Postgrad Med. 1977 Jun;61(6):92-8.
Treatment of acne with topical antibiotics.

Frank SB.

The introduction of topical antibiotics for acne vulgaris has ushered in a new era in the treatment of this troublesome disorder. Tetracycline, erythromycin, and clindamycin can now be prepared in lotion form in vehicles that are capable of carrying the antibiotic into the follicular canal, where the primary lesion of acne occurs. Topical antibiotics are practically as effective as oral antibiotics in treating acne and are particularly useful for mild papular acne of puberty and early adolescence and papular-pustular acne of adult women. Use of topical antibiotics avoids the possibility of the adverse effects of systemic therapy; the side effects from the formulations reported here are negligible. Above all, antibiotic lotions do not produce the dryness and scaling that occur with most other topical acne preparations.


Source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=141043&dopt=Abstract antibiotic, antibiotics



South Med J. 1977 Oct;70 Suppl 1:68-71.
Perioperative antibiotic prophylaxis against vascular graft infection.

Wilson SE, Wang S, Gordon HE.

This study investigated the efficacy of perioperative antibiotics in preventing bacteremic infection of vascular suture lines, Dacron grafts, and bovine heterografts. One hundred forty-nine dogs had either segmental excision of the abdominal aorta with primary repair, Dacron prosthesis, or bovine heterograft placement. Animals were randomly assigned to a control group, to receive 10(8) S aureus, or to receive this same dose of staphylococci plus cephalothin (15 mg/kg). After six weeks, graft cultures were obtained. All control animals had negative cultures. Often dogs with an aortic suture line subjected to bacteremia, five were infected. Eight dogs with aortic suture lines received bactermia and antibiotics resulting in only one positive culture. Nineteen animals with bovine grafts were given S aureus resulting in 18 infections, and seven of 12 bovine grafts became infected even with antibiotic coverage. Twenty-eight dogs had a Dacron graft and infusion of Staphylococcus, yielding 23 infections. Of the 24 Dacron graft subjects with induced bacteremia and antibiotics, only four were infected. Intraoperative antibiotics are significantly effective in preventing infection of vascular suture lines and Dacron prostheses but afford less protection to bovine heterografts.


Source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=143720&dopt=Abstract antibiotic, antibiotics



J Trauma. 2003 Apr;54(4):633-8; discussion 638-9.
Does bronchoalveolar lavage enhance our ability to treat ventilator-associated pneumonia in a trauma-burn intensive care unit?

Wahl WL, Franklin GA, Brandt MM, Sturm L, Ahrns KS, Hemmila MR, Arbabi S.

Department of Surgery, University of Michigan Health System, Ann Arbor 48109-0033, USA. wlwahmich.edu

BACKGROUND: Recent literature supports the notion that bronchoalveolar lavage (BAL) in ventilated trauma patients may improve our ability to diagnose and treat ventilator-associated pneumonia (VAP). We hypothesized that BAL would decrease the number of cases of VAP diagnosed and impact our antibiotic use and ventilator days. METHODS: Prospective data on all infectious complications were collected for patients admitted to the trauma-burn service for the year 2001. All VAPs between January 1, 2001, through June 30, 2001, were diagnosed without BAL (No BAL group) using clinical signs of fever, sputum production, leukocytosis, chest radiographs, and sputum culture. After July 1, 2001, VAP was diagnosed with the use of BAL. RESULTS: There were 37 cases of VAP in the No BAL group (11%) and 29 cases of VAP (8%) in the BAL group. There were no statistical differences in Injury Severity Score, hospital length of stay, ventilator days, or mortality between the two groups. The time to initial treatment of VAP was shorter for the BAL group, but did not reach significance. The number of patients who had their VAP pathogens correctly treated with empiric antibiotics was also the same between the two groups. There was no difference in the rate of recurrent pneumonias. The antibiotic costs and respiratory therapy/ventilator costs were not statistically different between the groups for trauma patients, although antibiotic costs were higher for burn patients. CONCLUSION: The routine use of BAL to diagnose VAP in our mixed trauma-burn population did not impact on clinical outcomes or antibiotic use. Our results do not justify the additional costs and potential risks of BAL for all patients. The means of VAP diagnosis may not be as important as choosing the appropriate antibiotics for common VAP organisms in any given intensive care unit.


Source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12707523&dopt=Abstract antibiotic, antibiotics



An Esp Pediatr. 2000 Feb;52(2):148-56.
[Antibiotic prescribing patterns for pediatric inpatients with acute respiratory tract infection]

[Article in Spanish]

Escorihuela Esteban R, Fernandez Merchan JA, Millan Jimenez A, Carrion Mera T, Gadea Girones I.

Servicio de Pediatria, Fundacion Jimenez Diaz, Universidad Autonoma, Madrid.

BACKGROUND: Children with acute respiratory tract infection (ARTI) represent an important target group for efforts aimed at reducing unnecessary antibiotic use. OBJECTIVE: To present the epidemiological data and evaluate the effect of clinical, laboratory, radiological and microbiological data on the decision to prescribe antibiotics to pediatric patients with ARTI as well as to seek criteria that would justify antibiotic use. PATIENTS AND METHODS: A retrospective review was made of the clinical histories of 147 previously healthy children, consecutively admitted to our hospital with ARTI for 1 year (May 1996-April 1997). Patients were divided in two groups: those not treated with antibiotics (n = 92) and those treated (n = 55). Data from the two groups were compared with a statistical computer program (R-Sigma). RESULTS: Of the 147 patients studied, mean age was 2.5 years (range 0-14 years) and 85 (58%) males. One-hundred-and-five patients (72%) had previously been attended to in the emergency room, and 45 patients (30%) had been treated with antibiotics. Upper respiratory tract infection was diagnosed in 81 patients (54%), bronchitis in 28 (18%), bronchiolitis in 23 (15%) and pneumonia in 15 (10%). Ninety-seven patients (66%) had viral infection and only two (1%) had bacterial infection. Syncytial respiratory virus was isolated in 41 patients (28%) and adenovirus in 30 (20%). In the untreated group, the longer duration of symptoms before admission, lymphocytosis, clinical diagnosis of bronchiolitis and normal thorax X-ray, were statistically significant. In the treated group, fever, leukocytosis, neutrophilia and a diagnosis of pneumonia were statistically significant. Length of stay was longer in this group than in the untreated group. CONCLUSIONS: It is difficult to prescribe antibiotics on the basis of bacteriologic data. Laboratory, analytic and radiological data can be helpful in the rational use of antibiotics.


Source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11003881&dopt=Abstract antibiotic, antibiotics



An Esp Pediatr. 2000 Feb;52(2):157-63.
[Antibiotic prescribing patterns in primary health care. Do pediatricians use antibiotics rationally?]

[Article in Spanish]

Calvo Rey C, Albanil Ballesteros R, Sanchez Mendez MY, Olivas Dominguez A.

Hospital Severo Ochoa, Leganes, Area 9, Madrid.

OBJECTIVES: To determine antibiotic prescribing patterns in the pediatric (infants and children) population attended to at a primary health care centre in the community of Madrid. We also wanted to determine the necessity or otherwise of antibiotic therapy and whether the selected antibiotic drug was appropriate for the pathology diagnosed. METHODS: Retrospective study of all infectious or respiratory processes diagnosed during 1 year and of the respective antibiotic cycles prescribed in all patients under the age of 4 years. The prescribing physician and the appropriateness of all therapeutic decisions, including those where the decision was not to treat with antibiotic drugs, were analyzed. RESULTS: We evaluated 910 children under the age of 4 years with a total of 3, 847 processes (mean of 4.55 +/-3.6 processes per child per year). Sixty-three percent of the children received at least one cycle of antibiotic drugs per year (mean 1.63+/-1.69 cycles of treatment per child per year). Of all therapeutic decisions, 85.2% were considered appropriate. In 36% of the processes antibiotics were prescribed (1,386 cycles), 46% of which were considered inappropriate either because no antibiotic therapy should have been given (71.6%) or because the chosen drug was not appropriate for the pathology (28.4%). There were significant differences among the evaluated physicians. The most correct decisions were taken by the pediatrician in the outpatient clinic, especially when compared with physicians in the emergency ward (p<0.0001). The most frequently prescribed antibiotic drugs were amoxicillin (41.2%) and amoxicillin combined with clavulanic acid (33%). Cephalosporin accounted only for 6.9% of the prescriptions. CONCLUSIONS: Antibiotic therapy is overprescribed in children, a situation that should be corrected.


Source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11003882&dopt=Abstract antibiotic, antibiotics



Eur J Clin Pharmacol. 2000 Aug;56(5):417-25.
Pattern of antibiotic use in primary health care in Italy.

Vaccheri A, Castelvetri C, Esaka E, Del Favero A, Montanaro N.

Interuniversity Research Centre on Pharmacoepidemiology, Department of Pharmacology, University of Bologna, Italy.

OBJECTIVE: The overuse and misuse of antibiotics have been related to the growing emergence of bacterial resistance. The aim of the present study was to assess the pattern of antibiotic use by Italian general practitioners (GPs) in the treatment of the most frequent infectious problems. METHODS: The study was performed with 131 GPs recruited on a voluntary basis from among the 181 GPs contacted in two Italian regions, Emilia Romagna and Umbria. GPs were requested to report all the infectious events encountered during six sample weeks on a special form, whether an antibiotic was administered or not. RESULTS: The GPs reported 7095 infectious cases, of which 5036 (77%) were respiratory-tract infections (RTIs) and 749 (11%) were urinary-tract infections (UTIs). Antibiotics were prescribed in 71% of the cases. The proportion of antibiotic-treated cases was highest in UTIs (97%), followed by lower respiratory-tract infections (LRTIs; 93%) and upper respiratory-tract infections (URTIs; 54%). Drugs belonging to 16 Anatomical Therapeutical Chemical groups (fourth level) were used. Wide-spectrum penicillins and macrolides ranked first (23%), followed by penicillins plus beta-lactamase inhibitors (15%), cephalosporins (15%) and fluoroquinolones (10%). The most prescribed antibiotics for the major disease groups were wide-spectrum penicillins for URTIs (36%), macrolides and cephalosporins for LRTIs (27% each) and fluoroquinolones for UTIs (46%). CONCLUSIONS: The present survey showed a high level of inappropriate use. In fact, a large number of infectious diseases, including infections commonly caused by viral agents, were treated with an anti-bacterial drug. Italian GPs had a tendency to preferentially prescribe wide-spectrum antibiotics and to use, in many cases, antibiotics that are rarely of choice in primary health care, such as cephalosporins and fluoroquinolones. In order to attain a more evidence-based prescription, local guidelines shared by specialists and GPs should be implemented.


Source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11009052&dopt=Abstract antibiotic, antibiotics



J Vet Med B Infect Dis Vet Public Health. 2000 Aug;47(6):453-60.
Influence of antibiotics used as feed additives on the immune effect of erysipelas live vaccine in swine.

Yamamoto K, Takagi M, Endoh YS, Kijima M, Takahashi T.

National Veterinary Assay Laboratory, Ministry of Agriculture, Forestry and Fisheries, Tokyo, Japan.

To investigate the influence of antibiotics used as feed additives on the immune response to erysipelas live vaccine, the pig inoculation test was applied. Avilamycin, oxytetracycline quaternary salt, enramycin, virginiamycin and tylosin phosphate were selected as test antibiotics. Five experimental feeds containing each antibiotic at the highest concentration permitted for feed additives in Japan, and the basal diet lacking antibiotics were examined. Twenty-nine pigs were divided into six groups. At first all the groups were fed with the antibiotic-free basal diet for 7 days, and then each group received the experimental feeds. On the 14th day after feeding with test feeds all the pigs, except for one control pig in each group, were immunized with the vaccine and all the pigs were then challenge-exposed to a virulent strain of Erysipelothrix rhusiopathiae 14 days after vaccination. The clinical response was observed every day for 14 days. In all the groups, most of the vaccinated pigs did not develop any clinical signs of acute erysipelas after the challenge exposure, whereas non-vaccinated control pigs died or showed severe generalized erythema with profound depression and anorexia. No differences in the protection against the challenge exposure were observed among the groups. Therefore, the present results suggest that these selected antibiotics would not interfere with the immune effect of the vaccine if given at the usual concentrations used for feed additives.


Source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11014067&dopt=Abstract antibiotic, antibiotics