowledge of a current clinical controversy and become aware of best medication practices. ...
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This is a general term, describing any of numerous classes of antibiotics. Common to all of them is their ability to effectively treat a wide range of bacteria.. These antibiotics would include:. Aminoglycoside. ...
Bloodstream infections (BSIs) by Klebsiella pneumoniae carbapenemase (KPC)-producing Klebsiella pneumoniae (Kp) are associated with high mortality. The aim of this study is to assess the relationship between time to administration of appropriate antibiotic therapy and the outcome of patients with BSI due to KPC-Kp hospitalized in intensive care unit (ICU). An observational study was conducted in the ICUs of two academic centers in Italy. Patients with KPC-Kp bacteremia hospitalized between January 2015 to December 2018 were included. The primary outcome was the relationship between time from blood cultures (BC) collection to appropriate antibiotic therapy and 30-day mortality. The secondary outcome was to evaluate the association of different treatment regimens with 30-day mortality and a composite endpoint (30-day mortality or nephrotoxicity). A Cox regression analysis to identify factors independently associated with 30-day mortality was performed. Hazard ratio (HR) and 95% confidence interval (CI)
TY - JOUR. T1 - An audit of the effect of intravenous antibiotic treatment on spirometric measures of pulmonary function in cystic fibrosis. AU - Bradley, Judy. AU - Wallace, Eric. AU - Elborn, JS. AU - Howard, JL. AU - McCoy, MP. PY - 1999/1. Y1 - 1999/1. M3 - Article. VL - 168. SP - 25. EP - 28. JO - IRISH JOURNAL OF MEDICAL SCIENCE. JF - IRISH JOURNAL OF MEDICAL SCIENCE. SN - 0021-1265. IS - 1. ER - ...
Learning platform for GPAT (Graduate Pharmacy Aptitude Test) aspirants. In this blog you will get free notes and objective questions for your GPAT preparation. This is an initiative to help all GPAT aspirants in their preparation. Below, categories are given from where you can go to the particular subject for your GPAT preparation. If you do not find any topic here do let us know. We will be happy to update the topic. All the best for your GPAT preparation.. ...
Among the various mastitis pathogens, Staphylococcus aureus (S. aureus) is identified as a chief etiological agent responsible for subclinical and chronic mastitis. Samples were collected from the clinically affected cattle showing typical symptoms of mastitis. 156 samples were screened by clinical symptoms specific for mastitis from the delta region of Tamilnadu. On the basis of cultural and biochemical properties, 52 isolates were presumptively identified as S. aureus. These 52 isolates were subjected to antibiotic sensitivity test, for which 15 antibiotic discs were used. The antibiotic sensitivity pattern of the used antibiotics of the 52 Staphylococcal isolates revealed maximum resistance for pencillin-G (90%), ampicillin (83%), erythromycin (60%), terramycin (54%), Ampicillin/ Cloxacillin (47%) and cotrimaxazole (46%). whereas, the isolates were highly sensitive to chloramphenical (84%), enrofloxacin (75%), ofloxacin (61%), ceftriaxone (45%), and amoxicillin + clavulanic acid (50%). All the
Effects of various antimicrobial agents on multi-directional differentiation potential of bone marrow-derived mesenchymal stem cells
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These are drugs used to treat or cure infections and to be effective they must kill or disable the pathogen, leaving host cells unharmed. Most antibiotics are used to treat bacterial and fungal infections, there are very few that are effective against viruses. A few antibiotics are synthetic but most are derived from living organisms. They work by either interfering with the growth or metabolism of the bacteria or fungi. They may inhibit the synthesis of the cell wall, translation or transcription of proteins, interfere with membrane function or enzyme action. Antibiotics need to be carefully chosen. This is done by screening them against the strain of bacterium or fungus obtained from the sufferer. The samples obtained are grown on agar plates and antibiotic discs placed on to the plate. The disc with the greatest diameter of inhibition zone, is the most effective. Broad spectrum antibiotics are effective against a wide range of bacteria, while narrow spectrum antibiotics affect only a few.
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Bacteria treated with different classes of antibiotics exhibit changes in susceptibility to successive antibiotic treatments. This study was designed to evaluate the influence of sequential antibiotic treatments on the development of antibiotic resistance in Klebsiella pneumoniae associated with β-lactamase and efflux pump activities. The antibiotic susceptibility, β-lactamase activity, and efflux activity were determined in K. pneumoniae grown at 37 °C by adding initial (0 h) and second antibiotics (8 or 12 h). Treatments include control (CON; no first and second antibiotic addition), no initial antibiotic addition followed by 1 MIC ciprofloxacin addition (CON-CIP), no initial antibiotic addition followed by 1 MIC meropenem addition (CON-MER), initial 1/4 MIC ciprofloxacin addition followed by no antibiotic addition (1/4CIP-CON), initial 1/4 MIC ciprofloxacin addition followed by 1 MIC ciprofloxacin addition (1/4CIP-CIP), and initial 1/4 MIC ciprofloxacin addition followed by 1 MIC meropenem
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Basically, antibiotic compounds play an important role of effector molecules in their natural environments, then their mechanism of action could be seen as using their specific targets as signal relays. For example, tetracyclines binding to the ribosome cause a breakdown in translation that ultimately lead to cell death at high concentrations; but at sub-inhibitory concentrations, the binding to the ribosomes causes a temporary stall in translation that leads to an mRNA build up thereby stabilizing mRNA transcript concentrations in target cells. (Fajardo et al., 2008). Therefore, the action of antibiotic is actually an interesting way of using ribosomes, DNA, RNA, carbohydrates (peptidoglycan) as signal effector receptors and transducers .If antibiotic compounds play the role of effector molecules in their natural environments, then their mechanism of action could be seen as using their specific targets as signal relays. An example, is when tetracyclines binding to the ribosome cause a breakdown ...
The purpose of this study was to investigate the relationship among Pseudomonas aeruginosa acquisition on the intensive care unit (ICU), environmental contamination and antibiotic selective pressure against P. aeruginosa. An open, prospective cohort study was carried out in a 16-bed medical ICU where P. aeruginosa was endemic. Over a six-month period, all patients without P. aeruginosa on admission and with a length of stay |72 h were included. Throat, nasal, rectal, sputum and urine samples were taken on admission and at weekly intervals and screened for P. aeruginosa. All antibiotic treatments were recorded daily. Environmental analysis included weekly tap water specimen culture and the presence of other patients colonized with P. aeruginosa. A total of 126 patients were included, comprising 1,345 patient-days. Antibiotics were given to 106 patients (antibiotic selective pressure for P. aeruginosa in 39). P. aeruginosa was acquired by 20 patients (16%) and was isolated from 164/536 environmental
London, Dec 21 (IANS): Antibiotic resistant bacteria are sleeper cells which can survive doses of antibiotics and lie resting in a dormant state, but have the ability to wake up and re-infect, research has found.. Antibiotic resistance is one of the most pressing public health challenges and threatens the ability to effectively fight infectious diseases including pneumonia and tuberculosis.. In the study, led by Stefano Pagliara, a biophysicist at the University of Exeter, the team used a miniaturised device which enabled them to isolate and study single bacteria over time.. Next, the team dosed bacteria with ampicillin. They found that the vast majority of the 1.3 per cent of cells that survived were live but non-growing.. These are sleeper cells because they look dormant and resemble the cells killed by antibiotics, but are potentially dangerous with the ability to wake up and re-infect humans or animals, Pagliara said, in the paper published in the journal BMC Biology.. Besides, these ...
The continuous spread of penicillin-resistant pneumococci represents a permanent threat in the treatment of pneumococcal infections, especially when strains show additional resistance to quinolones. The main objective of this study was to determine a treatment modality impeding the emergence of quinolone resistance. Exposure of a penicillin-resistant pneumococcus to increasing concentrations of trovafloxacin or ciprofloxacin selected for mutants resistant to these drugs. In the presence of sub-inhibitory concentrations of vancomycin, development of trovafloxacin-resistance and high-level ciprofloxacin-resistance were prevented. Considering the risk of quinolone-resistance in pneumococci, the observation might be of clinical importance.
n=1) were determined using the Kirby-Bauer disc diffusion method on Mueller-Hinton agar. The findings revealed that all the isolates showed multiple antibiotic resistances ranging from 30% to 100%, intermediate resistance 0%-20% and susceptibility 9.75-60%. Five (18.4%) isolates showed pan-resistance (100%). The highest resistance (100%) was shown to ampicillin, nalidixic acid, augmentin, trimethoprim-sulfamethoxazole and cephaplexin. The highest susceptibility was shown to levofloxacin (100%), ofloxaxin (66.7%), ciprofloxacin (60%) and perfloxacin (50%). The findings support the claim that ciprofloxacin is still the most effective second line broad spectrum antibiotic. The implications of drug resistance in health and economy, which include higher mortality rates, longer duration of illness and treatment, increased health-care costs and economic burden, the resort to alternative herbal treatments which further compound health problems and the emergence of pan-resistant bacterial pathogens ...
The Differences between Antibiotic and Antimicrobial Resistance. Antibiotic resistance is a major problem that humanity faces today, and that is why there are lots of sources of information providing insights on this problem. Sometimes people believe that antibiotic resistance and microbial resistance are the same.. If antibiotic resistance particularly means the resistance to antibiotics, microbial resistance means the resistance to various microbes, including fungi, parasites, viruses, and other organisms. Antimicrobial resistance has spread to various parts of the world, including Australia.. Since this condition is related to the longer period of treatment, the higher cost, and other problems, it really must be managed.. How Can Microbes Be Killed?. There are two basic agents used to control microbes, including bacteriocidal (disinfectants) and bacteriostatic (antiseptics) agents. The first ones will actually destroy vegetative cells and spores, and the other ones will slow or prevent the ...
Gram-positive spectrum antibiotics such as vancomycin, teicoplanin, daptomycin, and linezolid are frequently used in empirical treatment combinations in critically ill patients. Such inappropriate and unnecessary widespread use, leads to sub-optimal utilisation. However they are covered by the antibiotics restriction programme. This prospective observational study, evaluates gram-positive anti-bacterial utilisations in intensive care units (ICUs) with various evaluation criteria, to determine the frequency of inappropriate usage and the intervention targets required to ensure optimum use. This clinical study was conducted prospectively between 01.10.2018 and 01.10.2019 in the medical and surgical ICUs of Gazi University Faculty of Medicine Hospital, Turkey. The total bed capacity was 55. Patients older than 18 years and who were prescribed gram-positive spectrum antibiotics (vancomycin, teicoplanin, linezolid, and daptomycin) were included. Patients under this age or immunosuppressed patients
Treatment for patients presenting with sepsis due to an obstructing stone requires urgent urinary tract decompression. Following this, patients are hospitalized for hemodynamic support and broad spectrum antibiotics. Urine culture results are used to tailor outpatient antibiotic therapy. At times patients achieve early clinical stability but remain hospitalized while awaiting antibiotic sensitivities. Dr. Tran and his coauthors attempted to identify predictors of antibiotic resistance that may allow clinicians to select candidates for early discharge on empiric oral antibiotics prior to receiving culture results.
If you experience a worsening of symptoms because of a bacterial infection (known as an infective exacerbation) then youll need to be treated with antibiotics.. A sample of phlegm will be taken to determine what type of bacteria is causing the infection, although youll be initially treated with an antibiotic known to be effective against a number of different bacteria (a broad spectrum antibiotic) because it can take a few days to get the test results. Depending on the test results, you may be prescribed a different antibiotic, or in some cases, a combination of antibiotics known to be effective against the specific bacteria causing the infection.. If youre well enough to be treated at home, youll probably be prescribed two to three antibiotic tablets a day for 10-14 days. Its important to finish the course even if you feel better, as stopping the course prematurely could cause the infection to recur quickly.. If your symptoms are more severe (see symptoms of bronchiectasis for a detailed ...
Dr. Siddhartha Thakur, assistant professor of population health and pathobiology, had previously found that antibiotic-resistant C. coli, a leading cause of foodborne illness in the U.S., was present in both ABF-certified and conventionally raised pigs. The pathogen was present in both groups in all facilities from breeding to processing. Thakur wanted to determine whether the C. coli that he found in each group was genetically the same, in order to see if the presence or absence of antimicrobial usage had an effect on the pathogens genetic makeup.. The rise of antibiotic-resistant pathogens like C. coli is a concern for the food animal industry. Some pig farms have switched to raising ABF pigs in an attempt to get away from the conditions that facilitated antibiotic resistance in the first place. The hope is that once the selection pressure - in the form of antimicrobial use - on C. coli to retain antibiotic resistance decreases, the pathogen will lose its resistance.. Over several years, ...
If you experience a worsening of symptoms because of a bacterial infection (known as an infective exacerbation) then youll need to be treated with antibiotics.. A sample of phlegm will be taken to determine what type of bacteria is causing the infection, although youll be initially treated with an antibiotic known to be effective against a number of different bacteria (a broad spectrum antibiotic) because it can take a few days to get the test results. Depending on the test results, you may be prescribed a different antibiotic, or in some cases, a combination of antibiotics known to be effective against the specific bacteria causing the infection.. If youre well enough to be treated at home, youll probably be prescribed two to three antibiotic tablets a day for 10-14 days. Its important to finish the course even if you feel better, as stopping the course prematurely could cause the infection to recur quickly.. If your symptoms are more severe (see symptoms of bronchiectasis for a detailed ...
If you experience a worsening of symptoms because of a bacterial infection (known as an infective exacerbation) then youll need to be treated with antibiotics.. A sample of phlegm will be taken to determine what type of bacteria is causing the infection, although youll be initially treated with an antibiotic known to be effective against a number of different bacteria (a broad spectrum antibiotic) because it can take a few days to get the test results. Depending on the test results, you may be prescribed a different antibiotic, or in some cases, a combination of antibiotics known to be effective against the specific bacteria causing the infection.. If youre well enough to be treated at home, youll probably be prescribed two to three antibiotic tablets a day for 10-14 days. Its important to finish the course even if you feel better, as stopping the course prematurely could cause the infection to recur quickly.. If your symptoms are more severe (see symptoms of bronchiectasis for a detailed ...
Despite the extensive use of antibiotic agents and the existence of vaccination programs, infectious diseases, particularly bacterial infections are still a major cause of death worldwide. Indeed, because of the massive and often inadequate use of antibiotics, pathogenic bacteria have developed resistance mechanisms against most classes of currently available antibiotics. This trend has been particularly dramatic over the past twenty years. The possible transmission of genes that encode the mechanisms of resistance between different bacterial species has led to the emergence of multiresistant bacteria. This situation causes problems in therapy, particularly in hospitals, The recent and continuous emergence of conventionally used antibiotic-resistant strains in clinic is a serious public health issue. It is urgent new antibacterial agents be discovered. Such molecules must be targeted to proteins that are essential for cell viability, but absent in mammals.. The main objects of this research work ...
Jansen JP, Kauf T, Eapen S, Medic G, Kollef M. Relationship Between Microbiological Eradication and Clinical Outcome with Antibiotic Treatment in Nosocomial Pneumonia, Complicated Urinary Tract Infection, and Complicated Intra-Abdominal Infection. Value Health. 2014 Nov;17(7):A664. Presented at: ISPOR 17th Annual European Congress; November 12, 2014; Amsterdam, The Netherlands.. ...
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In this study using real-world data from the largest single site hospital in England, parenteral antimicrobials were prescribed to six percent of patients attending the ED and 23 % of patients admitted to hospital. Blood cultures were obtained from less than one-third of patients who were treated with parenteral antimicrobials at emergency admission to hospital and a micro-organism was identified in just 12 % of patients who had a blood culture. More than half of all patients prescribed a parenteral antimicrobial were treated with the broad spectrum antibiotics co-amoxiclav or piperacillin-tazobactam.. Although the rate of pathogen detection by blood culture was low in our study, it is comparable to other studies conducted in the ED [6, 7]. There are many factors that can reduce the sensitivity of blood cultures such as collection of a low volume sample, poor sampling technique and prior treatment with antimicrobials, and a further problem is the rate of false positive tests through blood ...
DESCRIPTION (provided by applicant): Helicobacter pylori (Hp), a gastric bacterial pathogen of humans; infection is the cause of type B gastritis and is also strongly associated with gastric carcinoma (intestinal type) and gastric MALT lymphoma. Combination antimicrobial therapy (triple therapy with a bismuth salt, metranidazole and a broad spectrum antibiotic) is successful in 80% of Hp-infected symptomatic patients; treatment failures are expressed as recrudescence of infection and clinical signs and are associated with development of antibiotic-resistant microbes and poor patient compliance. In a previous SBIR, we have demonstrated that parenteral immunization with an Hp proteolytic digest prevents colonization in Hp-challenged gnotobiotic swine. Preliminary data suggest that activated T cells and their products, in particular, interferon gamma (IFNg), are central for this immunoprotective effect. An ideal approach to the problem of recrudescence treatment failure is to combine antimicrobial ...
Bloodstream infections are associated with significant patient morbidity and mortality. Antimicrobial susceptibility patterns should guide the choice of empiric antimicrobial regimens for patients with bacteremia. From January to December of 2002, 82,569 bacterial blood culture isolates were reported to The Surveillance Network (TSN) Database-USA by 268 laboratories. Susceptibility to relevant antibiotic compounds was analyzed using National Committee for Clinical Laboratory Standards guidelines. Coagulase-negative staphylococci (42.0%), Staphylococcus aureus (16.5%), Enterococcus faecalis (8.3%), Escherichia coli (7.2%), Klebsiella pneumoniae (3.6%), and Enterococcus faecium (3.5%) were the most frequently isolated bacteria from blood cultures, collectively accounting for |80% of isolates. In vitro susceptibility to expanded-spectrum β-lactams such as ceftriaxone were high for oxacillin-susceptible coagulase-negative staphylococci (98.7%), oxacillin-susceptible S. aureus (99.8%), E. coli (97.3%), K.
About 60% of pneumonia cases in the developing world are caused mainly by bacteria. Antibiotics to a large extend can control pneumonia if provided well on time. Dr.Y.C.Govil (Professor of Pediatrics in Chatrapati Sahuji Maharaj Medical University) says, Penicillin was discovered in the 1930s, and before that there were no antibiotics and people use to die like flies. Similar thing will happen if pneumonia is not checked. It is unfortunate, but now a days, a lot of antibiotic misuse is happening in our country and the reason is that many a times patients are been treated by unqualified practitioners of medicine in rural areas. I think almost 20%-30% or even more of patients would initially go to an unqualified practitioner. So here they are in the habit of advising lots of broad spectrum antibiotics in the beginning. Even in viral infection, where antibiotics are not usually indicated, antibiotics are prescribed. This is also prevalent in the urban setup as well. Very often patients try to self ...
Scientists at Queen Mary, University of London are part of a national study seeking to establish the most significant reservoirs of an antibiotic resistant bacteria known as ESBL-positive E.coli that cause human and animal ...
An analysis by the Environmental Working Group found that a NARMS report issued in February showed most supermarket meat carries antibiotic resistant bacteria.
Craig MacLean, Professor of Evolution and Microbiology at Oxfords Department of Zoology, explains how evolutionary biology can help us to get rid of antibiotic resistant bacteria.
We know from clinical trials there is very little, if any, benefit to antibiotic treatments for acute cough because most of these illnesses are caused by a virus, he said. Among patients who receive antibiotics, about half of those will be very broad spectrum antibiotics that have the potential to increase antibiotic resistance. These are antibiotics that would be nice to still have around when we actually need them, like for someone who may have pneumonia ...
TY - JOUR. T1 - Antimicrobial susceptibility profiles of Gram-negative bacilli isolated from patients with hepatobiliary infections in Taiwan. T2 - Results from the Study for Monitoring Antimicrobial Resistance Trends (SMART), 2006-2010. AU - Toh, Han Siong. AU - Chuang, Yin Ching. AU - Huang, Chi Chang. AU - Lee, Yu Lin. AU - Liu, Yuag Meng. AU - Ho, Cheng Mao. AU - Lu, Po Liang. AU - Liu, Chun Eng. AU - Chen, Yen Hsu. AU - Wang, Jen Hsien. AU - Ko, Wen Chien. AU - Yu, Kwok Woon. AU - Liu, Yung Ching. AU - Chen, Yao Shen. AU - Tang, Hung Jen. AU - Hsueh, Po Ren. PY - 2012/6. Y1 - 2012/6. N2 - We investigated the trends in antimicrobial resistance among species of Gram-negative bacilli isolated from patients with hepatobiliary tract infections in Taiwan during the period 2006-2010 as part of the Study for Monitoring Antimicrobial Resistance Trends (SMART). During the study period, 1032 isolates of Gram-negative bacilli that had been collected from patients with hepatobiliary infections were ...
While broad spectrum antibiotics play an invaluable role in the treatment of bacterial infections, there are some drawbacks to their use, namely selection for and spread of resistance across multiple bacterial species, and the detrimental effect they can have upon the host microbiome. If the causative agent
Research into community acquired pneumonia over the past two decades has focused on developing tools to measure the severity of illness and which antibiotics to choose. Several tools can now help clinicians identify patients with severe community acquired pneumonia in clinical settings.1 In people with severe disease, international guidelines recommend early treatment with broad spectrum antibiotics, which provide cover for atypical pathogens.2 It is less clear how best to manage patients during their stay in hospital. In this weeks BMJ, a randomised trial by Oosterheert and colleagues reports the effect of switching from intravenous to oral antibiotics after three days rather than seven days in people with severe community acquired pneumonia.3 Until now, the lack of quality trial data in areas such as route of antibiotic administration, duration of treatment, and assessment of clinical stability has led to a conservative approach to … ...