Frontiers in Pharmacology,
Год журнала:
2023,
Номер
14
Опубликована: Июнь 6, 2023
Overuse
and
misuse
of
antibiotics
have
strongly
accelerated
the
progressive
increase
in
bacterial
antimicrobial
resistance
(AMR).
The
evidence
that
selective
pressure
was
greater
longer
antibiotic
therapy
continued
has
led
some
experts
to
reconsider
duration
testing
use
short-term
drug
administration.
If
as
effective
long-term
therapy,
could
been
an
easy
measure
limit
AMR
emergence.
In
present
narrative
review,
whether
knowledge
on
acute
streptococcal
pharyngitis
(ASF),
otitis
media
(AOM)
mild
moderate
community-acquired
pneumonia
(CAP)
allows
systematic
infants
children
with
these
diseases
is
discussed.
Literature
analysis
showed
reducing
for
most
common
pediatric
respiratory
infections
be
a
valid
contain
abuse
consequent
impact
emergence
AMR.
Several
data
seem
indicate
this
type
intervention
possible,
found
traditionally
recommended
cases
ASF,
AOM
CAP.
However,
further
studies
are
needed
better
characterize
who
can
benefit
infections.
Journal of Infection,
Год журнала:
2024,
Номер
88(4), С. 106135 - 106135
Опубликована: Март 8, 2024
BackgroundAntimicrobial
stewardship
interventions
mainly
focus
on
initial
antibiotic
prescriptions,
with
few
considering
within-episode
repeat
prescriptions.
We
aimed
to
describe
the
magnitude,
type
and
determinants
of
prescriptions
in
patients
presenting
primary
care
respiratory
tract
infections
(RTIs).MethodsWe
conducted
a
population-based
cohort
study
among
530
sampled
English
general
practices
within
Clinical
Practice
Research
Datalink
(CPRD).
All
individuals
RTI
consultation
for
which
an
was
prescribed
between
March
2018
February
2022.
Main
outcome
measurement
28
days
visit
stratified
by
age
(children
vs.
adults)
(lower
upper
RTI).
Multivariable
logistic
regression
principal
components
analyses
were
used
identify
risk
factors
patient
clusters
at
prescriptions.Findings905,964
episodes
least
one
prescription
identified.
In
adults,
19.9%
(95%
CI
19.3-20.5%)
had
lower
RTI,
compared
10.5%
10.3-10.8%)
RTI.
children,
this
around
10%
irrespective
type.
The
majority
occurred
median
10
after
same
class
48.3%
cases.
Frequent
related
GP
visits
prior
within-RTI-episode
main
associated
both
adults
children
Young
(<2
years)
older
(65+)
Among
those
aged
2-64
years,
allergic
rhinitis,
COPD
oral
corticosteroids
prescriptions.InterpretationsRepeat
use
accounts
significant
proportion
all
antibiotics
RTIs,
unlikely
confer
clinical
benefit
is
therefore
prime
target
future
antimicrobial
interventions.
Recent
advances
in
the
treatment
of
bacteremia
have
challenged
traditional
approaches,
particularly
regarding
duration
antibiotic
therapy
and
transition
from
intravenous
to
oral
regimens.
This
paper
reviews
these
updates,
focusing
on
evidence-based
strategies
for
managing
caused
by
Gram-positive
Gram-negative
organisms.
Criteria
transitioning
therapy,
clinical
decision-making
uncomplicated
cases,
evidence
supporting
shorter
courses
are
discussed.
article
is
a
narrative
review
current
literature,
integrating
guidelines,
trial
data,
specific
considerations
diverse
pathogens,
ensuring
comprehensive
perspective.
Antibiotics,
Год журнала:
2025,
Номер
14(2), С. 211 - 211
Опубликована: Фев. 19, 2025
Background/Objectives:
The
management
of
urinary
tract
infections
(UTIs)
has
become
an
increasingly
challenging
medical
intervention.
This
study
explores
whether
adoption
a
precision
medicine
model
could
improve
the
acute
uncomplicated
pyelonephritis
(uAPN)
or
complicated
UTIs
(cUTIs)
compared
with
standard
care
approach,
in
hospitalized
patients.
Methods:
From
January
2022
to
March
2024,
all
patients
affected
by
uAPN
cUTIs
and
attending
our
urological
institution
were
randomized
receive
following:
antibiotic
treatment
according
guidelines
recommendations
(standard
group)
(intervention
group).
main
outcome
measures
rates
clinical
success
length
hospitalization.
time
until
switching
oral
was
regarded
as
secondary
measure.
Results:
Eighty-three
enrolled
group,
while
seventy-nine
intervention
group.
While
overall
rate
similar
two
groups
(75
vs.
72;
p
=
0.97),
statistically
significant
difference
observed
between
terms
hospitalization
(8
days
5
days;
0.03)
switch
(96
h
72
h;
0.04).
A
found
regarding
need
change
antimicrobial
therapy
during
[12
out
80
6
77;
0.04].
Conclusions:
Adoption
appears
valuable
means
cUTIs.
By
reducing
period
treatment,
also
improves
stewardship
UTIs.
Antimicrobial Agents and Chemotherapy,
Год журнала:
2025,
Номер
unknown
Опубликована: Апрель 22, 2025
ABSTRACT
Infectious
Diseases
Society
of
America
guidelines
recommend
14
days
treatment
for
Candida
spp
.
urinary
tract
infections
(UTIs).
To
our
knowledge,
no
data
are
available
to
compare
<14
UTI.
This
was
a
single-center,
retrospective
cohort
study
between
01
January
2015
and
2024.
Hospitalized
adults
with
>
1
urine
culture
symptoms
who
initiated
>1
antifungal
dose
within
96
hours
were
included.
Multiple
exclusion
criteria
existed,
including
but
not
limited
if
isolated
from
another
site,
antifungals
received
indication,
or
the
participant
asymptomatic.
The
primary
outcome
clinical
success.
Binary
logistic
regression
performed
further
assess
relationship
fluconazole
duration
Among
2,400
patients
candiduria,
45
58
in
14-day
<14-day
cohorts
assessed
after
applied,
respectively.
Median
(interquartile
range)
(14–14)
7
(5–7)
cohort.
There
difference
success
treated
vs
(14
days:
93.3%
(42/45)
93.1%
(54/58),
P
=
1.000;
between-group
(95%
CI:
0.02
[−9.6
10]).
Fluconazole
did
have
significant
association
on
binary
(
0.503;
odds
ratio
0.917
[95%
0.712–1.181]).
statistically
median
symptomatic
These
support
potential
utility
shorter
durations
International Journal of Infectious Diseases,
Год журнала:
2025,
Номер
unknown, С. 107917 - 107917
Опубликована: Апрель 1, 2025
We
investigated
the
effectiveness
of
early
oral
switch
for
treating
Enterobacterales
bloodstream
infection
(BSI)
by
performing
a
post
hoc
emulation
trial
SIMPLIFY
trial.
conducted
analysis
randomised
controlled
specified
target
characteristics
selecting
patients
who
achieved
clinical
stability
on
day
5.
categorised
into
those
switched
5
and
continued
intravenously.
The
primary
outcome
was
cure
at
test
cure.
set
propensity
score
being
to
reduce
confounding.
ran
simple,
not-propensity-adjusted,
propensity-adjusted
logistic
regression
models
ascertain
association
with
Among
303
5,
110
(36.3%)
were
orally
193
(63.7%)
kept
detected
no
difference
in
between
intravenously
(RR
1.04,
95%
CI
0.98
-
1.10).
Propensity-adjusted
did
not
show
an
(OR
2.10,
0.96
7.41).
Oral
step-down
therapy
associated
worse
BSI.
Open Forum Infectious Diseases,
Год журнала:
2023,
Номер
10(3)
Опубликована: Фев. 16, 2023
Abstract
Background
Osteomyelitis-complicating
pressure
ulcers
are
frequent
among
patients
with
spinal
cord
injuries
(SCIs),
and
the
optimal
management
is
unknown.
In
our
referral
center,
current
debridement
flap
coverage
surgeries,
followed
by
a
short
antibiotic
treatment.
We
aimed
to
evaluate
patients’
outcomes
year
after
surgery.
Methods
performed
quasi-experimental
retrospective
before/after
study
on
SCI
presumed
osteomyelitis
associated
perineal
ulcers.
included
all
who
underwent
surgery
covering,
effective
treatment,
between
May
1,
2016,
October
30,
2020.
The
antimicrobial
treatment
duration
10
days
leading
up
January
2018
(before
period),
5
7
(after
period).
also
compared
efficacy
of
5–7-day
vs
10-day
uni-
multivariable
analyses
identify
factors
failure.
Results
Overall,
415
were
(77.6%
male
patients;
mean
age
±
SD,
53.0
14.4
years).
Multidrug-resistant
organisms
(MDROs)
involved
in
20.7%
cases.
Favorable
recorded
69.2%
cases:
117/179
(65.3%)
group
169/287
(71.9%)
(P
=
.153).
only
factor
failure
multivariate
analysis
was
positive
culture
from
suction
drainage
(odds
ratio,
1.622;
95%
CI,
1.005–2.617;
P
.046).
Effective
>7
intraoperative
samples
negative
for
MDROs
not
better
.153
.241,
respectively).
Conclusions
A
strategy
combining
surgical
seems
safe.
