Clin Microbiol Infect. 2002 Sep;8(9):598-603.
Prevalence of antibiotic resistance of Helicobacter pylori isolates in Estonia during 1995-2000 in comparison to the consumption of antibiotics used in treatment regimens.

Loivukene K, Maaroos HI, Kolk H, Kull I, Labotkin K, Mikelsaar M.

Department of Microbiology, University of Tartu, Tartu, Estonia Department of Polyclinic and Family Medicine, University of Tartu, Tartu, Tartu, Estonia. Krista.Loivukliinikum.ee

OBJECTIVE: To find a possible relation between the dynamics of antibiotic resistance of Helicobacter pylori isolates and the consumption of antibiotics during the last several years in Estonia. METHODS: Helicobacter pylori isolates were collected from the gastric mucosa of patients with peptic ulcer (153) and gastritis (68) and isolated on the Columbia Agar Base. From 1995 to 1997 the disk-diffusion method was used for testing of H. pylori susceptibility to metronidazole (115 isolates), erythromycin (119 isolates), tetracycline (119 isolates) and amoxicillin (119 isolates). From 1998 to 2000 the susceptibility of H. pylori to metronidazole (106 isolates), amoxicillin (30 isolates), clarithromycin (106 isolates) and ciprofloxacin (30 isolates) was assessed by E tests. Data from the Estonian State Agency of Medicines were used to determine the antibiotic consumption rate. RESULTS: Up to the year 2000 all the investigated H. pylori isolates were susceptible to ciprofloxacin; the resistance to clarithromycin, tetracycline, amoxicillin and erythromycin was 3%, 1.7%, 0.7% and 2.5%, respectively. Forty-six percent of H. pylori isolates were resistant to metronidazole. During 1995-2000 the consumption of amoxicillin, erythromycin and ciprofloxacin increased and the consumption of tetracycline decreased. The increasing consumption of amoxicillin reached a level 5.7 times than that of the consistent use of metronidazole. The resistance to amoxicillin appeared to be very low and resistance to metronidazole was continuously high. The increase of clarithromycin consumption (from 0.002 to 1.119 defined daily doses/1000) during three years was associated with the appearance of the first clarithromycin-resistant isolates in 2000. CONCLUSION: No relation was observed between the antibiotic consumption rate and the resistance pattern of H. pylori to metronidazole, amoxicillin, erythromycin, tetracycline and ciprofloxacin during recent years among the in population.


Source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12427220&dopt=Abstract antibiotic, antibiotics



Fam Pract. 2002 Dec;19(6):638-40.
The more time spent on listening, the less time spent on prescribing antibiotics in general practice.

Lundkvist J, Akerlind I, Borgquist L, Molstad S.

Department of Pharmaceutical Services Research, Uppsala University, Sweden. jonas.ealtheconomics.se

OBJECTIVE: To analyse the variation between primary care centres (PCCs) with regard to prescribing antibiotics and to investigate whether the variation can be explained by factors related to patient satisfaction and to socio-demographic characteristics of the populations in the catchment areas of the PCCs. METHODS: The frequency of prescription of antibiotics by GPs at the PCCs was used as the dependent variable in a multivariate regression analysis. Questionnaire data for patient satisfaction and register data for socio-demographic characteristics were used as explanatory variables. The study was set in a county in south-east Sweden, and 6734 patients consulting GPs at 39 out of the 41 PCCs in the county participated. Variables correlating with the frequency of antibiotics prescription at PCC level and with patient satisfaction were the main outcome measures. RESULTS: A seven-fold variation in the extent of the prescription of antibiotics between the PCCs was observed. In the multivariate analysis, a high antibiotic prescription rate relates to high overall patient satisfaction with GP consultation as well as to the share of males in the listed population but to low satisfaction with the time spent by the GP on listening to the patient. CONCLUSION: A high frequency of prescription of antibiotics at a PCC may reflect a general disposition among GPs to give priority to maintaining good relations with the patients. However, a low level of prescription may be consistent with patient satisfaction if more time is spent on listening to and informing the patients. Thus more time spent on listening to the patients may reduce the prescription of antibiotics without reducing patient satisfaction.


Source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12429667&dopt=Abstract antibiotic, antibiotics



Antimicrob Agents Chemother. 2003 May;47(5):1665-71.
Wolbachia pipientis growth kinetics and susceptibilities to 13 antibiotics determined by immunofluorescence staining and real-time PCR.

Fenollar F, Maurin M, Raoult D.

Unite des Rickettsies, CNRS UMR 6020, IFR 48, Faculte de Medecine, Universite de la Mediterranee, 13385 Marseille cedex 05, France.

Wolbachia spp. are strict intracellular bacteria that infect a wide range of arthropods and filarial nematodes. Filarial nematodes are important causes of human diseases. There is increasing evidence that Wolbachia spp. influence important functions in the biology of the hosts, specifically, infertility. Preliminary experiments with humans and animals have suggested that antibiotics with activity against Wolbachia may help to treat filariasis. In this study, we determined using a real-time quantitative PCR assay the growth kinetics of a strain of Wolbachia pipientis from a mosquito grown in Aa23 cells. The doubling time was estimated to be 14 h. We then determined the susceptibilities of this strain to 13 antibiotics by two methods: an immunofluorescent-antibody test and a real-time quantitative PCR assay. Both techniques gave similar results. Doxycycline and rifampin were the most effective compounds, with MICs of 0.125 and 0.06 to 0.125 micro g/ml, respectively. Fluoroquinolones were less effective, with MICs of 2 to 4 micro g/ml for ciprofloxacin, 2 micro g/ml for ofloxacin, and 1 micro g/ml for levofloxacin. beta-Lactams (penicillin G, amoxicillin, ceftriaxone) were not effective at concentrations up to 128 micro g/ml. The MIC of erythromycin was >32 micro g/ml, whereas that of telithromycin was 8 micro g/ml. Other antibiotic compounds were bacteriostatic only at high concentrations, including gentamicin, co-trimoxazole, and thiamphenicol. The real-time PCR assay was a convenient and reliable technique for determination of the antibiotic susceptibilities of WOLBACHIA: It may help in the future to simplify antibiotic susceptibility testing of strict intracellular pathogens.


Source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12709338&dopt=Abstract antibiotic, antibiotics



Infez Med. 2000;8(2):74-81.
[Antibiotics and kidney]

[Article in Italian]

Nardiello S, Catapano F, Galanti B.

Istituto di Malattie Infettive e Cattedra di Nefrologia, Seconda Universita degli Studi di Napoli, Italy.

Renal excretion is the most important route of elimination for the majority of antibiotics, and some antibiotics may cause renal injury by direct and/or immunologic mechanisms. These conditions determine a dose relationship between antibiotic therapy and renal function. In this review we report some practical guidelines for the correct administration of antibiotics in patients with decreased renal function. Currently used antibiotics that are most frequently associated to nephrotoxicity are also examined, and for each of them the incidence and degree of renal damage, pathogenic mechanisms and preventive measures are reported. This review emphasizes the need for a careful assessment of renal function in patients with acute and chronic infections undergoing antibiotic therapy.


Source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12709599&dopt=Abstract antibiotic, antibiotics [PubMed - as supplied by publisher]



J Vet Med B Infect Dis Vet Public Health. 2003 Feb;50(1):27-30.
Differences in antibiotic resistance in Escherichia coli, isolated from East-European swine herds with or without prophylactic use of antibiotics.

Docic M, Bilkei G.

Bilkei Consulting, Dubendorf, Switzerland.

The aim of the study was to compare the resistance patterns of Escherichia coli isolates from pig herds with or without prophylactic use of anti-microbial substances. The presented pig units received either antibiotics or oregano as preventive feed additives. The trial was performed from April to October 2001, in the large 'country-corner', Hungary-Rumania-Serbia. Thirty of 39 evaluated herds suffered E. coli O139 K88 ac or ad LT STb caused losses, the remaining were negative for E. coli O139. Thirteen of the selected 30 herds produced with oregano feed supplementation (Oregpig Pecs, Hungary) antibiotic-free pigs. These units had no history of prophylactic antibiotic use since 1995. The remaining 17 herds routinely used prophylactic antibiotic feed supplementation. In each herd, pigs of four different age groups (suckling piglets, weaners. fattening swine and breeding sows), showing the clinical symptoms of wasting, were investigated. E. coli O139 K88 ac or ad LT STb were tested for their resistance to antibiotics, available in this region. Oregano-fed herds demonstrated high significantly (P < 0.001) lower MICs (microg/ml) for ampicillin, doxycyclin, enrofloxacin, gentamycin, oxytetracyclin and sulfamethacin compared to herds with prophylactic use of antibiotics. Resistance to ceftiofur revealed significant (P < 0.05) differences between the antibiotic- or oregano-treated units. The present results confirm literature data, that prophylactic use of antibiotics likely plays a role in inducing resistance of E. coli and other intestinal bacteria. Thus, imposing greater restrictions on antibiotic use in animal agriculture is likely to reduce but not eliminate the occurrence of resistant isolates.


Source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12710497&dopt=Abstract antibiotic, antibiotics



Infez Med. 2000;8(3):156-166.
[Pharmaco-economic evaluation of antibiotic therapy in a ward for infections diseases]

[Article in Italian]

Sabbatani S, Cannella B, Fulgaro C, Pipitone E, Cesari R.

Unita Operativa Malattie Infettive, Ospedale Maggiore di Bologna, Italy.

For all hospitalized patients admitted in the first six months of 1999, we recorded the data relative to antibiotic therapy (TA) administered, establishing the period of treatment in days and the dosage, including any variations during the period in question. We calculated the prescribed daily dose (PDD) and were thus able to establish the expense incurred in antibiotic therapy, comparing the real overall cost per product used. For all patients, the discharge diagnosis was reported, and the whole case-study was aggregated into homogeneous groups. PDD was compared with DDD (defined daily doses). The Pareto curve was used to highlight the antibiotics with higher overall cost. Besides cotrimoxazole, ceftriaxone and ciprofloxacin were the antibiotics most frequently prescribed, while ceftriaxone, imipenem-cilastatine and vancomycin were the antibiotics incurring the greatest expense. With reference to the average duration of the treatment cycle, ceftriaxone (9.75 dd) and ciprofloxacin tbl (6.75 dd) were the only antibiotics (in monotherapy) used for less than 10 treatment days. Special attention was paid to analysing the TA costs in treating pneumonia, which accounted for the highest percentage of cases (50 cases). Ceftriaxone, especially pulmonary infections, was the most commonly used drug. In hospitalized subjects treated who show good therapeutic response, we recommend early discharge and continuation of the therapy at home (switch therapy). This strategy will allow the patient to return to his/her family in good time, also thereby reducing hospital management costs.


Source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12711894&dopt=Abstract antibiotic, antibiotics [PubMed - as supplied by publisher]



Med Pregl. 2002 Nov-Dec;55(11-12):506-12.
[Use of antibiotics in otorhinolaryngologic practice]

[Article in Serbo-Croatian (Roman)]

Stefan-Mikic S, Sabo A, Jovancevic L, Jovicevic J, Vasovic M, Jakovljevic V.

Klinika za infektivne bolesti, 21000 Novi Sad, Hajduk Veljkova 1-3. stefannunet.yu

INTRODUCTION: This study investigated utilization of antibacterial agents at the Ear, Nose and Throat Department of the Outpatient Service of the Health Center Novi Sad-Liman and at the Ear, Nose and Throat Clinic of the Clinical Center Novi Sad, in the period February-March 2001. MATERIAL AND METHODS: All antibacterial agents were classified as group J, regarding Anatomic-Therapeutic-Chemical Classification. Data on drug utilization were presented in Defined Daily Doses (DDD). Patients who were under observation were all treated with antibiotics. RESULTS: In regard to prescribed treatment in the Ear, Nose and Throat Department of the Outpatient Service of the Health Center Novi Sad-Liman, most outpatients were treated with macrolide antibiotics--in 26.21%; combination of penicillin and beta-lactamase inhibitors in 20.83% and pyranosides in 16.12%. At the Ear, Nose and Throat Clinic of the Clinical Center Novi Sad, macrolides and lincosamines were most frequently used--in 20.46%; cephalosporins in 19.87% and penicillins susceptible to beta-lactamase in 18.85%. It is extremely positive and in agreement with current pharmacotherapeutic principles that in both institutions peroral ampicillins have not been prescribed. Aminoglycosides have been prescribed in less than 1% of patients of the Ear, Nose and Throat Department of the Outpatient Service of the Health Center Novi Sad-Liman, whereas they were much more frequently prescribed at the Ear, Nose and Throat Clinic of the Clinical Center Novi Sad--in 11.25%. Although there is a positive postantibiotic effect in regard to these antibiotics and it is recommended to use them once a day, in both examined institutions aminoglycosides were given twice a day. In regard to bacterial identification it was done in 80.76% of patients of the Ear, Nose and Throat Department of the Outpatient Service of the Health Center Novi Sad-Liman, while in the Ear, Nose and Throat Clinic of the Clinical Center Novi Sad it was done only in 32.42%. CONCLUSIONS: Although treatment performed on empirical basis and clinical findings is usually correct, a greater percentage of antibiotic prescriptions should be confirmed by antibiograms providing optimal therapy and decreased degree of resistance.


Source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12712895&dopt=Abstract antibiotic, antibiotics