Mycoplasma pneumoniae (MP) is the most common cause of childhood bacterial pneumonia. Although macrolide is known to be effective as a first-line therapy, the proportion of macrolide resistance in MP pneumonia has strikingly increased during recent 2 decades in East Asia. This is challenging to physicians since they have to decide more often whether to use secondary treatment. Diagnostic methods to detect macrolide-resistance of MP are currently not available in Korean hospitals. Even in the diagnosis of MP infection, both serologic and molecular test have limitation: inability to differentiate current illness from carriage or asymptomatic infection. Combining these 2 diagnostic methods and excluding infection caused by other respiratory pathogens allow a more reliable diagnosis. This effort is even more demanding in recent years to keep children from unnecessary exposure to secondary antibiotics. Although several observational studies have reported that tetracycline and fluoroquinolone, which are considered in the treatment of refractory MP pneumonia, have efficacy of shortening the duration of fever and respiratory symptoms, those findings need to be proven by well-designed prospective studies. The use of tetracycline and fluoroquinolone in children is generally tolerable, as supported by many observational data. However, since concerns about side effects still remain, careful consideration about benefits and risks is needed to decide their use.
Different treatment options are available according to the stage and duration of the empyema. Stage I empyema (exudate stage) is treated concurrently by the administration of appropriate antibiotics and chest tube drainage. Stage III empyema (organized stage) is considered for decortication through an open thoracotomy. However, the treatment of fibrinopurulent, stage II empyema remains controversial. Recently, debridement with the use of Video-Assisted Thoracoscopic Surgery (VATS) has been proposed for the treatment of stage II empyema. We analyzed and report our initial experience of 5 cases of stage II empyema, treated with the use of VATS. Material and Method: Between June 2001 and February 2002, 5 patients with fibrinopurulent empyema that did not respond to antibiotics, chest tube drainage or Percutaneous Catheter drainage (PCD), and instillation of fibrinolytic agent were treated by debridement and irrigation with the use of VATS. A CT scan was performed in all patients before the operation to confirm the diagnosis of loculated empyema and to detect additional lung parenchymal diseases. Result: All 5 patients underwent successful debridement and irrigation with the use of VATS and the chest tube was inserted properly. And no patients needed conversion to open thoracotomy. The ratio of sex was 4 : 1 (male : female), the mean age was 53 years old (range, 26~73 years), the mean operative time was 73.4 minutes (range, 52~95 minutes), the mean duration of postoperative chest tube placement was 12.4 days (range, 6~19 days), and the mean duration of postoperative hospital stay was 20.8 days (range, 10~36 days). In all patients, clinical symptoms such as pain and fever subsided and simple chest PA view revealed satisfactory lung expansion. No major postoperative complication was observed during the hospital course and no patient suffered from the recurrence of empyema in the follow-up period. Conclusion: We think that early operation with the use of VATS is safe and efficient for stage II empyema which did not respond to medical treatment(antibiotics and chest tube drainage), therefore, it can prevent stage II empyema from advancing to stage III, organized empyema.
The objective of this study was to find out guardians' understanding on the antibiotic use for their children under elementary school age. Survey analysis was performed on 671 questionnaire response sheets from the guardians for children ($\leq$13 years old) attending daycare centers, kindergartens, or elementary schools located in eastern part and vicinity of Seoul, Korea. Result showed that majority of the guardians did not follow right direction for the use of antibiotic medications. About 80% of the guardians discontinued or reduced dosage of the antibiotic medications if symptoms relieved, and about 66% of them administered the drug always after meal although interval was not consistent. Furthermore, only one-fifth of the guardians understood right indication of antibiotic medications that it is of no use to take antibiotics for the treatment of common cold. About 65% of the guardians participated in this study responded that they received drug information for antibiotic medications from doctors or pharmacists. However, in terms of knowledge score regarding antibiotic drug use, their score was significantly lower than that of guardians who received the information from internet or mass media. This result suggests that patients counsel is not efficiently being practiced among healthcare professionals in the region surveyed in this study. Therefore, in conclusion, it appears that community pharmacists need to be more interactive in patients counsel when they dispense antibiotic medications.
Na, Yongmin;Kang, Ji Hoon;Jung, Mi Ran;Ryu, Seong Yeob;Jeong, Oh
Journal of Gastric Cancer
/
v.19
no.4
/
pp.451-459
/
2019
Purpose: Laparoscopic surgery is associated with lower surgical site infection (SSI) rates due to minimal skin incision and non-exposure of visceral organs. Most previous studies have analyzed the efficacy of prophylactic antibiotic use in open surgery. Here, we investigated the feasibility of total laparoscopic distal gastrectomy (TLDG) for gastric carcinoma without prophylactic antibiotic use. Materials and Methods: Seventy-one patients who underwent TLDG without prophylactic antibiotic use were 1:1 propensity score matched with 393 patients who underwent TLDG with antibiotic prophylaxis. The short-term surgical outcomes, including SSI rates, were compared between the groups. Results: After matching, 65 patients were selected in each group. The baseline clinicopathological characteristics were well balanced in the matched sample. In the matched group, there was no significant increase in postoperative morbidity in the non-prophylactic group compared with the prophylactic group (18.5% vs. 15.4%, P=0.640), and there were no grade 3≤ complications (1.4% vs. 0%, respectively; P=1.000). The SSI rates in the non-prophylactic and prophylactic groups were 3.1% and 1.5%, respectively (P=0.559). The time to gas passage, diet initiation, and mean hospital stay were not significantly different between the 2 groups. The SSI rate did not increase in the non-prophylactic group in the different subgroups based on different clinicopathological characteristics. Conclusions: Postoperative morbidity, including SSI rates, did not significantly increase in patients undergoing TLDG without prophylactic antibiotic use. A large prospective randomized trial is warranted to reappraise the efficacy of prophylactic antibiotic use in patients undergoing TLDG.
Background: The statistical methods to analyze and predict the related dangerous factors of deep fungal infection in lung cancer patients were several, such as logic regression analysis, meta-analysis, multivariate Cox proportional hazards model analysis, retrospective analysis, and so on, but the results are inconsistent. Materials and Methods: A total of 696 patients with lung cancer were enrolled. The factors were compared employing Student's t-test or the Mann-Whitney test or the Chi-square test and variables that were significantly related to the presence of deep fungal infection selected as candidates for input into the final artificial neural network analysis (ANN) model. The receiver operating characteristic (ROC) and area under curve (AUC) were used to evaluate the performance of the artificial neural network (ANN) model and logistic regression (LR) model. Results: The prevalence of deep fungal infection from lung cancer in this entire study population was 32.04%(223/696), deep fungal infections occur in sputum specimens 44.05%(200/454). The ratio of candida albicans was 86.99% (194/223) in the total fungi. It was demonstrated that older (${\geq}65$ years), use of antibiotics, low serum albumin concentrations (${\leq}37.18g/L$), radiotherapy, surgery, low hemoglobin hyperlipidemia (${\leq}93.67g/L$), long time of hospitalization (${\geq}14$days) were apt to deep fungal infection and the ANN model consisted of the seven factors. The AUC of ANN model($0.829{\pm}0.019$)was higher than that of LR model ($0.756{\pm}0.021$). Conclusions: The artificial neural network model with variables consisting of age, use of antibiotics, serum albumin concentrations, received radiotherapy, received surgery, hemoglobin, time of hospitalization should be useful for predicting the deep fungal infection in lung cancer.
Journal of Physiology & Pathology in Korean Medicine
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v.21
no.1
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pp.333-337
/
2007
Cellulitis is a infectious disease characterized by acute purulent inflammation clinically manifested by erythema, pain or heating sensation caused by palpation, chilling sign and mild to moderate fever. in western medicine most part of the treatment is focused on injecting routine antibiotics hoping for the pathogen(in the case bacteria) to be treated but instead causing the bacteria to be resistant to antibiotics and consequently leads to longer admission. In oriental medicine Cellulitis belongs to the cathegory of Ong(癰), Bal(發) or Dandok(丹毒) on symptoms. The chief cause of acute Cellulitis is the evil of wet and heat blended and the postraumatic infection evil. We experienced a case of acute cellulitis defined as Bicheonbal(비천발) and Chokbaebal(足背發). We attempted to use both methods using acupuncture, herbal medicine(Gamidangkwuijeomtong-tang(加味當歸拈痛湯)) as well as routine antibiotic treatment and as a result we have achieved remarkable results in laboratory tests though there was no difference in shortening the curing process compared to the average time that it take to cure when admitted to western medical center.
The beneficial effects of antibiotics in acute diarrhea of children were analysed 10 assess their effectiveness since many physicians use them to treat acute diarrhea. Searching 124 charts of patients admitted from August 1996 to July 1997, they were divided into two groups, an antibiotic negative (N) group of 28 patients and a positive (P) group of 96 patients. The admission period was significantly shorter in N group than P group (P=0.0057). Duration of fever and diarrhea were also shorter in N group (P=0.0328 and 0.0184 respectively). Although it was not statistically significant. duration of vomit and frequency of diarrheal episodes per day were lower in N group (P=0.7091 and 0.061, respectively). Age, sex, duration of diarrhea before the admission and CRP collected on the day of admission were not statistically different between the two groups (P=0.5866, 0.093, 0.3502 and 0.2628 respectively).
Kim, Moon-Seob;Kim, Su-Gwan;Moon, Seong-Yong;Oh, Ji-Su;Park, Jin-Ju;Jeong, Mi-Ae;Yang, Seok-Jin;Jung, Jong-Won;Kim, Jeong-Sun
Maxillofacial Plastic and Reconstructive Surgery
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v.33
no.5
/
pp.445-448
/
2011
Mortality associated with maxillofacial infection is relatively low due to the development of antibiotics, and improved oral care. However, inappropriate treatment, delayed treatment, old age, underlying systemic disease, and drug-resistant microorganisms can potentially result in life threatening situations such as cavernous sinus thrombosis, mediastinitis, and sepsis. Sepsis is the most dangerous state with high mortality, ranging from 20~60%. The treatment of sepsis involves properly monitoring vital functions, fluid resuscitation, surgical drainage, and empirical use of high doses of antibiotics until culture results are available. Ventilatory support maybe be required as well. We encountered a 64-year-old patient who died from sepsis that developed as the result of an odontogenic infection. The initial diagnosis was right temporal, infraorbital, buccal, pterygomandibular space abscess. Despite surgical and medical supportive care, the condition progressed to sepsis and after four days the patient died due to multiple organ failure.
A 6-year-old Thoroughbred mare presented to the Korea Racing Authority Equine Hospital with dropping of the left front fetlock due to an injury sustained while racing. Radiographic examination revealed a comminuted fracture of both proximal sesamoid bones of the affected fetlock. Arthrodesis of the fetlock joint using a broad dynamic compression plate with a tension band wire was performed as a salvage procedure for the future use as a broodmare. After surgery, however, a delayed union of the bones and surgical site infection was present for a prolonged period. Staphylococcus aureus was persistently identified from the surgical site, and antimicrobial therapies were based on antibiotic sensitivity tests, including regional perfusions. The removal and replacement of surgical implants associated with seropurulent discharge was based on coordinating the development of fetlock ankylosis and infection control over 13 months. Firstly, seven screws associated with surgical drainage were replaced and bone morphogenetic protein-2 (BMP-2) and local antibiotics were placed into the surgical site to accelerate bone fusion at postoperative month 7. Further six screws, along with drainage, were removed at postoperative month 10. The plate and screws were removed from the limb due to the progression of bone fusion at postoperative month 13; BMP-2 and local antibiotics were also used. Delayed healing of arthrodesis due to surgical site infection and implant instability were treated by implant removals and antibiotic therapies, and the horse eventually showed improved weight-bearing ability of the affected limb.
Journal of Fisheries and Marine Sciences Education
/
v.29
no.3
/
pp.834-846
/
2017
Aquaculture practices to ensure greater production, such as high density breeding and excessive feeding, are become stressors that raise the prevalence of diseases. Accordingly, increasingly large volumes of antibiotics are used more frequently each year. Long term use antibiotics can generate resistant bacteria, which interrupt treatments and cause a potential transfer to human bodies. Thus, antibiotic resistance is of importance in public health. Tetracycline (Tc) is one of the typical medicines used in the aquaculture drugs, which has a wide range of application including gram-positive and gram-negative bacteria. In the examination of 153 strains isolated from olive flounder (Paralichthys olivaceus) farms located in Jeju in 2016, it turned out that a total of 84 strains were resistant to Tc or oxytetracycline (OTC). The extent to which the strains are resistant to Tc and OTC was confirmed through MIC test, mostly within the range of 25 to $100{\mu}g/m{\ell}$. Twelve different types of tet genes were detected using single and multiplex PCR in the 84 Tc-resistant strains. The PCR was used to find tet(K), tet(M), tet(O), and tet(S), which are known to exist primarily in gram positive strains. According to the results, - tet(S) is the most dominant gene in 49 strains of Streptococcus parauberis, accounting for 63.2%. And there were two strains that have two different types of resistant genes. The multiplex PCR was used to detect tet(A), tet(B), tet(C), tet(D), tet(E), and tet(G), which are commonly found in gram-negative strains. Each of tet(B), tet(D), and tet(B)&(M) was found in a strain presumed to be Vibrio sp., and only tet(D) was found in 10 Edwardsiella tarda strains.
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