Outpatient antibiotic therapy as a predisposing factor for bacterial resistance: a rational approach to airway infections

Nascimento‐Carvalho, Cristiana M.

doi:10.2223/jped.1548

Cited by 9 publications

(8 citation statements)

References 65 publications

(59 reference statements)

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“…Staphylococci rapidly develop resistance to antimicrobials, thus causing therapeutic problems. In infections, there is a localized and painful inflammatory reaction, which undergoes central suppuration and heals rapidly when the pus is drained [14].…”

Section: Antimicrobialsmentioning

confidence: 99%

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Main Microbial Genres and Its Profile of Resistance and Sensitivity to Antimicrobials Used in the Treatment of Oncological Patients with Febril Neutropenia

Póvoa¹,

Vieira²,

Sathler³

et al. 2018

JBM

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Objective: To determine the main microbial genotypes and their antimicrobial resistance and susceptibility profile commonly used in the treatment of oncologic patients with febrile neutropenia, carried out through the review of the clinical histories of the patients' medical records at the Hospital do Câncer de Muriaé-Fundação Cristiano Varella. Methods: Quantitative research, determined the susceptibility profile of microorganisms in patients with febrile neutropenia from April 2007 to April 2008 by reviewing clinical histories of patients' medical records at the referred hospital. Results: Of the total of 8 patients evaluated with Gram-negative microorganisms, 50% of the patients were female and 50% were male. Of the 18 patients evaluated with Gram-positive microorganisms 66% were female and 34% male. Gram-positive bacteria are prevalent and cause around 60% of documented bacteremias, although Gram-negative bacteria are more common in febrile neutropenic patientes. Conclusion: Exaggerated use of antimicrobials in hospitalized patients leads to the suppression of drug-sensitive microorganisms from the intestinal flora and promotes the persistence and growth of resistant bacteria. The antibiotic should be used in a curative manner with other therapeutic measures with the determined bacterial infection.

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Section: Antimicrobialsmentioning

confidence: 99%

“…This is a very worrying situation, considering the great ease of transportation in the present day, where the traffic of people between different localities can quickly contribute to the dissemination of resistant strains [14].…”

Section: Antimicrobialsmentioning

confidence: 99%

Main Microbial Genres and Its Profile of Resistance and Sensitivity to Antimicrobials Used in the Treatment of Oncological Patients with Febril Neutropenia

Póvoa¹,

Vieira²,

Sathler³

et al. 2018

JBM

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“…On the contrary, however, they are overprescribed in its treatment, as well as in the treatment of other respiratory tract infections [11][12][13][14][15]. Inappropriate use of antibiotics is a major contributor to the rising incidence of antimicrobial resistance, currently recognized as a global health problem [14].…”

Section: Introductionmentioning

confidence: 99%

“…Therefore microbiological examination is not recommended in patients in whom clinical presentation suggests viral pharyngitis, since in such cases detection of GAS causes unnecessary "treatment" of carrier state [12,[16][17][18].…”

mentioning

confidence: 99%

Management of acute streptococcal pharyngitis: still the subject of controversy

Mazur

2013

Open Medicine

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AbstractAlthough most cases of acute pharyngitis are viral in origin, antibiotics are overused in its treatment. Streptococcus pyogenes (group A streptococcus, GAS), the principal bacterial pathogen of acute sore throat, is responsible for merely 5–30% of cases. Moreover, GAS pharyngitis is currently the only commonly occurring form of acute pharyngitis for which antibiotic therapy is definitely indicated. Therefore the differentiation between GAS pharyngitis and that of viral etiology is crucial. Accordingly, scientific societies as well as respected advisory bodies in Europe and North America, issued guidelines for the management of acute pharyngitis with the aim of minimizing unnecessary antibiotic prescriptions in its treatment. The aim of this review work is to confront the state of the art in acute GAS pharyngitis diagnosis and treatment with different approaches to its management represented by current European and North American guidelines. Although based on scientific evidence, international guidelines differ substantially in opinions whether GAS pharyngitis diagnosis should be based on microbiological testing, clinical algorithm or a combination of both. On the other hand, some European guidelines consider GAS pharyngitis to be a mild, self-limiting disease that does not require a specific diagnosis or antimicrobial treatment except in high-risk patients. There is an agreement among guidelines that if antibiotic therapy is indicated, phenoxymethyl penicillin should be the drug of choice to treat GAS pharyngitis.

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“…When medication is chosen, the recommendation is that in uncomplicated cases wide-spectrum antibiotics should be avoided in view of the increased likelihood of inducing bacterial resistance. Despite this, prescribing antibiotics for infections with probable viral etiology is very common and this class of medicine continues to be over-utilized, especially with children (3,(5)(6)(7)(8)(9)(10)(11)(12)(13) .…”

Section: Introductionmentioning

confidence: 99%

Perfil de prescritores e prescrição de antimicrobianos nas infecções das vias aéreas superiores em Pediatria

Rocha

Fiol

Junqueira

et al. 2012

Rev. paul. pediatr.

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OBJETIVO: Traçar um perfil dos médicos que atendem crianças nos sistemas público (Sistema Único de Saúde) e privado de saúde e verificar como são prescritos antimicrobianos nas infecções das vias aéreas superiores. MÉTODOS: Médicos de algumas cidades do interior do Estado de São Paulo receberam via correio ou nas Unidades Básicas de Saúde uma carta explicativa sobre a pesquisa e o questionário, com perguntas sobre: tempo de graduação, residência médica, carga horária e local de trabalho, forma de atualização, fatores que consideram ao prescrever antimicrobianos e casos clínicos sobre as infecções das vias aéreas superiores. Os dados pessoais dos médicos foram relacionados com as respostas aos casos clínicos. Para análise estatística, foram aplicados os testes Z e de Tukey-Kramer, sendo p<0,05 significante. RESULTADOS: A amostra foi composta por 170 prescritores: 86,5% possuíam residência em Pediatria, 75% trabalhavam no Sistema Único de Saúde e 71% tinham carga horária superior a 40 horas semanais. Os formados há menos de dez anos valorizaram mais os laboratórios farmacêuticos como forma de atualização do que os graduados há mais de 30 anos; 33% dos médicos do Sistema Único de Saúde atendem mais de cinco pacientes por hora. A média de acerto nos casos clínicos foi de 87%. O uso das entidades médicas como forma de atualização foi associado a respostas corretas, enquanto o uso de materiais de laboratório estava ligado a respostas incorretas (p<0,05). Houve clara tendência de diminuição dos acertos conforme o número de pacientes atendidos por hora aumentava. CONCLUSÕES: Educação adequada sobre o tema e melhora nas condições de trabalho podem ser eficientes para reduzir a prescrição de antibióticos para infecções das vias aéreas superiores em crianças.

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Outpatient antibiotic therapy as a predisposing factor for bacterial resistance: a rational approach to airway infections

Cited by 9 publications

References 65 publications

Main Microbial Genres and Its Profile of Resistance and Sensitivity to Antimicrobials Used in the Treatment of Oncological Patients with Febril Neutropenia

Main Microbial Genres and Its Profile of Resistance and Sensitivity to Antimicrobials Used in the Treatment of Oncological Patients with Febril Neutropenia

Management of acute streptococcal pharyngitis: still the subject of controversy

Perfil de prescritores e prescrição de antimicrobianos nas infecções das vias aéreas superiores em Pediatria

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