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- Holloway, Bronwen, et al.
(author)
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Antibiotic use before, during and after seeking care for acute febrile illness at a hospital outpatient department : a cross-sectional study from rural India
- 2022
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In: Antibiotics. - : MDPI AG. - 0066-4774 .- 2079-6382. ; 11:5
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Journal article (peer-reviewed)abstract
- Antibiotic resistance is a naturally occurring phenomenon, but the misuse and overuse of antibiotics is accelerating the process. This study aimed to quantify and compare antibiotic use before, during, and after seeking outpatient care for acute febrile illness in Ujjain, India. Data were collected through interviews with patients/patient attendants. The prevalence and choice of antibiotics is described by the WHO AWaRe categories and Anatomical Therapeutic Chemical classes, comparing between age groups. Units of measurement include courses, encounters, and Defined Daily Doses (DDDs). The antibiotic prescription during the outpatient visit was also described in relation to the patients’ presumptive diagnosis. Of 1000 included patients, 31.1% (n = 311) received one antibiotic course, 8.1% (n = 81) two, 1.3% (n = 13) three, 0.4% (n = 4) four, 0.1% (n = 1) five, and the remaining 59.0% (n = 590) received no antibiotics. The leading contributors to the total antibiotic volume in the DDDs were macrolides (30.3%), combinations of penicillins, including β-lactamase inhibitors (18.8%), tetracyclines (14.8%), fluoroquinolones (14.6%), and third-generation cephalosporins (13.7%). ‘Watch’ antibiotics accounted for 72.3%, 52.7%, and 64.0% of encounters before, during, and after the outpatient visit, respectively. Acute viral illness accounted for almost half of the total DDDs at the outpatient visit (642.1/1425.3, 45.1%), for which the macrolide antibiotic azithromycin was the most frequently prescribed antibiotic (261.3/642.1, 40.7%).
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| 2. |
- Yao, Yuhan, et al.
(author)
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The Tidal Disruption Event AT2021ehb : Evidence of Relativistic Disk Reflection, and Rapid Evolution of the Disk-Corona System
- 2022
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In: Astrophysical Journal. - : American Astronomical Society. - 0004-637X .- 1538-4357. ; 937:1
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Journal article (peer-reviewed)abstract
- We present X-ray, UV, optical, and radio observations of the nearby (≈78 Mpc) tidal disruption event AT2021ehb/ZTF21aanxhjv during its first 430 days of evolution. AT2021ehb occurs in the nucleus of a galaxy hosting a≈107 M⊙ black hole (MBH inferred from host galaxy scaling relations). High-cadence Swift and Neutron Star Interior Composition Explorer (NICER) monitoring reveals a delayed X-ray brightening. The spectrum first undergoes a gradual soft → hard transition and then suddenly turns soft again within 3 days at δt≈272 days during which the X-ray flux drops by a factor of 10. In the joint NICER+NuSTAR observation (δt = 264 days, harder state), we observe a prominent nonthermal component up to 30 keV and an extremely broad emission line in the iron K band. The bolometric luminosity of AT2021ehb reaches a maximum of 6.0+10.4-3.8%LEdd when the X-ray spectrum is the hardest. During the dramatic X-ray evolution, no radio emission is detected, the UV/optical luminosity stays relatively constant, and the optical spectra are featureless. We propose the following interpretations: (i) the soft → hard transition may be caused by the gradual formation of a magnetically dominated corona; (ii) hard X-ray photons escape from the system along solid angles with low scattering optical depth (∼a few) whereas the UV/optical emission is likely generated by reprocessing materials with much larger column density—the system is highly aspherical; and (iii) the abrupt X-ray flux drop may be triggered by the thermal–viscous instability in the inner accretion flow, leading to a much thinner disk.
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