The burden of community-acquired pneumonia (CAP) is set to increase with ageing populations and with it the need for appropriate antibiotic prescribing in the face of increasing bacterial resistance. This review provides an update on the epidemiology of bacterial CAP and the patterns of antibiotic resistance around the world.
There is currently no generally accepted strategy for the clinical diagnosis of acute uncomplicated cystitis. This study evaluated the diagnostic value of recently proposed draft guidelines for the clinical diagnosis of this condition by the US FDA and EMA using the previously validated Acute Cystitis Symptom Score (ACSS).
Overuse of antibiotics for respiratory tract infection (RTI) and urinary tract infection (UTI) is widespread in primary care and long-term care settings, respectively. This paper describes the Using Antibiotics Wisely campaign that sought to boost antimicrobial stewardship among community prescribers in Canada. Prescribers were enlisted to develop practice change statements to support the appropriate use of antibiotics for RTIs and UTIs in the community.
Patient health literacy is an important factor that impacts antimicrobial stewardship (AMS) in the community. Using a Centers for Disease Control and Prevention (CDC) framework, the authors of this paper describe four core elements for enhancing AMS health literacy in the outpatient setting.
It is recommended to avoid fluoroquinolones as first-line treatment for uncomplicated cystitis due to the risk of serious side effects but their use in this setting is still widespread. This study evaluated the extent and appropriateness of empiric fluoroquinolone use for uncomplicated cystitis compared with that of nitrofurantoin and identified predictors of empiric fluoroquinolone use for this indication.
UTI is a common infection in children but can be a challenge to diagnose. In addition, controversies exist regarding its investigation and management and recommendations vary across guidelines. This review paper gives an overview of these aspects with highlights from recent evidence and guideline recommendations.
Serious bacterial infections (SBIs) occur more frequently in infants aged ≤90 days than in other paediatric groups and are increasingly due to multi-drug-resistant organisms (MDROs). This study assessed the epidemiology and bacteriology of SBIs in early infancy and compared the characteristics and outcomes of infections due to MDROs versus non-MDROs.
People with diabetes are more prone to UTIs due to immune system and bladder dysfunction than people without diabetes. In light of controversies regarding the incidence, clinical pattern and microbiology of UTIs in diabetes patients, this prospective study sought to compare these aspects of UTI in patients with and without diabetes.
The worldwide antimicrobial resistance crisis requires immediate actions in stewardship. This study shows a substantial global variation in antibiotic use in hospitalised neonates and children. The Access, Watch and Reserve (AWaRe) classification can be used in monitoring antibiotic prescription patterns and can potentially be a key stewardship strategy in hospitals.
The correlation between the overuse of antibiotics and the development of resistant bacteria is well known. However, it is still to be clarified how much of this resistance depends on individual characteristics or aggregate environmental measures such as neighbourhoods. The dissemination of antimicrobial resistance in the community is increasingly recognised as a serious global health threat which warrants further investigation.
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