Use of oral third generation cephalosporins and quinolones and occurrence of antibiotic-resistant strains in the neurogenic bladder (NB) outpatient setting: a retrospective chart audit

Kitagawa, Koichi; Shigemura, Katsumi; Nomi, Masashi; Takami, Nozomi; Yamada, Naoki; Fujisawa, Masato

doi:10.1038/s41393-020-0416-8

Cited by 9 publications

(5 citation statements)

References 17 publications

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“…However, bacterial resistance to TMP/SMT has recently declined in Korea, which might result from the long period of decreased use [ 29 ]. This result agrees with the result of a 6-year research on antibiotic resistance that noted a decreased resistance to antibiotics as the prescription frequency of the antibiotics decreased [ 30 ]. Considering the results of our study, the therapeutic effect of TMP/SMT on UTI, and a decreased resistance to TMP/SMT in Korea, TMP/SMT may be considered for first-line antibiotic treatment in Korean patients with SCI.…”

Section: Discussionsupporting

confidence: 91%

Should We Delay Urodynamic Study When Patients With Spinal Cord Injury Have Asymptomatic Pyuria?

et al. 2021

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Objective To assess the incidence of urinary tract infection (UTI) with post-urodynamic study (post-UDS) in patients with spinal cord injury (SCI) and study its relationship with pre-UDS pyuria. Methods Patients with SCI who were hospitalized and underwent UDS during a 4-year period were reviewed. Patients with pre-test lower urinary tract symptoms were excluded. Urinalysis and urine culture were performed before and 24 hours after UDS. Prophylactic antibiotics were administered for 5 days starting from the morning of the UDS. UTI was defined as bacteriuria with accompanying symptoms. Results Of 399 patients reviewed, 209 (52.4%) had pyuria in pre-UDS urinalysis, and 257 (64.4%) had bacteriuria in pre-UDS culture. Post-UDS UTI occurred in 6 (1.5%) individuals who all complained of fever: 5 (2.4%) of the post-UDS UTI cases occurred in patients with pre-UDS pyuria, and 1 (0.5%) in a person without. The differences between groups were not statistically significant (p=0.218). Of 221 patients with bacteriuria (gram-negative isolates) on pre-UDS culture, resistance to ciprofloxacin, cephalosporin, and trimethoprim/sulfamethoxazole (TMP/SMT) was noted in 52.9% (117 cases), 57.0% (126 cases), and 38.9% (86 cases), respectively. Conclusion No difference was found in the prevalence of post-UDS UTI based on the presence of pyuria in pre-UDS urinalysis. UDS may be performed even in SCI cases of pre-UDS pyuria without increasing the prevalence of post-UDS UTI if prophylactic antibiotics are administered. TMP/SMT could be used as a first-line antibiotic for the prevention of post-UDS UTI in Korea.

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Section: Discussionsupporting

confidence: 91%

Should We Delay Urodynamic Study When Patients With Spinal Cord Injury Have Asymptomatic Pyuria?

et al. 2021

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“…According to the relevant literature and drug properties, we selected four inhibitors with antibacterial or bactericidal effects: Cefuroxime, Erythromycin, Lincomycin, and Ofloxacin from Cephalosporins, Macrolides, Lincosamides, and Quinolone, respectively [48][49][50][51][52]. To understand the interactional mechanisms of the inhibitors with S_RBD, we obtained the structures of S_RBD with small molecules/ACE2 by AutoDock method and performed molecular dynamics simulations for the six systems, the S_RBD system, the S_RBD in the presence of ACE2 system, the S_RBD in the presence of Cefuroxime system, the S_RBD in the presence of Erythromycin system, the S_RBD in the presence of Lincomycin system and the S_RBD in the presence of Ofloxacin system.…”

Section: Resultsmentioning

confidence: 99%

Interactive Mechanism of Potential Inhibitors with Glycosyl for SARS-CoV-2 by Molecular Dynamics Simulation

et al. 2021

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Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is a type of Ribonucleic Acid (RNA) coronavirus and it has infected and killed many people around the world. It is reported that the receptor binding domain of the spike protein (S_RBD) of the SARS-CoV-2 virus is responsible for attachment to human angiotensin converting enzyme II (ACE2). Many researchers are attempting to search potential inhibitors for fighting SARS-CoV-2 infection using theoretical or experimental methods. In terms of experimental and theoretical research, Cefuroxime, Erythromycin, Lincomycin and Ofloxacin are the potential inhibitors of SARS-CoV-2. However, the interactive mechanism of the protein SARS-CoV-2 and the inhibitors are still elusive. Here, we investigated the interactions between S_RBD and the inhibitors using molecular dynamics (MD) simulations. Interestingly, we found that there are two binding sites of S_RBD for the four small molecules. In addition, our analysis also illustrated that hydrophobic and π-π stacking interactions play crucial roles in the interactions between S_RBD and the small molecules. In our work, we also found that small molecules with glycosyl group have more effect on the conformation of S_RBD than other inhibitors, and they are also potential inhibitors for the genetic variants of SARS-CoV-2. This study provides in silico-derived mechanistic insights into the interactions of S_RBD and inhibitors, which may provide new clues for fighting SARS-CoV-2 infection.

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“…Prior use of broad-spectrum antibiotics, including quinolones, is a risk factor for acquiring quinolone-resistant E. coli infections, which is an independent predictor of mortality [ 22 , 23 ]. Switching to narrower spectrum coverage antibiotics can prevent unnecessary broad-spectrum antimicrobial use, improve patient outcomes, and be cost effective in the treatment of infectious diseases [ 24 , 25 ]. A retrospective observational study demonstrated that the resistance rates of E. coli and P. aeruginosa to quinolones decreased through the reduced consumption of antibiotics and surgical antibiotic prophylaxis [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

Effect of Antimicrobial Stewardship on Oral Quinolone Use and Resistance Patterns over 8 Years (2013–2020)

et al. 2021

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Since 2014, several global and national guidelines have been introduced to address the problem of antimicrobial resistance. We conducted a campaign in a tertiary hospital to promote appropriate quinolone use through educational lectures in 2018. The aim of this retrospective study was to evaluate the changes in the following: prescription characteristics, trend of oral quinolone use, and antibiotic susceptibility of bacteria from 2013 to 2020. Antimicrobial use was assessed as days of therapy per 1000 patient-days. We found a significant reduction in unnecessary antibiotic prescriptions between December 2013 and December 2020. Significant negative trends were detected in the use of quinolones over 8 years (outpatients, coefficient = −0.15655, p < 0.001; inpatients, coefficient = −0.004825, p = 0.0016). In particular, the monthly mean use of quinolones among outpatients significantly decreased by 11% from 2013 to 2014 (p < 0.05) and reduced further by 31% from 2017 to 2020 (p < 0.001). A significant positive trend was observed in the susceptibility of Pseudomonas aeruginosa to levofloxacin (p < 0.001). These results demonstrate that the use of oral quinolones was further reduced following educational intervention and the bacterial susceptibility improved with optimal quinolone usage compared to that in 2013.

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Use of oral third generation cephalosporins and quinolones and occurrence of antibiotic-resistant strains in the neurogenic bladder (NB) outpatient setting: a retrospective chart audit

Cited by 9 publications

References 17 publications

Should We Delay Urodynamic Study When Patients With Spinal Cord Injury Have Asymptomatic Pyuria?

Should We Delay Urodynamic Study When Patients With Spinal Cord Injury Have Asymptomatic Pyuria?

Interactive Mechanism of Potential Inhibitors with Glycosyl for SARS-CoV-2 by Molecular Dynamics Simulation

Effect of Antimicrobial Stewardship on Oral Quinolone Use and Resistance Patterns over 8 Years (2013–2020)

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