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Related Concept Videos

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Antibiotic resistance is a major public health concern that arises when bacteria evolve mechanisms to withstand the effects of antibiotic treatments. This resistance can be intrinsic, acquired through genetic mutations, or transferred between bacteria via horizontal gene transfer. The development of antibiotic resistance poses significant challenges in treating bacterial infections and necessitates ongoing research to develop new therapeutic strategies.Intrinsic resistance occurs when bacterial...
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Microorganisms play a fundamental role in vaccine development, gene therapy, and therapeutic production. Their biological properties are harnessed to advance medicine and public health. Beyond immunization, microorganisms contribute to gut health, antibiotic synthesis, and genetic disease treatment.Live Attenuated and Inactivated VaccinesLive attenuated vaccines, such as the measles, mumps, and rubella (MMR) vaccine, utilize weakened forms of pathogens to closely resemble natural infections.
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Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
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[Antibiotic stewardship - recent developments].

Winfried V Kern1, Stephan Horn1, Geertje Fink1

  • 1Abteilung Infektiologie, Klinik für Innere Medizin II, Universitätsklinikum Freiburg.

Deutsche Medizinische Wochenschrift (1946)
|November 30, 2020
PubMed
Summary
This summary is machine-generated.

Antibiotic prescribing in Germany shows a shift away from fluoroquinolones and cephalosporins towards penicillin derivatives. Aminoglycosides are re-emerging as viable options for urinary tract infections and severe sepsis, while specific guidelines exist for hematology-oncology patients.

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Area of Science:

  • Pharmacology
  • Infectious Diseases
  • Clinical Pharmacy

Background:

  • Recent trends indicate a decrease in fluoroquinolone and cephalosporin use in German healthcare settings.
  • Penicillin derivatives are increasingly favored, and aminoglycosides are being reconsidered for specific infections.
  • Limited updates exist on antibiotic strategies for hematology-oncology patients, particularly concerning fever and neutropenia.

Purpose of the Study:

  • To review current trends in antibiotic prescribing in Germany.
  • To evaluate the re-emergence of aminoglycosides as therapeutic options.
  • To discuss rational antibiotic use in hematology-oncology, including empirical and targeted therapies.

Main Methods:

  • Analysis of antibiotic consumption data in hospital and outpatient settings.
  • Review of current clinical guidelines and evidence for antibiotic use in specific patient populations.
  • Discussion of antibiotic resistance patterns and therapeutic alternatives.

Main Results:

  • Decreased prescription rates for fluoroquinolones and cephalosporins, with a rise in penicillin derivative use.
  • Aminoglycosides show renewed utility for urinary tract infections and potentially sepsis due to favorable activity and low resistance.
  • For fever and neutropenia in hematology-oncology, piperacillin-tazobactam or carbapenems remain first-line, with extended infusions recommended. Linezolid is a reserve drug.
  • Careful patient history can identify subgroups suitable for re-exposure to penicillins despite alleged allergies.

Conclusions:

  • Antibiotic prescribing patterns are evolving, necessitating updated therapeutic strategies.
  • Aminoglycosides offer a valuable alternative in specific clinical scenarios.
  • Evidence-based guidelines are crucial for optimizing antibiotic use, especially in immunocompromised patients.
  • Accurate allergy assessment can safely expand penicillin use.