The Journal of antimicrobial chemotherapy
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J. Antimicrob. Chemother. · Dec 2010
Antibiotic prescribing in general practice--the rhythm of the week: a cross-sectional study.
Overprescribing of antibiotics in primary care is a worldwide phenomenon. Prescriptions can be used to reduce the uncertainty inherent in general practice. We assumed a heightened prescribing rate on Fridays because of more uncertainty before the pending weekend. ⋯ There is periodic fluctuation of antibiotic prescribing rates over the week. This cannot be explained by morbidity itself. Factors beyond biomedical indication are well known to influence prescribing patterns. These factors should not only be further explored, but also acknowledged when trying to reduce overprescribing.
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J. Antimicrob. Chemother. · Dec 2010
Repurposing FDA-approved drugs to combat drug-resistant Acinetobacter baumannii.
The rising occurrence of drug-resistant pathogens accentuates the need to identify novel antibiotics. We wanted to identify new scaffolds for drug discovery by repurposing FDA-approved drugs against Acinetobacter baumannii, an emerging Gram-negative nosocomial drug-resistant pathogen. ⋯ The paucity of identified compounds active against drug-resistant A. baumannii exemplifies its ability to resist antimicrobials as well as the resilience of drug-resistant Gram-negative pathogens. Repurposing of approved drugs is a viable alternative to de novo drug discovery and development.
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J. Antimicrob. Chemother. · Dec 2010
Rifaximin modulates the colonic microbiota of patients with Crohn's disease: an in vitro approach using a continuous culture colonic model system.
Rifaximin, a rifamycin derivative, has been reported to induce clinical remission of active Crohn's disease (CD), a chronic inflammatory bowel disorder. In order to understand how rifaximin affects the colonic microbiota and its metabolism, an in vitro human colonic model system was used in this study. ⋯ We demonstrated that rifaximin, while not altering the overall structure of the human colonic microbiota, increased bifidobacteria and led to variation of metabolic profiles associated with potential beneficial effects on the host.
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J. Antimicrob. Chemother. · Dec 2010
Recurrent healthcare-associated community-onset infections due to Klebsiella pneumoniae producing VIM-1 metallo-beta-lactamase.
To investigate the extrahospital dissemination of carbapenem-resistant Klebsiella pneumoniae isolates and the mechanisms of acquired resistance. ⋯ This is the first study to document the dissemination of an MBL-producing K. pneumoniae strain in the community. The successful strain caused recurrent community-onset infections and was most likely acquired during patients' previous hospitalization.
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J. Antimicrob. Chemother. · Nov 2010
ReviewOptimizing antibiotic prescribing in primary care settings in the UK: findings of a BSAC multi-disciplinary workshop 2009.
Several UK resources, including the National Institute for Health and Clinical Excellence (NICE), Clinical Knowledge Summaries, the Infection Specialist Library, the HPA Management of Infection Guide, the Map of Medicine and the Royal College of General Practitioners (RCGP) web site, produce primary care antibiotic prescribing guidance. A BSAC 2009 workshop aimed to discuss how guidance could be best translated into practice using public and professional educational programmes. Workshop participants were asked to consider approaches within the context of a behaviour change model, in which readiness to change is recognized as a product of the individual's perception of the importance of change (the 'why' of change; 'Why should I change my antibiotic prescribing') and their confidence that they can achieve a change (the 'how' of change). ⋯ Videos are a useful tool for demonstrating good and poor communication skills and approaches to eliciting and addressing patient concerns and expectations. Well-designed patient information can facilitate consultations. Feedback and audit on antibiotic use to clinicians is essential; this can be facilitated by incentive schemes, especially if clinical records link diagnosis with prescriptions.