Many infections commonly treated in the outpatient setting with antibiotics (eg, urinary tract infections, streptococcal pharyngitis), which previously caused significant morbidity and mortality, are now typically benign. However, with antibiotic therapy come side effects, ranging in severity from mild nausea to life-threatening cytopenias.
Full Answer
What are the most common outpatient antibiotic outcomes?
Many infections commonly treated in the outpatient setting with antibiotics (eg, urinary tract infections, streptococcal pharyngitis), which previously caused significant morbidity and mortality, are now typically benign. However, with antibiotic therapy come side effects, ranging in severity from mild nausea to life-threatening cytopenias.
What are antibiotic complications?
Long-term antibiotic use can also result in minor and major complications, such as diarrhea, antibiotic resistance, or life-threatening leukopenia. …
Which antibiotics increase the risk of overanticoagulation in acutely ill outpatients?
Jun 12, 2015 · Recently, a report linked four classes of antibiotics commonly prescribed for respiratory infections in the outpatient setting to an increased incidence of nonsusceptible pneumococcal isolates . Inappropriate antibiotic prescribing not only impacts bacterial resistance but also is associated with adverse reactions, such as the development of CDI ( 17 , – 19 ).
Are antibiotic-related adverse events more common in the elderly?
Cefotaxime had the highest rate of neutropenia at 1.6 occurring in 33% of patients receiving cefotaxime. Oxacillin use had the highest rate of both rash (2.4) and hepatitis (1.4). Forty-three percent of patients receiving oxacillin developed rash and 27% developed hepatitis.
What are the most common complications of antibiotic therapy?
What is the problem with taking too many antibiotics?
What are some concerns with antibiotic therapy?
Why does overuse of antibiotics cause resistance?
What are the dangers of antibiotic resistance?
What complications can occur from antibiotic resistance both in humans and in livestock?
What are the adverse effects of systemic antibiotics?
... Adverse effects of systemic antibiotic use include organ toxicity, reduction of beneficial bacteria populations, and overgrowth of naturally resistant organisms, like Candida and Clostridium difficile [21]. Sustained local delivery of antibiotics from a delivery device avoids many of the pitfalls of systemic delivery [22] [23] [24]. Hydrogels have been extensively explored as vehicles for localized drug delivery due to their high water content, excellent biocompatibility, and ease of drug loading [24] [25] [26]. Passive loading and release of antibiotics from hydrogels generally does not provide for significantly prolonged release [27,28]. ...
Do antibiotics have side effects?
However, with antibiotic therapy come side effects, ranging in severity from mild nausea to life-threatening cytopenias. This article highlights important complications of antibiotic therapy that may be encountered by outpatient providers. Side effects by system are discussed, and a few important drug-specific complications and important drug-drug interactions highlighted.
Can antibiotics cause spondylitis?
Conservative therapy with appropriate antibiotics is essential for most patients with infectious spondylitis. Although most antibiotics do not cause problems if it used properly and serious side effects are rare, side effects can occur with any class of drugs and adverse reactions of antibiotics can range from mild allergic reactions to serious and fulminant adverse events. These side effects are also extremely variable from patient to patient and from antibiotic to antibiotic. A side effect of antibiotics may paradoxically increase inflammatory marker levels. Here, the author presents two cases of antibiotic-induced increase in inflammatory markers in cured infectious spondylitis. The patients were successfully treated after stopping the antibiotic therapy. The differential diagnosis between antibiotic side effects and infection should be considered very carefully because the treatment is completely different. Although the exact mechanisms underlying successful treatment without antibiotics are unclear, we should consider the side effects of antibiotics when following inflammatory markers during treatment of infectious spondylitis.
How many prostate biopsies are performed in the US?
"Approximately 1 million prostate biopsies are performed each year in the United States. This procedure has traditionally been performed using a transrectal approach, which is associated with a significant risk of infectious complications including sepsis. In recent years, transperineal prostate biopsy has been increasingly adopted due to its lower associated infectious risk. In this review, we explore the benefits of the transperineal approach for performing prostate biopsy and detail technical advancements that have allowed for this procedure to now be routinely performed in the outpatient settings under local anesthesia."
What is sepsis associated with?
Sepsis is a common condition that is associated with unacceptably high mortality and, for many of those who survive, long-term morbidity. Increased awareness of the condition resulting from ongoing campaigns and the evidence arising from research in the past 10 years have increased understanding of this problem among clinicians and lay people, and have led to improved outcomes. The World Health Assembly and WHO made sepsis a global health priority in 2017 and have adopted a resolution to improve the prevention, diagnosis, and management of sepsis. In 2016, a new definition of sepsis (Sepsis-3) was developed. Sepsis is now defined as infection with organ dysfunction. This definition codifies organ dysfunction using the Sequential Organ Failure Assessment score. Ongoing research aims to improve definition of patient populations to allow for individualised management strategies matched to a patient's molecular and biochemical profile. The search continues for improved diagnostic techniques that can facilitate this aim, and for a pharmacological agent that can improve outcomes by modifying the disease process. While waiting for this goal to be achieved, improved basic care driven by education and quality-improvement programmes offers the best hope of increasing favourable outcomes.
What is PM2.5 in the air?
Respiratory diseases like chronic obstructive pulmonary disease (COPD) are associated with the presence of particulate matter 2.5 (PM2.5) in the air. In the present study, the effect of synthesized ursolic acid derivatives on mice model of PM2.5‐induced COPD was investigated in vivo. The mice model of COPD was established by the administration of 25 μL of PM2.5 suspension through intranasal route daily for 1 week. The levels of oxidative stress markers and inflammatory cytokines like tumor necrosis factors‐α and interleukin‐6 in the mice bronchoalveolar fluids increased markedly on administration with PM2.5. However, treatment with ursolic acid derivative caused a significant suppression in PM2.5‐induced increase in oxidative stress markers and inflammatory cytokines in dose‐dependent manner. Hematoxylin and eosin staining showed excessive inflammatory cell infiltration in pulmonary tissues in mice with COPD. The inflammatory cell infiltration was inhibited on treatment of the mice with ursolic acid derivative. The ursolic acid derivative treatment increased level of superoxide dismutase in mice with COPD. The lung injury induced by PM2.5 in mice was also prevented on treatment with ursolic acid derivative. Thus, ursolic acid derivative inhibits pulmonary tissues damage in mice through suppression of inflammatory cytokine and oxidative enzymes. Therefore, ursolic acid derivative can be of therapeutic importance for treatment of PM2.5‐induced COPD.
What are polymer based microparticles used for?
In this study, polymer-based microparticles are used to improve the therapeutic properties of ceftriaxone (CEF) and render them safer. Poly-3-hydroxybutyrate (P3HB) and poly-3-hydroxybutyrate/polyethylene glycol (P3HB-PEG)-based microparticles were prepared by two methods: a double emulsification technique and spray-drying. The microparticles were characterized in terms of size and zeta potential, morphology, total drug loading and drug release. The microparticles had spherical shapes with diameters of a size range from 0.74 to 1.55 µm (emulsification technique) and from 3.84 to 6.51 µm (spray-drying); CEF encapsulation efficiency was around 63% and 49% for these methods respectively. The CEF release from microparticles obtained by spray-drying reached 100% after 150 h, while for microparticles obtained by emulsification technique the total release of CEF did not exceed 34% after 312 h. The release profiles could be best explained by Zero order kinetics model, Higuchi and Korsmeyer-Peppas models, as the plots showed high linearity. Antibacterial activity of the microparticles was evaluated against gram-positive and gram-negative bacterial strains. In general, CEF encapsulation in polymeric microparticles preserves the therapeutic efficacy of the CEF and provides its prolonged effect.
Materials and methods
The records of patients who received OPAT under our care between January 1, 1995, and June 30, 1999, were retrospectively reviewed. All records were reviewed, and information was recorded using a data collection form and entered into an Excel database.
Results
A total of 229 patients with a mean age of 8 years (median, 8 years; range, 14 days to 19 years) received 237 courses of OPAT. The majority of patients were male [127 (55%)] and Caucasian [170 (74%)]. The infections treated with OPAT are listed in Table 1.
Discussion
Although large retrospective reviews in adults receiving OPAT have been published, 21, 22 reports of large number of pediatric patients are lacking. 1–20 This review represents the report of the largest number of children studied, for the longest period and for a longer post-OPAT follow-up period than any previous study of pediatric patients.
What is a superinfection?
Superinfections, resulting from a difficult-to-treat overgrowth of opportunistic organisms (e.g., fungi or resistant bacteria), usually occur with broad-spectrum antimicrobials, prolonged use, or combinations of agents that alter the normal microbial flora of the upper respiratory, intestinal, and genitourinary tracts.5 An example is C difficile–associated diarrhea and pseudomembranous colitis secondary to fluoroquinolone use.
What is direct toxicity?
Direct toxicity results from high serum levels of certain antibiotics that directly affect cellular processes in the host. An example of the result of direct toxicity is ototoxicity secondary to aminoglycosides.5.
Can folic acid cause seizures?
Folic acid deficiency may lead to megaloblastic anemia.18. Fluoroquinolone-related seizures: Fluoroquinolones are associated with central nervous system (CNS) stimulatory effects; the most prominent CNS effects are headache, dizziness, and light-headedness. While seizures are rare, these agents should be used with caution or avoided in patients ...
What are some examples of inappropriate use of antibiotics?
Most inappropriate use of antibiotics in outpatient facilities occurs when antibiotics are prescribed for viral respiratory infections, such as viral bronchitis, otitis, and sinusitis. 2. Other examples of inappropriate use include prescribing a non–first-line antibiotic or an antibiotic with excessively broad-spectrum activity for ...
Why is it important to use antibiotics?
Appropriate use of antibiotics is necessary to target drug-resistant bacterial infections and prevent further bacterial resistance from emerging.
Antibiotic-Related Adverse Events in Seniors
Complications of Antibiotic Therapy
- Complications can occur and may be unrelated to the drug’s antimicrobial activity; these include: Superinfections,resulting fromadifficult-to-treat overgrowth of opportunistic organisms (e.g., fungior resistant bacteria), usually occur with broad-spectrumantimicrobials, prolonged use, or combinations of agents that alter thenormal microbial flora o...
Prevention of Antibiotic-Associated Adverse Reactions
- Specific recommendations to decrease the toxicity potential of antibiotics consist of: 20,25 •Infusing vancomycin over 2 hours when appropriate •Administering aminoglycosides once daily when appropriate •Advising patients to swallow oral doxycycline with copious amounts of water and to avoid taking it at bedtime •Reviewingdrug-allergy history with patients and reviewing the …
Conclusion
- An age-related decline in the immunesystem, in conjunction with comorbidities and other factors, increasessusceptibility to infection; age-related physiological changespredispose seniors to the risk of antibiotic-related adverse reactionsas well. Considering evidence-based data, in conjunction with clinicalexperience and judgment, is an important aspect of individualizingantibi…