• Archives of Plastic Surgery
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• v.51 no.1
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• pp.36-41
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• 2024

Background Among breast reconstruction methods, implant-based breast reconstruction has become the mainstream. However, periprosthetic infection is still an unresolved problem. Although published articles have revealed that limited use of antibiotics is sufficient to reduce infection rates, the number of surgeons still preferring elongated usage of antibiotics is not less. The aim of our study is to validate the appropriate duration of antibiotic use to reduce infection rate after implant-based breast reconstruction. Methods A retrospective study reviewed medical record of 235 patients (274 implants for reconstruction) who underwent prepectoral direct to implant breast reconstruction using acellular dermal matrix wrapping technique. Infection rates were analyzed for the patients administered postoperative prophylactic antibiotics until drain removal and those who received only perioperative prophylactic antibiotics for 24 hours. Results Of the 274 implants, 98 who were administered prophylactic antibiotics until drain removal had an infection rate of 3.06% (three implants) and 176 who received prophylactic antibiotics no longer than 24 hours postoperatively had an infection rate of 4.49% (eight implants). A total of 11 patients diagnosed with postoperative infection clinically, 8 were salvaged by antibiotic treatment, and 3 had implant removal and replacement with autologous flap. Postoperative antibiotic prophylaxis duration had no statistically significant effects in the risk of infection (p = 0.549). Conclusion The duration of prophylactic antibiotics after surgery was not related to infection risk. Further study with a large number of patients, randomized control study, and route of antibiotics is needed.

• Korean Journal of Clinical Pharmacy
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• v.9 no.1
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• pp.35-43
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• 1999

Over the last 50 years, a number of antibiotic agents have been developed and clinically used in the area of infectious diseases. Due to antimicrobial resistance problems and increasing health care costs, the rational use of antibiotics has been required. As a drug of choice to treat infections caused by MRSA, vancomycin has been extensively prescribed since the late 1970's. Recently, reports of vancomycin-resistant organisms such as VRE and VRSA have been increased to draw medical concerns. The objectives of this study were to evaluate the rational use of vancomycin and the appropriateness of the Restrictional Program of Antibiotic Utilization (RPAU) which has been operated at Samsung Medical Center. A retrospective chart review was performed in 132 hospitalized patients treated with vancomycin in the surgery departments from. January to June 1998. The guidelines of ASHP and HICPAC for vancomycin were modified and used as our criteria to determine the vancomycin DUE. In one hundred out of the patients, uses of vancomycin were approved by the Department of Infectious Diseases (DID) based on the RPAU. Vancomycin was appropriately used in $62.5\%$ of the 100 patients according to the criteria of justification of use, while $60.0\%,\;60.0\%,\;79.0\%,\;and\;51.0\%$ of the patients showed appropriate according to those of lab reports such as applicable culture obtained, pretreatment SCr, WBC and serum drug concentration monitoring, respectively. Although the rest 32 patients were not approved to receive vancomycin by the DID, twenty two percent continued receiving vancomycin treatment. This might result from the fact that the RPAU was started not before the use of antibiotics but in the middle of antimicrobial therapy. Continual education should be provide to the related health professionals and the RPAU should be simultaneously modified in order to increase the rate of appropriate uses of antibiotics.

• Journal of Dairy Science and Biotechnology
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• v.31 no.1
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• pp.1-7
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• 2013

Probiotics are traditionally defined as viable microorganisms that have a beneficial effect in the prevention and treatment of pathologic conditions when they are ingested. Although there is a relatively large volume of literature that supports the use of probiotics to prevent or treat intestinal disorders, the scientific basis behind probiotic use has only recently been established, and clinical studies on this topic are just beginning to get published. Currently, the best studied probiotics are lactic acid bacteria, particularly Lactobacillus and Bifidobacterium species. Other organisms used as probiotics in humans include Escherichia coli, Streptococcus sp., Enterococcus sp., Bacteroides sp., Bacillus sp., Propionibacterium sp., and various fungi, and some probiotic preparations contain more than one bacterial strain. Probiotic use for the prevention and treatment of antibiotic-associated diarrhea caused by Clostridium difficile induced intestinal disease as well as for other gastrointestinal disorders has been discussed in this review.

• Korean Journal of Clinical Pharmacy
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• v.22 no.4
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• pp.291-303
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• 2012

As respiratory tract infections (RTI) account for about 60% of all antibiotic prescriptions in outpatient care setting, there are significant concerns about emerging resistance that are largely due to the excessive or inappropriate use of antibacterial agents for viral respiratory infections. This study was aimed to develop retrospective drug utilization review (DUR) program of antibiotics for RTIs using Delphi methods. Retrospective DUR criteria of antibiotics for RTIs were identified based on clinical practice guidelines and opinion of experts. Expert panel members were clinical doctors and pharmacists and Delphi method was applied by survey on 16 members of panels. The claim data from Korean Health Insurance Review & Assessment (HIRA) were used to examine trends in outpatient antibiotic prescription between Janunary to December of 2008. As results, Quality index for RTI was assessed for the claim type, antibiotics use of quantity, duration, number and cost. Antibiotic prescription rate for RTIs, Defined Daily Dose (DDD), and duration of antibiotics use were more recognized as significant quality index by experts' opinion. Use of first line agents suggested by guidelines was low and duration of antibiotics use was shorter compared to the recommendations. Antibiotics were over prescribed for RITs. However, dose and duration of antibiotics were under-used.

• International journal of advanced smart convergence
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• v.11 no.4
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• pp.227-239
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• 2022

Purpose: In our study, in order to find lactic acid bacteria (LAB) with multi-drug resistance to antibiotics, we isolated 140 strains from 15 types of kimchi commercially available in Korea and 20 types of Kimchi made at home from January to December in 2016, and investigated their H₂O₂ generating ability and multi-drug resistance to antibiotics. Methods: In order to observe the H₂O₂ generation ability of LAB, we performed the experiment with methods such as Rabe, Hillier, and Kang. To test the antibacterial susceptibility of LAB, we used the disc agar diffusion method using MRS agar (Difco, USA) according to the CLSI and WHO test methods. There are 18 types of antibiotic discs used. Results: Out of the total numbers of 140 strains, 6 strains of Ent. Faecium, 25 strains of L. plantarum, 1 strain of L. rhamnosus, 3 strains of L. sakei, 1 strain of L. acidophilus, 1 strains St. thermophilus, and 7 of unidentified strains generated H₂O₂. The antibiotic susceptibility of Ent. Faecium indicated SXT, OX, NA, and E; and the antibiotic susceptibility of L. plantarum indicated NA; and the antibiotic susceptibility of St. thermophilus indicated NA, CC, RA, CTT, CM, and P ; and the antibiotic susceptibility of L. rhamnosus indicated SXT, VA, NA and CTT; and the antibiotic susceptibility of 6 strains of L. sakei indicated SXT, OX, NOR, NA, CTT and CIP, all indicating antibiotic resistance. In the case of multi-drug resistance to antibiotics for 53 strains of L. antarum, 8-drug resistance was the most common with 25 strains, followed by 7-drug-resistant strains with 18 strains, 9-drug-resistant strains with 4 strains, 6-drug-resistant strains with 3 strains, 5-drug-resistant strains with 2 strains, and 17-drug-resistant strains with 1 strain. In the case of multi-drug resistance to antibiotics for Ent. Faecium 27 strains, 9-drug resistance was most commonly identified as 9 strains, 8-drug resistance was identified as 6 strains, 7- and 11 drug resistances were identified as 4 strains each, and 4- and 6-drug resistances were identified as 1 strain each. Conclusion: Ent. Faecium, L. plantarum, L. rhamnosus, L. sakei, and St. thermophilus, shown to have anantibacterial activity in previous studies on LAB and shown to have and H₂O₂ generating ability, antibiotic resistance and multi-drug resistance in this study, are expected to be able to play an excellent role for long-term inpatients to use as an alternative to antibiotics and to cope with emerging antibiotic resistance.

• Proceedings of the Korean Society of Food Science and Nutrition Conference
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• 2001.12a
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• pp.161-169
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• 2001

Lactic acid producing bacteria were isolated from baby feces and characterized to be used as a probiotic with anti Helicobacter pylori functions. The selected bacteria had inhibition activity on the adherance and growth of H. pylori. These bacteria had additional beneficial characteristics for the probiotic such as antibacterial activity, antitumor activity, immunostimulation activity, resistance to antibiotic and bile salt, ability to bind to the intestinal cells, and safe for the human use.

• Asian-Australasian Journal of Animal Sciences
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• v.16 no.11
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• pp.1656-1660
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• 2003

The aim of this study was to investigate the effect of fermented fruits (FF) on the growth performance, Enterobacteriaceae and Lactobacillus counts in faeces of the post-weaning piglets. A total of twenty-four 4 weeks old Landrace${\times}$ Large White${\times}$Duroc with initial body weight of 6 kg were used in this study. The piglets were housed individually in metabolic cage and randomly assigned to four groups with six piglets per group. The piglets were fed on basal diet without antibiotic (AF), basal diets with antibiotic (Ab), basal diet with 10% (w/w) fermented fruit (10% FF) and basal diet with 20% (w/w) fermented fruit (20% FF). Faecal samples were taken directly from the rectum of each piglet and cultured for Enterobacteriaceae and Lactobacillus counts. In the growth performance, the piglets of Ab and 10%FF had significantly higher (p<0.05) average daily gain than those of 20%FF. However, no differences (p>0.05) were observed between AF, Ab and 10%FF. Studies showed that the use of fermented fruits (FF) could significantly (p<0.05) reduce Enterobacteriaceae population in piglets' faeces compared to the use of normal feed (AF) and antibiotic (Ab). However, the Lactobacillus population in the faeces was increased in those piglets fed with diets added with FF.

• Journal of Korean Traditional Oncology
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• v.28 no.1
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• pp.25-31
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• 2023

Objectives: With antibiotic resistance one of the biggest threats to global health, we report a case of surgical site infection (SSI) after breast cancer surgery that improved only with the treatment of Taglisodog-eum (托裏消毒飮), Korean herbal medicine, without the use of antibiotics. Methods: The patient diagnosed with ductal carcinoma in situ of left breast underwent nipple areola skin sparing mastectomy and reconstruction using deep inferior epigastric perforator flap. About a month later, superficial SSI occurred at the incision site of breast cancer surgery with general weakness, and Taglisodog-eum treatment was started. To evaluate the effectiveness of the treatment, we compared the infection site conditions before and after treatment. Results: About three weeks after taking Taglisodog-eum, the SSI improved along with the improvement of general weakness. Conclusions: This study shows that Taglisodog-eum may be effective for SSI after breast cancer surgery, and the potential for alternatives to reduce antibiotic use and antibiotic resistance.

• Journal of Korean Society of Health-System Pharmacists
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• v.35 no.4
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• pp.391-399
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• 2018

Background : The Antimicrobial Stewardship Program promotes interdisciplinary interventions and targeted recommendations for the proper utilization of antibiotics. In particular, the aim of the program is to avoid indiscriminate use of broad-spectrum antibiotics based on the documented literature on the significant impact of unsystematic usage of antibiotics on the distribution of antibiotic-resistant microorganisms. To improve the care process for pneumonia treatment using antimicrobial agents, institution-level guidelines were established and disseminated at the Seoul National University Bundang Hospital in April 2016. In this study, we evaluated changes in the physicians'antibiotic prescribing patterns both before-and after-the implementation of the guidelines. Methods : The electronic medical records of inpatients who were prescribed with one or more antibiotics in May 2014 (Group A) and May 2016 (Group B) were reviewed. Data on demographic characteristics, clinical outcomes, and antibiotic prescriptions were collected and the prescription records were compared both before- and after- the implementation of the guidelines. Results : A total of 180 patients were included in the study: 77 patients in group A and 103 patients in group B. The baseline characteristics of the patients were not significantly different between the two groups. Community-acquired pneumonia was the most common diagnosis in both the groups and the difference was not significant (68.8% vs. 67.9%; p=0.67). The type of antibiotic prescriptions used for empirical treatment was not different between the two groups. The most commonly prescribed empirical antibiotics were cephalosporins, with no significant difference (p=0.31). One of the most inappropriately used antibiotics was piperacillin/tazobactam and the rate of prescription was similar in both the groups (p=0.68). The rates of appropriate empirical selection of antibiotics remained unaltered between the two groups (67.5% vs. 71.8%; p=0.53). Conclusions : Implementation of the guidelines only exhibited no significant effect on the antibiotic prescribing patterns of physicians for the treatment of pneumonia. To improve the adequate use of empiric antibiotics, more active interventions and closer monitoring of the feedbacks should be additionally considered and evaluated in future studies.

• Asian-Australasian Journal of Animal Sciences
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• v.14 no.3
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• pp.414-422
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• 2001

Antibiotic resistance in human pathogens is a major public health issue. Some of the resistance problem can be attributed to the transfer of resistant bacteria from animals to people and the transfer of resistance genes from animal pathogens and commensal bacteria to human pathogens. Control measures include improvements in food hygiene to reduce the spread of zoonotic bacteria to people via the food chain. However, to specifically address the issue, the medical profession must control misuse and overuse of antibiotics in hospitals and community practice. In addition, the livestock industries and their advisors must reduce and refine the use of antibiotics in animal production and replace antibiotics with alternative disease control measures as much as possible.