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281. Machine Learning Leveraging Genomes from Metagenomes Identifies Influential Antibiotic Resistance Genes in the Infant Gut Microbiome Full Text available with Trip Pro

Machine Learning Leveraging Genomes from Metagenomes Identifies Influential Antibiotic Resistance Genes in the Infant Gut Microbiome Antibiotic resistance in pathogens is extensively studied, and yet little is known about how antibiotic resistance genes of typical gut bacteria influence microbiome dynamics. Here, we leveraged genomes from metagenomes to investigate how genes of the premature infant gut resistome correspond to the ability of bacteria to survive under certain environmental (...) conditions, even in the absence of antibiotic therapy. Using a machine learning approach, we identified genes that are predictive of an organism's direction of change in relative abundance after administration of vancomycin and cephalosporin antibiotics. The most accurate results were obtained by reducing annotated genomic data to five principal components classified by boosted decision trees. Among the genes involved in predicting whether an organism increased in relative abundance after treatment

2018 mSystems

282. Antibiotic resistance patterns of urinary tract pathogens in Turkish children Full Text available with Trip Pro

Antibiotic resistance patterns of urinary tract pathogens in Turkish children Knowledge of local antimicrobial resistance patterns is essential for evidence- based empirical antibiotic prescribing. We aimed to investigate the distribution and changes in causative agents of urinary tract infections in children and the resistance rates, and to recommend the most appropriate antibiotics.In this retrospective study, we evaluated causative agents and antimicrobial resistance in urine isolates from

2018 Global health research and policy

283. Impact of antibiotics on smell dysfunction Full Text available with Trip Pro

Impact of antibiotics on smell dysfunction Viral or bacterial respiratory infections can cause long-lasting olfactory dysfunction. Antibiotic therapy is indicated in severe cases; however, it is unclear whether antibiotic use produces a positive, negative, or null effect on olfactory function. This retrospective study sought to determine whether antibiotic use has an influence on odor identification and detection threshold test scores of patients with smell dysfunction secondary to upper (...) respiratory infections (URIs), lower respiratory infections (LRIs), or rhinosinusitis.Data from a total of 288 patients presenting to the University of Pennsylvania Smell and Taste Center were evaluated.Patients with a URI etiology who had taken bactericidal antibiotics had lower detection thresholds than did patients who had not taken antibiotics (P < 0.023; analysis of covariance with age and time since infection onset as covariates). Moreover, thresholds were lower for bactericidal antibiotic users

2018 World journal of otorhinolaryngology - head and neck surgery

284. Appropriate and timely antibiotic administration for neonatal sepsis in Mesoamérica Full Text available with Trip Pro

Appropriate and timely antibiotic administration for neonatal sepsis in Mesoamérica Neonatal sepsis is a leading cause of mortality among children under-5 in Latin America. The Salud Mesoamérica Initiative (SMI), a multicountry results-based aid programme, was designed to improve maternal, newborn and child health in impoverished communities in Mesoamérica. This study examines the delivery of timely and appropriate antibiotics for neonatal sepsis among facilities participating in the SMI (...) project. A multifaceted health facility survey was implemented at SMI inception and approximately 18 months later as a follow-up. A random sample of medical records from neonates diagnosed with sepsis was reviewed, and data regarding antibiotic administration were extracted. In this paper, we present the percentage of patients who received timely (within 2 hours) and appropriate antibiotics. Multilevel logistic regression was used to assess for potential facility-level determinants of timely

2018 BMJ global health

285. Antibiotics and activity spaces: protocol of an exploratory study of behaviour, marginalisation and knowledge diffusion Full Text available with Trip Pro

Antibiotics and activity spaces: protocol of an exploratory study of behaviour, marginalisation and knowledge diffusion Antimicrobial resistance (AMR) is a global health priority. Leading UK and global strategy papers to fight AMR recognise its social and behavioural dimensions, but current policy responses to improve the popular use of antimicrobials (eg, antibiotics) are limited to education and awareness-raising campaigns. In response to conceptual, methodological and empirical weaknesses (...) of this approach, we study people's antibiotic-related health behaviour through three research questions.RQ1: What are the manifestations and determinants of problematic antibiotic use in patients' healthcare-seeking pathways?RQ2: Will people's exposure to antibiotic awareness activities entail changed behaviours that diffuse or dissipate within a network of competing healthcare practices?RQ3: Which proxy indicators facilitate the detection of problematic antibiotic behaviours across and within communities?We

2018 BMJ global health

286. Synthesis, characterization, computational studies and biological activity evaluation of Cu, Fe, Co and Zn complexes with 2-butanone thiosemicarbazone and 1,10-phenanthroline ligands as anticancer and antibacterial agents Full Text available with Trip Pro

Synthesis, characterization, computational studies and biological activity evaluation of Cu, Fe, Co and Zn complexes with 2-butanone thiosemicarbazone and 1,10-phenanthroline ligands as anticancer and antibacterial agents Mixed-ligand metal (II) (M=Cu, Fe, Co and Zn) complexes containing 2-butanone thiosemicarbazone and 1, 10-phenanthroline have been synthesized and characterized by melting point, FT-IR, 1H-NMR, UV-spectrophotometry and molar conductance measurements. All the complexes were (...) and tetracycline. The ligand was tested for its potential anticancer activity against MDA-MB-231 cell line using MTT assay. Antibacterial activity of the complexes was tested against Staphylococcus aureus and Escherichia coli using the disc diffusion method. Cu (II) complex showed maximum activity against the MDA cells and also exhibited mild antibacterial activity against S. aureus.

2018 EXCLI journal

287. Overuse of Antibiotics and the Rise of Superbugs: A Major Global Health Crisis

Overuse of Antibiotics and the Rise of Superbugs: A Major Global Health Crisis I not a bot. Resume. Are you not a robot? Click on the button to continue: I not a bot. Resume.

2018 MedicalVideos

288. Hospital-based antibiotic use in patients with Mycobacterium avium complex Full Text available with Trip Pro

Hospital-based antibiotic use in patients with Mycobacterium avium complex Treatment guidelines exist for pulmonary Mycobacterium avium complex (MAC) infection, although studies suggest poor concordance in clinician practice. Using a national database including hospital encounters of laboratory-confirmed MAC patients, we sought to characterise US treatment practices. We assessed patients in the Premier Healthcare Database from 2009 to 2013 with two or more MAC-positive cultures or one MAC (...) % resistance-associated therapy. Patients were more likely to receive guidelines-based therapy if they had multiple hospital encounters (aRR 1.5), codes for PNTM (aRR 5.7) or tuberculosis (aRR 4.5) or radiological procedures (aRR 10.9); multiple hospital encounters (aRR 0.8) or a tuberculosis code (aRR 0.1) were less likely to be associated with receiving resistance-promoting regimens. In hospital-based MAC patients, half received antibiotics active against MAC, a low proportion received therapy based

2018 ERJ open research

289. Characterization of Wild and Captive Baboon Gut Microbiota and Their Antibiotic Resistomes Full Text available with Trip Pro

Characterization of Wild and Captive Baboon Gut Microbiota and Their Antibiotic Resistomes Environmental microbes have harbored the capacity for antibiotic production for millions of years, spanning the evolution of humans and other vertebrates. However, the industrial-scale use of antibiotics in clinical and agricultural practice over the past century has led to a substantial increase in exposure of these agents to human and environmental microbiota. This perturbation is predicted to alter (...) the ecology of microbial communities and to promote the evolution and transfer of antibiotic resistance (AR) genes. We studied wild and captive baboon populations to understand the effects of exposure to humans and human activities (e.g., antibiotic therapy) on the composition of the primate fecal microbiota and the antibiotic-resistant genes that it collectively harbors (the "resistome"). Using a culture-independent metagenomic approach, we identified functional antibiotic resistance genes in the gut

2018 mSystems

290. A review of antibiotic prophylaxis for traveler’s diarrhea: past to present Full Text available with Trip Pro

A review of antibiotic prophylaxis for traveler’s diarrhea: past to present As there is rapid increase in international travel to tropical and subtropical countries, there will likely be more people exposed to diarrheal pathogens in these moderate to high risk areas and subsequent increased concern for traveler's diarrhea. The disease may appear as a mild clinical syndrome, yet a more debilitating presentation can lead to itinerary changes and hospitalization. As bacterial etiologies (...) are the most common causative agents of TD, the use of antibiotic prophylaxis to prevent TD has been reported among travelers for several years. The most common type of antibiotic used for TD has changed over 50 years, depending on many influencing factors. The use of antibiotic prophylaxis for TD prevention in travelers is still controversial, mainly because of difficulties balancing the risks and benefits. Many factors, such as emerging drug resistance, side effects, cost and risk behavior need

2018 Tropical diseases, travel medicine and vaccines

291. Can Procalcitonin Levels Guide Antibiotic Therapy in Bacterial Infections and Reduce Antibiotic Overconsumption Without Having a Negative Effect on Clinical Outcomes?

Can Procalcitonin Levels Guide Antibiotic Therapy in Bacterial Infections and Reduce Antibiotic Overconsumption Without Having a Negative Effect on Clinical Outcomes? SystematicReviewSnapshot TAKE-HOME MESSAGE The use of procalcitonin to guide antibiotic initiation or withdrawal in bacterial infections may reduce overall exposure to antibiotics without affecting mortality. However, further multicenter trials based in North America are needed before widespread adoption of procalcitonin-guided (...) the intervention used mea- sured procalcitonin levels to in- form decisions (guide initiation or duration) of antibiotic therapy compared with standard care. DATA EXTRACTION AND SYNTHESIS Investigators independently ob- tained data from the selected tri- als by using a standardized data abstraction tool. Results were pooled and odds ratios with 95% con?dence intervals were calcu- lated for overall mortality rates. Antibiotic exposure and outcome data were summarized and grouped by clinical setting. Can

2012 Annals of Emergency Medicine Systematic Review Snapshots

292. Bronchoscopy-guided antimicrobial therapy for cystic fibrosis. Full Text available with Trip Pro

Bronchoscopy-guided antimicrobial therapy for cystic fibrosis. Early diagnosis and treatment of lower respiratory tract infections are the mainstay of management of lung disease in cystic fibrosis. When sputum samples are unavailable, treatment relies mainly on cultures from oropharyngeal specimens; however, there are concerns regarding the sensitivity of these to identify lower respiratory organisms.Bronchoscopy and related procedures (including bronchoalveolar lavage) though invasive, allow (...) the collection of lower respiratory specimens from non-sputum producers. Cultures of bronchoscopic specimens provide a higher yield of organisms compared to those from oropharyngeal specimens. Regular use of bronchoscopy and related procedures may help in a more accurate diagnosis of lower respiratory tract infections and guide the selection of antimicrobials, which may lead to clinical benefits.This is an update of a previous review.To evaluate the use of bronchoscopy-guided antimicrobial therapy

2018 Cochrane

293. Antimicrobial prescribing: Ceftazidime/avibactam

in combination with an antibacterial agent active against gram-positive pathogens when these are known or suspected to be contributing to the infectious process. d The total duration shown may include intravenous ceftazidime/avibactam followed by appropriate oral therapy. e There is very limited experience with the use of ceftazidime/avibactam for more than 14 days. Antimicrobial prescribing: Ceftazidime/avibactam (ES16) © NICE 2018. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk (...) Antimicrobial prescribing: Ceftazidime/avibactam Antimicrobial prescribing: Ceftazidime/ Antimicrobial prescribing: Ceftazidime/ a avibactam vibactam Evidence summary Published: 13 November 2017 nice.org.uk/guidance/es16 pathways Ov Overview erview This evidence summary outlines the best available evidence for a new intravenous antimicrobial, ceftazidime/avibactam (Zavicefta). It is indicated for treating: complicated intra-abdominal infections complicated urinary tract infections, including

2017 National Institute for Health and Clinical Excellence - Advice

294. Neonatal infection: antibiotics for prevention and treatment

Neonatal infection: antibiotics for prevention and treatment Neonatal infection ( Neonatal infection (early onset): early onset): antibiotics for pre antibiotics for prev vention and treatment ention and treatment Clinical guideline Published: 22 August 2012 nice.org.uk/guidance/cg149 © NICE 2018. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and-conditions#notice-of- rights).Y Y our responsibility our responsibility The recommendations in this guideline (...) inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with complying with those duties. Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible. Neonatal infection (early onset): antibiotics for prevention and treatment (CG149) © NICE 2018. All rights reserved. Subject to Notice of rights (https

2012 National Institute for Health and Clinical Excellence - Clinical Guidelines

295. L-Methionine associated with Hibiscus sabdariffa and Boswellia serrata extracts are not inferior to antibiotic treatment for symptoms relief in patients affected by recurrent uncomplicated urinary tract infections: Focus on antibiotic-sparing approach. Full Text available with Trip Pro

L-Methionine associated with Hibiscus sabdariffa and Boswellia serrata extracts are not inferior to antibiotic treatment for symptoms relief in patients affected by recurrent uncomplicated urinary tract infections: Focus on antibiotic-sparing approach. To evaluate the efficacy of a phytotherapic combination of L-Methionine associated with Hibiscus sabdariffa and Boswellia serrata for treatment of acute episodes of uncomplicated urinary tract infections (UTI) in women affected by recurrent (...) UTIs.In this randomized phase III clinical trial, adult females with uncomplicated UTI were enrolled into one of the following treatment groups: Group A: phytotherapic combination 1 tablet in the morning and 1 tablet in the evening for 7 days; Group B: Short term antibiotic treatment according to international guidelines recommendations. At baseline, all patients were evaluated by a urologist and quality of life (QoL) questionnaires and mid-stream urine culture. Same clinical and laboratory

2018 Archivio italiano di urologia, andrologia : organo ufficiale [di] Societa italiana di ecografia urologica e nefrologica Controlled trial quality: uncertain

296. Procalcitonin-Guided Antibiotic Therapy Reduces Antibiotic Use for Lower Respiratory Tract Infections in a United States Medical Center: Results of a Clinical Trial. Full Text available with Trip Pro

Procalcitonin-Guided Antibiotic Therapy Reduces Antibiotic Use for Lower Respiratory Tract Infections in a United States Medical Center: Results of a Clinical Trial. European trials using procalcitonin (PCT)-guided antibiotic therapy for patients with lower respiratory tract infections (LRTIs) have demonstrated significant reductions in antibiotic use without increasing adverse outcomes. Few studies have examined PCT for LRTIs in the United States.In this study, we evaluated whether a PCT (...) algorithm would reduce antibiotic exposure in patients with LRTI in a US hospital. We conducted a controlled pre-post trial comparing an intervention group of PCT-guided antibiotic therapy to a control group of usual care. Consecutive patients admitted to medicine services and receiving antibiotics for LRTI were enrolled in the intervention. Providers were encouraged to discontinue antibiotics according to a PCT algorithm. Control patients were similar patients admitted before the intervention.The

2018 Open forum infectious diseases Controlled trial quality: uncertain

297. Is the routine practice of antibiotic prescription and microbial culture and antibiotic sensitivity testing justified in primary maxillofacial space infection patients? A prospective, randomized clinical study. (Abstract)

Is the routine practice of antibiotic prescription and microbial culture and antibiotic sensitivity testing justified in primary maxillofacial space infection patients? A prospective, randomized clinical study. The purpose of this prospective, randomized, comparative clinical study was to compare treatment outcome of removal of foci and incision and drainage, with or without oral antibiotic therapy, in the management of single primary maxillofacial space infection with a known focus.A total (...) of 40 patients with single primary maxillofacial space infection with a known infectious focus were divided into two groups, one treated with incision and drainage only, and the other with incision and drainage along with oral antibiotics. The focus of infection was addressed in both groups. Parameters evaluated included pain score, maximum mouth opening, swelling, purulent discharge and return to normal life, which were assessed on days 1, 2, 3, 5 and 7. The patients were followed up until

2018 Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery Controlled trial quality: uncertain

298. Is very short-course antibiotic therapy possible in postoperative intra-abdominal infections? Discussion on "Short-course antibiotic therapy for critically ill patients treated for postoperative intra-abdominal infection: the DURAPOP randomised clinical t (Abstract)

Is very short-course antibiotic therapy possible in postoperative intra-abdominal infections? Discussion on "Short-course antibiotic therapy for critically ill patients treated for postoperative intra-abdominal infection: the DURAPOP randomised clinical t 29654347 2018 06 21 2019 03 08 1432-1238 44 5 2018 05 Intensive care medicine Intensive Care Med Is very short-course antibiotic therapy possible in postoperative intra-abdominal infections? Discussion on "Short-course antibiotic therapy

2018 Intensive Care Medicine Controlled trial quality: uncertain

299. Colonoscopy in automated peritoneal dialysis patients: value of prophylactic antibiotics: a prospective study on a single antibiotic. (Abstract)

Colonoscopy in automated peritoneal dialysis patients: value of prophylactic antibiotics: a prospective study on a single antibiotic. To evaluate the need for prophylactic antibiotics in automated peritoneal dialysis (APD) patients undergoing flexible colonoscopy.A total of 93 patients on automated peritoneal dialysis (APD) undergoing diagnostic colonoscopy were enrolled in a prospective, randomized study. Patients were randomized into 2 age- and sex-matched groups; group A (46 patients (...) ) with intraperitoneal (IP) ceftazidime prior to colonoscopy and group B (47 patients) without prophylactic antibiotics. The relations between peritonitis and different parameters were analyzed.Of all colonoscopies, 60.2% showed normal findings, 17.2% with colonic polyps at different sites, 12.9% with angiodysplastic-like lesions, 5.4% with colonic ulcer(s), 3.2% with diverticulae without diverticulitis and 1.1% had transverse colon stricture. Post-colonoscopy peritonitis was documented in 3 (6.5%) and 4 (8.5

2018 The International journal of artificial organs Controlled trial quality: uncertain

300. Multicentre, controlled, randomized clinical trial to compare the efficacy and safety of ambulatory treatment of mild acute diverticulitis without antibiotics with the standard treatment with antibiotics. (Abstract)

Multicentre, controlled, randomized clinical trial to compare the efficacy and safety of ambulatory treatment of mild acute diverticulitis without antibiotics with the standard treatment with antibiotics. Acute diverticulitis (AD) is a highly prevalent disease in Spain. Its chronic-recurrent appearance and high rate of relapse mean that it has a major epidemiological and economic impact on our health system. In spite of this, it has not been studied in any great depth. Reassessing its (...) etiopathology, recent studies have observed that it is an inflammatory disease-not, as classic theories had postulated, an infectious one. In the light of these findings, the suitability of antibiotics for its treatment has been reconsidered. At present, however, the evidence for incorporating these findings into clinical practice guidelines remains insufficient.This study was designed to analyse the safety and efficacy of a non-antibiotic treatment for mild AD. Patients with mild AD (grade 0

2018 International journal of colorectal disease Controlled trial quality: uncertain

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