• Pediatric Infection and Vaccine
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• v.27 no.1
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• pp.45-52
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• 2020

Purpose: This pilot study aimed to evaluate the efficacy of high dose ampicillin-sulbactam and colistin combination therapy for ventilator-associated pneumonia (VAP) caused by carbapenem-resistant Acinetobacter baumannii (CRAB) in the pediatric intensive care unit of Pusan National University Children's Hospital. Methods: We retrospectively reviewed 17 pediatric patients with VAP caused by CRAB from June 2017 to August 2018. Ten (58.8%) patients were treated with high dose ampicillin-sulbactam and colistin combination therapy (combination therapy group), whereas 7 were treated with colistin only or with various combinations with or without colistin (other antibiotics group). Clinical and bacteriological outcomes were compared between the groups. Results: The mean duration of fever after antibiotic use was 1.30±1.70 days in the combination therapy group and 1.71±1.49 days in the other antibiotics group. The mean duration of days for negative conversion of endotracheal aspirate bacterial culture after antibiotic therapy was 3.40±1.71 days in the combination therapy group and 11.80±8.86 days in the other antibiotics group. The mortality rate within 30 days of antibiotic therapy was 1/10 (10%) in the combination therapy group and 3/7 (42.9%) in the other antibiotics group. Conclusions: High dose ampicillin-sulbactam and colistin combination therapy as early antibiotic treatment in VAP caused by CRAB in children could improve clinical outcomes.

• Journal of Plant Biotechnology
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• v.3 no.3
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• pp.113-121
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• 2001

The use of a marker gene in a transformation process aims to give a selective advantage to the transformed cells, allowing them to grow faster and better, and to kill the non-transformed cells. In general, the selective gene is introduced into plant genome along with the genes of interest. In some cases, the marker gene can be the gene of interest that will confer an agronomic characteristic, such as herbicide resistance. In this review we list and discuss the use of the most common selective marker genes on plant transformation and the effects of their respective selective agents. These genes could be divided in categories according their mode of action: genes that confer resistance to antibiotics and herbicides; and genes for positive selection. The contention of the marker gene flow through chloroplast transformation is further discussed. Moreover, strategies to recover marker-free transgenic plants, involving multi-auto-transformation (MAT), co-transformation, site specific recombination and intragenomic relocation of transgenes through transposable elements, are also reviewed.

• Journal of Microbiology and Biotechnology
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• v.29 no.11
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• pp.1683-1692
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• 2019

The rise of antimicrobial resistance (AR) is a major threat to global health. The food animal industry contributes to the increasing occurrence of AR. Multiple factors can affect the occurrence and dissemination of AR in the animal industry, including antibiotic use and farm management. Many studies have focused on how the use of antibiotics in food-producing animals has led to the development of AR. However, a few effective mitigating strategies for AR have been developed in food-producing animals, especially those exposed to the environment. The aim of this review is to summarize potential strategies applicable for mitigating AR at the environment-livestock interface.

• Journal of Sasang Constitutional Medicine
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• v.21 no.2
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• pp.153-162
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• 2009

1. Objectives : The purpose of this rase study is to evaluate the superiority of Sasang constitutional diagnosis and treatment in skin disease compared with western medicine and is to notify the importance of elevating requsite qi(保命之主) in treatment of skin disease. 2. Method : We compared to remedical value in two case. One is to use herbal medicine as well as routine antibiotic treatment. The other one is to use only herbal medicine. Antibiotics was focused on attacking the pathogen and herbal medicine was focused on elevating requsite qi(保命之主). 3. Result and conclusions : In result, the one using only herbal medicine showed satisfactory progress and predominant remedical value compared with one using herbal medicine and routine antibiotic. So It is necessary to approach skin disease in view of elevating requsite qi(保命之主).

• Journal of The Korean Association For Science Education
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• v.16 no.4
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• pp.461-469
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• 1996

The purpose of this study was to assess the attitudes of secondary school students in Korea toward science-technology related issues. A questionnaire was designed in which students were confronted with personal, global, and philosophical levels of arguments, which were composed of three against and three in favor of each eight issues, i.e., use of antibiotics, family planning, transplant of organs, genetic engineering, use of microorganisms. exploitation of the sea, land reclamation from the sea, and nature reserves. Student was requested to rate each argument independently and to vote for or against each issue. It was shown that most of students voted in favor of using technologies except land reclamation from the sea, and that students having more learning experiences on each topic vote more favorably. It is thought that our science education might be effective in increasing awareness and appreciation of benifits of technology, but it is not as effective in developing ambivalence attitudes.

• Clinical and Experimental Pediatrics
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• v.51 no.10
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• pp.1031-1037
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• 2008

Macrolide antimicrobial agents including erythromycin, roxithromycin, clarithromycin, and azithromycin are commonly used in the treatment of respiratory tract infections in children. Newer macrolides that have structural modifications of older drug erythromycin show improved change in the spectrum of activity, dosing, and administration. However, recent studies reported that increasing use of macrolide antibiotics is the main force driving the development of macrolide resistance in streptococci. In particular, azithromycin use is more likely to select for macrolide resistance with Streptococcus pneumoniae than is clarithromycin use, a possible reflection of its much longer half life. Recently, erythromycin resistance rates of S. pneumoniae and Streptococcus pyogenes are rapidly increasing in Korea. Two main mechanisms of acquired macrolide resistance have been described, altered binding site on the bacterial ribosome encoded by the ermB gene and active macrolide efflux pump encoded by the mef gene. Relationship between the susceptibility of S. pneumoniae and the response to macrolides has been shown in studies of acute otitis media, but less clear in cases of pneumonia. This article reviews the spectrum of activity, pharmacokinetic properties, mechanisms of action and resistance, and clinical implication of resistance on the treatment of respiratory tract infections in children.

• Korean Journal of Clinical Pharmacy
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• v.28 no.3
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• pp.174-180
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• 2018

Objective: Clostridium difficile Infection (CDI) is one of the common nosocomial infections. As elderly population increases, the proper treatment has been emphasized. We investigated the risk factors associated with CDI unimprovement in elderly patients. Furthermore, we performed drug use evaluation of old CDI patients and oldest-old CDI patients. Methods: It was a retrospective study using electronic medical record at Kangbuk Samsung Medical Center (KBSMC) from January 2016 to December 2017. Seventy three patients aged 65 years or older, diagnosed with CDI by Clostridium difficile Toxin B Gene [Xpert] were screened and they were assessed for risk factors regarding unimprovement status. We also evaluated drug use evaluation in old patients ($65{\leq}age$<80) and oldest-old patients ($80{\leq}age$) by assessing the use of initial therapy, severity, dose, route, treatment course, days of use, total days of use and treatment outcome of initial therapy. Results: Out of 73 patients aged over 65 years, four patients were excluded because they did not receive any treatment. There were 31 improved patients and 38 unimproved patients after initial therapy. We were able to find out patients with surgical comorbidity or endocrine comorbidity (especially, diabetes mellitus) had 2.885 more risk of becoming unimproved than those patients without surgical comorbidity or endocrine comorbidity. Drug use evaluation for CDI was generally fair, but vancomycin as initial therapy is more recommended than metronidazole. Conclusion: Although age, antibiotics exposure, use of antacids are all important risk factors for CDI, our result did not show statistical significance for these risk factors. However, the study is meaningful because the number of elderly population keeps increasing and recently updated guideline suggests the use of vancomycin as drug of choice for CDI.

• Quality Improvement in Health Care
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• v.1 no.1
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• pp.32-43
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• 1994

The 'Pharmacy and Therapeutic Committee' decided to restrict the use of vancomycin which was categorized into restricted antimicrobials, among general, reserved and restricted antimicrobials. The committee also established prescribing guidelines of vancomycin in Seoul National University Hospital, May, 1991. Especially, the restricted antimicrobials should be used after approval by infectious disease specialist physician. A retrospective drug use evaluation (DUE) on vancomycin has been conducted to compare with the previous vancomycin DUE study in 1990. 'Criteria for DUE on vancomycin' was modified from Am J Hosp Pharm. Total 65 charts of patients were retrospectively reviewed from July 1991 to June 1992 in Seoul National University Children's Hospital. The justification of use was improved from 56% to 75% comparing with the previous study. In analyzing process indicators, several criteria including body temperature monitoring, WBC monitoring and use of concomitant antibiotics were well documented, but serum creatinine monitoring, culture and sensitivity test and level monitoring were infrequently performed, while the accepted level has been improved. Accepted level for appropriate initial dosage and duration of therapy were decreased. In outcome analysis, blood culture after discontinuing the drug was relatively well documented compared with the previous study. As the results, the approval vancomycin use was shown to be effective and rational in antibiotic therapy. And it is suggested that the above findings should be communicated to the medical staff, and a active intervention, such as feedback control, also be necessary for rational drug use.

• YAKHAK HOEJI
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• v.53 no.3
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• pp.107-113
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• 2009

Since 2006, the Computerized Restricted Antibiotic Control Program (CRACP) has been incorporated to facilitate a more efficient approval process of vancomycin use at the Chonbuk National University Hospital. The purposes of the study were to evaluate proper use of vancomycin and to examine if there is any improvement when administering the CRACP. The use of vancomycin was retrospectively reviewed by a medical record review based on the American Society of Hospital Pharmacists (ASHP) criteria (i.e., indication, use of critical process indicators and use of outcome measurements) and compared before (Group I) and after the CRACP (Group II). Two hundred fifty six patient records were evaluated (138 in Group I and 118 in Group II). There was a statistically significant improvement in the report of justification for vancomycin use after CRACP (42.0% vs. 62.7%, p=0.001). Out of eight critical process indicators, two indicators (appropriate cultures prior to medication [68.8% vs. 85.6%, p=0.002] and serum vancomycin level measurement [0% vs. 7.6%, p=0.001]) were significantly improved after CRACP. The total incidence of adverse effects was decreased from 14.5% to 6.8%. In addition, there was a statistically significant difference in WBC count reduction within normal range (52.8% vs. 73.1%, p=0.024). The CRACP appears to be a promising approach to improve use of vacomycin in a hospital setting. However, further evaluation for the long-term period should be performed to confirm the performance of the program.

• Journal of Animal Science and Technology
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• v.57 no.1
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• pp.2.1-2.5
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• 2015

Among the main intimidation to the sheep and goat population, PPR outbreaks are causing huge losses especially in endemic areas. During recent times, six outbreaks of PPR were confirmed at semi-organized goat farms/herds in various regions of Punjab province and Islamabad capital territory (ICT), Pakistan. The disease started after introduction of new animals at these farms with no history of previous PPR vaccination. The clinical signs appeared affecting respiratory and enteric systems and spread quickly. Disease caused mortality of 10-20% and morbidity of 20-40% within a time period of four weeks. Morbidity and mortality rates were 30.38% (86/283) and 15.55% (44/283), respectively. Three treatment regimes were executed to demonstrate the role of vaccination during outbreak at these farms. First was to use only the broad spectrum antibiotics (Penicillin & Streptomycin and/or Trimethoprim and Sulfadiazine) at two farms (Texilla and Attock). Second treatment regime was to use the same broad spectrum antibiotic along with extensive fluid therapy (Farms at ICT-1 and ICT-2). The third regime was to use of broad spectrum antibiotic plus fluid therapy along with vaccinating the herd against PPR during first week of outbreak (ICT-3 and ICT-4). The third scheme of treatment gave the better results as there was no mortality in third week post-outbreak. Therefore, it is suggested to give proper importance to PPR vaccination along with conventional symptomatic treatment when dealing the PPR outbreaks in endemic disease conditions.