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Objective To evaluate the efficacy of single or double-antibiotic regimen for the treatment of complicated appendicitis in children,with the purpose to guide the rational use of antibiotics in clinic.Methods Six hundred and sixty-three patients with acute appendicitis admitted to the department of pediatric surgery in Jinhua Municipal Central Hospital between March 2011 and February 2015.One hundred and seventy-two of 663 patients with complicated appendicitis which confirmed by intra-operative macroscopic or post-operative pathological examination were eligible for the study.These patients were divided into two groups based on the regimen of their postoperative antibiotics:single or double-antibiotic regimen(treatment group,n=66);triple antibiotics regimen(control group,n=106).Demographic data,blood routine test and C-response protein(CRP),length of hospital stay,postoperative complications and duration of antibiotic treatment were recorded and statistically analyzed.Results There was no difference between the treatment group and control group with respect to age distribution,blood routine examination and CRP, length of hospital stay, duration of antibiotic treatment or postoperative complications.Although the number of patients changed of antibiotics on the basis of bacterial culture of pyogenic fluids in treatment group were more frequently than those in the control group(7/66 vs.1/106), the therapeutic effective rate of changed of antibiotics was 100% in both two groups.The culture positive rate of peritoneal fluids was 72.09% (124/172), the most common pathogens were escherichia coli(80.15%, 105/131),pseudomonas aeruginosa(5.34%,7/131)and klebsiella pneumonia (3.05%,4/131).The results of bacterial culture of peogenic fluids showed no difference in both two groups.Conclusion Children with complicated appendicitis can be managed effectively with single or double broad-spectrum antibiotics after appendectomy,and it may be beneficial to guide the rational use of antibiotics and decrease the irrational use of multi-antibiotics combination in clinic.
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Data from across the world have shown an overall decline in the antibiotic pipeline and continually rising resistance to all first-line and last-resort antibiotics. The gaps in our knowledge of existing prevalence and mechanisms of antibiotic resistance (ABR) are all too well known. Several decades of antibiotic abuse in humans, animals, and agricultural practices have created health emergency situations and huge socio-economic impact. This paper discusses key findings of the studies conducted by several national and international collaborative organizations on the current state of affairs in ABR. Alongside, a brief overview of the antibacterial agents׳ discovery in recent years approved by the US FDA is discussed.
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OBJECTIVE:To provide reference for safe application of antibiotic drugs in single or inter-medical institution ser-vices. METHODS:An antibiotic drug safety evaluation index system was established by reference to literatures. Medical records tracing method was adopted to obtain the medical records of children with respiratory infectious diseases under the medical consor-tium model. The medical records were matched and evaluated by experts to analysis the safety of antibiotic drug use in single medi-cal institution and the connection between two medical institutions with respect to the safety of antibiotic drug use. RESULTS:248 effective medical records had been obtained. Under the medical consortium model,the rate of the combination of antibiotic drugs in large hospitals was 86.29%,higher than the community hospitals of 77.02%(χ2=5.49,P<0.05). The error rate of antibiotic drug use by children in large hospitals was 14.52%,lower than the community hospitals of 25.81%(χ2=9.733,P<0.05). There were many contradictions in antibiotic drug use between the medical institution where children received treatment initially and the medi-cal institution which the children were referred to and hospitalized in. There were totally 128 cases of unsafe antibiotic drug use, with the overall incidence of 51.61%. CONCLUSIONS:Under the medical consortium model,the safety of antibiotic drug use by the hospitalized children in single medical institution is worrying,and the connection between two medical institutions with respect to the safety of antibiotic drug use by children who are referred and hospitalized is less reliable.
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Objective To investigate the drug resistance of Staphylococcus haemolyticus and provide basis for selection of clini‐cal drugs .Methods A total of 59 strains of Staphylococcus haemolyticus were isolated from patients ,and analyzed the clinical dis‐tribution and drug resistance of them .Results Staphylococcus haemolyticus were mainly isolated from the sputum and oropharyn‐geal swabs in pediatric and ICU .The patients were mainly newborns .Staphylococcus haemolyticus mainly included methicillin re‐sistant Staphylococcus haemolyticus (MRSH) ,accounting for 89 .8% (53 strains) .MRSH showed high‐drug resistance and multi‐drug resistance .However ,it was sensitive to vancomycin ,teicoplanin and linezolid ,the antibiotic sensitive rate was 100 .0% .Conclu‐sion Staphylococcus haemolyticus is an important coagulase negative staphylococci ,mainly including MRSH ,which shows high‐drug resistance and multi‐drug resistance .
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OBJECTIVE To investigate the clinical distribution and resistance of Acinetobacter baumannii in our hospital in order to provide evidence to proper use of antibiotic drugs in clinics. METHODS A. baumannii isolates were collected in our hospital from Jan 2004 to Dec 2006. Antimicrobial susceptibility testing was performed by disk-diffusion method,according to the standards of CLSI/NCCLS, the data were analyzed by WHONET5.4 software. RESULTS The isolating rate of A. baumannii from 2004 to 2006 was 2.5%,3.8%, and 10.9%, respectively.It was distributed mainly from ICU (29.2%), respiratory ward (19.3%) and emergency ward (10.9%). The highest appearing rate was the sputum, up to 78.0%. More than 60% of isolates were resistant to antimicrobial agents tested such as PIP, CTX, CRO and ATM. A. baumannii showed the highest susceptibility to carbopenems with about 80%. CONCLUSIONS The infection of A. baumannii is one of the most complex problems. Therefore, monitoring A. baumannii constantly and regularly, finding out resistant strains timely, and adjusting the treatment regimen are very important to the prevention of nosocomial infection. The disinfection should be strengthened for hospital environment and medical staff in order to control existence and spread of A. baumannii.
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0.05);the preoperative use rate was 8.6% and 65.1%(P0.05);both groups used drug mainly in vein and in single mode.CONCLUSIONS After the implementation of the Guideline the rational use of antibiotics is improved but there are some problems needed to manage further.
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OBJECTIVE To improve efficiency and quality of antibiotic drug usage in order to assure patients′ security of antibiotic drug usage. METHODS Inducted by strengthening security quality of medical treatment,we are bring antibiotic drug usage into medical quality management by using information technique,training medical workers,putting antibiotic drug into different classifications and surveillancing the usage of antibiotic drug.Moreover,we develop significant basic study for clinic to improve the level of rational use of drug. RESULTS Frequency and number of days for drug usage were reduced by putting measures into effect and inspecting numbers and sorts of drug usage.At the same time,we instituted individualized drug using scheme to critical patients,thereby many critical patients were retrieved. CONCLUSIONS Rational use of drug is a system project which must redeploy all enthusiasm and take comprehensive measures to fight for a safe,effective,economical goal in our work.