• Tuberculosis and Respiratory Diseases
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• 제70권3호
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• pp.191-198
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• 2011

Ventilator-associated pneumonia (VAP) is the most frequent nosocomial infection in the intensive care unit (ICU), with an incidence ranging from 8% to 38%. Patients who acquire VAP have higher mortality rates and longer ICU and hospital stays. Because there are other potential causes of fever, leukocytosis, and pulmonary infiltrates, clinical diagnosis of VAP is overly sensitive. The only alternative approach to the clinical diagnosis of VAP is the Clinical Pulmonary Infection Score (CPIS). Employing quantitative cultures of respiratory secretions in the diagnosis of VAP leads to less antibiotic use and probably to lower mortality. With respect to microbiologic diagnosis, however, it is not clear that the use of invasive sampling using bronchoscopy is associated with better outcomes. Delayed administration of antibiotic therapy is associated with an increased mortality, and inadequate antibiotic therapy is also associated with higher mortality. Therefore, prompt initiation of adequate antibiotic therapy is a cornerstone of the treatment of VAP. The initial antibiotic therapy should be based on the most common organisms in each hospital and the most likely pathogens for that specific patient. When final cultures and susceptibilities are available, de-escalation to less broad spectrum antibiotics should be done. Since clinical improvement usually takes 2 to 3 days, clinical responses to the initial empirical therapy should be evaluated by day 3. A short course of antibiotic therapy appears to be equivalent to a traditional course of more than 14 days, except when treating non-fermenting gram-negative organisms. If patients receive initially adequate antibiotic therapy, efforts should be made to shorten the duration of therapy to as short as 7 days, provided that the etiologic pathogen is not a non-fermenting gram-negative organism.

• 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.

• 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 (HU_post) and non-enhanced CT (HU_pre). The degree of appendiceal wall enhancement (HU_sub) was calculated as the subtracted value between HU_post and HU_pre. 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 HU_post (46.7 ± 21.3 HU vs. 58.9 ± 22.0 HU; p = 0.027) and HU_sub (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.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제23권1호
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• pp.35-48
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• 2020

Purpose: Gastrointestinal symptoms are often related to antibiotic treatment. Their incidence, risk and protective conditions in children are not well defined and represent the aims of this study. Methods: We prospectively enrolled inpatient children submitted to antibiotic treatment. Indication, type, dose and duration of treatment, probiotic supplementation and gastrointestinal symptoms were recorded at recruitment, after two and four weeks. Antibiotic-associated diarrhea (AAD) was defined as the presence of at least 3 loose/liquid stools within 14 days from antibiotic onset. Results: AAD occurred in 59/289 (20.4%) of patients, with increased risk in children younger than 3 years (relative risk [RR]=4.25), in lower respiratory (RR=2.11) and urinary infections (RR=3.67), intravenous administration (RR=1.81) and previous AAD episodes (RR=1.87). Abdominal pain occurred in 27/289 (9.3%), particularly in children >6 years (RR=4.15), with previous abdominal pain (RR=7.2) or constipation (RR=4.06). Constipation was recorded in 23/289 (8.0%), with increased risk in children having surgery (RR=2.56) or previous constipation (RR=7.38). Probiotic supplementation significantly reduced AAD (RR=0.30) and abdominal pain (RR=0.36). Lactobacillus rhamnosus GG (LGG) and L. reuteri significantly reduced AAD (RR=0.37 and 0.35) and abdominal pain (RR=0.37 and 0.24). Conclusion: AAD occurred in 20.4% of children, with increased risk at younger age, lower respiratory and urinary tract infections, intravenous treatment and previous AAD. LGG and L. reuteri reduced both AAD and associated abdominal pain.

• 대한간호학회지
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• 제41권6호
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• pp.742-749
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• 2011

Purpose: This study was conducted to examine public level of knowledge and attitudes regarding antibiotic use and potential drug resistance. Methods: A cross-sectional face-to-face survey of 1,177 residents aged 18 or over was conducted in Korea. A quota sampling method was used. Results: Most respondents (70%) did not know that antibiotics are ineffective in treating coughs and colds. Two-thirds of the respondents were unaware of the conditions under which antibiotic resistance occurs, despite understanding the concept of resistance. Lower education level and older age were independently associated with inadequate knowledge. Lower education level, older age, inadequate knowledge and no exposure to the education campaign were independently associated with poor attitude. Conclusion: The results of this study demonstrate that the general public has misunderstandings and a lack of knowledge with regard to antibiotic use, despite a national educational campaign. However, the campaign may have had an effect on the public's attitudes towards antibiotics.

• Clinical and Experimental Pediatrics
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• 제62권4호
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• pp.113-118
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• 2019

Inappropriate antibiotic use is the most important factor causing increased bacterial resistance to antibiotics, thus affecting patient outcomes. Multidrug-resistant bacteria have become a serious public health threat, causing significant morbidity and mortality worldwide. In Korea, the burden of antibiotic-resistant bacteria has become an important public health issue. There is increasing evidence of overuse and misuse of antibiotics in Korea, as observed in cohorts with large sample sizes. Antibiotic use among children should receive particular attention because of the frequency of community-associated infections among this population and the elevated risk of transmission. Recent studies from Korea have demonstrated that the use of broad-spectrum antibiotics, either for inpatient or outpatient treatment, has increased among many age groups, especially children. In this review, we aim to describe the patterns of antibiotic prescription and evaluate recent trends in antibiotic use among children. Coordinated efforts toward communication and education in order to address misunderstandings regarding antibiotic use, involving interprofessional antimicrobial stewardship programs, are required in the near future.

• 한국생물공학회:학술대회논문집
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• 한국생물공학회 2003년도 생물공학의 동향(XIII)
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• pp.723-729
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• 2003

본 연구에서는 국내 토양에서 분리된 곤충병원성 선충 Steinernema carpocapsae Kor-A1에서 분리된 공생박테리아 X. nematophilus Kor-A1 균주를 이용하여 액체 배양을 통해 생산조건에 따른 균주의 성장과 항균활성의 영향을 검증하고 항균물질의 생산조건 최적화를 검토하고 하였다. Flask 상에서 배양시간에 따른 항균활성을 조사한 결과 growth associated form을 보여 주었으며, 공생박테리아의 성장의 정지기에 최대 활성을 타나내었다. 또한 5L jar fermentor 상에서 최적 배양 조건을 알아보기 위해 교반속도와 DO의 영향에 대한 실험을 수행한 결과 교반속도는 400rpm에서 DO는 50%일 때 X. nematophilus Kor-A1의 균체 성장 및 항균물질 분비에 최적임을 알 수 있었다.

• 도시과학
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• 제12권2호
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• pp.7-12
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• 2023

The purpose of this study is to explore the issue of antibiotic misuse and the associated environmental problems, focusing on the antibiotic sulfamethoxazole used in animal agriculture. Antibiotic resistance is currently a global problem, exacerbated by the misuse of antibiotics in agriculture and animal husbandry. This study emphasizes the importance of investigating the potential environmental toxicity of antibiotics and discovering efficient treatment technologies. It discusses the use of advanced oxidation processes and artificial wetlands as potential approaches to mitigate the environmental impact of antibiotics, particularly sulfamethoxazole. In conclusion, the study underscores the need for research, data collection, monitoring, and effective environmental protection policies to combat antibiotic misuse and environmental pollution. It also emphasizes the significance of raising awareness and implementing proactive measures to address these issues.

• 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.

• Journal of Korean Neurosurgical Society
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• 제56권1호
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• pp.34-41
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• 2014

Objective : The purpose of this study was to describe the clinical characteristics, treatment outcomes, and prognostic factors in patients with brain abscesses treated in a single institute during a recent 10-year period. Methods : Fifty-one patients with brain abscesses who underwent navigation-assisted abscess aspiration with antibiotic treatment were included in this study. Variable parameters were collected from the patients' medical records and radiological data. A comparison was made between patients with favorable [Glasgow Outcome Scale (GOS) ${\geq}4$] and unfavorable (GOS <4) outcomes at discharge. Additionally, we investigated the factors influencing the duration of antibiotic administration. Results : The study included 41 male and 10 female patients with a mean age of 53 years. At admission, 42 patients (82%) showed either clear or mildly disturbed consciousness (GCS ${\geq}13$) and 24 patients (47%) had predisposing factors. The offending microorganisms were identified in 25 patients (49%), and Streptococcus species were the most commonly isolated bacteria (27%). The mean duration of antibiotic administration was 42 days. At discharge, 41 patients had a favorable outcome and 10 had an unfavorable outcome including 8 deaths. The decreased level of consciousness (GCS <13) on admission was likely associated with an unfavorable outcome (p=0.052), and initial hyperglycemia (${\geq}140mg/dL$) was an independent risk factor for prolonged antibiotic therapy (p=0.032). Conclusion : We found that the level of consciousness at admission was associated with treatment outcomes in patients with brain abscesses. Furthermore, initial hyperglycemia was closely related to the long-term use of antibiotic agents.