RESUMO
Antimicrobial control programs are widely used to decrease antibiotic utilization, but effects on antimicrobial resistance and outcomes for patients remain controversial. The purpose of this study was to determine the impact of rotation of antibiotic classes used as empirical surgical prophylaxis on the emergence of bacterial resistance organisms and antibiotics drug use when compared with non-rotation period. Method: Three core, broad spectrum agents [cephalosporins, beta-lactam-inhibitors, and fluoroquinolones] were selected for inclusion in the quaternary rotation for 21 months, based on prior 8 months baseline data from GIT and urology surgical wards in Ibn Sina hospital. Intensive surveillance done for patients admitted to the selected settings. 1681 surveillance samples obtained from 2359 eligible inpatients admitted to hospital from Jan 2008 to May 2010. A significant reduction in the percentage of positive growth had been observed with antibiotic rotation for both wards from 65% and 49% in baseline to 59% and 33% in rotation [1] and 25% and 33% in rotation [2] in GIT and urology ward respectively [p 0.0001]. As general there was a divergent effect of the antimicrobial rotation on the prevalence of resistance among G+ve and G-ve bacteria. We concluded that antimicrobial drug use in surgical departments could be optimized after implementation of antimicrobial cycling policy, and associated in reduction in the incidence of infectious mortality and morbidity but stabilize antibiotic resistance, without significant reduction
RESUMO
Acne vulgaris is the most common dermatological disorder in adolescence. Treatment is essential to prevent physical and psychological scarring. Although many treatments for acne are available, effective management has become increasingly challenging with the emergence of antibiotic-resistant strains of Propnionibacterium acnes. The aim of this study is to evaluate the efficacy of oral azithromycin in acne by comparing its effect with the most common therapy used for acne; doxycycline. An opened label r and omized comparative study was carried out in 40 patients of mild, moderate and Severe acne vulgaris divided into two groups, group [A] 20 patients received azithromycin capsules in a specified and scheduled dose regimen and group [B] 20 patients administered doxycycline tablets as a usual regimen of therapy. The results obtained from oral azithromycin therapy when compared with oral doxycycline showed that there was statistically no difference between the two drugs in response at end of 22 weeks. The overall efficacy measured in terms of reduction of the severity of condition was up to 83% with azithromycin compared to 50% with doxycycline. In assessment of adverse effects and dropped-out rates the higher dropped- out rate was found in doxycycline group. Also the patients' opinion as an outcome measure confirmed that most of patients felt much better with azithromycin. The conclusion from the present study is that oral azithromycin provides additionally effective and safe treatment option to the patients, and benefits may be further extended to those patients not responding to currently recommended antibiotic therapy