J Endod. 2002 May;28(5):396-404.
Antibiotic use by members of the American Association of Endodontists in the year 2000: report of a national survey.

Yingling NM, Byrne BE, Hartwell GR.

The purpose of this study was to determine the prescribing habits of active members of the American Association of Endodontists (AAE) with regard to antibiotics. A one-page, double-sided questionnaire was sent to the active members of the AAE living in the United States. The 1999 mailing list of 3203 members was obtained from the AAE, and the return rate was 50.1% (1606 surveys). With a sample size over 1000, the study was able to distinguish differences to within 0.5% with power = 80% (at alpha = 5%). The data were analyzed using descriptive statistics and chi-square tests of independence. Penicillin VK, 500 mg, 4 times a day, was the first choice antibiotic prescribed by 61.48% of respondents. Clindamycin (Cleocin), 150 mg, 4 times a day, was selected by 29.59%. For those patients with a penicillin allergy, 57.03% prescribed clindamycin and various erythromycin preparations were prescribed by 26.65%. A loading dose was used by 85.14%. The average duration of antibiotic therapy was 7.58 days. Those respondents involved in academics, either part-time or full-time, were significantly more likely to prescribe penicillin VK, 500 mg, 4 times a day at a rate of 85% versus those in part-time or full-time private practice at a rate of 67%. For cases of irreversible pulpitis, 16.76% of responding endodontists prescribed antibiotics. For the scenario of a necrotic pulp, acute apical periodontitis, and no swelling, 53.93% prescribed antibiotics. Almost 12% prescribed antibiotics for necrotic pulps with chronic apical periodontitis and a sinus tract. For the most part, the majority of the members of the AAE were selecting the appropriate antibiotic for use in orofacial infections, but there are still many who are prescribing antibiotics inappropriately. Although there were trends of improvement in some areas with regards to prescribing antibiotics, there were other areas where there had been no improvement in 25 years. Unless these trends change, our generation and those to come may not have effective antibiotics for use in the management of true orofacial infections.


Source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12026927&dopt=Abstract antibiotic, antibiotics



Med Hypotheses. 2002 Apr;58(4):327-31.
Treatment of post-burns bacterial infections by bacteriophages, specifically ubiquitous Pseudomonas spp. notoriously resistant to antibiotics.

Ahmad SI.

Department of Life Sciences, Nottingham Trent University, Nottingham, England. Shamim.ahmatu.ac.uk

Post-burn microbial infections are a major problem in recovering from the trauma of third-degree burns, and the survival of patients can depend upon the severity of the burn and the infections encountered. Within 24 hours, patients can start suffering from opportunistic bacterial attacks, which can vary from simple infection, such as those easily treatable by antibiotics, to more complicated types, which may have natural or acquired resistance to drugs. Infection by multiple drug-resistant bacteria can create additional complexity to the problem. As an alternative to treating bacterial infections by antibiotics, bacteriophages have been in use in certain parts of the world, such as at Tbilisi in Georgia and in Poland, and this approach has now been more widely recognized. Results have shown that phage therapy has an 80% success rate against Enterococcus infections and up to 90% against Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli and Klebsiella pneumoniae. Here it is proposed that bacteriophages can effectively be used for the treatment of post-burn infections, particularly the ubiquitous opportunistic pathogens, Pseudomonas spp., known to be notoriously resistant to a variety of antibiotics. This kind of treatment may be of particular importance in Third World countries where the incidence of burns and infections, due to lack of stringent safety regulations and proper hygiene respectively, may be more common and where cocktails of antibiotics may be less affordable. Phages that can possibly be employed in the treatment and their advantages compared to the use of antibiotics are also highlighted. 2002 Elsevier Science Ltd. All rights reserved.


Source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12027527&dopt=Abstract antibiotic, antibiotics



Eur Respir J. 2002 May;19(5):944-51.
Effects of antibiotics on protected specimen brush sampling in ventilator-associated pneumonia.

Prats E, Dorca J, Pujol M, Garcia L, Barreiro B, Verdaguer R, Gudiol F, Manresa F.

Serveis de Pneumologia, Hospital de Belivitge, Barcelona, Spain. ufisssub.scs.es

The effects of antibiotic treatment on the results of protected specimen brushing (PSB) in ventilator-associated pneumonia were prospectively assessed by performing this procedure before antibiotic treatment, and 12, 24, 48 and 72 h after initiation of antibiotic treatment, in 35 ventilated patients who developed pneumonia during mechanical ventilation. The number of micro-organisms isolated, their concentration (colony-forming units (cfu) mL(-1)), and the number of cases with a positive PSB (> or =10(3) cfu x mL(-1)) were evaluated. Within 12 h of the initiation of effective antibiotic treatment a rapid, significant decrease in the numbers of organisms isolated, their individual concentrations and the percentage of positive PSB results were observed. Certain bacterial species (Streptococcus pneumoniae, Haemophilus influenzee) appeared to be more vulnerable to antibiotics than others (Staphylococcus aureus, Pseudomonas aeruginosa, Acinetobacter baumanni). This data confirms that prior antibiotic treatment, even after only a few hours of activity, significantly decreases the sensitivity of protected brush specimen; this effect appears to be particularly marked among the species involved in early ventilator associated pneumonia.


Source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12030737&dopt=Abstract antibiotic, antibiotics



Aliment Pharmacol Ther. 2002 Jun;16(6):1083-90.
Sequential intravenous/oral antibiotic vs. continuous intravenous antibiotic in the treatment of pyogenic liver abscess.

Ng FH, Wong WM, Wong BC, Kng C, Wong SY, Lai KC, Cheng CS, Yuen WC, Lam SK, Lai CL.

Department of Medicine, Ruttonjee Hospital, Hong Kong, ROC.

AIM: Pyogenic liver abscesses result in substantial morbidity and mortality. Antimicrobial regimens using sequential intravenous/oral therapy may reduce the length of hospital stay. In this retrospective analysis, the efficacy of continuous intravenous antibiotic therapy (group I) vs. sequential intravenous/oral antibiotic therapy (group II) was studied in patients with pyogenic liver abscess. METHODS: One hundred and twelve consecutive patients (55 in group I and 57 in group II) with pyogenic liver abscess were analysed. Clinical response, length of hospital stay and relapse rates were examined. RESULTS: Group II had a significantly shorter duration of intravenous antibiotic treatment (3.2 weeks vs. 5.9 weeks, P < 0.01) and a shorter length of hospital stay (28 days vs. 42 days, P < 0.01) when compared to group I. Oral antibiotics were prescribed for a median duration of 2.9 weeks in group II after discharge. No relapse occurred within 6 weeks after the completion of treatment in both groups. The cost of therapy was significantly lower in group II than in group I by 33%. CONCLUSIONS: A sequential intravenous/oral antibiotic regime is a safe and effective treatment for pyogenic liver abscess. This reduces the cost of therapy and the length of hospital stay.


Source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12030949&dopt=Abstract antibiotic, antibiotics



Med Pregl. 2002 Jan-Feb;55(1-2):19-22.
[Aminoglycoside antibiotics and post-antibiotic effects]

[Article in Serbo-Croatian (Roman)]

Stefan-Mikic S, Sabo A, Fabri M, Gobor-Fodor A, Vasovic M.

Klinika za infektivne bolesti, Klinicki centar, Novi Sad, Medicinski fakultet, Novi Sad. stefannunet.yu

INTRODUCTION: Man has been fighting diseases for centuries. One of the major battles is against microorganisms and diseases they cause. A health education course was organized on prescribing aminoglycoside antibiotics and postantibiotic effect. The aim of the course was to change the prescription habits in our colleagues. The postantibiotic effect of aminoglycoside antibiotics as well as impact of subinhibiting doses on duration of postantibiotic effect requires modification of previous therapeutic protocols. Single daily dose has the same or even greater effect than multiple daily doses. The toxicity of aminoglycosides is not increased and remains the same or smaller in single daily regimens. RESULTS: The single daily dose regimen of aminoglycosides has been used in 63.6% of cases in Clinic for Infectious Diseases of the Clinical Center of Novi Sad, 41.2% in Outpatient Health Care Center of Novi Sad "Liman" and this regimen has not been used in General Practice Department, Children's Health Care Department and Ear, Nose and Throat Clinic at all. The twice daily regimen has been used instead. CONCLUSION: Doctors are aware of the postantibiotic effect, but vast majority are still bound to their old habits in regard to prescribing antibiotics. Our educational course failed to achieve its goal.


Source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12037932&dopt=Abstract antibiotic, antibiotics



Arch Pediatr Adolesc Med. 2002 Jun;156(6):621-4.
Antibiotic use for upper respiratory tract infections: how well do pediatric residents do?

Nambiar S, Schwartz RH, Sheridan MJ.

Department of Pediatrics, Inova Fairfax Hospital for Children, Falls Church, VA, USA. nambiarder.fda.gov

BACKGROUND: Antibiotics are often used inappropriately for the treatment of upper respiratory tract infections in children, and the emergence of resistant bacteria is a growing public health concern. OBJECTIVE: To assess awareness and compliance with the Centers for Disease Control and Prevention (Atlanta, Ga) and American Academy of Pediatrics (Elk Grove Village, Ill) principles for judicious antibiotic use for upper respiratory tract infections among residents from a sample of pediatric residency programs in the mid-Atlantic region of the United States. PARTICIPANTS AND METHODS: Residents at the participating programs were requested to complete a survey questionnaire. RESULTS: Of the 524 pediatric residents surveyed, 74% (388 participants) completed the questionnaire. Familiarity with the principles increased with a year of training; 16%, 36%, and 50% of first-year (PL1), second-year (PL2), and third- or fourth-year (PL3/PL4) residents, respectively, had heard or read about the principles (chi(2)(trend); P<.001). In response to a direct question about the use of antibiotics for an otherwise well, afebrile 18-month-old child with purulent rhinorrhea, 29%, 25%, and 15% of PL1, PL2, and PL3/PL4 residents, respectively, would prescribe antibiotics within 10 days of onset of illness (chi(2)(trend); P =.008). A significant difference was found between PL1 vs PL3/PL4 participants (difference = 20%; 95% CI = 3%-26%). If the same infant had a temperature of 38.8 degrees C, then 63%, 45%, and 47% of PL1, PL2, and PL3/PL4 residents, respectively, would prescribe antibiotics (chi(2)(trend); P =.008). CONCLUSIONS: Awareness among pediatric residents about the judicious use of antibiotics for upper respiratory tract infections is often lacking, and inappropriate use of antibiotics for this condition continues to be prevalent. This was especially noted among PL1 residents, with an improving trend noted with increasing years of training.


Source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12038897&dopt=Abstract antibiotic, antibiotics



An Esp Pediatr. 2002 Nov;57(5):420-5.
[Changes in antibiotics prescription in primary care]

[Article in Spanish]

Albanil Ballesteros MR, Calvo Rey C, Sanz Cuesta T.

Centro de Salud Cuzco. Fuenlabrada. Madrid. Spain. a60061eleline/es

BACKGROUND: Bacterial resistance to antimicrobial drugs constitutes a considerable problem in clinical practice. Overprescribing of these drugs contributes to bacterial resistance and current literature shows a growing interest in the rationalization of antibiotic use. OBJECTIVES: To observe the appropriateness of antibiotic prescriptions to children in an outpatient primary care setting, before and after a critical analysis of prescribing habits was performed. PATIENTS AND METHODS: Children aged 0-4 years attending the outpatient pediatric clinic were surveyed in two different periods: 1997 and 2000. The number of visits, infectious and respiratory diseases observed, and courses of antibiotics prescribed was determined. RESULTS: A total of 456 children, 2,339 diseases, and 829 antibiotic prescriptions were included. Several differences were observed between the two periods: the number of antibiotic courses administered to each child in one year averaged 2.3 in the first period and 1.5 in the second (p < 0.001). The number of processes receiving antibiotic prescription decreased from 38.8 % to 31.7 % (p < 0.001). The appropriateness of the decision to treat increased from 85.1 % to 93.3 % (p < 0.001), and the appropriateness of the antibiotic prescribed increased from 56.3 % to 78.7 % (p < 0.001). The most frequently diagnosed infectious diseases were common cold, tonsillopharyngitis, otitis and bronchitis. The most frequently prescribed antibiotic drugs were amoxicillin, amoxicillin-clavulanate and V penicillin. CONCLUSIONS: Physicians' knowledge of their own antibiotics prescription profiles with subsequent critical comparative analysis with current literature on the subject can help to modify prescribing habits.


Source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12467545&dopt=Abstract antibiotic, antibiotics