Am J Respir Crit Care Med. 2002 Jul 1;166(1):72-5.
Lack of association between antibiotic use in the first year of life and asthma, allergic rhinitis, or eczema at age 5 years.

Celedon JC, Litonjua AA, Ryan L, Weiss ST, Gold DR.

Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA. juan.celedohanning.harvard.edu

Five retrospective studies have reported an association between antibiotic use in early life and asthma in childhood. We studied the relationship between the use of oral antibiotics in the first year of life and asthma, allergic rhinitis, and eczema at age 5 years among 448 children with a parental history of atopy monitored from birth. After adjustment for potential confounders, we found no significant association between antibiotic use in the first year of life and asthma (odds ratio [OR] for one versus no courses of antibiotics, 0.5; 95% confidence interval [CI] for OR, 0.2 to 1.5; OR for two or more versus no courses of antibiotics, 1.0; 95% CI for OR, 0.5 to 2.2), recurrent wheezing, allergic rhinitis, or eczema at age 5 years. There was no significant association between antibiotic use in the first year of life and having at least one of three atopic diseases (asthma, allergic rhinitis, or eczema) at age 5 years (OR for one versus no courses of antibiotics, 0.7; 95% CI, 0.4 to 1.4; OR for two or more versus no courses of antibiotics, 0.9; 95% CI, 0.5 to 1.4). Our findings do not support the hypothesis that antibiotic use in early life is associated with the subsequent development of asthma and atopy in childhood.


Source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12091174&dopt=Abstract antibiotic, antibiotics



Rev Esp Salud Publica. 2002 May-Jun;76(3):207-14.
[Characteristics of antibiotic prescription during office visits in the Hospital Cayetano Heredia in Lima, Peru]

[Article in Spanish]

Llanos-Zavalaga F, Mayca Perez J, Contreras Rios C.

Facultad de Salud Publica y Administracion Carlos Vidal Layseca, Universidad Peruana Cayetano Heredia, Instituto Nacional de Salud, Lima, Peru. fllanopch.edu.pe

BACKGROUND: The present descriptive cross-sectional study, assesses the proportion of antibiotic prescription (PPA), and the quality of it (CPA) in the ambulatory consultation of the department of medicine at the Cayetano Heredia Hospital, as an approach to antibiotic use in Peruvian hospitals. METHODS: The study population was conformed by the patients who went to outpatient care from January 8th to February 2nd, 2001; a sample size of 120 patients was determined out of 1449 patients, to assess CPA. Data on antibiotic prescription was collected, revised and qualified by three experienced physicians, using as gold standard the United States Pharmacopeial Drug Information criteria. RESULTS: PPA was 13.53% (CI 95%: 11.77%-15.29%), without significant differences according to age, sex, doctor's offices and turns. The most frequent diagnoses with antibiotic prescription were: urinary tract infection and pharyngoamigdalitis; the antibiotics more frequently prescribed were: ciprofloxacine and cotrimoxazol. Of the antibiotics, 70.00% were prescribed as non commercial name and 70.83% were registered in the National Petitory of Essential Drugs. We found that 81.67% (CI 95%: 79.68%-83.66%) of the prescriptions were inadequate mainly due to: duration (59.20%) and dose (20.00%) of the antibiotic treatment. CONCLUSIONS: PPA obtained is lower than those published in, and CPA is as high as the reported one in other studies. The investigations in this field are still scarce. It is important new research in order to know about prescription, use and adverse reactions of antibiotics. It is necessary to develop a antibiotic policy to improve access and rational use of antibiotic.


Source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12092467&dopt=Abstract antibiotic, antibiotics



Shock. 2002 Jul;18(1):69-74.
Differences in neutrophil death among beta-lactam antibiotics after in vitro killing of bacteria.

Matsuda T, Saito H, Fukatsu K, Han I, Inoue T, Furukawa S, Ikeda S, Hidemura A, Kang W.

Department of Surgery, The University of Tokyo, Japan.

Antibiotic therapy is an essential treatment for gram-negative bacterial infections. Antibiotic-induced endotoxin release and subsequent production of inflammatory cytokines reportedly depend on the type of antibiotic action. This study examined the effects of various beta-lactam antibiotics on cell death of human polymorphonuclear neutrophils (PMNs) cocultured with Escherichia coli (E. coli) in vitro. E. coli morphology after antibiotic treatment was determined. PMNs and E. coli were cocultured with antibiotics for 0, 4, or 12 h. Levels of endotoxin and cytokines (TNF-alpha, IL-1beta, and IL-6) in the supernatants were measured. The filtrates of antibiotic-treated E. coli supernatants were cocultured with PMNs for 0, 4, or 12 h. In all experiments, ampicillin (ABPC), cefazolin sodium (CEZ), cefoperazone sodium (CPZ), latamoxef sodium (LMOX), imipenem (IPM), and polymyxin B sulfate (PLB) were used at 30 microg/mL. PMNs were isolated from healthy volunteers. PMN cell death was assessed by flow cytometry and light microscopy. ABPC, CEZ, CPZ, and LMOX, which induce bacterial filament formation with lysis, caused PMN necrosis when cocultured with E. coli. In contrast, IPM, which induces bacterial spheroplast formation with lysis, caused PMN apoptosis. Levels of endotoxin, TNF-alpha and IL-6 in the supernatants with IPM and PLB were significantly lower than in those with other beta-lactam antibiotics. The filtrates of IPM- and PLB-treated E. coli supernatants induced PMN apoptosis, whereas those treated with other beta-lactam antibiotics increased PMN necrosis. Beta-lactam antibiotics have different impacts on the types of PMN cell death after E. coli killing. Underlying mechanisms and the clinical relevance of IPM-induced PMN apoptosis in severe gram-negative infection warrant further investigation.


Source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12095137&dopt=Abstract antibiotic, antibiotics



Soc Sci Med. 2003 Jan;56(2):313-20.
Online commentary during the physical examination: a communication tool for avoiding inappropriate antibiotic prescribing?

Mangione-Smith R, Stivers T, Elliott M, McDonald L, Heritage J.

Department of Pediatrics, 12-365 Marion Davies Children's Center, University of California, Los Angeles, 10833 LeConte Avenue, Los Angeles, CA 90095-1752, USA. ritamcla.edu

A previously identified communication behavior, online commentary, is physician talk that describes what he/she is seeing, feeling, or hearing during the physical examination of the patient. The investigators who identified this communication behavior hypothesized that its use may be associated with successful physician resistance to perceived or actual patient expectations for inappropriate antibiotic medication. This paper examines the relationship between actual and perceived parental expectations for antibiotics and physician use of online commentary as well as the relationship between online commentary use and the physician's prescribing decision. We conducted a prospective observational study in two private pediatric practices. Study procedures included a pre-visit parent survey, audiotaping of study consultations, and post-visit surveys of the participating physicians. Ten pediatricians participated (participation rate=77%) and 306 eligible parents participated (participation rate=86%) who were attending sick visits for their children with upper respiratory tract infections between October 1996 and March 1997. The main outcomes measured were the proportion of consultations with online commentary and the proportion of consultations where antibiotics were prescribed. Two primary types of online commentaries were observed: (1) online commentary suggestive of a problematic finding on physical examination that might require antibiotic treatment ('problem' online commentary), e.g., "That cough sounds very chesty"; and (2) online commentary that indicated the physical examination findings were not problematic and antibiotics were probably not necessary ('no problem' online commentary), e.g., "Her throat is only slightly red". For presumed viral cases where the physician thought the parent expected to receive antibiotics, if the physician used at least some 'problem' online commentary, he/she prescribed antibiotics in 91% (10/11) of cases. Conversely, when the physician exclusively employed 'no problem' online commentary, antibiotics were prescribed 27% (4/15) of the time (p = 0.07). Use of 'no problem' online commentary did not add significantly to visit length. 'No problem' online commentary is a communication technique that may provide an effective and efficient method for resisting perceived expectations to prescribe antibiotics. 2002 Elsevier Science Ltd.


Source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12473316&dopt=Abstract antibiotic, antibiotics



Surg Today. 2002;32(7):581-6.
Changes in the intestinal flora after the administration of prophylactic antibiotics to patients undergoing a gastrectomy.

Takesue Y, Yokoyama T, Akagi S, Ohge H, Imamura Y, Murakami Y, Sueda T.

First Department of Surgery, Hiroshima University School of Medicine, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan.

PURPOSE: Changes in the intestinal flora were investigated in patients administered antibiotics for 4 days after a gastrectomy. METHODS: Twenty-four patients were divided into each of the following groups: cefazolin, 1 g every 8 h; cefozopran, 0.5 g every 8 h; flomoxef, 1 g every 8 h. All drugs were administered intravenously for a 4-day period. RESULTS: Antibiotic prophylaxis caused no major change in the total number of anaerobes because of the preservation of the Bacteroides fragilis group. However, the number of Bifidobacterium, Lactobacillus, Eubacterium, and Veillonella spp. decreased by an average of 100-fold. These changes were accompanied by an overgrowth of Enterococcus spp. and Pseudomonas aeruginosa. CONCLUSIONS: Four days of antibiotic prophylaxis after surgery caused a suppression of colonization resistance in the intestinal flora. Certain genera of anaerobes may thus play an important role in preventing overgrowth of antibiotic-resistant organisms after surgery. Surgeons should decide the duration of antibiotic use after carefully considering its influence on the intestinal flora.


Source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12111513&dopt=Abstract antibiotic, antibiotics



Arch Microbiol. 2002 Aug;178(2):102-14. Epub 2002 May 14.
Cloning and analysis of the simocyclinone biosynthetic gene cluster of Streptomyces antibioticus Tu 6040.

Galm U, Schimana J, Fiedler HP, Schmidt J, Li SM, Heide L.

Pharmazeutische Biologie, Pharmazeutisches Institut, Auf der Morgenstelle 8, 72076 Tubingen, Germany.

The biosynthetic gene cluster of the aminocoumarin antibiotic simocyclinone D8 was cloned by screening a cosmid library of Streptomyces antibioticusTu 6040 with a heterologous probe from a gene encoding a cytochrome P450 enzyme involved in the biosynthesis of the aminocoumarin antibiotic novobiocin. Sequence analysis of a 39.4-kb region revealed the presence of 38 ORFs. Six of the identified ORFs showed striking similarity to genes from the biosynthetic gene clusters of the aminocoumarin antibiotics novobiocin and coumermycin A(1). Simocyclinone also contains an angucyclinone moiety, and 12 of the ORFs showed high sequence similarity to biosynthetic genes of other angucyclinone antibiotics. Possible functions within the biosynthesis of simocyclinone D8 could be assigned to 23 ORFs by comparison with sequences in GenBank. Experimental proof for the function of the identified gene cluster was provided by a gene inactivation experiment, which resulted in the abolishment of the formation of the aminocoumarin moiety of simocyclinone. Feeding of the mutant with the aminocoumarin moiety of novobiocin led to a new, artificial simocyclinone derivative.


Source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12115055&dopt=Abstract antibiotic, antibiotics



Ann R Coll Surg Engl. 2002 Nov;84(6):422-5.
An investigation into the sensitivities of translocating bacteria to a prophylactic antibiotic regimen.

Woodcock NP, Mahadeva S, Sudworth P, Johnstone D, MacFie J.

Combined Gastroenterology Unit, Scarborough Hospital, North Yorkshire, UK.

INTRODUCTION: It is well established that bacterial translocation is associated with a significant increase in septic morbidity. The purpose of this study was to determine the antibiotic sensitivities of translocating bacteria on the basis that this information may influence antibiotic prophylaxis in surgical patients. METHODS: Routine microbiological techniques were used to assess the antibiotic sensitivities of those bacteria cultured from a mesenteric lymph node harvested at laparotomy in a large series of patients. RESULTS: Culture of the mesenteric lymph nodes yielded growth in 51 out of a total of 447 patients studied (11.4%). The isolates from 40 patients, a total of 60 organisms, were available for sensitivity testing. The most common species grown was Escherichia coli (48% of isolates). Thirty-three patients (83%) grew organisms sensitive to the antibiotic prophylaxis used, but there was no significant difference in the incidence of postoperative septic complications between these patients and those in whom resistant bacteria were grown (39% versus 29%, P = 0.64 Fisher's Exact test mid P). CONCLUSIONS: The majority of translocating bacteria are sensitive to the prophylactic antibiotics commonly used in patients undergoing laparotomy. However, the occurrence of postoperative septic morbidity is independent of this variable.


Source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12484584&dopt=Abstract antibiotic, antibiotics