Ultra-Short-Course #Antibiotics for Patients With Suspected #Ventilator-Associated #Pneumonia but Minimal and Stable Ventilator Settings
https://academic.oup.com/cid/article-abstract/64/7/870/2756965/Ultra-Short-Course-Antibiotics-for-Patients-With
Background.
Many patients started on antibiotics for possible ventilator-associated pneumonia (VAP) do not have pneumonia. Patients with minimal and stable ventilator settings may be suitable candidates for early antibiotic discontinuation. We compared outcomes among patients with suspected VAP but minimal and stable ventilator settings treated with 1–3 days vs >3 days of antibiotics.
Conclusions.
Very short antibiotic courses (1–3 days) were associated with outcomes similar to longer courses (>3 days) in patients with suspected VAP but minimal and stable ventilator settings. Assessing serial ventilator settings may help clinicians identify candidates for early antibiotic discontinuation.
https://academic.oup.com/cid/article-abstract/64/7/870/2756965/Ultra-Short-Course-Antibiotics-for-Patients-With
Background.
Many patients started on antibiotics for possible ventilator-associated pneumonia (VAP) do not have pneumonia. Patients with minimal and stable ventilator settings may be suitable candidates for early antibiotic discontinuation. We compared outcomes among patients with suspected VAP but minimal and stable ventilator settings treated with 1–3 days vs >3 days of antibiotics.
Conclusions.
Very short antibiotic courses (1–3 days) were associated with outcomes similar to longer courses (>3 days) in patients with suspected VAP but minimal and stable ventilator settings. Assessing serial ventilator settings may help clinicians identify candidates for early antibiotic discontinuation.
A Placebo-Controlled Trial of #Antibiotics for Smaller Skin #Abscesses
http://www.nejm.org/doi/10.1056/NEJMoa1607033
Uncomplicated skin abscesses are common, yet the appropriate management of the condition in the era of community-associated methicillin-resistant Staphylococcus aureus (MRSA) is unclear.
CONCLUSIONS
As compared with incision and drainage alone, clindamycin or TMP-SMX in conjunction with incision and drainage improves short-term outcomes in patients who have a simple abscess. This benefit must be weighed against the known side-effect profile of these antimicrobials
http://www.nejm.org/doi/10.1056/NEJMoa1607033
Uncomplicated skin abscesses are common, yet the appropriate management of the condition in the era of community-associated methicillin-resistant Staphylococcus aureus (MRSA) is unclear.
CONCLUSIONS
As compared with incision and drainage alone, clindamycin or TMP-SMX in conjunction with incision and drainage improves short-term outcomes in patients who have a simple abscess. This benefit must be weighed against the known side-effect profile of these antimicrobials
New England Journal of Medicine
A Placebo-Controlled Trial of Antibiotics for Smaller Skin Abscesses | NEJM
Original Article from The New England Journal of Medicine — A Placebo-Controlled Trial of Antibiotics for Smaller Skin Abscesses
Association Between Use of #Acid-Suppressive Medications and #Antibiotics During Infancy and #Allergic Diseases in Early Childhood
https://jamanetwork.com/journals/jamapediatrics/fullarticle/2676167
Of 792 130 children (395 215 49.9% girls) included for analysis, 60 209 (7.6%) were prescribed an H2RA, 13 687 (1.7%) were prescribed a PPI, and 131 708 (16.6%) were prescribed an antibiotic during the first 6 months of life. Data for each child were available for a median of 4.6 years. Adjusted hazard ratios (aHRs) in children prescribed H2RAs and PPIs, respectively, were 2.18 (95% CI, 2.04-2.33) and 2.59 (95% CI, 2.25-3.00) for food allergy, 1.70 (95% CI, 1.60-1.80) and 1.84 (95% CI, 1.56-2.17) for medication allergy, 1.51 (95% CI, 1.38-1.66) and 1.45 (95% CI, 1.22-1.73) for anaphylaxis, 1.50 (95% CI, 1.46-1.54) and 1.44 (95% CI, 1.36-1.52) for allergic rhinitis, and 1.25 (95% CI, 1.21-1.29) and 1.41 (95% CI, 1.31-1.52) for asthma. The aHRs after antibiotic prescription in the first 6 months of life were 2.09 (95% CI, 2.05-2.13) for asthma, 1.75 (95% CI, 1.72-1.78) for allergic rhinitis, 1.51 (95% CI, 1.38-1.66) for anaphylaxis, and 1.42 (95% CI, 1.34-1.50) for allergic conjunctivitis.
Conclusions and Relevance This study found associations between the use of acid-suppressive medications and antibiotics during the first 6 months of infancy and subsequent development of allergic disease. Acid-suppressive medications and antibiotics should be used during infancy only in situations of clear clinical benefit
https://jamanetwork.com/journals/jamapediatrics/fullarticle/2676167
Of 792 130 children (395 215 49.9% girls) included for analysis, 60 209 (7.6%) were prescribed an H2RA, 13 687 (1.7%) were prescribed a PPI, and 131 708 (16.6%) were prescribed an antibiotic during the first 6 months of life. Data for each child were available for a median of 4.6 years. Adjusted hazard ratios (aHRs) in children prescribed H2RAs and PPIs, respectively, were 2.18 (95% CI, 2.04-2.33) and 2.59 (95% CI, 2.25-3.00) for food allergy, 1.70 (95% CI, 1.60-1.80) and 1.84 (95% CI, 1.56-2.17) for medication allergy, 1.51 (95% CI, 1.38-1.66) and 1.45 (95% CI, 1.22-1.73) for anaphylaxis, 1.50 (95% CI, 1.46-1.54) and 1.44 (95% CI, 1.36-1.52) for allergic rhinitis, and 1.25 (95% CI, 1.21-1.29) and 1.41 (95% CI, 1.31-1.52) for asthma. The aHRs after antibiotic prescription in the first 6 months of life were 2.09 (95% CI, 2.05-2.13) for asthma, 1.75 (95% CI, 1.72-1.78) for allergic rhinitis, 1.51 (95% CI, 1.38-1.66) for anaphylaxis, and 1.42 (95% CI, 1.34-1.50) for allergic conjunctivitis.
Conclusions and Relevance This study found associations between the use of acid-suppressive medications and antibiotics during the first 6 months of infancy and subsequent development of allergic disease. Acid-suppressive medications and antibiotics should be used during infancy only in situations of clear clinical benefit
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US Emergency Department Visits for #Adverse Drug Events From #Antibiotics in Children, 2011–2015
https://academic.oup.com/jpids/advance-article/doi/10.1093/jpids/piy066/5063274
Two-fifths (40.7%) of ED visits for antibiotic ADEs involved a child aged ≤2 years, and 86.1% involved an allergic reaction. Amoxicillin was the most commonly implicated antibiotic among children aged ≤9 years. When we accounted for dispensed prescriptions, the rates of ED visits for antibiotic ADEs declined with increasing age for all antibiotics except sulfamethoxazole-trimethoprim. Amoxicillin had the highest rate of ED visits for antibiotic ADEs among children aged ≤2 years, whereas sulfamethoxazole-trimethoprim resulted in the highest rate among children aged 10 to 19 years (29.9 and 24.2 ED visits per 10000 dispensed prescriptions, respectively).
Conclusions
Antibiotic ADEs lead to many ED visits, particularly among young children. Communicating the risks of antibiotic ADEs could help reduce unnecessary prescribing. Prevention efforts could target pediatric patients who are at the greatest risk of harm
US Emergency Department Visits for #Adverse Drug Events From #Antibiotics in Children, 2011–2015
https://academic.oup.com/jpids/advance-article/doi/10.1093/jpids/piy066/5063274
Two-fifths (40.7%) of ED visits for antibiotic ADEs involved a child aged ≤2 years, and 86.1% involved an allergic reaction. Amoxicillin was the most commonly implicated antibiotic among children aged ≤9 years. When we accounted for dispensed prescriptions, the rates of ED visits for antibiotic ADEs declined with increasing age for all antibiotics except sulfamethoxazole-trimethoprim. Amoxicillin had the highest rate of ED visits for antibiotic ADEs among children aged ≤2 years, whereas sulfamethoxazole-trimethoprim resulted in the highest rate among children aged 10 to 19 years (29.9 and 24.2 ED visits per 10000 dispensed prescriptions, respectively).
Conclusions
Antibiotic ADEs lead to many ED visits, particularly among young children. Communicating the risks of antibiotic ADEs could help reduce unnecessary prescribing. Prevention efforts could target pediatric patients who are at the greatest risk of harm
OUP Academic
US Emergency Department Visits for Adverse Drug Events From Antibiotics in Children, 2011–2015 | Journal of the Pediatric Infectious…
Nearly 70000 estimated pediatric emergency department (ED) visits are made annually for an antibiotic adverse drug event (ADE). Young children had the highest n
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Association Between #Antibiotics in the First Year of Life and #Celiac Disease
https://www.gastrojournal.org/article/S0016-5085(19)32507-7/fulltext?mobileUi=0
The intestinal microbiota is thought to be involved in pathogenesis of celiac disease, along with genetic variants and dietary gluten. The gut microbiota is strongly influenced by systemic antibiotics—especially in early life. We explored the association between exposure to a systemic antibiotic in the first year of life and risk of diagnosed celiac disease
We found a dose-dependent relationship between an increasing number of dispensed antibiotics and the risk of celiac disease (pooled odds ratio for each additional dispensed antibiotic, 1.08; 95% CI, 1.05–1.11). No specific type of antibiotic or age period within the first year of life was prominent. Adjustment for hospital admissions with an infectious disease in the first year of life did not change the estimates; adjustment for the number of maternally reported infections in the child in 2 large sub-cohorts reduced the association slightly (pooled odds ratio, 1.18; 95% CI, 0.98–1.39).
Conclusion
In a nationwide study of children in Denmark and Norway, we found exposure to systemic antibiotics in the first year of life to be associated with a later diagnosis of celiac disease. These findings indicate that childhood exposure to systemic antibiotics may be a risk factor for celiac disease.
Association Between #Antibiotics in the First Year of Life and #Celiac Disease
https://www.gastrojournal.org/article/S0016-5085(19)32507-7/fulltext?mobileUi=0
The intestinal microbiota is thought to be involved in pathogenesis of celiac disease, along with genetic variants and dietary gluten. The gut microbiota is strongly influenced by systemic antibiotics—especially in early life. We explored the association between exposure to a systemic antibiotic in the first year of life and risk of diagnosed celiac disease
We found a dose-dependent relationship between an increasing number of dispensed antibiotics and the risk of celiac disease (pooled odds ratio for each additional dispensed antibiotic, 1.08; 95% CI, 1.05–1.11). No specific type of antibiotic or age period within the first year of life was prominent. Adjustment for hospital admissions with an infectious disease in the first year of life did not change the estimates; adjustment for the number of maternally reported infections in the child in 2 large sub-cohorts reduced the association slightly (pooled odds ratio, 1.18; 95% CI, 0.98–1.39).
Conclusion
In a nationwide study of children in Denmark and Norway, we found exposure to systemic antibiotics in the first year of life to be associated with a later diagnosis of celiac disease. These findings indicate that childhood exposure to systemic antibiotics may be a risk factor for celiac disease.
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Use of #Antibiotics Without a #prescription in the U.S. Population: A Scoping Review
..Depending on population characteristics, prevalence of nonprescription antibiotic use varied from 1% to 66%, storage of antibiotics for future use varied from 14% to 48%, and prevalence of intention to use antibiotics without a prescription was 25%. Antibiotics were obtained without a prescription from various sources, including previously prescribed courses, local markets or stores, and family or friends.
Reported factors contributing to nonprescription use included easy access through markets or stores that obtain antibiotics internationally for under-the-counter sales, difficulty accessing the health care system, costs of physician visits, long waiting periods in clinics, and transportation problems.
Nonprescription antibiotic use is a seemingly prevalent and understudied public health problem in the United States. An increased understanding of risk factors and pathways that are amenable to intervention is essential to decrease this unsafe practice.
Use of #Antibiotics Without a #prescription in the U.S. Population: A Scoping Review
..Depending on population characteristics, prevalence of nonprescription antibiotic use varied from 1% to 66%, storage of antibiotics for future use varied from 14% to 48%, and prevalence of intention to use antibiotics without a prescription was 25%. Antibiotics were obtained without a prescription from various sources, including previously prescribed courses, local markets or stores, and family or friends.
Reported factors contributing to nonprescription use included easy access through markets or stores that obtain antibiotics internationally for under-the-counter sales, difficulty accessing the health care system, costs of physician visits, long waiting periods in clinics, and transportation problems.
Nonprescription antibiotic use is a seemingly prevalent and understudied public health problem in the United States. An increased understanding of risk factors and pathways that are amenable to intervention is essential to decrease this unsafe practice.
A Randomized Trial Comparing #Antibiotics with Appendectomy for #Appendicitis
https://2medical.news/2020/10/09/a-randomized-trial-comparing-antibiotics-with-appendectomy-for-appendicitis/
..In total, 1552 adults (414 with an appendicolith) underwent randomization; 776 were assigned to receive antibiotics (47% of whom were not hospitalized for the index treatment) and 776 to undergo appendectomy (96% of whom underwent a laparoscopic procedure). Antibiotics were noninferior to appendectomy on the basis of 30-day EQ-5D scores (mean difference, 0.01 points; 95% confidence interval [CI], −0.001 to 0.03). In the antibiotics group, …
https://2medical.news/2020/10/09/a-randomized-trial-comparing-antibiotics-with-appendectomy-for-appendicitis/
..In total, 1552 adults (414 with an appendicolith) underwent randomization; 776 were assigned to receive antibiotics (47% of whom were not hospitalized for the index treatment) and 776 to undergo appendectomy (96% of whom underwent a laparoscopic procedure). Antibiotics were noninferior to appendectomy on the basis of 30-day EQ-5D scores (mean difference, 0.01 points; 95% confidence interval [CI], −0.001 to 0.03). In the antibiotics group, …
Empiric #antibiotics for community-acquired #pneumonia in adult patients: a systematic review and a network meta-analysis
https://2medical.news/2021/03/21/empiric-antibiotics-for-community-acquired-pneumonia-in-adult-patients-a-systematic-review-and-a-network-meta-analysis/
The main aim of this network meta-analysis is to identify the empiric antibiotic (Em-ATB) with the highest probability of being the best (HPBB) in terms of (1) cure rate and (2) mortality rate in hospitalised patients with community acquired pneumonia (CAP) . Method Inclusion criteria: (1) adult patients (>16 years old) diagnosed with CAP that required hospitalisation; (2) randomised to at least two different Em-ATBs, (3) …
https://2medical.news/2021/03/21/empiric-antibiotics-for-community-acquired-pneumonia-in-adult-patients-a-systematic-review-and-a-network-meta-analysis/
The main aim of this network meta-analysis is to identify the empiric antibiotic (Em-ATB) with the highest probability of being the best (HPBB) in terms of (1) cure rate and (2) mortality rate in hospitalised patients with community acquired pneumonia (CAP) . Method Inclusion criteria: (1) adult patients (>16 years old) diagnosed with CAP that required hospitalisation; (2) randomised to at least two different Em-ATBs, (3) …
Appropriate Use of Short-Course #Antibiotics in Common #Infections: Best Practice Advice From the American College of Physicians
https://2medical.news/2021/04/06/appropriate-use-of-short-course-antibiotics-in-common-infections-best-practice-advice-from-the-american-college-of-physicians/
Antimicrobial overuse is a major health care issue that contributes to antibiotic resistance. Such overuse includes unnecessarily long durations of antibiotic therapy in patients with common bacterial infections, such as acute bronchitis with chronic obstructive pulmonary disease (COPD) exacerbation, community-acquired pneumonia (CAP), urinary tract infections (UTIs), and cellulitis. This article describes best practices for prescribing appropriate and short-duration antibiotic therapy for patients presenting with these …
https://2medical.news/2021/04/06/appropriate-use-of-short-course-antibiotics-in-common-infections-best-practice-advice-from-the-american-college-of-physicians/
Antimicrobial overuse is a major health care issue that contributes to antibiotic resistance. Such overuse includes unnecessarily long durations of antibiotic therapy in patients with common bacterial infections, such as acute bronchitis with chronic obstructive pulmonary disease (COPD) exacerbation, community-acquired pneumonia (CAP), urinary tract infections (UTIs), and cellulitis. This article describes best practices for prescribing appropriate and short-duration antibiotic therapy for patients presenting with these …
#Antibiotics Use and Subsequent Risk of #Colorectal Cancer: A Swedish Nationwide Population-Based Study
https://2medical.news/2021/09/17/antibiotics-use-and-subsequent-risk-of-colorectal-cancer-a-swedish-nationwide-population-based-study/
https://2medical.news/2021/09/17/antibiotics-use-and-subsequent-risk-of-colorectal-cancer-a-swedish-nationwide-population-based-study/
2Medical.News
#Antibiotics Use and Subsequent Risk of #Colorectal Cancer: A Swedish Nationwide Population-Based Study
Antibiotics use may increase colorectal cancer (CRC) risk by altering the gut microbiota, with suggestive evidence reported. Our study aims to investigate antibiotics use in relation to subsequent …
#Antibiotics Not Associated with Shorter Duration or Reduced Severity of Acute Lower #Respiratory Tract Infection
https://2medical.news/2024/04/17/antibiotics-not-associated-with-shorter-duration-or-reduced-severity-of-acute-lower-respiratory-tract-infection/
https://2medical.news/2024/04/17/antibiotics-not-associated-with-shorter-duration-or-reduced-severity-of-acute-lower-respiratory-tract-infection/
2Medical.News
#Antibiotics Not Associated with Shorter Duration or Reduced Severity of Acute Lower #Respiratory Tract Infection
BackgroundAntibiotic use remains common for the treatment of lower respiratory tract infections. The objective of this study was to evaluate the impact of antibiotic use on the duration and severit…