• Childhood Kidney Diseases
• /
• v.18 no.2
• /
• pp.116-122
• /
• 2014

Renal and perinephric abscesses are a rare but potentially fatal complication of urinary tract infection (UTI). Diagnosing renal and perinephric abscesses has been known to be difficult. These abscesses may occur when the appropriate antibiotic treatment for a UTI is delayed, or in cases with a congenital malformation of the urinary system, especially in children. In the present report, we describe 2 cases of renal abscesses with extra-capsular invasion in children with febrile UTI. A 4-month-old male infant with vesicoureteral reflux developed a renal abscess that infiltrated the perinephric area and the left psoas muscle, despite early antibiotic treatment. A 9-year-old boy with prolonged fever also showed a multi-loculated renal abscess that infiltrated the spleen and diaphragm. Both patients were successfully treated with appropriate antibiotics and percutaneous drainage.

• Pediatric Infection and Vaccine
• /
• v.12 no.2
• /
• pp.124-134
• /
• 2005

Purpose : It has been known that the diagnostic confirmation of group A streptococcal pharyngitis is accompanied with the results of throat culture and/or rapid antigen detection test(RADT). This study was designed to evaluate the usefulness and cost benefits of the RADT in patients with a sore throat compared the empirical antibiotic treated group without using RADT or throat culture with the antibiotic treated group according to the results of RADT test and/or throat culture. Methods : From April 2003 to August 2003, total 369 patients were enrolled this study. They were redistributed into two groups. In one group, the RADT test and throat culture were used and the patients received antibiotic treatment according to the results of test and in the other group, no diagnostic examinations were used and the patients were treated with antibiotics which were chosen empirically. The flow sheet with questionnaire was drawing up and obtained the clinical symptoms, signs and the name of antibiotics that were administered. Results : A total of 244 patients were treated after the throat culture and/or RADT, and 125 patients were treated empirically. The prevalence of bacteriologically confirmed group A streptococcal pharyngitis was 20.1%. The sensitivity and specificity of RADT were 89.8% and 86.1%, respectively. Positive predictive value and negative predictive value were 62.0% and 97.1%, respectively. The rate of antibiotic use was high in both groups. Because the physician used the antibiotics even if the result of RADT was negative. So about 37% of reduction of antibiotics use might be possible if we used antibiotics according to the results of RADT. There were no cost differences between the RADT applied group and the empirically treated antibiotic group if we could reduce the price of RADT to 63% of the current price. Conclusion : The RADT could be applied for the easy and rapid diagnosis and prompt treatment for group A streptococcal pharyngitis, and RADT could reduced the number of antibiotics used if the price of RADT was reduced to 63% of current price. For accurate evaluation of efficacy and cost effect, further controlled study is needed.

• Monthly Korean Chicken
• /
• v.17 no.6
• /
• pp.66-75
• /
• 2011

국면의 먹거리를 책임지고 있는 우리 축산이 변화의 시기를 맞이했다. 2005년부터 "국가 항생제 내성관리사업" 일환으로 축산용 항생제 절감 정책이 추진되어 사용가능한 배합사료 제조용 항생제가 단계적으로 축소되어 왔는데 2011년 7월이면 전면 금지될 것이다. 배합사료 제조용 항생제 사용금지로 인해 생산성 감소, 질병 발생률 증가, 축산물 품질 저하, 치료용 항생제 사용량 증가 등의 문제가 유발될 수 있다는 우려의 목소리도 들린다. 그러나 효율적으로 대처한다면 축산 선진국으로 도약할 수 있는 기회가 될 수 있다고 생각한다. 성장촉진용 항생제를 사용한 목적은 가축 생산성 향상과 질병 예방에 있으며 이들의 배제 시 가장 우려되는 부분 역시 생산성 감소와 질병 발생 증가이다. 가축의 생산성을 높이고 질병을 예방하기 위해 기본이 되는 것은 그 주체인 가축의 강건성을 키워주는 것이다. 가축 건강 증진을 통해 질병 및 환경에 대한 저항성을 키워주고 양과 질적 향상을 꾀할 수 있는 것이다. 이를 위해서는 양질의 사료 제공 쾌적한 사육환경 조성, 현대화된 사육시설, 정확한 백신 접종 및 효율적인 차단방역 등 가축을 둘러싼 내 외부 환경의 종합적인 관리가 기본이 되어야 하지만 본고에서는 생산성 향상 및 건강성 증진을 위한 방법으로 부각되고 있는 항생제 대체제에 대해 소개하고자 한다.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.27 no.2
• /
• pp.208-215
• /
• 2000

Patient with congenital heart disease are susceptible to infective endocarditis, and bacteremia following dental procedures may lead to infective endocarditis is these patients. Therefore prophylactic antibiotics are recommended for patients with congenital heart disease who are undergoing dental procedures that are associated with infective endocarditis. In 1997 American Heart Association revised guidelines for a prophylaxis against infective endocarditis. The new American Heart Association recommendations for the prevention of infective endocarditis represent a substantial departure from past guidelines. Major change involve the indications for prophylaxis, antibiotic choice and dosing that may reduce bacteremic risk. Previously, antibiotic prophylaxis was suggested for dental procedures associated with any amount of bleeding. Now only those that are associated with significant bleeding are recommended for prophylaxis as dictated by clinical judgement. Recommended antibiotic prophylaxis regimens now consist of a single preprocedural dose, no second dose is recommended. This report presents three cases of dental treatment of patients with congenital heart disease under the most recent American Heart Association recommendations for antibiotic prophylaxis.

• Clinical and Experimental Pediatrics
• /
• v.51 no.2
• /
• pp.156-161
• /
• 2008

Purpose : Neutropenic enterocolitis is an acute, life-threatening inflammation of the small and large bowel, often seen in children with malignancies during periods of prolonged or severe neutropenia. The optimal management for typhlitis in pediatric oncology patients has been debateful between operative and nonoperative approaches. The purpose of this study was to review the outcome of medical management of patients who were diagnosed as typhlitis. Methods : The records of 207 pediatric cancer patients who were diagnosed and treated at the pediatric department of Yeungnam University Hospital for cancer between August, 2002 and July, 2007 were reviewed. Results : Among 207 patients, 12 (5.7%) children aged 9 to 14 years, were diagnosed clinically to have typhlitis. Clinical symptoms and signs of patients were fever, abdominal pain and tenderness, diarrhea, vomiting and rebound tenderness. Bowel-wall thickening (> 4mm) was seen on CT or ultrasonography. All patients were treated with antibiotics combinations of teicoplanin, carbapenem, aminoglycoside, or other third generation cephalosporin and metronidazole or clindamycin. Eight patients were treated with additional antifungal agents. Other supportive management included bowel rest, total parenteral nutrition, and G-CSF administration. All patients recovered completely and did not need any surgical management. Conclusion : Early diagnosis and aggressive supportive treatment appears to be important for complete recovery and survival of typhlitis.

• Clinical and Experimental Pediatrics
• /
• v.48 no.7
• /
• pp.760-765
• /
• 2005

Purpose : We studied the changes in antibiotic sensitivity to the causative organisms of urinary tract infection(UTI), in order to provide useful information on the choice of adequate drugs in the treatment of UTI. Methods : We retrospectively analyzed the major causative organisms and their antibiotic sensitivities in 69 patients diagnosed with UTI in the Department of Pediatrics, Samsung Cheil Hospital from 2002 to 2003. Results : The frequency of UTI was the highest in infants younger than 1 year of age(88.4 percent). The male to female ratio was 3.05 : 1. Escherichia coli was the most frequent organism(78.3 percent), followed by Klebsiella(11.6 percent), Pseudomonas(2.9 percent), Proteus(2.9 percent), Enterobacter, Morganelle, and Enterococcus(1.4 percent) in descending order. Antibiotic sensitivity of gram negative organisms was above 90 percent against imipenem, amikacin, 80 percent against aztreonam, cefepime, ceftriaxone, 50-70 percent against gentamicin, trimethoprime-sulfamethoxazole (TMP/SMX), and 23 percent against ampicillin(23.4 percent). Conclusion : Antibiotict sensitivity of gram negative organisms was high to amikacin and third generation cephalosporins but low to ampicillin, gentamicin and TMP/SMX. The use of ampicillin or TMP/SMX, as the first choice of the empiric and prophylactic treatment for UTI, should be reconsidered and investigated further.

• Childhood Kidney Diseases
• /
• v.10 no.1
• /
• pp.77-82
• /
• 2006

Renal abscess in childhood is a rare disease, and generally treatment of renal abscesses in childhood follows the guidelines in adults. The guidelines of treatment of renal abscesses in adults include the following : renal abscesses smaller than 3 cm in size can be managed by antibiotics administration, while renal abscesses above 3 cm in size must be considered for percutaneous abscess drainage or open drainage. We experienced a case of a 2 year-old girl with multiple renal abscesses greater than 4 cm in size which resolved by oral antibiotics administration after 2 weeks of intravenous administration. We report this case with literature review.

• Journal of Food Hygiene and Safety
• /
• v.38 no.4
• /
• pp.193-201
• /
• 2023

Antimicrobials in human medicine are classified by The World Health Organization (WHO) into three groups: critically important antimicrobials (CIA), highly important antimicrobials (HIA), and important antimicrobials (IA). CIA are antibiotic classes that satisfy two main criteria: that they are the sole or the only available limited therapeutic option to effectively treat severe bacterial infections in humans (Criterion 1), and infections where bacteria are transmitted to humans from non-human sources or have the potential to acquire resistance genes from non-human sources (Criterion 2). WHO emphasizes the need for cautious and responsible use of the CIA to mitigate risk and safeguard human health. Specific antimicrobials within the CIA with a high priority for management are reclassified as "highest priority critically important antimicrobials (HP-CIA)" and include the 3^rd generation of cephalosporins and the next generation of macrolides, quinolones, glycopeptides, and polymyxins. The CIA list is the scientific basis for risk assessment and risk management policies that warrant using antimicrobials to reduce antimicrobial resistance in several countries. In addition, the CIA list ensures food safety in the food industry, including for the popular food chain companies McDonald's and KFC. The continuous update of the CIA list reflects the advancement in research and emerging future challenges. Thus, active and deliberate evaluation of antimicrobial resistance and the construction of a list that reflects the specific circumstances of a country are essential to safeguarding food security.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.33 no.1
• /
• pp.131-138
• /
• 2006

A mixture of metronidazole, ciprofloxacin and minocycline(3Mix) in distilled water or in a root canal sealer were used to disinfect the infected endodontic and periapical lesions. It has been well acknowledged in recent literature that minocycline, a semisynthetic tetracycline derivative, causes discolorations in adult teeth and various other collagenous tissues. In these cases, pulp treatments were finished successfully using a combination of antibiotics but severe discolorations of the teeth were observed. Discolored non-vital posterior tooth was treated using the prosthodontic procedure. And anterior tooth was successfully treated using the walking bleach technique. Bleaching was performed by temporarily placing a mixture of sodium perborate and distilled water into the pulp chamber. There were significant esthetic improvement.

• Tuberculosis and Respiratory Diseases
• /
• v.63 no.1
• /
• pp.13-16
• /
• 2007

현 상태에서 패혈증에서 최선의 치료는 조기, 목표지향치료, 저일호흡량을 포함한 폐 보호 기계환기, 그리고 activated protein C 등을 들 수 있으며, 코티코스테로이드 치료나 적극적인 인슐린 치료법에 대해서는 아직 치료효과가 검증되지 않은 상태이다. 전통적으로 시행되고 있는 조기에 광범위한 항생제 투여, 창상의 치료 등은 한상 강조되어야 할 치료 방법이다.