Antibiotic Consumption in Hospitals and Resistance Rate of Klebsiella pneumoniae and Escherichia coli in Montenegro

Mijović, Gordana; Cizmovic, Lidija; Vuković, Mirjana Nedović; Stamatovic, Sinisa; Lopičić, Milena

doi:10.20471/acc.2020.59.03.11

Cited by 5 publications

(8 citation statements)

References 16 publications

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“…Longer hospital stays increase the risk of hospital infections ( 20 ). Prolonged hospital stay in children is also important because it increases the anxiety of the child and the mother ( 21 ).…”

Section: Discussionmentioning

confidence: 99%

Comparison of Laparoscopic and Open Pyeloplasty Impact on Comfort and Success: A Retrospective, Single Center Study

Aldemir

2023

ACC

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SUMMARY Ureteropelvic junction obstruction causes hydronephrosis and may lead to renal parenchymal damage unless timely diagnosed and treated. Although open pyeloplasty is still the gold standard, it needs to be compared with new techniques. In this study, we compared laparoscopic and open pyeloplasty. Data on 113 patients who had undergone surgery between 2008 and 2014 were evaluated retrospectively. Thirty-nine patients had undergone laparoscopic pyeloplasty, and 74 had undergone open pyeloplasty. Ultrasonography was performed at 3 months and scintigraphy at 6 months postoperatively. Parameters such as the length of surgery, need for analgesics, length of hospital stay, complications, and success rates were compared. When compared to open pyeloplasty (mean 9.8 dexketoprofen 50 mg IV dose), the need for an analgesic was significantly lower in the laparoscopic pyeloplasty (mean 4.5, paracetamol 15 mg/kg IV dose) group (p<0.05). The length of hospital stay was also shorter in the laparoscopic pyeloplasty group (mean 4.0 days) than in the open pyeloplasty group (mean 7.3 days) (p<0.05). This study demonstrated that laparoscopic pyeloplasty could be safely used in the treatment of ureteropelvic junction obstruction with a lower need for analgesics and a shorter length of hospital stay than with open pyeloplasty.

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Section: Discussionmentioning

confidence: 99%

Comparison of Laparoscopic and Open Pyeloplasty Impact on Comfort and Success: A Retrospective, Single Center Study

Aldemir

2023

ACC

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“…Yet, if we look at the distribution of the most sensitive antibiotics in patients with positive bile cultures, we can see that these were third- and fourth-generation cephalosporin and ciprofloxacin, which were not administered. However, care should be taken because increase in the administration of third-generation cephalosporin is associated with a high rate of resistance to Escherichia coli in neighboring countries ( 11 ).…”

Section: Discussionmentioning

confidence: 99%

The Use of Microbiological and Laboratory Data in the Choice of Empirical Antibiotic Therapy in Patients Undergoing Laparoscopic Cholecystectomy – the Role of Local Antibiograms

Pašić

2022

ACC

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SUMMARY Antibiotic therapy is indicated during acute cholecystitis. However, in the treatment of uncomplicated cholelithiasis, prophylactic use of antibiotics is controversial. Microbiological and laboratory data are the basis for the choice of antibiotic treatment. However, monitoring and updating local antibiograms is important because they ensure effective therapy in the given clinical environment. The study included 110 consecutive patients who underwent laparoscopic cholecystectomy, divided into the group of uncomplicated cholelithiasis (n=60) and the group of acute cholecystitis (n=50). Preoperative data included age, sex, body mass index, leukocytes, C-reactive protein, and ultrasound examination. Bile samples for bacteriological testing were obtained under aseptic conditions during the surgery. Cultures were evaluated for aerobic, anaerobic and fungal organisms using routine tests. After the surgery, gallbladder specimens were sent for histopathological examination. In the group of uncomplicated cholelithiasis, 6/60 positive samples were found, and in the group of acute cholecystitis, there were 25/50 positive microbiological findings. Citrobacter sp. and Enterococcus faecalis predominated in the group of uncomplicated cholelithiasis, and Escherichia coli, Enterococcus faecalis, Proteus mirabilis and Citrobacter sp. in the group of acute cholecystitis. Antibiotics were administered to 49/50 patients with acute cholecystitis and to 32/60 patients with uncomplicated cholelithiasis. Cefazolin was the most frequently used antibiotic and also the most resistant antibiotic. To conclude, the administration of antibiotics in elective patients is not justified. The results of this study indicate that third-generation cephalosporin or ciprofloxacin + metronidazole should be administered in mild and moderate acute cholecystitis, and fourth-generation cephalosporin + metronidazole in severe acute cholecystitis in this local setting. The appropriate use of antibiotic agents is crucial and should be integrated into good clinical practice and standards of care.

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“…Their mechanism of developing antibiotic resistance is the production of an enzyme called beta-lactamase, which degrades beta-lactam antibiotics, namely, amoxicillin, penicillin and generational cephalosporines. Among them, Klebsiella pneumoniae is commonly resistant to carbapenem antimicrobials [19,20].…”

Section: Amr Before Covid-19 Pandemicmentioning

confidence: 99%

Antimicrobial Resistance and Antimicrobial Stewardship: Before, during and after the COVID-19 Pandemic

Khaznadar,

Petrovic

et al. 2023

Microbiology Research

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Antimicrobial resistance (AMR) is an ongoing phenomenon. It is a significant public health issue that has existed long before the coronavirus disease of 2019 (COVID-19) pandemic. It develops as microorganisms undergo genetic mutations that allow them to survive despite antimicrobial treatment. This process is highly associated with excessive and often unnecessary antimicrobial pharmacotherapy, which was often discussed during the COVID-19 pandemic. This article explores how the pandemic has affected antimicrobial stewardship by shifting the focus away from antimicrobial resistance, as well as the impact of enhanced antibiotic usage and measures such as lockdowns, mandatory testing and vaccination on antimicrobial resistance. Although these measures were regarded as successful in terms of limiting the pandemic, they have significantly contributed to an already escalating AMR issue. Outpatient methods in primary care and intensive care units aiming to prevent severe COVID-19 disease have contributed to the spread of multidrug-resistant bacteria, while laboratories burdened with COVID-19 testing have indirectly interrupted the detection of these bacteria. In this review, we summarize the pathogens whose AMRe has been greatly affected by COVID-19 measures and emphasize the importance of efficient antimicrobial stewardship in future pandemic and non-pandemic states to promote the responsible use of antibiotics and minimize AMR.

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Antibiotic Consumption in Hospitals and Resistance Rate of Klebsiella pneumoniae and Escherichia coli in Montenegro

Cited by 5 publications

References 16 publications

Comparison of Laparoscopic and Open Pyeloplasty Impact on Comfort and Success: A Retrospective, Single Center Study

Comparison of Laparoscopic and Open Pyeloplasty Impact on Comfort and Success: A Retrospective, Single Center Study

The Use of Microbiological and Laboratory Data in the Choice of Empirical Antibiotic Therapy in Patients Undergoing Laparoscopic Cholecystectomy – the Role of Local Antibiograms

Antimicrobial Resistance and Antimicrobial Stewardship: Before, during and after the COVID-19 Pandemic

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