Antibióticos y trastornos de la marcha / Antibiotics and gait disorders

Resumen. La toxicidad neurológica de muchos antibióticos se ha documentado en numerosos artículos y notas clínicas. En esta revisión se clasifican los antibióticos en función del mecanismo fisiopatogénico por el que pueden provocar un trastorno de la marcha, teniendo en cuenta tanto datos clínicos como experimentales. Se ha realizado una búsqueda exhaustiva en Google Scholar y PubMed con el objetivo de encontrar revisiones, artículos y casos clínicos acerca de trastornos de la marcha secundarios a distintos antibióticos. Se han separado los diferentes antibióticos en función del mecanismo fisiopatogénico por el cual podrían producir una alteración de la marcha. Se han clasificado en antibióticos capaces de producir ataxia cerebelosa, ataxia vestibular, ataxia sensitiva o un trastorno de la marcha extrapiramidal. El principal objetivo era agrupar todos los fármacos que pueden provocar un trastorno de la marcha, para facilitar la sospecha clínica y, en consecuencia, el tratamiento de los pacientes (AU)

Summary. The neurological toxicity of many antibiotics has been reported in a number of articles and clinical notes. In this review antibiotics are classified according to the physiopathogenic mechanism that can give rise to a gait disorder, taking both clinical and experimental data into account. An exhaustive search was conducted in Google Scholar and PubMed with the aim of finding reviews, articles and clinical cases dealing with gait disorders secondary to different antibiotics. The different antibiotics were separated according to the physiopathogenic mechanism that could cause them to trigger a gait disorder. They were classified into antibiotics capable of producing cerebellar ataxia, vestibular ataxia, sensitive ataxia or an extrapyramidal gait disorder. The main aim was to group all the drugs that can give rise to a gait disorder, in order to facilitate the clinical suspicion and, consequently, the management of patients (AU)

An assessment of antimicrobial consumption in food producing animals in Kenya.

Antimicrobial agents are useful for control of bacterial infections in food animals and man. Their prudent use in these animals is important to control any possible development and transfer of resistance between animals and man. The objective of this study was to generate quantitative information to evaluate antimicrobial usage patterns by animal species, route of administration, antimicrobial class and type of use from 1995 to 1999 in Kenya. Theses data are essential for risk analysis and planning and can be helpful in interpreting resistance surveillance data, and evaluating the effectiveness of prudent use efforts and antimicrobial resistance mitigation strategies. Data on quantities of active substance classes were collected from the official records of the Pharmacy and Poisons Board of the Ministry of Health and analysed in MS Excel 2000 program. The mean antimicrobial consumption for the 5-year period was 14 594 +/- 1457 kg per year. This was distributed in the various antimicrobial classes as follows: 7975 kg (54.65%) of tetracyclines, 3103.96 kg (21.27%) of sulfonamides and 954.5 kg (6.56%) of aminoglycosides, 905 kg (6.20%) of beta-lactams, 94 kg (0.64%) of quinolones, 35 kg (0.24%) of macrolides and 24 kg (0.16%) of others (tiamulin). Mean consumption per year among the various food animals was: 10 989 +/- 357 kg in large animals (cattle, sheep, pigs and goats), 2906 +/- 127 kg in poultry alone and 699 +/- 427 kg in both large animals and poultry. These quantities represented 56.56% (8255 kg) consumption per year for parenteral use, 41.79% (6098 kg) for oral use and 1.65% (241 kg) for topical use (intramammary and eye ointments) in cattle. With respect to intended use in food producing animals, the mean consumption per year was: 13 178 kg (90.30%) for therapeutic use (ST), 4 kg (0.03%) for prophylactic treatment (PT) and 1411 +/- 246 kg (9.67%) was used both for therapeutic and prophylactic purposes (GPT). The study confirmed that antimicrobials are not used for growth promotion in Kenya. There was no specific trend in the quantities of active antimicrobial classes. This study has revealed that the tetracyclines, sulfonamides and trimethoprim, nitrofurans aminoglycosides, beta-lactams and the quinolones are the most commonly used drugs in food-producing animals in Kenya. Tetracyclines contributed approximately 55% of the total consumption, and there was an increasing trend in the consumption of quinolones from 1998.

[Comparative study of antibiotic consumption in Hungarian hospitals during 1989-1991]. / Az antibiotikum fogyasztás összehasonlító vizsgálata magyar kórházakban 1989 és 1991 között.

The data of case histories of the year of 1989 of seven Hungarian hospitals and also the 1990 and 1991 data of two hospitals were collected and integrated in a database. Consumption of antibiotics were represented in DDD (Defined Daily Dose)/1000 hospital day. These data were compared with the data of the drugs delivered by the hospital pharmacy in one of the mentioned hospitals between 1989 and 1992. It was concluded that data based on case histories represent better the real antibiotic consumption than those of the hospital pharmacy. Reason of this phenomenon is the fact, that considerable amount of drug supply gets out of institutions. Great differences were observed between the seven hospitals in the total amount of antibiotic consumption and between the different antibiotic groups as well. Drugs most frequently used were tetracyclines, broad spectrum penicillins, sulfonamides and aminoglycosides. Consumption of penicillins was decreasing. Regarding new drugs only utilisation of quinolones was increasing. It was concluded, that structure of antibiotic selection did not follow the recommendations of the medical literature. The authors suggest that "antibiotic policy" should be introduced in Hungarian hospitals so as to imporve antibiotic utilisation.