‘Antibiotic Ireland'. Antimicrobial Resistance: A Major Cause for Concern. Improper Prescribing or Patient’s Misconceptions, Expectation and Pressure on Dr’s to prescribe ? By Theresa Lowry-Lehnen. Nurse Practitioner and Lecturer.
‘Antibiotic Ireland’: Antimicrobial Resistance A Major Cause for Concern. Improper Prescribing or Patient’s Misconceptions, Expectation and Pressure on Dr’s to prescribe ?
‘Antibiotic Ireland’ Antimicrobial Resistance A Major Cause for ConcernImproper Prescribing or Patient’s Misconceptions, Expectation and Pressure on Dr’s to prescribe ?
Parthiv Mehta Rational Use of Antibiotics 20180722Parthiv Mehta
Antibiotic resistance is a Global Threat, Antibiotic prescription practices are varied and rationalization of usage can find a way to reduce! Understanding ideal prescription practice for antibiotics shall help clinician improvise outcomes.
As the world faces from Covid pandemic it's high time we should take care of our patients suffering from respiratory issues.
On the occasion of World Asthma Day I humbly present you this educational video. I focussed on what realy asthma is,current research in India,use of Artificial Intelligence in the field of Asthma.Most importantly,
I addressed myths about Asthma and shown the true pictures.
Your queries are always welcome.
I hope this video will help lot of Asthma patients and their dear ones who are taking care of them.
‘Antibiotic Ireland’ Antimicrobial Resistance A Major Cause for ConcernImproper Prescribing or Patient’s Misconceptions, Expectation and Pressure on Dr’s to prescribe ?
Parthiv Mehta Rational Use of Antibiotics 20180722Parthiv Mehta
Antibiotic resistance is a Global Threat, Antibiotic prescription practices are varied and rationalization of usage can find a way to reduce! Understanding ideal prescription practice for antibiotics shall help clinician improvise outcomes.
As the world faces from Covid pandemic it's high time we should take care of our patients suffering from respiratory issues.
On the occasion of World Asthma Day I humbly present you this educational video. I focussed on what realy asthma is,current research in India,use of Artificial Intelligence in the field of Asthma.Most importantly,
I addressed myths about Asthma and shown the true pictures.
Your queries are always welcome.
I hope this video will help lot of Asthma patients and their dear ones who are taking care of them.
Tuberculosis Treatment Symposia - The CRUDEM Foundation presented in Milot, Haiti at Hôpital Sacré Coeur.
CRUDEM’s Education Committee (a subcommittee of the Board of Directors) sponsors one-week medical symposia on specific medical topics, i.e. diabetes, infectious disease. The classes are held at Hôpital Sacré Coeur and doctors and nurses come from all over Haiti to attend.
Of all the drugs, namely antibiotics are often capable of causing allergic reaction. It should be noted that allergic reaction to antibiotics is very common among patients of any age group.
Tuberculosis Treatment Symposia - The CRUDEM Foundation presented in Milot, Haiti at Hôpital Sacré Coeur.
CRUDEM’s Education Committee (a subcommittee of the Board of Directors) sponsors one-week medical symposia on specific medical topics, i.e. diabetes, infectious disease. The classes are held at Hôpital Sacré Coeur and doctors and nurses come from all over Haiti to attend.
Of all the drugs, namely antibiotics are often capable of causing allergic reaction. It should be noted that allergic reaction to antibiotics is very common among patients of any age group.
Similar to ‘Antibiotic Ireland'. Antimicrobial Resistance: A Major Cause for Concern. Improper Prescribing or Patient’s Misconceptions, Expectation and Pressure on Dr’s to prescribe ? By Theresa Lowry-Lehnen. Nurse Practitioner and Lecturer.
Rational use of antibiotics by M. Jagadeesh, Creative Educational Society's C...Dr. Jagadeesh Mangamoori
Rational use of antibiotics is extremely important as injudicious use can adversely affect the patient, cause emergence of antibiotic resistance and increase the cost of health care.
Dr. Sachin Verma is a young, diligent and dynamic physician. He did his graduation from IGMC Shimla and MD in Internal Medicine from GSVM Medical College Kanpur. Then he did his Fellowship in Intensive Care Medicine (FICM) from Apollo Hospital Delhi. He has done fellowship in infectious diseases by Infectious Disease Society of America (IDSA). He has also done FCCS course and is certified Advance Cardiac Life support (ACLS) and Basic Life Support (BLS) provider by American Heart Association. He has also done a course in Cardiology by American College of Cardiology and a course in Diabetology by International Diabetes Centre. He specializes in the management of Infections, Multiorgan Dysfunctions and Critically ill patients and has many publications and presentations in various national conferences under his belt. He is currently working in NABH Approved Ivy super-specialty Hospital Mohali as Consultant Intensivists and Physician.
Drug Rsistance in Nose, Ear and Throat Infections.pptxAdeeba Aslam
slide#1
Introduction:
Antimicrobials are the agents that kill or inhibit the growth of Microorganism.
The ability of bacteria and other microorganisms to resists the effect of an antimicrobial agents (AMAs) is called Antimicrobial Resistance.
Resistant organisms lead to treatment failure.
Increased mortality.
May spread in Community.
Low level resistance can go undetected.
Added burden on healthcare costs.
Threatens to return to pre-antibiotic era.
Slide#4
Ear, Nose and Throat Infections:
Ear infection begins after a cold or other respiratory infection. The bacteria travel into the middle ear through the Eustachian tube. This tube connects the middle ear to the back of the throat.
Causative agent:
Streptococcus pneumonia
Moraxella catarrhalis
Haemophilus influenzae
ABRS is caused by bacteria that infect the lining of your nasal cavity and sinuses.
Causative agent:
Streptococcus pneumonia
Haemophilus influenza
Moraxella catarrhalis
Streptococcus pyogenes
Strep throat is an infection in the throat and tonsils caused by bacteria.
Causative agent:
Group A streptococcus.
Slide#6
Penicillin Resistance in Streptococcus pneumoniae :
The resistant microbe elaborates an enzyme which inactivates the Penicillin.
β lactamase enzyme production:
It breaks down the B lactam rings, there by inactivating the β lactam antibiotics.
Enzyme present in low quantity but located periplasmically, drug is inactivated soon after entry.
Present in large quantities which diffuse into the surrounding and destroy the drug before entry.
slide#8
Antibiotic Resistance What Physician can do:
Prevent infections by ensuring your hands, instruments and environment are clean.
Keep your patient’s vaccinations up to date.
If you think a patient might need antibiotics, where possible, test to confirm and find out which one.
Only prescribe and dispense antibiotics when they are truly needed.
Prescribe and dispense the right antibiotic at the right dose for the right duration.
slide#10
Antibiotic Resistance What You can do:
Only use antibiotics when prescribed by a certificated health professional.
Always take the full prescription, even if you feel better.
Never use left over antibiotics.
Never share antibiotics with others.
Prevent infections by regularly washing your hands, avoiding contacts with sick people and keep your vaccinations up to date.
ANTIBIOTIC RESISTANCE
BY- RICHA KRISHNA
(M.PHARMACY)
Antibiotic resistance occurs when bacteria change in response to the use of these medicines. Bacteria, not humans or animals, become antibiotic-resistant. These bacteria may infect humans and animals, and the infections they cause are harder to treat than those caused by non-resistant bacteria.
Similar to ‘Antibiotic Ireland'. Antimicrobial Resistance: A Major Cause for Concern. Improper Prescribing or Patient’s Misconceptions, Expectation and Pressure on Dr’s to prescribe ? By Theresa Lowry-Lehnen. Nurse Practitioner and Lecturer. (20)
'A day in the Life of a College Nurse'.
Nursing in General Practice Journal. issue 3 Volume 11 2018.
Theresa Lowry-Lehnen explains her role as the College Nurse Practitioner at Institute of Technology, Carlow, Ireland.
'A day in the Life of a College Nurse'.
Nursing in General Practice Journal. issue 3 Volume 11 2018.
Theresa Lowry-Lehnen explains her role as the College Nurse Practitioner at Institute of Technology, Carlow, Ireland.
Monitoring and Assessment in Secondary Schools.
Reflective article on the Monitoring and Assessment of Students work during my Teacher Training at St Mary’s University Teacher Training College London and Partner Schools (2004-2005)
Theresa Lowry-Lehnen
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
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These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journey
‘Antibiotic Ireland'. Antimicrobial Resistance: A Major Cause for Concern. Improper Prescribing or Patient’s Misconceptions, Expectation and Pressure on Dr’s to prescribe ? By Theresa Lowry-Lehnen. Nurse Practitioner and Lecturer.
2. Penicillin
Thanks to the work of Alexander Fleming (1881-1955), Howard
Florey ( 1898-1968) and Ernst Chain (1906-1979), penicillin was first
discovered, developed and eventually produced on a large scale for
human use in 1943. Antibiotic therapy has played a major role in the
treatment of bacterial infectious diseases and the entire world has
benefited from one of the greatest medical advancements in history.
A. Fleming
E. Chain
H. Florey
3.
A chemical substance
produced by a
microorganism, which
has the capacity to
inhibit the growth of or
to kill other
microorganisms;
antibiotics sufficiently
nontoxic to the host are
used in the treatment of
infectious diseases.
3
4.
Although a large number of antibiotics exist, they fall into
only a few classes with an even more limited number of
targets.
–β-lactams (penicillins) –cell wall biosynthesis
–Glycopeptide (vancomycin) –cell wall biosynthesis
–Aminoglycosides (gentamycin) –protein synthesis
–Macrolides (erythromycin) –protein synthesis
–Quinolones (ciprofloxacin) –nucleic acid synthesis
–Sulfonamides (sulfamethoxazole) –folic acid metabolism
4
5. Antibiotic resistance: a global problem
Resistance is inevitable with improper
use.
No new class of antibiotic has been
introduced over the last two decades
Appropriate use is the only way of
prolonging the useful life of an
antibiotic.
6.
Antibiotic misuse, sometimes called antibiotic
abuse or antibiotic overuse, refers to the misuse
or overuse of antibiotics, with potentially serious
effects on health.
It is a contributing factor to the creation
of multidrug-resistant bacteria, informally called
"super bugs": relatively harmless bacteria can
develop resistance to multiple antibiotics and
cause life-threatening infections
7.
Several International
studies have demonstrated
that patterns of antibiotic
usage greatly affect the
number of resistant
organisms which develop.
Overuse of broadspectrum antibiotics, such
as second- and thirdgeneration
Cephalosporins, generate
7
9.
The resistant strains arise
either by mutation and
selection or by genetic
exchange in which sensitive
organisms receive the genetic
material ( part of DNA) from the
resistant organisms and the part
of DNA carries with it the
information of mode of
inducing resistance against
one or multiple antimicrobial
agents.
9
10. Some doctors give patients antibiotics when they might not be
helpful. For example, a patient with a cold may pressure a doctor
into prescribing an antibiotic because the patient hopes to get a
quick fix to his/her illness. Antibiotics won't cure a cold because
colds are caused by viruses, not bacteria.
Antibiotics have no effect on viral infections. The treatment for a
cold is generally rest, plenty of fluids and medicines for fever and
headache (if required).
Antibiotics are misused because many patients do not take them
according to their doctor's instructions. They may stop taking
their antibiotics too soon, before their illness is completely cured.
This allows bacteria to become resistant by not killing them
completely.
Some patients save unused medicine and take it later for another
illness, or pass it to other ill family members or friends. These
practices may result in the wrong antibiotics being used. They can
also lead to the development of resistant bacteria.
11. 75% of outpatient antibiotics are used
inappropriately (WHO 2012).
Patient’s misconceptions, expectations and
pressure on Doctors to prescribe antibiotics
inappropriately is a real problem in Ireland
and globally.
Patients then frequently ask - Why am I no
better after taking the antibiotics?
Side effects include gastric
disturbances, diarrhoea, rash and allergy.
11
13. For the treatment of bacterial infections.
However;
Not all fevers are due to bacterial infections
Not all infections are due to bacteria
Most viral infections self resolve in 1-3
weeks; colds, flu, gastric virus’s
There is no evidence that antibiotics will
prevent secondary bacterial infection in
patients with viral infection
13
14. Antibiotics have no effect on viral infections
such as the common cold.
They are also ineffective against most sore
throats, which are usually viral and selfresolving.
Most cases of bronchitis (90–95%) are
viral, passing after a few weeks—the use of
antibiotics against bronchitis is superfluous
and can put the patient at risk of suffering
adverse reactions
15. Patient concerns
Prescriber concerns
Expect to be cured
Need to return to work/school
Similar symptoms treated with
antibiotics in the past.
• Patient satisfaction
• Time pressures
• Diagnostic uncertainty
ANTIBIOTIC PRESCRIPTION
16. RHINITIS:
1. Antibiotics should not be
given for viral rhino-sinusitis.
2. Muco-purulent rhinitis
(thick, opaque, or discolored
nasal discharge) frequently
accompanies viral rhinosinusitis. It is not an indication
for antibiotic treatment unless
it persists without
improvement for more than
10-14 days.
SINUSITIS:
Diagnosed as sinusitis only in the
presence of:
prolonged nonspecific upper
respiratory signs and symptoms
(e.g. rhinorrhea and cough
without improvement for > 10-14
days), or
more severe upper respiratory
tract signs and symptoms (e.g.
fever >39C, facial swelling, facial
pain).
2. Initial antibiotic treatment of
acute sinusitis should be with the
most narrow-spectrum agent
which is active against the likely
pathogens
17.
18.
Most sore throats are viral and self- limiting
Strep is isolated in 30% of sore throats BUT
asymptomatic carriage can be as high as
40%
Typical features only present in 15% of
patients with strep throat
Recent studies do not support antibiotics
as preventative of non-suppurative
complications (which are rare anyway).
20. 1.Coughs and bronchitis in children rarely warrant antibiotic treatment.
2. Antibiotic treatment for prolonged cough (>10 days) may
occasionally be warranted:
- Pertussis should be treated according to established
recommendations.
- Mycoplasma pneumonia infection may cause pneumonia and prolonged
cough (usually in children > 5 years); a macrolide agent (or tetracycline
in children ≥ 8 years) may be used for treatment.
- Children with underlying chronic pulmonary disease (not including
asthma) may occasionally benefit from antibiotic therapy for acute
exacerbations.
21.
Guidelines do not recommend antibiotics for asthma
attacks. The worse the symptoms, the more often this
practice seems to occur.
Unless there is a coexisting bacterial infectious such as
pneumonia or sinusitis, antibiotics should not be used.
Over use can cause drug resistant bacterial infections.
In adults, bacterial infections are almost never the cause
of asthma exacerbations, and antibiotics are rarely needed.
The most common triggers of an asthma attack in adults are
viral infections, allergens, and irritants, non of which
responds to an antibiotics.
22.
Viral infection is disseminated throughout the
system (URT/LRT). Fever is usually high at
onset, settles by day 3-4.
Bacterial infection is localized to one part of the
system ( acute tonsillitis does not usually
present with running nose or chest signs). Fever
is generally moderate at the onset and peaks by
day 3-4.
24. DO ask your doctor whether your infection or your family
member's infection will respond to antibiotics.
DO ask your doctor about antibiotic-resistant bacteria and
what you can do to help prevent its occurrence.
DO follow the instructions for taking antibiotic’s. Always
take the exact amount specified on the label at a specified
time. Take the medicine for the entire time that your
doctor has prescribed. Even if you feel better, take all of
the medicine!
25.
DO NOT always expect the doctor to prescribe an
antibiotic. Many infections are viral and will not respond
to antibiotics.
DO NOT take antibiotics prescribed for a different
illness which have been stored at home.
DO NOT share or give antibiotics to other people. Their
illness is probably different and they might even be
harmed by this medicine.
DO NOT take antibiotics due to exposure to someone
with an infection. This only increases the chance of
picking up a resistant infection. If exposed to an
infectious disease, seek medical advice.
26. Practices Contributing to
Misuse of Antibiotics and Resistance
Inappropriate specimen selection and collection
Inappropriate clinical tests
Failure to use stains/smears
Failure to use cultures and susceptibility tests
Use of antibiotics with no clinical indication (example viral
infections)
Broad spectrum antibiotics when not indicated
Inappropriate choice of empiric antibiotics
Empiric therapy is a medical term referring to the initiation
of treatment against an anticipated and likely cause of
infection prior to determination of a firm diagnosis. Most
often used when antibiotics are given to a person before the
specific microorganism causing an infection is known.
26
27. Bad prescribing habits lead to:
Ineffective and unsafe treatment
Exacerbation or prolongation of
illness
Distress and harm to the patient
Higher cost
Increased mortality and morbidity
27
28.
Misuse of antibiotics threatens to undermine the
progress that has been made in medicine over
recent decades. The overuse of antibiotics makes
patients less likely to respond to treatment, warns
Ireland’s leading clinicians.
Launching the action on antibiotics campaign to mark
European Antibiotic Awareness Day (November
2013), Dr Fidelma Fitzpatrick, Consultant
Microbiologist and HSE/RCPI Clinical Lead said that a
casual attitude to antibiotics is damaging their
effectiveness and that we are we are seeing an
alarming global rise in so called ‘superbugs’, such as
drug-resistant bacteria that cause pneumonia and
meningitis, MRSA and E.coli.
29.
“Taking antibiotics when they aren’t needed means
that they might not work when you really need
them for a serious infection. That is why the action
on antibiotics campaign - supported by the
Department of Health, Health Service Executive, Irish
College of General Practitioners, Irish Pharmacy
Union, Royal College of Physicians and Royal College
of Surgeons in Ireland – is aiming to raise public
awareness on the correct use of antibiotics and to
preserve this precious resource for the use of future
generations.
(Dr Fidelma Fitzpatrick, Consultant Microbiologist and HSE/RCPI Clinical Lead)
30.
“Leading clinicians from the Health Service
Executive, general practice, hospital
care, surgery, dentistry and pharmacy all agree that
everyone has an important role to play in ensuring
correct use of antibiotics, and tackling the global
health threat of antibiotic resistance. The evidence
is very clear – overuse and misuse of antibiotics has
allowed bacteria to develop resistance and they are
becoming immune to the drugs we use to defend
ourselves against them”.
(Dr Fidelma Fitzpatrick, Consultant Microbiologist and HSE/RCPI Clinical Lead)
31.
“Antibiotics have utterly transformed modern
medicine. Before antibiotics were available, common
injuries such as cuts and scratches that became
infected could result in death or serious illness because
there was no treatment available. Thankfully, this
does not happen anymore as we have antibiotics
available to treat these infections. However
antibiotics must be used appropriately and by
misusing them we face the risk of returning to the
pre-antibiotic era,”
(Dr Fidelma Fitzpatrick, Consultant Microbiologist and HSE/RCPI Clinical Lead)
34. 12 Steps to Prevent Antimicrobial
Resistance
12 Break the chain
11 Isolate the pathogen
10 Stop treatment when cured
9 Know when to say “no”
8 Treat infection, not colonization
7 Treat infection, not contamination
6 Use local data
5 Practice antimicrobial control
4 Access the experts
3 Target the pathogen
2 Get the catheters out
1 Vaccinate
Prevent Transmission
Use Antimicrobials Wisely
Diagnose & Treat Effectively
Prevent Infections
34
36. Provide educational materials and
explain how the risks of antibiotics
outweigh the benefits when used
inappropriately.
Build cooperation and trust.
Responsibility to the community is
to use antibiotics correctly, for
appropriate indications.
37.
Be fully informed about the
appropriate use and misuse
of antibiotics.
Are you demanding or
pressurizing your Dr into
prescribing antibiotics
unnecessarily for your
child?
Are misconceptions/
demands for inappropriate
antibiotics doing your child
more harm than good?
The answer is YES.
37
38. ADA Council on Scientific Affairs. Combating antibiotic resistance. 2004;135:484.
American Academy of Pediatrics and American Academy of Family Physicians, Pediatrics
2004;113:1451-1.
Fatehy, H, Consultant Pulmonologist: Abuse of antibiotics in clinical Practice .Power-pointaccessed on slideshare, February 4th 2014.
Harrison JW, Svec TA (April 1998). "The beginning of the end of the antibiotic era? Part II.
Proposed solutions to antibiotic abuse". Quintessence International 29 (4): 223–9
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Disease Control and Prevention, National Center for Health Statistics, 2009.
Health, United States, 2010: U.S. Department of Health and Human Services, Centers for
Disease Control and Prevention, National Center for Health Statistics, April 2010.
HSE Guidelines (2013) Keeping antibiotics effective is everyone’s responsibility. HSE, Ireland
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T.Rao MD, Antibiotics- Use, Misuse and Consequences (Power-point)- accessed on
slideshare, February 4th 2014)
Weiss AJ, Elixhauser A. Origin of Adverse Drug Events in U.S. Hospitals, 2011. HCUP Statistical
Brief #158. Agency for Healthcare Research and Quality, Rockville, MD. July 2013.PMID 9643260
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