• 제목/요약/키워드: Antibiotic treatment

검색결과 934건 처리시간 0.03초

Clinical Characteristics of Spinal Epidural Abscess Accompanied by Bacteremia

  • Chae, Ho-jun;Kim, Jiha;Kim, Choonghyo
    • Journal of Korean Neurosurgical Society
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    • 제64권1호
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    • pp.88-99
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    • 2021
  • Objective : The treatment of choice for spinal epidural abscess (SEA) generally is urgent surgery in combination with intravenous antibiotic treatment. However, the optimal duration of antibiotic treatment has not been established to date, although 4-8 weeks is generally advised. Moreover, some researchers have reported that bacteremia is a risk factor for failure of antibiotic treatment in SEA. In this study, we investigated the clinical characteristics of SEA accompanied by bacteremia and also determined whether the conventional 4-8 weeks of antibiotic treatment is sufficient. Methods : We retrospectively reviewed the medical records and radiological data of 23 patients with bacterial SEA who underwent open surgery from March 2010 to April 2020. All patients had bacteremia preoperatively and underwent weeks of perioperative antibiotic treatments based on their identified organisms until all symptoms of infection disappeared. All patients underwent microbiological studies of peripheral blood, specimens from SEA and concomitant infections. The mean follow-up duration was 35.2 months, excluding three patients who died. Results : The male : female ratio was 15 : 8, and the mean age was 68.9 years. The SEA most commonly involved the lumbar spinal segment (73.9%), and the mean size was 2.9 vertebral body lengths. Mean time periods of 8.4 days and 16.6 days were required from admission to diagnosis and from admission to surgery, respectively. Concomitant infections more frequently resulted in delayed diagnosis (p=0.032), masking the symptoms of SEA. Methicillin-sensitive Staphylococcus aureus was the most commonly identified pathogen in both blood and surgical specimens. Seventeen patients (73.9%) showed no deficits at the final follow-up. The overall antibiotic treatment duration was a mean of 66.6 days, excluding three patients who died. This duration was longer than the conventionally advised 4-8 weeks (p=0.010), and psoas or paraspinal abscess required prolonged duration of antibiotic treatment (p=0.038). Conclusion : SEA accompanied by bacteremia required a longer duration (>8 weeks) of antibiotic treatment. In addition, the diagnosis was more frequently delayed in patients with concomitant infections. The duration of antibiotic treatment should be extended for SEA with bacteremia, and a high index of suspicion is mandatory for early diagnosis, especially in patients with concomitant infections.

Computed Tomography Findings Associated with Treatment Failure after Antibiotic Therapy for Acute Appendicitis

  • Wonju Hong;Min-Jeong Kim;Sang Min Lee;Hong Il Ha;Hyoung-Chul Park;Seung-Gu Yeo
    • Korean Journal of Radiology
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    • 제22권1호
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    • pp.63-71
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    • 2021
  • Objective: To identify the CT findings associated with treatment failure after antibiotic therapy for acute appendicitis. Materials and Methods: Altogether, 198 patients who received antibiotic therapy for appendicitis were identified by searching the hospital's surgery database. Selection criteria for antibiotic therapy were uncomplicated appendicitis with an appendiceal diameter equal to or less than 11 mm. The 86 patients included in the study were divided into a treatment success group and a treatment failure group. Treatment failure was defined as a resistance to antibiotic therapy or recurrent appendicitis during a 1-year follow-up period. Two radiologists independently evaluated the following CT findings: appendix-location, involved extent, maximal diameter, thickness, wall enhancement, focal wall defect, periappendiceal fat infiltration, and so on. For the quantitative analysis, two readers independently measured the CT values at the least attenuated wall of the appendix by drawing a round region of interest on the enhanced CT (HUpost) and non-enhanced CT (HUpre). The degree of appendiceal wall enhancement (HUsub) was calculated as the subtracted value between HUpost and HUpre. A logistic regression analysis was used to identify the CT findings associated with treatment failure. Results: Sixty-four of 86 (74.4%) patients were successfully treated with antibiotic therapy, with treatment failure occurring in the remaining 22 (25.5%). The treatment failure group showed a higher frequency of hypoenhancement of the appendiceal wall than the success group (31.8% vs. 7.8%; p = 0.005). Upon quantitative analysis, both HUpost (46.7 ± 21.3 HU vs. 58.9 ± 22.0 HU; p = 0.027) and HUsub (26.9 ± 17.3 HU vs. 35.4 ± 16.6 HU; p = 0.042) values were significantly lower in the treatment failure group than in the success group. Conclusion: Hypoenhancement of the appendiceal wall was significantly associated with treatment failure after antibiotic therapy for acute appendicitis.

선택적 복강경하 자궁근종절제술 환자의 예방적 항생제 투여기간이 회복에 대한 불확실성에 미치는 영향 (Influence of Duration of Prophylactic Antibiotics Therapy on Uncertainty of Recovery in Elective Laparoscopic Uterine Myomectomy Patients)

  • 정미영;박경연
    • 기본간호학회지
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    • 제25권4호
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    • pp.240-249
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    • 2018
  • Purpose: The study was done to explore whether the duration of perioperative prophylactic antibiotics therapy influenced uncertainty of recovery in patients with elective laparoscopic uterine myomectomy. Methods: A prospective study was conducted using self-report questionnaires and electrical medical records for patients with uterine myomectomy. According to the length of the perioperative prophylactic antibiotics therapy, the patients were divided into three groups: single-dose antibiotic treatment group, short-term antibiotic treatment group, and long-term antibiotic treatment group. Data were collected from December 20, 2016 to July 31, 2017 from 161 patients who underwent laparoscopic myomectomy at a metropolitan city general hospital. Results: Level of uncertainty of recovery was $2.98{\pm}0.22$. The uncertainty was highest in the long-term antibiotic treatment group, followed by the short-term antibiotic treatment group and the single-dose antibiotic treatment group (F=89.40, p<.001). In the regression analysis, factors influencing uncertainty of recovery among uterine myomectomy patients were duration of perioperative prophylactic antibiotic therapy (${\beta}=.70$, p<.001) and duration of NPO (${\beta}=-.11$, p=.047) which explained 51.5% of the variance (F=83.75, p<.001). Conclusion: Based on these results, information including the administration of antibiotics before surgery should be provided to the patients to help reduce the uncertainty of postoperative recovery.

Antibiotic-Induced Increase in Inflammatory Markers in Cured Infectious Spondylitis : Two Case Reports

  • Eom, Ki Seong
    • Journal of Korean Neurosurgical Society
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    • 제62권4호
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    • pp.487-491
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    • 2019
  • Conservative therapy with appropriate antibiotics is essential for most patients with infectious spondylitis. Although most antibiotics do not cause problems if it used properly and serious side effects are rare, side effects can occur with any class of drugs and adverse reactions of antibiotics can range from mild allergic reactions to serious and fulminant adverse events. These side effects are also extremely variable from patient to patient and from antibiotic to antibiotic. A side effect of antibiotics may paradoxically increase inflammatory marker levels. Here, the author presents two cases of antibiotic-induced increase in inflammatory markers in cured infectious spondylitis. The patients were successfully treated after stopping the antibiotic therapy. The differential diagnosis between antibiotic side effects and infection should be considered very carefully because the treatment is completely different. Although the exact mechanisms underlying successful treatment without antibiotics are unclear, we should consider the side effects of antibiotics when following inflammatory markers during treatment of infectious spondylitis.

Distribution of Antibiotic-Resistant Bacteria in the Livestock Farm Environments

  • Kim, Youngji;Seo, Kun-Ho;Kim, Binn;Chon, Jung-Whan;Bae, Dongryeoul;Yim, Jin-Hyeok;Kim, Tae-Jin;Jeong, Dongkwan;Song, Kwang-Young
    • Journal of Dairy Science and Biotechnology
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    • 제39권1호
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    • pp.1-8
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    • 2021
  • The surroundings of livestock farms, including dairy farms, are known to be a major source of development and transmission of antibiotic-resistant bacteria. To control antibioticresistant bacteria in the livestock breeding environment, farms have installed livestock wastewater treatment facilities to treat wastewater before discharging the final effluent in nearby rivers or streams. These facilities have been known to serve as hotspots for inter-bacterial antibiotic-resistance gene transfer and extensively antibiotic-resistant bacteria, owing to the accumulation of various antibiotic-resistant bacteria from the livestock breeding environment. This review discusses antibiotic usage in livestock farming, including dairy farms, livestock wastewater treatment plants as hotspots for antibiotic resistant bacteria, and nonenteric gram-negative bacteria from wastewater treatment plants, and previous findings in literature.

항생제 투여중 발생한 설사 환자 치험 1례 (A Case Report of Antibiotic-associated Diarrhea Treated with Traditional Korean Medicine)

  • 서윤정;박성운;최현정;류재환
    • 대한한방내과학회지
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    • 제38권2호
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    • pp.172-179
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    • 2017
  • Objectives: The aim of this clinical study is to describe the case of a patient with antibiotic-associated diarrhea, which was improved by treatment with herbal medicine. Methods: The antibiotic-associated diarrhea improved following treatment with Boikyangwi-tang and Opae-san for two months. During this period, western medicine, including antibiotics, was also administered. To evaluate the effect of the treatment, the Bristol Stool Form Scale was used. Results: During the treatment, the Bristol Stool Form Scale changed from type 7 to type 5. Conclusion: The results suggest that traditional Korean medicine may be an effective treatment for antibiotic-associated diarrhea.

일차진료 항생제 치료기간과 비인두 항생제 내성률에 대한 연구 고찰 (A Review of Studies on Antibiotic Course and Antibiotic Resistance in Nasopharyngeal Pathogens in Primary Care Setting)

  • 신향화;이선행;윤성중;장규태
    • 대한한방소아과학회지
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    • 제32권2호
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    • pp.64-71
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    • 2018
  • Objectives The purpose of this study is to examine the correlation of antibiotics administration duration and antimicrobial resistance by reviewing domestic and foreign literatures. Methods We searched literatures dated up to 23 February, 2018 in PubMed and Cochrane Library using terms of "Anti-Bacterial Agents", "Carrier State", "Nasopharynx", "Drug Administration Schedule", and also searched via RISS (Research Information Service System), KISS (Koreanstudies Information Service System), DBpia (DataBase Periodical Information Academic) using terms of antibiotics, resistance, and dose. Results In comparison with shortened and standard antibiotic course, longer treatment duration is associated with greater antimicrobial resistance or non-significant difference, but we cannot find literature that shortened antibiotic course increases antimicrobial resistance on human nasopharyngeal flora. Conclusions Currently, there is no evidence that completing the standard antibiotic course reduces antimicrobial resistance. It can be a strategy for reducing antibiotic use to apply Korean medicine treatment, as well as short-course antibiotic therapy or delayed antibiotic prescription. Additional well-designed trials should be conducted in domestic and foreign settings about the appropriate duration of antibiotic therapy.

Synergistic Effect of Bacteriophage and Antibiotic against Antibiotic-Resistant Salmonella Typhimurium

  • Petsong, Kantiya;Vongkamjan, Kitiya;Ahn, Juhee
    • 한국식품위생안전성학회지
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    • 제35권2호
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    • pp.189-194
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    • 2020
  • 본 연구는 항생제 내성 Salmonella Typhimurium CCARM 8009을 저해하기 위한 phage와 항생제 조합처리의 효과를 평가하였다. 디스크 확산법과 액체배지 희석법에 의해 phage와 항생제의 상승 저해효과를 측정하였고 배양을 통한 항생제 내성 유도를 평가하였다. Phage를 처리한 cefotaxime, chloramphenicol, ciprofloxacin, erythromycin의 디스크의 저해 구역은 각각 13.6%, 19.3%, 12.7%, 78.8%로 증가되었다. Phage와 항생제 조합 처리에 의해 tetracycline, chloramphenicol, ciprofloxacin, erythromycin, streptomycin의 최소생육억제농도는 각각 64, 4, 0.0078, 64, 256 mg/mL으로 감소되었다. Phage와 항생제의 조합 처리는 항생제 내성 S. Typhimurium CCARM 8009을 효과적으로 저해하였다 (4 log reduction). 본 결과는 phage와 항생제의 조합처리는 항생제 내성균을 제어하기 위한 방법으로 충분히 응용가치가 높음을 보여주고 있다.

항생제, 생균제 및 효모제 첨가가 육계의 성장과 육질에 미치는 영향 (Effects of Supplemention of Antibiotic, Probiotic and Yeast Culture of Performance and Meat Quality in Broiler Chicks)

  • 박성진;유성오
    • 한국가금학회지
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    • 제27권3호
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    • pp.203-208
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    • 2000
  • The present study was conducted to investigate the effects of dietary supplementions of 0.1% probiotic and 0.1% yeast culture on the growth performance and meat quality of broiler chicks. A total of 160 Arbor Acre broiler chicks were randomly allotted to 16 pens ; four pens per treatment and 10 birds per pen. Feeding trial lasted for 6 weeks. The results obtained are summerized as follows : The body weight gain and feed intake was slightly higher in group of broiler chick supplemented antibiotic than those of other treatment groups, but were not significantly different among treatments. The feed conversion were slightly lower in groups of broiler chick supplemented antibiotic and probiotic than those of other treatment groups, but were not significantly different among treatments. The pH of thigh musle was slightly higher in group of broiler chick supplemented probiotic than those of other treatment groups. Crude protein, crude fat and crude ash of thigh muscle were lower in groups of broiler chick supplemented probiltic and yeast culture than those of other treatment groups, but were not significantly different among treatments. The saturated fatty acid content of the thigh muscle was tende to be higher in group of broiler chick supplemented yeast culture, but the unsaturated fatty acid content was tende to be lower in group of broiler chick supplemented yeast culture than those of other treatment groups.

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Antibiotic Sensitivity Patterns in Children with Urinary Tract Infection: Retrospective Study Over 8 Years in a Single Center

  • Woo, Byungwoo;Jung, Youngkwon;Kim, Hae Sook
    • Childhood Kidney Diseases
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    • 제23권1호
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    • pp.22-28
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    • 2019
  • Purpose: We studied the pathogens and trends in antibiotic sensitivity pattern in children with urinary tract infection (UTI) over 8 years in order to evaluate adequate treatment. Methods: We performed a retrospective review of medical records of children with UTI from January 2009 to December 2016 in Daegu Fatima Hospital. Uropathogens and antibiotic sensitivity patterns were selected. Only 1 bacterial species with a colony count of ${\geq}105CFU/mL$ was considered a positive result. We compared 2 periods group (A: 2009~2012, B: 2013~2016) to investigate trends of antibiotic sensitivity pattern. Results: During the 8 year period, 589 cases are identified (E. coli was cultured in 509 cases, 86.4%). Among all patients, this study investigated the antibiotic sensitivity of E. coli. Antimicrobial susceptibility to ampicillin was steadily low for both periods (A: 32.6%, B: 40.1%, P=0.125), and to amikacin was consistently high for both periods (A: 99.4%, B: 99.3%, P=1.000). Antibiotic sensitivity to third-generation cephalosporin decreased from period A to B (A: 91.7%, B: 75.5%, P=0.000). Antibiotic sensitivity to quinolone significantly decreased from A to B (A: 88.4%, B: 78.2%, P=0.003). The prevalence of extended-spectrum ${\beta}$-lactamase-producing E. coli increased from period A to B (A: 6.1%, B: 17.1%, P=0.000). Conclusion: This study showed that conventional antibiotic therapy for the treatment of pediatric UTI needs to be reevaluated. A careful choice of antibiotic is required due to the change in antibiotic sensitivity and the emergence of antibiotic-resistant bacteria.