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Recent News and Articles on the Keywords: antibiotic use + acute care + care  Related to the article below (Last Update: 5/12/2008)

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I explained that it wasn't antibiotic use that was the issue, but the overall health of the child at the time of the vaccination. ...
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PR-Inside.com (Pressemitteilung), Austria - May 9, 2008
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Source: Google News

Reducing antibiotic use for acute bronchitis in primary care: blinded, randomised controlled trial … -
J Macfarlane, W Holmes, P Gard, D Thornhill, R … - BMJ: British Medical Journal, 2002 - pubmedcentral.nih.gov
... Copyright ? 2002, BMJ. Reducing antibiotic use for acute bronchitis in primary care:
blinded, randomised controlled trial of patient information leaflet. ...

… care based randomised, double blind trial of amoxicillin versus placebo for acute otitis media in … -
RAMJ Damoiseaux, FAM van Balen, AW Hoes, TJM … - BMJ: British Medical Journal, 2000 - pubmedcentral.nih.gov
... otitis media, regular attendance at a day care centre, and ... of 240 children randomised
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Antibiotic Resistance Among Gram-Negative Bacilli in US Intensive Care Units: Implications for … -
MM Neuhauser, RA Weinstein, R Rydman, LH Danziger, … - JAMA: The Journal of the American Medical Association, 2003 - jama.waldenu.edu
... among aerobic gram-negative bacilli in intensive care units in 5 ... Principles of
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Decreasing Antibiotic Use in Ambulatory Practice Impact of a Multidimensional Intervention on the … -
R Gonzales, JF Steiner, A Lum, PH Barrett, Jr - JAMA, 1999 - Am Med Assoc
... coupled with an increase in the use of a diagnosis for which antibiotics are
appropriate ... office visit rates for adults with uncomplicated acute bronchitis at ...

… of Clostridium difficile Infection in a Long-Term Care Facility: Association with Gatifloxacin Use -
R Gaynes, D Rimland, E Killum, HK Lowery, TM … - Clinical Infectious Diseases, 2004 - UChicago Press
... contacts of patients with antibiotic-associated colitis ... associated diarrhea in an
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Parenteral Antibiotic Use in Acute-Care Hospitals: A Standardized Analysis of Fourteen Institutions -
PC Carling, T Fung, JS Coldiron - Clinical Infectious Diseases, 1999 - UChicago Press
... Parenteral Antibiotic Use in Acute-Care Hospitals: A Standardized Analysis of Fourteen
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How Good Is the Quality of Health Care in the United States?. -
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Antimicrobial Use in Long-Term-Care Facilities -
LE Nicolle, DW Bentley, R Garibaldi, EG Neuhaus, … - Infection Control and Hospital Epidemiology, 2000 - UChicago Press
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… Broad-Spectrum Antibiotic Prescribing for Acute Respiratory Tract Infections in Adult Primary Care -
MA Steinman, CS Landefeld, R Gonzales - JAMA, 2003 - Am Med Assoc
... sore throat by community primary care physicians: a ... for the treatment of acute
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Source: Google Scholar

Investigating antibiotic use in acute care patients

Pigs could be the key to understanding how antibiotic resistant bacteria persist in Intensive Care Units in hospitals.

NSW Department of Primary Industries (NSW DPI) Immunology & Molecular Diagnostic Research Unit Team Leader, Dr James Chin, says it is commonly believed that each time an antibiotic is used only pathogens or disease-causing bacteria will be killed.

"Antibiotic use in hospitals is often perceived to be solely directed against only bad bacteria.

"In reality, antibiotics also act against entire microbial communities, including the good bacteria which can protect patients from pathogenic bacteria.

"Antibiotics do not just eliminate bad bacteria", Dr Chin said. "They also maintain a pool of antibiotic resistance genes within the microbial community of patients treated with antibiotics."

Using pigs as a model, Dr Chin and Dr Toni Chapman at NSW DPI’s Elizabeth Macarthur Agricultural Institute have examined how E.coli bacteria – a common cause of diarrhoea in pigs and humans - respond to treatment by antibiotics.

Dr Chin told the 2007 Australian Society for Microbiology’s annual conference in Adelaide in July that: "The current theory of antibiotic resistance is that the ‘fittest’ bacteria, that is, those carrying genes for resistance, are the most likely to survive.

"Because antibiotic treatment will never kill all bacteria, bad or good, there will always be a pool of antibiotic resistance bacteria that can potentially transfer resistance to incoming pathogens. 

"It is important to identify the antimicrobial resistant gene pool in entire microbial communities before antibiotic treatment.

Dr Chin said this has been tested with E. coli in pigs.

"Our research shows clearly that  use of one antibiotic to treat E. coli not only increases resistance against that antibiotic but also increases the carriage of resistance genes against other classes of antibiotics. 

"This creates a real problem because subsequent therapy with a second antibiotic may be ineffective because resistance against the second antibiotic had already been increased by the first antibiotic."

In the United States an estimated 10 percent of patients get sick because of infections acquired whilst being treated in hospital. More careful use of antibiotics is regarded as vital.

Dr Chin said the use of antibiotics for disease prevention is critical in patients admitted to intensive care. However there is currently a major bottleneck when it comes to deciding which antibiotics to use.

"Current protocols require pathogens to be cultured, leading to delays of some days before the bacteria to be targeted can be accurately identified.

Dr Chin said for this reason it is important to develop a molecular detection method that can identify antibiotic resistance signatures of entire microbial communities.  

"Our hope is that this kind of information will equip clinicians to better manage prescribing of antibiotics."

This latest research is being planned in collaboration with clinical microbiologists and intensive care specialists at Westmead Hospital.

Contact: Dr James Chin, Elizabeth Macarthur Agricultural Institute, (02) 4640 6359, james.chin@dpi.nsw.gov.au.
 
 
 
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