Antibiotic Management of Uncomplicated Skin and Soft Tissue Infections in the Real World.

Background: Skin and soft tissue infections are one of the main causes of consultations worldwide. The objective was to determine the treatment of a group of patients with uncomplicated skin and soft tissue infections in Colombia. Methods: Follow-up study of a cohort of patients with skin infections who were treated in the Colombian Health System. Sociodemographic, clinical and pharmacological variables were identified. Treatments were evaluated using clinical practice guidelines for skin infections. Results: A total of 400 patients were analyzed. They had a median age of 38.0 years and 52.3% were men. The most commonly used antibiotics were cephalexin (39.0%), dicloxacillin (28.0%) and clindamycin (18.0%). A total of 49.8% of the subjects received inappropriate antibiotics, especially those with purulent infections (82.0%). Being cared for in an outpatient clinic (OR: 2.09; 95% CI: 1.06-4.12), presenting pain (OR: 3.72; 95% CI: 1.41-9.78) and having a purulent infection (OR: 25.71; 95% CI: 14.52-45.52) were associated with a higher probability of receiving inappropriate antibiotics. Conclusions: Half of patients with uncomplicated skin and soft tissue infections were treated with antibiotics that were not recommended by clinical practice guidelines. This inappropriate use of antibiotics occurred in the vast majority of patients with purulent infections because the antimicrobials used had no effect on methicillin-resistant Staphylococcus aureus.

Surgical research in Colombia part 3: Authorship and publications of Colombian medical students in surgery in Colombian medical journals-cross-sectional study.

Research training, scientific activity and publications are cornerstones of academic surgery. Knowing the activity and trends of medical students aspiring to become surgeons it allows to identify gaps and skills to be strengthened. Currently, there is no data on the authorship and scientific activity of medical students in surgery in Latin America and Colombia. Methods: A bibliometric cross-sectional study was carried out, in which the Colombian medical journals were reviewed from 2010 to 2020. The articles with topics in general surgery and subspecialties where the authorship of medical students could be identified, were selected. Data on the sociodemographic and scientific characteristics of the authors and their publications were extracted and analyzed. Results: A total of 14 383 articles from 34 Colombian medical journals were reviewed. From 2010 to 2020, 807 articles related to surgery were published in Colombia. The most frequent typology of these articles was original articles (n=298; 37%), followed by case reports (n=222; 28.2%) and reviews (n=137; 17.3%). A total of 132 medical students and 141 authorships and were found, specifically in 9.9% (n=80/807) of these publications, with a higher frequency in original articles (n=32; 40%) and case reports (n=29; 36.2%). Collaboration of students with professors or surgeons was evidenced in 97.5% of the publications. Conclusions: The authorship of Colombian medical students in scientific publications in surgery in Colombian medical journals was low. From 2010 to 2020, student authors were found in 1 out of every 10 publications, mainly in original articles and clinical cases.

Knowledge, attitudes and experience of physicians working in Chile toward the prescription of pre-exposure prophylaxis (PrEP): A cross-national survey.

BACKGROUND: Pre-exposure prophylaxis (PrEP) involves administering antiretroviral drugs to prevent human immunodeficiency virus (HIV) infection in at-risk subjects. Chile is considered one of the countries with the highest number of new cases per year of HIV infections. METHODS: A nationwide cross-sectional study was carried out in Chile. A questionnaire of physicians' attitudes toward the prescription of PrEP was used. RESULTS: 632 doctors responded correctly the survey. 58.5% (n = 370) were women, and median age was 34 years (IQR 25-43). 55.4% (n = 350) responded that they have never prescribed antiretrovirals for HIV-negative individuals to prevent HIV infection, and only 10.1% have prescribed PrEP. 60.8% (n = 384) mentioned having informed about the possibility of using antiretroviral post-exposure prophylaxis in case of risky sexual activity. 76.3% (n = 482) believed each institution should formulate internal protocols for administering these drugs, and 98.4% (n = 622) stated that with the currently available evidence, PrEP should be suggested to cope with the HIV pandemic. CONCLUSION: It was concluded that knowledge, attitudes and experience toward PrEP prescribing are variable and related to patient care. However, Chile has a marked tendency in favor of this therapy, which is similar to that reported in studies worldwide.

Molecular and serological prevalence of Coronavirus in Chiropterans: A systematic review with meta-analysis.

In recent years, and now especially with the arrival of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), there has been increased interest in understanding the role of bats in the dynamics of transmission and origin of this pandemic agent. To date, no systematic reviews have been published on this topic. This systematic review aimed to summarize and highlight the frequency of bat infections reported in currently available observational studies for coronavirus. The purpose of this study was also to examine the differences between the pool prevalence by technique and country. We performed a systematic literature review with meta-analysis, using three databases to assess coronavirus (CoV) infection in bats and its diagnosis by serological and molecular tests. We carried out random-effects model meta-analysis to calculate the pooled prevalence and 95% confidence interval (95% CI). In all, 824 articles were retrieved (1960-2021). After screening by abstract/title, 43 articles were selected for full-text assessment. Of these, 33 were finally included for qualitative and quantitative analyses. From the total of studies, the pool prevalence by RT-PCR (n=14,295 bats) for CoV was 9.8% (95% CI 8.7-10.9%); Italy reported the highest pooled prevalence (44.9%, 95% CI 31.6-58.1%), followed by the Philippines (29.6%). Regarding the ELISA, the pool prevalence for coronavirus from 15 studies, including 359 bats, was 30.2% (95% CI 14.7-45.6%). The results for coronaviruses with the MIF were significantly lower, 2.6% (95% CI 1.5-3.7%). A considerable proportion of infected bats tested positive, particularly by molecular tests. This essential condition highlights the relevance of bats and the need for future studies to detail their role as potential reservoirs of SARS-CoV-2. In this meta-analysis, bats were positive in almost 10% by RT-PCR, suggesting their relevance and the need to understand their potential participation in maintaining wild zoonotic transmission.