Shortening antibiotic duration in the treatment of acute cholangitis: rationale and study protocol for an open-label randomized controlled trial

DiscussionThis trial is expected to reveal whether SCT is non-inferior to conventional LCT or not, and may provide evidence that one can shorten the treatment duration for acute cholangitis for the benefit of patients.Trial registrationUniversity Hospital Medical Information Network,UMIN000028382. Registered on 30 August 2017.
Source: Trials - Category: Research Source Type: clinical trials

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Antimicrobial resistance in N'Djamena (Chad): Four-year experience of the French Forward Medical and Surgical Team engaged in the "Barkhane Operation". Med Mal Infect. 2020 Feb 05;: Authors: Cardinale M, Bourbotte-Salmon F, Scheiwe C, Boulezaz S, Ridet M, Laitselart P Abstract OBJECTIVES: Knowledge of local antimicrobial resistance (AMR) patterns is required for effective empirical treatment of bacterial diseases. Very little is known about current resistance patterns of common pathogenic bacteria in the African region and particularly in the Sahel region. We aimed to describe the local bacte...
Source: Medecine et Maladies Infectieuses - Category: Infectious Diseases Tags: Med Mal Infect Source Type: research
This study also demonstrates the need for vigilance in the form of surveillance for AMR based on robust sampling to manage AMR risks in the food-chain.ImportanceCampylobacter is one of the most common causes of gastroenteritis in humans with infections frequently resulting from exposure to under-cooked poultry products. Although human illness is typically self-limiting, a minority of cases do require antimicrobial therapy. Ensuring that Campylobacter originating from meat-chickens do not acquire resistance to fluoroquinolones is therefore a valuable outcome for public-health. Australia has never legalised the use of fluoro...
Source: Applied and Environmental Microbiology - Category: Microbiology Authors: Tags: Appl Environ Microbiol Source Type: research
AbstractAntimicrobial de-escalation (ADE) is defined as the discontinuation of one or more components of combination empirical therapy, and/or the change from a broad-spectrum to a narrower  spectrum antimicrobial. It is most commonly recommended in the intensive care unit (ICU) patient who is treated with broad-spectrum antibiotics as a strategy to reduce antimicrobial pressure of empirical broad-spectrum therapy and prevent antimicrobial resistance, yet this has not been convincingl y demonstrated in a clinical setting. Even if it appears beneficial, ADE may have some unwanted side effects: it has been associated wi...
Source: Intensive Care Medicine - Category: Intensive Care Source Type: research
Minimising antimicrobial overuse is needed to limit antimicrobial resistance. There is little evidence on how often microbiological testing informs antimicrobial de-escalation (e.g. stopping, shortening durati...
Source: BMC Infectious Diseases - Category: Infectious Diseases Authors: Tags: Research article Source Type: research
ConclusionsThe crude mortality rate was significantly higher in patients with a VIM-PA bacteremia compared to patients with a CS-PA bacteremia; however, when analyzing the data in a multivariable model this difference was non-significant. Awareness of the presence ofP. aeruginosa in the hospital environment that may be transmitted to patients and rapid microbiological diagnostics are essential for timely administration of appropriate antibiotics. Acquisition ofP. aeruginosa should be prevented, independent of resistance profile.
Source: Antimicrobial Resistance and Infection Control - Category: Infectious Diseases Source Type: research
ConclusionsThe combination of fosfomycin and doxycycline should be evaluated further with additional LRVREF isolates. In vivo studies should also be performed prior to usage in clinical situations.
Source: Journal of Global Antimicrobial Resistance - Category: Infectious Diseases Source Type: research
ConclusionVancomycin resistance did not influence outcome among patients withEnterococcus faecium bacteraemia after OLT. Only underlying severity of disease predicted poor outcome among this homogenous patient population.Trial registrationThis study was registered at the German clinical trials register (DRKS-ID:DRKS00013285).
Source: Antimicrobial Resistance and Infection Control - Category: Infectious Diseases Source Type: research
Pallab Ray, Shreya Singh, Swati GuptaIndian Journal of Medical Microbiology 2019 37(3):299-308 Topically applied antibacterial agents are widely used. Opinions regarding the clinical efficacy of topical antibiotics are conflicting, and for most indications, alternative oral therapies are available. Topical application has many potential advantages over systemic therapy that includes high and sustained concentrations of drug directly at the infected site, low quantity of antibiotic needed, better compliance, fewer systemic side effects and potentially less chance of antimicrobial resistance. Despite these advantages, an im...
Source: Indian Journal of Medical Microbiology - Category: Microbiology Authors: Source Type: research
Conclusions: No significant difference in treatment outcomes was found between pediatric patients receiving AT and IAT for the treatment of UTI. In the era of increasing antimicrobial resistance, third-generation cephalosporins may still be a good choice as an empirical antimicrobial for children diagnosed with community-onset UTI.
Source: The Pediatric Infectious Disease Journal - Category: Infectious Diseases Tags: Antimicrobial Reports Source Type: research
Jia Huang Antimicrobial resistance (AMR) causes millions of illnesses every year, threatening the success of lifesaving antibiotic therapy and, thus, public health. To examine the rise and spread of antimicrobial resistance around the world, our study performs a multivariate statistical analysis of antimicrobial resistance gene data from eight different countries: the US, the UK, China, Brazil, Mexico, Canada, Australia, and South Africa. Multi-dimensional data points were projected onto a two-dimensional plane using principal component analysis and organized into a dendrogram utilizing hierarchical clustering to ...
Source: International Journal of Environmental Research and Public Health - Category: Environmental Health Authors: Tags: Article Source Type: research
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