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- van Houten, C. B., et al.
(författare)
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Antibiotic misuse in respiratory tract infections in children and adultsa prospective, multicentre study (TAILORED Treatment)
- 2019
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Ingår i: European Journal of Clinical Microbiology & Infectious Diseases. - : Springer Science and Business Media LLC. - 0934-9723 .- 1435-4373. ; 38:3, s. 505-514
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Tidskriftsartikel (refereegranskat)abstract
- Respiratory tract infections (RTI) are more commonly caused by viral pathogens in children than in adults. Surprisingly, little is known about antibiotic use in children as compared to adults with RTI. This prospective study aimed to determine antibiotic misuse in children and adults with RTI, using an expert panel reference standard, in order to prioritise the target age population for antibiotic stewardship interventions. We recruited children and adults who presented at the emergency department or were hospitalised with clinical presentation of RTI in The Netherlands and Israel. A panel of three experienced physicians adjudicated a reference standard diagnosis (i.e. bacterial or viral infection) for all the patients using all available clinical and laboratory information, including a 28-day follow-up assessment. The cohort included 284 children and 232 adults with RTI (median age, 1.3years and 64.5years, respectively). The proportion of viral infections was larger in children than in adults (209(74%) versus 89(38%), p<0.001). In case of viral RTI, antibiotics were prescribed (i.e. overuse) less frequently in children than in adults (77/209 (37%) versus 74/89 (83%), p<0.001). One (1%) child and three (2%) adults with bacterial infection were not treated with antibiotics (i.e. underuse); all were mild cases. This international, prospective study confirms major antibiotic overuse in patients with RTI. Viral infection is more common in children, but antibiotic overuse is more frequent in adults with viral RTI. Together, these findings support the need for effective interventions to decrease antibiotic overuse in RTI patients of all ages.
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| 2. |
- Weinberg, David H., et al.
(författare)
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Chemical Cartography with APOGEE : Multi-element Abundance Ratios
- 2019
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Ingår i: Astrophysical Journal. - : Institute of Physics Publishing (IOPP). - 0004-637X .- 1538-4357. ; 874:1
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Tidskriftsartikel (refereegranskat)abstract
- We map the trends of elemental abundance ratios across the Galactic disk, spanning R = 3-15 kpc and midplane distance vertical bar Z vertical bar = 0-2 kpc, for 15 elements in a sample of 20,485 stars measured by the SDSS/APOGEE survey (O, Na, Mg, Al, Si, P, S, K, Ca, V, Cr, Mn, Fe, Co, Ni). Adopting Mg rather than Fe as our reference element, and separating stars into two populations based on [Fe/Mg], we find that the median trends of [X/Mg] versus [Mg/H] in each population are nearly independent of location in the Galaxy. The full multi-element cartography can be summarized by combining these nearly universal median sequences with our measured metallicity distribution functions and the relative proportions of the low-[Fe/Mg] (high-alpha) and high-[Fe/Mg] (low-alpha) populations, which depend strongly on R and vertical bar Z vertical bar. We interpret the median sequences with a semi-empirical "two-process" model that describes both the ratio of core collapse and Type Ia supernova (SN Ia) contributions to each element and the metallicity dependence of the supernova yields. These observationally inferred trends can provide strong tests of supernova nucleosynthesis calculations. Our results lead to a relatively simple picture of abundance ratio variations in the Milky Way, in which the trends at any location can be described as the sum of two components with relative contributions that change systematically and smoothly across the Galaxy. Deviations from this picture and future extensions to other elements can provide further insights into the physics of stellar nucleosynthesis and unusual events in the Galaxy's history.
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