Helicobacter. 2002 Dec;7(6):364-6.
No association between Helicobacter pylori genotypes and antibiotic resistance phenotypes within families.

Zschausch HC, Han SR, Meyer HG, Maeurer MJ.

Institute of Medical Microbiology, University of Mainz, Hochhaus Augustusplatz, 55101 Mainz, Germany.

BACKGROUND: Triple therapy combining a proton pump inhibitor with two antibiotics, e.g. clarythromycin (CLR), metronidazole (MTZ) or amoxicillin (AMX), represents the standard in Helicobacter pylori eradication regimens. Resistance to antimicrobial agents, particularly MTZ (up to 56% in Western countries) and CLR (up to 15% in southern Europe), is frequently observed and may be associated with treatment failure [1]. Recently, several studies indicated that individual H. pylori colonies from a single anatomic site may not always yield identical genotypes, or the identical patterns of susceptibility to antibiotics [2-5]. Representative for every single patient we analyzed 27 H. pylori antrum isolates for susceptibility to antimicrobial agents in order to test whether identical H. pylori genotypes exhibit a similar pattern of susceptibility to antibiotics. METHODS: PCR, RELP, PFGE, antibiotic susceptibility testing. RESULTS: H. pylori genotype and antibiotic susceptibility pattern in families do not segregrate. CONCLUSION: Molecular typing of H. pylori from family members does not predict antibiotic susceptibility pattern.


Source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12485123&dopt=Abstract antibiotic, antibiotics



Pharmacol Res. 2002 May;45(5):369-74.
Exploring the variability in antibiotic prescribing profiles among paediatricians from two different areas of Italy.

Cucinotta G, Mazzaglia G, Toscano MA, Arcoraci V, Tempera G, Salmeri M, Rosignoli M, Bottaro G, Boccazzi A, Nicoletti G, Caputi AP.

Institute of Pharmacology, School of Medicine, University of Messina, Italy.

We carried out a multicentre community-based study in order to describe the antibiotic therapeutic approach of paediatricians from two different areas of Italy in the treatment of respiratory tract infection (RTIs), and to assess which factors are involved in a possible variability of prescribing habits. Forty paediatricians participated in the study between October 1998 and April 1999. They had to complete a questionnaire for each therapeutic intervention resulting in an antibiotic prescription. A logistic regression model was used to identify possible predictors in choosing parenteral antibiotics for the treatment of RTIs. In 2 975 questionnaires of antibiotic treatment, RTIs represented 90.2% of the total antibiotics used. Upper respiratory tract infections were the most commonly treated diagnostic group (59.6%), followed by lower respiratory tract infections (20.4%), and middle ear infections (19.8%). Statistically significant differences between northern and southern Italy were reported in the antibiotic prescription profile and the duration of the therapy. Another marked difference was reported in the frequency of laboratory analysis requests. The logistic regression model indicated that the use of parenteral antibiotics appears significantly related to the type of infections [lower RTIs: (OR: 3.99; 95% CI: 2.49-6.37)], the geographic location [northern Italy: (OR: 0.20; 95% CI: 0.20-0.39)], and the presence of concurrent diseases (OR: 3.21; 95% CI: 1.46-7.02). The lack of adherence to clinical guidelines and the marked variability of antibiotic prescription rates between different areas of the country appear to be related to factors other than bacterial resistance, and highlight the importance of carrying out educational programmes targeted at the national level for improving the antibiotic prescription habits for the treatment of RTIs.


Source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12123624&dopt=Abstract antibiotic, antibiotics



J Fam Pract. 2002 Nov;51(11):954-9.
Delayed antibiotic prescriptions: what are the experiences and attitudes of physicians and patients?

Arroll B, Goodyear-Smith F, Thomas DR, Kerse N.

Division of General Practice Primary Health Care, Faculty of Medical Health Sciences, University of Auckland Private Bag 92019, Auckland, New Zealand. b.arroluckland.ac.nz

OBJECTIVE: To explore the experiences and opinions of family physicians and patients regarding the delay of antibiotic prescriptions, to be dispensed if symptoms persist or worsen over time, in treating upper respiratory tract infections. STUDY DESIGN: Qualitative study using semistructured interviews conducted in family practice in Auckland, New Zealand. POPULATION: Thirteen physicians recruited from a study of family physicians' reported antibiotic prescribing and 13 patients recruited from the intervention arm of a randomized controlled trial on delayed antibiotic prescribing. OUTCOMES MEASURED: Patients' and physicians' experiences of delayed antibiotic prescriptions for upper respiratory tract infections. RESULTS: The primary themes identified were value judgments of antibiotics, decreased antibiotic use, patient-centered factors, effects on the physician-patient relationship, patient convenience, adverse effects of delaying prescription, and selectivity for use of antibiotics. Many themes were common to both patients and physicians. Physicians valued empowering patients' decision making about their health care management more highly than did patients. Decreasing antibiotic use was not a key factor for most patients. Both groups acknowledged the value in saving patients time and money. Physicians viewed the strategy as giving patients reassurance and meeting their expectations for antibiotics. Negative implications included perception of physician incompetence and physician loss of management control. Opinions were mixed regarding which patients, under which conditions, were suitable for delayed antibiotic prescriptions. CONCLUSIONS: Although delayed antibiotic prescriptions are effective in decreasing antibiotic use for conditions not clinically warranting antibiotics, neither patients nor physicians universally endorsed this strategy. Research to establish formalized recommendations for patient suitability and instructions for use would be of value.


Source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12485551&dopt=Abstract antibiotic, antibiotics



Int J Clin Pract. 2002 Jun;56(5):353-6.
The choice of antibiotic in open fractures in a teaching hospital in a developing country.

Alonge TO, Salawu SA, Adebisi AT, Fashina AN.

Department of Surgery, University College Hospital, Ibadan, Nigeria.

Open fracture wounds may be contaminated, and the use of an appropriate antibiotic in the early stages of management reduces the risk of osteomyelitis developing. Environmental factors influence both the type of micro-organisms that are isolated from these wounds and the antibiotics that are chosen to manage the wounds. Before this study, the choice of antibiotic in the management of open fractures in our hospital was based on tradition and 'best guess' antibiotics. In a prospective study of 52 open fractures seen in the accident and emergency unit of University College Hospital, Ibadan, between January and June 2000, the positive bacterial culture yield was more than 70%. Staphylococcus aureus was the commonest microbial isolate, accounting for 37.5% of total isolates. The antibiotic sensitivity pattern revealed high efficacies for pefloxacin, ciprofloxacin and ceftriaxone against the isolated micro-organisms. In comparative costs, these antibiotics are cheaper than the combination of the 'best guess' antibiotics that were used previously. On the strength of this finding, we have suggested a change in the antibiotic policy of the hospital with regard to the antibiotic regimen to be used to complement the surgical management of open fractures.


Source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12137444&dopt=Abstract antibiotic, antibiotics



Protein Pept Lett. 2002 Aug;9(4):275-82.
CRAMP analog having potent antibiotic activity without hemolytic activity.

Kang SW, Lee DG, Yang ST, Kim Y, Kim JI, Hahm KS, Shin SY.

Department of Chemistry, Pusan National University, Pusan, 609-735, Korea.

CRAMP-18 is an 18-residue functional region, corresponding to residues 16-33 of a mouse-derived antibiotic peptide CRAMP. To develop novel antibiotic peptides possessing strong antibiotic activity against bacterial, fungal and tumor cells without hemolytic activity, three analogs of CRAMP-18 were synthesized containing either Leu- or Lys-substitution. Leu-substitution ([L(1, 8)]-CRAMP-18) in the hydrophobic helix face of CRAMP-18 induced a dramatic increase in antibiotic activity without a significant increase in hemolytic activity. Lys-substitution ([K(2, 13)]-CRAMP-18 or [K(9, 16)]-CRAMP-18) in the hydrophilic helix face produced a smaller response. Therefore, [L(1, 8)]-CRAMP-18 may be an attractive candidate for developing novel peptide antibiotics.


Source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12144503&dopt=Abstract antibiotic, antibiotics



Eur J Intern Med. 2002 Aug;13(5):324-328.
Modern management of non-chemotherapy drug-induced agranulocytosis: a monocentric cohort study of 90 cases and review of the literature.

Andres E, Maloisel F, Kurtz JE, Kaltenbach G, Alt M, Weber JC, Sibilia J, Schlienger JL, Blickle JF, Brogard JM, Dufour P.

Department of Internal Medicine, Service de Medecine Interne, Clinique Medicale B, Hopitaux Universitaires de Strasbourg, 1 Place de l'Hopital, 67 091 Cedex, Strasbourg, France

BACKGROUND: The present study reports a monocentric experience of 90 drug-induced agranulocytosis cases and discusses their management, in particular the role of hematopoietic growth factors. METHODS: Data from 90 patients with drug-induced agranulocytosis who met the criteria of the IAAAS group and of Benichou and Solal-Celigny [Nouv Rev Fr Hematol 1993; 33: 257.] were retrospectively reviewed. All cases were extracted from a cohort study of the Hopitaux Universitaires de Strasbourg, France. Data were specifically analyzed with regard to the use of hematopoietic growth factors (in 42 patients). RESULTS: Mean patient age was 63 (range 17-95) years and the sex ratio (M/F) was 0.39. An underlying disease was present in 37% of the patients. Antibiotics (25%), antithyroid drugs (23%), and antiaggregative platelet agents (16%) were the most frequent causative drugs. Main clinical features included isolated fever (41%), septicemia or septic shock (31%), and pneumonia (10%). Mean neutrophil count was 0.13 (range 0-0.46)x10(9)/l. Outcome was favorable in 98% of patients. The mean durations of hematological recovery (neutrophil count over 1.5x10(9)/l), antibiotic therapy, and hospitalization was 8.5 (range 2-21) days, 9.2 (range 2-21) days, and 10.5 (range 3-23) days, respectively. All patients were treated with broad-spectrum antibiotics and 42 patients with hematopoietic growth factors. In these 42 patients, the mean durations for hematological recovery, antibiotic therapy, and hospitalization were significantly reduced at: 6.3 (range 2-16) days, 7.1 (range 2-16) days, and 9.1 (range 3-23) days, respectively (all P<0.05). CONCLUSIONS: The present study shows that new causative drugs are emerging (antibiotics, antithyroid, and antiaggregative platelet agents), that drug-induced agranulocytosis remains typically a serious accident with severe sepsis, and that modern management with broad spectrum antibiotics and hematopoietic growth factors may reduce the mortality.


Source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12144912&dopt=Abstract antibiotic, antibiotics [PubMed - as supplied by publisher]



Presse Med. 2002 Jun 15;31(21 Pt 2):S15-8.
[Update on the use of levofloxacin in the management of acute exacerbations of chronic bronchitis with risk factors]

[Article in French]

Zuck P.

Service de Pneumologie, CHR de Metz-Thionville 57038 Metz.

INDICATIONS FOR ANTIBIOTICS: In patients with acute exacerbation of chronic bronchitis depend on the stage of the chronic disease. Theoretically, antibiotics are not necessary for acute exacerbation of simple chronic bronchitis, but may be needed to reinforce bronchodilatation therapy and respiratory physical therapy. If fever persists for more than three days, group 1 antibiotics can be prescribed. In a second stage (obstructive chronic bronchitis), antibiotic therapy can be useful for patients with two or three Anthonisen criteria: group 1 antibiotics for occasional exacerbation, group 2 antibiotics in case of failure or as first line treatment for patients with frequent exacerbations; anti-pneumococcal fluoroquinolones are a possible alternative. At a third stage (chronic respiratory failure), first line therapy should include group 2 antibiotics. THE BRONCHEA STUDY: Was designed to search for risk factors favoring frequent acute exacerbation of chronic bronchitis in adults. The findings suggest that certain classical risk factors such as age should be revisited. This study demonstrated the crucial need for rigorous surveillance by a lung specialist, the importance of not smoking, and the beneficial effect of optimized treatment. It was also found that earlier initiation of group 2 antibiotic therapy may be useful for patients with a high risk of exacerbation.


Source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12148385&dopt=Abstract antibiotic, antibiotics