Acta Clin Belg
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Despite the implementation of strategies aiming at improving antimicrobial utilisation, inappropriate use remains an increasing problem with important consequences on both antibiotic resistance and hospital costs. ⋯ This study identified two main areas for improving amoxicillin/clavulanate prescribing: (1) the intravenous to oral switch, which is often too late or nonexistent and (2) the duration of therapy, which is too long particularly in respiratory tract infections. The results have been presented to clinicians and specific interventions for optimisation are being discussed and implemented.
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Anti-N-methyl-D-aspartate receptor (NMDA-R) encephalitis is a severe form of encephalitis that has been identified within the context of acute neuropsychiatric manifestations. We report the case of an 18-year-old adolescent referred for a first episode of acute psychosis. ⋯ Immunosuppressive treatment and repeated plasma exchange resulted in slow recovery. The literature on diagnosis and treatment of this specific type of encephalitis is reviewed.
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Despite guidelines and recommendations, a large proportion of patients with cancer still have inadequate pain control. Transdermal opioid administration can overcome problems such as swallowing and compliance, because only one application every three days is needed. Transdermal buprenorphine was documented to provide effective pain relief in cancer and non-cancer patients. A ceiling effect was described in animals at supratherapeutic dose levels. ⋯ Transdermal buprenorphine control cancer pain in the majority of palliative patients.