The Journal of antimicrobial chemotherapy
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J. Antimicrob. Chemother. · Nov 2012
ReviewApplying biomarkers to clinical practice: a guide for utilizing procalcitonin assays.
Prudent use of antimicrobial therapies is an important component in decreasing bacterial resistance. Procalcitonin (PCT) is a novel biomarker proposed as both a diagnostic and prognostic agent for use in various severe infections. Elevated PCT levels have a high sensitivity and specificity for diagnosing infections. ⋯ Determining the utility of PCT in practice requires a comprehensive evaluation of the impact this biomarker has on outcomes to the patient and healthcare system, as well as examining convenience and cost factors. PCT can be used to assist clinicians in initiating and guiding antimicrobial therapies for specific patient populations, as an adjunct to other diagnostic tools. Further studies examining long-term outcomes of PCT are needed to determine the effect of this intervention on resistance patterns and overall prescribing trends.
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J. Antimicrob. Chemother. · Jul 2012
ReviewColistin resistance of Acinetobacter baumannii: clinical reports, mechanisms and antimicrobial strategies.
Colistin is the last resort for treatment of multidrug-resistant Acinetobacter baumannii. Unfortunately, resistance to colistin has been reported all over the world. The highest resistance rate was reported in Asia, followed by Europe. ⋯ Pharmacokinetic/pharmacodynamic studies revealed that colistin monotherapy is unable to prevent resistance, and combination therapy might be the best antimicrobial strategy against colistin-resistant A. baumannii. Colistin/rifampicin and colistin/carbapenem are the most studied combinations that showed promising results in vitro, in vivo and in the clinic. New peptides showing good activity against colistin-resistant A. baumannii are also being investigated.
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J. Antimicrob. Chemother. · May 2012
Review Practice GuidelineGood practice recommendations for outpatient parenteral antimicrobial therapy (OPAT) in adults in the UK: a consensus statement.
These good practice recommendations for outpatient parenteral antimicrobial therapy (OPAT) are an update to a previous consensus statement on OPAT in the UK published in 1998. They are based on previous national and international guidelines, but have been further developed through an extensive consultation process, and are underpinned by evidence from published literature on OPAT. They provide pragmatic guidance on the development and delivery of OPAT services, looking at all aspects of service design, care delivery, outcome monitoring and quality assurance, with the aim of ensuring that OPAT services provide high-quality, low-risk care, whatever the healthcare setting. They will provide a useful resource for teams developing new services, as well as a practical set of quality indicators for existing services.
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J. Antimicrob. Chemother. · Mar 2012
Review Meta AnalysisAntibiotic prophylaxis in cardiac surgery: systematic review and meta-analysis.
Antibiotic prophylaxis is recommended in cardiac surgery. Current debate concerns the type of antibiotic(s), dosing and the duration of prophylaxis. ⋯ Evidence supports second- or third-generation cephalosporins for cardiac surgery prophylaxis and points at a possible advantage of prophylaxis prolongation up to 48 h post-operatively.
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J. Antimicrob. Chemother. · Oct 2011
Review Meta AnalysisAntibiotic prescribing for acute respiratory tract infections in primary care: a systematic review and meta-ethnography.
Numerous interventions have been developed to promote prudent antibiotic use for acute respiratory tract infections (ARTIs). While reviews have assessed which interventions may be most effective, none has examined why some interventions may be more effective than others. Knowing what general practitioners (GPs) feel is acceptable and feasible to implement may help to answer this question. ⋯ The findings suggest that interventions should incorporate five aspects to promote prudent use whilst remaining attractive to GPs and feasible in practice. In order to maximize acceptability, interventions should: allow GPs to reflect on their own prescribing; help decrease uncertainty about appropriate ARTI management; educate GPs about appropriate prescribing; facilitate more patient-centred care; and be beneficial to implement in practice.