| 1. |
- Andersson, Roland E.
(författare)
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The Role of Antibiotic Therapy in the Management of Acute Appendicitis
- 2013
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Ingår i: Current Infectious Disease Reports. - : Current Medicine Group. - 1523-3847 .- 1534-3146. ; 15:1, s. 10-13
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Tidskriftsartikel (refereegranskat)abstract
- Nonsurgical treatment with antibiotics has recently been proposed as the first line of treatment for noncomplicated appendicitis. This has met with considerable interest, illustrated by the number of reviews and meta-analyses, which exceed the number of original reports of the issue. The results in these studies are seriously biased due to inclusion of patients with resolving appendicitis. At a time when we need to reduce inappropriate use of antibiotics in the struggle against the increasing rate of antibiotics resistance, there must be strong requirements of a proven effect and an improved cost-benefit ratio before antibiotics treatment is introduced for a new group of patients. These requirements have not yet been met for nonsurgical treatment with antibiotics for assumed uncomplicated appendicitis. Due to the high rate of spontaneous resolution, a randomized placebo-controlled trial is needed that can compare the efficiency of antibiotics treatment and expectant management in this group of patients. Antibiotics treatment, however, remains indicated for treatment of perforated appendicitis with localized abscess or phlegmone and in selected surgical high-risk patients.
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| 2. |
- Gisselsson-Solén, Marie
(författare)
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Acute otitis media in children-current treatment and prevention.
- 2015
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Ingår i: Current Infectious Disease Reports. - : Springer Science and Business Media LLC. - 1534-3146 .- 1523-3847. ; 17:5, s. 22-22
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Tidskriftsartikel (refereegranskat)abstract
- Acute otitis media (AOM) is the most common bacterial infection in children and has a very varied clinical spectrum, ranging from spontaneous resolutions to serious complications. The effect of antibiotics in AOM depends on the chosen outcome, but has been shown to reduce pain somewhat, and have a greater beneficial effect in severe cases of AOM. Today, not all episodes of AOM are treated with antibiotics, but most countries have issued guidelines that include an option of watchful waiting in many cases. Prevention of AOM reaches from modification of environmental risk factors to vaccinations and surgery. Conjugate pneumococcal vaccines and influenza vaccines have been shown to somewhat reduce the number of AOM episodes in different groups of children. Grommets, with or without adenoidectomy, are effective at least during the first 6 months after surgery.
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| 3. |
- Hanberger, Håkan, et al.
(författare)
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When and how to cover for resistant gram-negative bacilli in severe sepsis and septic shock.
- 2011
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Ingår i: Current Infectious Disease Reports. - : Springer. - 1523-3847 .- 1534-3146. ; 13:5, s. 416-425
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Tidskriftsartikel (refereegranskat)abstract
- In the 80s and 90s, increasing antibiotic resistance was met by the introduction of new effective agents with broader antibacterial spectra for the empirical treatment of severe infections. In recent years, however, few novel antimicrobials have been developed, and this has critically weakened our strength in the fight against resistant bacteria, especially Gram-negative bacilli. It has been well proven that mortality increases if initial empirical antibiotic treatment for severe infection is inappropriate due to resistance of the pathogen. Physicians are already faced with the increasing challenge of untreatable or almost untreatable Gram-negative infections due to antibiotic resistance. Empirical treatment with broader spectra and high antibiotic pressure both in- and outside hospital is the driving force behind resistance. Since new efficient drugs against Gram-negative bacilli will not be available for some time, the best we can do to stop infections caused by multidrug-resistant bacteria is to improve infection control and choice of antibiotics, which should be based on surveillance of local antibiotic consumption and resistance. We must learn more about the revived antibacterial agents colistin and fosfomycin, and the few next generation Gram-negative antibiotics that have been developed. The aim of this review is to give an update on present therapeutic options in the fight against multidrug-resistant Gram-negative bacteria.
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