The Burden of Antimicrobial Resistance in Zambia, a Sub-Saharan African Country: A One Health Review of the Current Situation, Risk Factors, and Solutions
Pharmacology & Pharmacy,
Год журнала:
2024,
Номер
15(12), С. 403 - 465
Опубликована: Янв. 1, 2024
Язык: Английский
Sepsis in Internal Medicine: blood culture-based subtypes, hospital outcomes, and predictive biomarkers
Frontiers in Medicine,
Год журнала:
2025,
Номер
12
Опубликована: Янв. 30, 2025
Background
Sepsis
is
a
challenging
condition
increasingly
managed
in
medical
wards,
however
literature
and
clinical
evidence
this
hospital
setting
are
lacking.
Methods
Using
the
computational
i2b2
framework,
we
retrospectively
analyzed
data
from
patients
admitted
to
internal
medicine
units
of
four
hospitals
Lombardy
(Italy)
between
January
2012
December
2023,
with
discharge
diagnosis
sepsis,
septic
shock,
or
septicemia.
Results
A
total
4,375
were
recruited.
Median
length
stay
(LOS)
was
14
days,
mean
ward-to-intensive
care
unit
(ICU)
transfer
in-hospital
mortality
rates
11
26%,
respectively;
significant
differences
observed
over
years,
LOS
peaks
preceding
by
1
year.
Blood
culture-negative
sepses
showed
shorter
stays
higher
(acute
kidney
injury
fast
deterioration)
compared
culture-positive
ones;
polymicrobial
ICU
respiratory
distress);
while
multidrug-resistant
(MDR
+
)
and/or
longer
(complicated
course)
drug-sensitive
monomicrobial
ones.
C-reactive
protein
elevation
predicted
rapidly
evolving
whereas
lower
leukocyte
counts
prolonged
hospitalization;
fractions
inspired
oxygen
lactate
transfer;
ferritin
increased
MDR
further
decreased
platelet
death.
From
2016
sepsis
frequency
declined,
due
resistance
several
antibiotic
classes,
such
as
cephalosporins,
fluoroquinolones,
aminoglycosides;
however,
carbapenemase-
extended-spectrum
beta-lactamase-producing
Gram-negative
bacteria,
well
vancomycin-resistant
enterococci,
increased,
did
following
COVID-19
outbreak.
Conclusion
This
work
provides
novel
insights
into
management
units,
highlighting
need
for
validated
biomarkers
implemented
therapies
scenario.
Язык: Английский
Impact of an antimicrobial time-out program on antimicrobial consumption rate in hospitalized patients: a quasi-experimental study on the national antimicrobial stewardship program in Iran
Journal of Pharmaceutical Health Care and Sciences,
Год журнала:
2025,
Номер
11(1)
Опубликована: Май 19, 2025
Abstract
Background
This
study
evaluated
the
impact
of
national
antimicrobial
stewardship
program
(NASP)
on
consumption
agents.
Methods
A
quasi-experimental
was
conducted
hospitalized
patients
at
a
referral
hospital
in
Tehran,
Iran.
We
compared
antimicrobial-defined
daily
dose
(DDD)
and
index
(ACI)
between
third
quarter
2022
(before
implementation
NASP
after
COVID-19
pandemic
October
2022)
same
timeframe
2023,
following
implementation.
The
based
time-out
assessment.
Within
72
h
prescribing
meropenem,
imipenem,
linezolid,
vancomycin,
voriconazole,
caspofungin,
amphotericin
B
liposomal,
infectious
disease
specialists
audited
clinical
microbiological
evidence
to
assess
whether
it
consistent
with
correct
prescription.
Results
rate
assessed
13,794
15,030
during
respectively.
mean
length
stay
mortality
showed
no
significant
differences.
all
restricted
antimicrobials
decreased.
reduction
for
linezolid.
total
cost
agents
had
22.24%
(
P
=
0.01).
Conclusions
associated
use
antimicrobials,
including
vancomycin
antifungals,
such
as
caspofungin
without
increasing
rate.
can
be
recommended
beneficial
method
reducing
broad-spectrum
antimicrobials.
Язык: Английский