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Clinical Significance of Antibiotic Resistance01:25

Clinical Significance of Antibiotic Resistance

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Methicillin-resistant Staphylococcus aureus (MRSA) presents a critical public health threat, arising from its capacity to resist β-lactam antibiotics due to acquisition of the mecA gene within the staphylococcal cassette chromosome mec (SCCmec). This gene encodes penicillin-binding protein 2a (PBP2a), which impairs binding efficacy of methicillin and other β-lactams. MRSA has evolved into distinct clonal lineages impacting humans and animals alike, reinforcing its significance within...
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Antibiotic resistance in bacteria arises when microorganisms evolve the ability to withstand drugs designed to kill them or inhibit their growth, rendering once-effective treatments useless. This phenomenon, driven by genetic change and selection under antibiotic exposure, poses a profound threat to modern medicine. Mechanisms include drug-inactivating enzymes (e.g., β-lactamases), efflux pumps that eject antibiotics, mutations altering antibiotic targets, decreased drug uptake, and...
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A urine culture and sensitivity test is a diagnostic procedure used to identify urinary tract bacterial infections and determine the most effective antibiotics for treatment. This test is generally preferred when a patient shows manifestations of a urinary tract infection, such as frequent or painful urination, cloudy or foul-smelling urine, or lower abdominal pain.Purpose of the TestThe primary goals of a urine culture and sensitivity test are to:Determine the specific bacteria causing the...
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In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
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Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...
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Neonatal Epilepsy: Beyond Seizures in a Developing Brain-A Narrative Review.

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Correction to: Real-world use of Serial Clinical Observation in culture-proven early-onset sepsis: timing of recognition, treatment and retrospective comparison with the Neonatal Sepsis Calculator.

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Real-world use of Serial Clinical Observation in culture-proven early-onset sepsis: timing of recognition, treatment and retrospective comparison with the Neonatal Sepsis Calculator.

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Updated: Mar 29, 2026

A Neonatal Imaging Model of Gram-Negative Bacterial Sepsis
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Restricting C-Reactive Protein Use in Early-Onset Neonatal Sepsis Reduces Unnecessary Antibiotic Exposure.

Valeria Capone1, Sophie Venturelli1, Eleonora Cresta2

  • 1Pediatric Post-Graduate School, University of Modena e Reggio Emilia, 41125 Modena, Italy.

Antibiotics (Basel, Switzerland)
|March 27, 2026
PubMed
Summary

Discontinuing routine C-reactive protein (CRP) testing for early-onset neonatal sepsis (EOS) reduced antibiotic exposure without harming patient outcomes. This strategy supports neonatal antibiotic stewardship.

Keywords:
antimicrobial stewardshipearly-onset sepsisnewborn

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Area of Science:

  • Neonatal Medicine
  • Clinical Pathology
  • Pediatric Infectious Diseases

Background:

  • Consensus guidelines vary on C-reactive protein (CRP) use for early-onset neonatal sepsis (EOS) diagnosis.
  • Routine CRP testing's diagnostic performance in EOS is debated.
  • Center-specific data can clarify CRP's clinical utility in neonatal sepsis.

Purpose of the Study:

  • To assess the impact of discontinuing routine CRP testing for suspected EOS.
  • To evaluate changes in laboratory utilization and antibiotic therapy after a policy change.
  • To determine the effect on neonatal outcomes following reduced CRP use.

Main Methods:

  • Retrospective analysis of neonates with suspected EOS at a level III center.
  • Comparison of laboratory use, antibiotic treatment, and outcomes before (2021-2022) and after (2024-2025) policy change.
  • Inclusion of neonates of all gestational ages.

Main Results:

  • CRP testing and complete blood counts significantly decreased post-policy change.
  • The proportion of short antibiotic courses (≤48 h) and overall antibiotic duration reduced significantly.
  • No worsening of neonatal outcomes was observed; antibiotic duration decreased further in preterm infants.

Conclusions:

  • Restricting CRP testing in EOS evaluation led to reduced unnecessary antibiotic exposure.
  • This approach aligns with and supports neonatal antibiotic stewardship programs.
  • The findings suggest a potential strategy for optimizing antibiotic use in neonates.