The World Health Organization has issued new guidelines for the treatment of chlamydia, gonorrhea, and syphilis in response to the growing threat of antibiotic resistance. According to the international health organization, each year, 131 million people are infected with chlamydia, 78 million are infected with gonorrhea, and 5.6 million are infected with syphilis.
Breastfeeding is associated with less frequent bacterial infections and with less subsequent obesity. Using antibiotics reduces or removes these favorable effects of breastfeeding, perhaps via alterations in the intestinal microbiota.
The most notable new recommendation of the updated hospital-acquired pneumonia/ventilator-associated pneumonia guideline may be its endorsement of limiting the duration of antibiotic therapy to seven days in most cases.
In the United States in 2010 and 2011, an estimated 30% of outpatient oral antibiotic prescriptions may have been inappropriate, a finding that supports the need for establishing a goal for outpatient antibiotic stewardship.
Nine hundred ninety-eight patients admitted to 67 adult ICUs in 32 hospitals in the United States over a 24-hour period in 2011 were studied. Prolonged empiric antibiotic therapy was defined as continuing empiric antibiotics beyond 72 hours in patients in the absence of adjudicated infection as defined by CDC criteria. Three hundred thirty-three of 660 (50%) antibiotics were continued for at least 72 hours in patients who did not meet the CDC case definition of infection. Suspected pneumonia was the most common diagnosis in patients receiving PEAT. ICUs using invasive techniques to diagnose ventilator-associated pneumonia had lower rates of PEAT.
A randomized, placebo-controlled clinical trial from the Netherlands found that longer-term antibiotic therapy for Lyme disease did not improve health-related quality of life compared to a standard course of treatment.
Universal antibiotic use in the community-based treatment of uncomplicated severe acute malnutrition in children likely is not necessary in regions where suitable access to healthcare facilities is available.
A multicenter, double-blind, randomized clinical trial found that a 7-day course of trimethoprim-sulfamethoxazole following incision and drainage (I&D) resulted in a higher rate of cure for skin abscesses compared to I&D and placebo (80.5% vs 73.6%, respectively; P = 0.005).
While the widespread overuse and misuse of antibiotics is frequently cited in discussions of increasing bacterial resistance, there are instances where even correct use for an individual patient raises the question of potential harm to others. A prevailing paradox in antibiotic therapy is that what is good for the one may be bad for the many.
Once largely consigned to separate silos, infection prevention and antibiotic stewardship are starting to show signs of a powerful partnership. The CDC’s most recent update on the threat of antibiotic-resistant bacteria emphasizes that drug stewardship and infection control must essentially be inseparable if they are going to be successful.