Community-acquired Pneumonia in North American Emergency Departments: Drug Resistance and Treatment Success with Clarithromycin

2007 ◽  
Vol 14 (7) ◽  
pp. 607-615
Author(s):  
B. H. Rowe ◽  
S. G. Campbell ◽  
E. D. Boudreaux ◽  
I. Colman ◽  
R. B. Abu-Laban ◽  
...  
Keyword(s):  
Drug Resistance ◽  
North American ◽  
Emergency Departments ◽  
Treatment Success ◽  
Community Acquired Pneumonia

scholarly journals Genomic Variations in Drug Resistant Mycobacterium tuberculosis Strains Collected from Patients with Different Localization of Infection

Antibiotics ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. 27
Author(s):  
Ekaterina Chernyaeva ◽  
Mikhail Rotkevich ◽  
Ksenia Krasheninnikova ◽  
Alla Lapidus ◽  
Dmitrii E. Polev ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Mycobacterium Tuberculosis ◽  
Pulmonary Tuberculosis ◽  
Central Asia ◽  
Phylogenetic Analyses ◽  
Treatment Success ◽  
Point Mutations ◽  
Whole Genome Sequence ◽  
Public Health Importance ◽  
Resistance Patterns

Mycobacterium tuberculosis is a highly studied pathogen due to public health importance. Despite this, problems like early drug resistance, diagnostics and treatment success prediction are still not fully resolved. Here, we analyze the incidence of point mutations widely used for drug resistance detection in laboratory practice and conduct comparative analysis of whole-genome sequence (WGS) for clinical M. tuberculosis strains collected from patients with pulmonary tuberculosis (PTB) and extra-pulmonary tuberculosis (XPTB) localization. A total of 72 pulmonary and 73 extrapulmonary microbiologically characterized M. tuberculosis isolates were collected from patients from 2007 to 2014 in Russia. Genomic DNA was used for WGS and obtained data allowed identifying major mutations known to be associated with drug resistance to first-line and second-line antituberculous drugs. In some cases previously described mutations were not identified. Using genome-based phylogenetic analysis we identified M. tuberculosis substrains associated with distinctions in the occurrence in PTB vs. XPTB cases. Phylogenetic analyses did reveal M. tuberculosis genetic substrains associated with TB localization. XPTB was associated with Beijing sublineages Central Asia (Beijing CAO), Central Asia Clade A (Beijing A) and 4.8 groups, while PTB localization was associated with group LAM (4.3). Further, the XPTB strain in some cases showed elevated drug resistance patterns relative to PTB isolates. HIV was significantly associated with the development of XPTB in the Beijing B0/W148 group and among unclustered Beijing isolates.

scholarly journals 5 giorni di antibiotico per le polmoniti non complicate sono sufficienti: i risultati di non inferiorità del SAFER RCT

2021 ◽  
Vol 28 (5) ◽  
pp. 1
Author(s):  
Gruppo di lettura di Reggio Emilia
Keyword(s):  
Primary Care ◽  
Emergency Departments ◽  
Protocol Analysis ◽  
Brief Therapy ◽  
Community Acquired Pneumonia ◽  
High Dose ◽  
Evidence Based ◽  
Clinical Recovery ◽  
First Choice

5 days of antibiotic for uncomplicated pneumonia is enough: the non-inferiority results of the SAFER RCT The most important guidelines for the treatment of community-acquired pneumonia (CAP) indicate amoxicillin as the drug of first choice, however there is a lack of evidence-based indications about the duration of this therapy. This study conducted in 2 emergency departments in Canada randomized 281 children aged 6 months to 10 years with CAP without the need for hospitalization to treatment with high-dose amoxicillin for 5 days versus a traditional 10 day therapy. In terms of clinical recovery, both groups presented comparable results. In fact, the “per protocol” analysis, recommended for a “non-inferiority” design, did not formally provide this result. The exclusively clinical recruitment criteria (any investigations were optional), well reflect the reality of primary care, and the results, albeit with some limitations, suggest that in uncomplicated CAP, brief therapy should be considered in the guidelines.

Oral Antibiotics for Treating Children With Community-Acquired Pneumonia Complicated by Empyema

2019 ◽  
Vol 58 (13) ◽  
pp. 1401-1408 ◽  
Author(s):  
Lauren E. Kushner ◽  
Delma J. Nieves ◽  
Stephanie Osborne ◽  
Hita Vora ◽  
Antonio Arrieta ◽  
...  
Keyword(s):  
Primary Outcome ◽  
Treatment Success ◽  
Community Acquired Pneumonia ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Length Of Treatment ◽  
Erythrocyte Sedimentation ◽  
End Of Treatment ◽  
Wbc Count ◽  
Serial Measurements

No consensus exists on management of children with community-acquired pneumonia complicated by empyema (CAP-Em). We evaluated outpatient oral (O-Abx) compared with parenteral antibiotics (OPAT) in children with CAP-Em. We also evaluated inflammatory markers to guide length of treatment. We conducted a retrospective cohort study of patients discharged (2006-2016) with CAP-Em. Primary outcome measured was treatment success (no change in antibiotics or readmission to hospital for treatment of CAP-Em). White blood cell (WBC) count, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) serial measurements were identified. Success was achieved in 133/144 (92.4%) O-Abx and 7/12 (58%) OPAT patients ( P = .0031). WBC and CRP decreased early; and ESR increased initially (admit and switch to O-Abx) and decreased by end of treatment. O-Abx is the modality of choice for treatment of CAP-Em after hospital discharge. WBC and CRP are useful to monitor success of O-Abx switch; and ESR provides guidance for length of treatment.

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