The hospital antibiotic policy should be implemented to rationalize the antibiotic use and to decrease the risk of spread of resistant bacteria. The aim of this study was to describe the antibiotic consumption patterns in a single oncosurgery ward before and after the implementation of hospital antibiotic policy. We conducted a retrospective analysis of the antibiotic use at the oncosurgery ward in Warsaw, Poland, in the years 2011-2016. Calculations were based on daily defined doses (DDD), DDD/100 hospitalizations, and DDD/100 person-days. Drug utilization rates (DU 90% and DU 100%) were also analyzed. After the implementation of hospital antibiotic policy, a total antibiotic consumption increased (365.35 DDD in 2011 vs. 1359.22 DDD in 2016). A significant change was observed in the antibiotic consumption patterns: the use of amoxicillin clavulanate and carbapenems or glycopeptides decreased significantly (p < 0.05), while the use of ciprofloxacin and aminoglycosides increased (p < 0.05). The DU100% rate varied from 6 in 2011 to 12 in 2016; while DU 90% rate varied from 2 in 2011 to 3-5 in 2013-2016. Although the implementation of hospital antibiotic policy did not result in a decrease in the antibiotic consumption, it seems to provide a favorable change into the antibiotic consumption pattern.
Guillain-Barre syndrome (GBS) is an acute inflammatory polyneuropathy, characterised by progressive, symmetrical muscle weakness and sensory disorder due to autoimmunologic myelin nerve sheats and/or peripheral nerves axonal damage. The course of the disease in children is usually milder than in adults. The most common variant of GBS is acute inflammatory demyelinating polyneuropathy (AIDP). GBS is a rare disorder with morbidity rate of 0,5-1,5/100 000/ year, more often seen in males. The course of disease in children is usually milder than in adults. Early diagnosis and proper treatment enables complete recovery in 80% of cases, while approximately 10% of patients suffer from symptoms recurrence, mainly after infection. Almost 2/3 of GBS cases are preceded by upper respiratory or gastrointestinal infection. The emergence of antibodies in various mechanisms, which cross react with nerve sheats or axon antigens (through a phenomenon known as molecular mimicry), leads to development of the syndrome. Known triggers inducing GBS include viral and bacterial infections, injuries, surgery, bone marrow transplantation and rarely childhood vaccinations. In still rarer cases, GBS may develop in the course of paraneoplastic syndrome (PNS), and be the first symptom of an underlying neoplastic process.
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