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A study on the ongoing monitoring programmes in 13 European countries was made as part of a concerted action funded by the European Commission. Five main reference systems were used in the surveyed countries and three categories o...
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A study on the ongoing monitoring programmes in 13 European countries was made as part of a concerted action funded by the European Commission. Five main reference systems were used in the surveyed countries and three categories of bacteria were monitored, zoonotic agents, indicator bacteria and veterinary pathogens. The five reference systems and an overview of the national monitoring programmes are described. Differences exist and there is a real need for standardisation at the European level. This harmonisation could be set up both for microbiological methods and the epidemiological results derived from common methods. Disk diffusion methods are most widely used and many of the monitored species and control strains are similar in the action's participating countries. (C) 2000 Elsevier Science B.V. and International Society of Chemotherapy. All rights reserved. [References: 22]
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Measurement of antimicrobial use before and after an intervention and the associated outcomes are key activities of antimicrobial stewardship programs. In the United States, the recommended metric for aggregate antibiotic use is d...
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Measurement of antimicrobial use before and after an intervention and the associated outcomes are key activities of antimicrobial stewardship programs. In the United States, the recommended metric for aggregate antibiotic use is days of therapy/1000 patient-days. Clinical outcomes, including response to therapy and bacterial resistance, are critical measures but are more difficult to document than economic outcomes. Interhospital benchmarking of risk adjusted antimicrobial use is possible, although several obstacles remain before it can have an impact on patient care. Many challenges for stewardship programs remain, but the methods and science to support their efforts are rapidly evolving.
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In the last 30 years, development of new classes of antibiotics has slowed, increasing the necessity for new options to treat multidrug resistant bacterial infections. Development of antibiotic adjuvants that increase the effectiv...
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In the last 30 years, development of new classes of antibiotics has slowed, increasing the necessity for new options to treat multidrug resistant bacterial infections. Development of antibiotic adjuvants that increase the effectiveness of currently available antibiotics is a promising alternative approach to classical antibiotic development. Reports of the ability of the natural product meridianin D to modulate bacterial behavior have been rare. Herein, we describe the ability of meridianin D to inhibit biofilm formation of methicillin-resistant Staphylococcus aureus (MRSA) and to increase the potency of colistin against colistin-resistant and sensitive Gram-negative bacteria. Analogues were identified that are capable of inhibiting and dispersing MRSA biofilms and lowering the colistin MIC to below the CLSI breakpoint against Acinetobacter baumannii , Klebsiella pneumoniae , and Escherichia coli .
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Antimicrobial resistance is now being recognized as a major factor determining morbidity, mortality, and cost in the intensive care unit (ICU). Various strategies to limit its spread have evolved with our understanding and are bas...
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Antimicrobial resistance is now being recognized as a major factor determining morbidity, mortality, and cost in the intensive care unit (ICU). Various strategies to limit its spread have evolved with our understanding and are based on four basic principles: infection prevention, infection eradication, containment of resistant species, and optimization of antibiotic utilization. The optimization of antibiotic utilization, at its most basic level, is the appropriate use of antibiotics and the limitation of unnecessary antibiotic administration/exposure consisting of appropriate diagnosis, acquiring appropriate culture and sensitivity data, implementing the most appropriate treatment, selecting appropriate antibiotics, and dosing appropriately. In addition various antibiotic utilization strategies including antibiotic utilization guidelines, formulary restriction, and antibiotic cycling or rotation have evolved from our understanding of the impact of changes in antibiotic utilization on subsequent antibiotic susceptibility patterns. These strategies can be utilized as a part of a multidisciplinary approach to limit the appearance and dissemination of antimicrobial resistance in our ICUs.
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The aim of this survey was to describe the attitudes and self-reported practices of French dentists towards antibiotic use and resistance and to compare practices with national guidelines. A nationwide cross-sectional internet-bas...
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The aim of this survey was to describe the attitudes and self-reported practices of French dentists towards antibiotic use and resistance and to compare practices with national guidelines. A nationwide cross-sectional internet-based survey was conducted among the 41,800 French dentists. The online questionnaire was distributed through professional networks from April 2017 to April 2018. Seven-hundred seventy-five dentists participated but only 455 questionnaires were complete enough to be included in the analyses. Amoxicillin was the most frequently prescribed antibiotic (65.8%, 1783/2711), followed by spiramycin + metronidazole fixed-dose combination (11.6%, 312/2711) and amoxicillin-clavulanic acid (10.3%, 279/2711). The main indications for use were abscess (349/423, 82.5%), cervicofacial cellulitis (74.2%, 314/423), and pericoronitis (58.6%, 239/408). Most dentists (90.5%, 381/421) considered that antibiotic resistance is of concern but only half of them (56.3%, 238/423) felt adequately informed about antibiotic use. Many dentists did not comply with the national guidelines: the majority of them declared inappropriate antibiotic prescriptions for 11/17 clinical situations. They did not prescribe antibiotics for 5/6 clinical situations requiring prophylaxis. They reported that the publication of clinical guidelines is the main factor influencing their prescriptions (71.0%, 299/421). They wished to receive regular updates of national guidelines in the form of practical sheets (93.0%, 172/185). French dentists should urgently be targeted by antibiotic stewardship initiatives.
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Introduction Antimicrobial resistance is a global public health crisis. A major driver of resistance is inappropriate antibiotic use, resulting from practices of prescribers, dispensers and patients. The purpose of this study was ...
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Introduction Antimicrobial resistance is a global public health crisis. A major driver of resistance is inappropriate antibiotic use, resulting from practices of prescribers, dispensers and patients. The purpose of this study was to identify the perception of service providers and policymakers about the inappropriate use of antibiotics in Nepal. Methods A qualitative study was conducted to explore factors influencing antibiotic use. Participants included 17 service providers and policymakers from the Rupandehi district in Nepal, with a semi-structured interview schedule adopted. Data were analysed using thematic analysis to identify themes relating to the inappropriate use of antibiotics. Results Inappropriate use of antibiotics was found to result from the interaction of demand and supply factors, together with a weak regulatory environment. Lack of knowledge by consumers and financial constraints resulted in practices such as self-medication and pressure being placed on providers to prescribe or dispense antibiotics. An insufficient choice of antibiotics, and health services not having investigation facilities, was also factors leading to inappropriate use of antibiotics. Additionally, in the private sector, the profit motive arising from incentives provided by pharmaceutical companies contributed to prescribing or dispensing antibiotics inappropriately. Conclusion Promoting appropriate antibiotic use is critical to reduce the growing public health threat of antibiotic resistance. A multi-faceted approach involving policymakers, providers, and the general public using both educational and regulatory measures is required to address this problem in Nepal, and potentially also in other low-income countries with a similar healthcare system.
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The antibiotic resistance arena is fraught with myths and misconceptions, leading to wrong strategies to combat it. It is crucial to identify them, discuss them in light of current evidence, and dispel those that are unequivocally...
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The antibiotic resistance arena is fraught with myths and misconceptions, leading to wrong strategies to combat it. It is crucial to identify them, discuss them in light of current evidence, and dispel those that are unequivocally wrong. This article proposes some concepts that may qualify as misconceptions around antibiotic resistance: the susceptible-resistant dichotomy; that incomplete antibiotic courses cause resistance; that resistance "emerges" in patients and hospitals; that antibiotics are mostly abused clinically; that resistance is higher in countries that use more antibiotics; that reducing antibiotic usage would reduce resistance; that financial incentives would "jumpstart" research and development of antibiotics; that generic and "original" antibiotics are the same; and that new anti-infective therapies are just around the corner. While some of these issues are still controversial, it is important to recognize their controversial status, instead of repeating them in specialized literature and lectures and, especially, in the planning of strategies to cope with resistance.
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Aim The use of antibiotics by health care professionals has benefitted humankind to a great extent. Recent reports show an increasing trend of antibiotic prescription by paediatric dentists. This systematic review aims to address ...
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Aim The use of antibiotics by health care professionals has benefitted humankind to a great extent. Recent reports show an increasing trend of antibiotic prescription by paediatric dentists. This systematic review aims to address the current pattern of antibiotics prescription among the paediatric dental population according to the evidence-based literature. The question of research addressed here deals with the assessment of the correlation of the injudicious prescription of antibacterial agents and antibiotic resistance among the population of interest.
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