Survey of Parental Use of Antimicrobial Drugs for Common Childhood Infections, China.
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ABSTRACT:
SUBMITTER: Lin L
PROVIDER: S-EPMC7323518 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BackgroundRoutine laboratory investigations are not rapidly available to assist clinicians in the diagnosis of pediatric acute infections. Our objective was to evaluate some common blood parameters and use them for the differential diagnosis of childhood infections.MethodsThis retrospective study was conducted between October 2019 and September 2020 at Guangzhou Women and Children's Medical Center, China. We performed blood tests in patients infected with DNA viruses (n = 402), RNA viruses (n = 602), gram-positive organisms (G+; n = 421), gram-negative organisms (G-; n = 613), or Mycoplasma pneumoniae (n = 387), as well as in children without infection (n = 277). The diagnostic utility of blood parameters to diagnose various infections was evaluated by logistic regression analysis.ResultsThe most common G+ organism, G- organism, and virus were Streptococcus pneumoniae (39.7%), Salmonella typhimurium (18.9%), and influenza A virus (40.2%), respectively. The value of logit (P) = 0.003 × C-reactive protein (CRP) - 0.011 × hemoglobin (HGB) + 0.001 × platelets (PLT) was significantly different between the control, RNA virus, DNA virus, M. pneumoniae, G- organism, and G+ organism groups (2.46 [95% CI, 2.41-2.52], 2.60 [2.58-2.62], 2.70 [2.67-2.72], 2.78 [2.76-2.81], 2.88 [2.85-2.91], and 2.97 [2.93-3.00], respectively; p = 0.00 for all). The logistic regression-based model showed significantly greater accuracy than the best single discriminatory marker for each group (logit [Pinfection] vs. CRP, 0.90 vs. 0.84, respectively; logit [PRNA] vs. lymphocytes, 0.83 vs. 0.77, respectively; p = 0.00). The area under curve values were 0.72 (0.70-0.74) for HGB and 0.81 (0.79-0.82) for logit (Pvirus/bacteria) to diagnose bacterial infections, whereas they were 0.72 (0.68-0.74) for eosinophils and 0.80 (0.78-0.82) for logit (Pvirus/bacteria) to diagnose viral infections. Logit (Pvirus/bacteria) < -0.45 discriminated bacterial from viral infection with 78.9% specificity and 70.7% sensitivity.ConclusionsThe combination of CRP, HGB, PLT, eosinophil, monocyte, and lymphocyte counts can distinguish between the infectious pathogens in children.
| S-EPMC9467365 | biostudies-literature
Project description:BackgroundA point prevalence survey (PPS) on healthcare-associated infections (HAI) and antimicrobial use was conducted in Swiss acute care hospitals in 2017.AimOur objective was to assess antimicrobial use in Swiss acute care hospitals.MethodsAll patients hospitalised in any acute care hospital in Switzerland were eligible. We used the most recent version of the PPS protocol of the European Centre for Disease Prevention and Control.ResultsData from 12,931 patients of 96 hospitals were collected. Of these, 4,265 (33%; 95% confidence interval (CI): 32.2-33.8) were on 5,354 antimicrobials for 4,487 indications. Most of the 2,808 therapeutic indications addressed 1,886 community-acquired infections (67.2%; 95% CI: 65.4-68.9). Of the 1,176 surgical prophylaxes, 350 (29.8%; 95% CI: 27.1-32.4) exceeded the duration of 1 day. Of the 1,090 antimicrobial regimens that were changed, 309 (28.3%; 95% CI: 25.7-31.0) were escalated and 337 (30.9%; 95% CI: 28.2-33.7) were de-escalated. Amoxicillin/clavulanic acid was the most frequent antimicrobial (18.8%; 95% CI: 17.7-19.8), prescribed mainly for therapeutic indications (76.0%; 95% CI: 73.3-78.7). A total of 1,931 (37.4%; 95% CI: 36.1-38.8) of the 5,158 antimicrobials for systemic use were broad-spectrum antibiotics, most frequently third- and fourth-generation cephalosporins (35.9%; 95% CI: 33.8-38.1).ConclusionsAntimicrobial consumption was at European average, the use of broad-spectrum antibiotics in the lower third. Swiss acute care hospitals should invest in antimicrobial stewardship, particularly in reducing the use of broad-spectrum antibiotics.
| S-EPMC6702796 | biostudies-literature
Project description:This study sought to investigate the actual status of awareness regarding the appropriate use of antimicrobial drugs among patients of a wide age range who visit dispensing pharmacies in order to explore more effective intervention methods for improving awareness of the appropriate use of antimicrobial drugs for patients. A questionnaire survey was conducted with 1301 patients who visited different Tsuruha Holdings-operated pharmacies between 1 September 2018 and 31 October 2018. Using multiple regression analysis, we calculated scores based on the patients' answers regarding their knowledge of antimicrobial drugs and antimicrobial resistance and examined factors related to these scores. Of the 1185 respondents who successfully completed the survey (mean age ± SD, 52.5 ± 18.2 years), 37.2% were 60 years old or older, 13.2% had never or were not sure whether they had taken antimicrobial drugs, and 73.2% did not understand the problem of antimicrobial resistance. Older age, the non-usage of drugs and self-reports of the "lack" of knowledge of antimicrobial resistance were identified as the group that needs education regarding the appropriate use of antimicrobial drugs. Intervention studies should be conducted to examine the efficacy of interventions based on these factors.
| S-EPMC9844386 | biostudies-literature
Project description:BackgroundThere is limited information about the types of recreational drugs used by men who have sex with men (MSM) in China or the consequent impact on sexual health and human immunodeficiency virus (HIV) acquisition.MethodsWe recruited MSM from seven cities in China between 2012 and 2013 using multiple approaches including advertisements on gay websites, collaborating with local MSM community-based organizations, peer referrals, and venues such as gay bars and bathrooms visited by MSM. We divided participants into four subgroups based on the number of recreational drugs (RDs) used in the previous 6 months. We defined use of multiple RDs as use of ≥2 types of RDs. Demographics and HIV-related high-risk behaviors were collected, and blood samples were tested for recent HIV infection by the HIV-1 subtypes B, E, and D immunoglobulin G capture enzyme immunoassay (BED-CEIA). We used multivariable logistic regression adjusted for sociodemographics to determine the adjusted odds ratios (aORs) and associated 95% confidence intervals (CIs) of the subgroups of RD use for recent or established HIV infection.ResultsA total of 4496 Chinese MSM participated; 28.4% used RDs, and 5% used multiple types of RDs. The prevalence of each RD use was as follows: poppers (25.9%), ecstasy (2.4%), ketamine (1.2%), amphetamine (0.6%), tramadol (0.4%), methamphetamine (3.8%), and codeine (1.9%). Users of multiple RDs commonly used poppers combined with one or more other types of RDs. Multiple RD users were likely to be aged 26-30 years (vs. 18-25 and > 30 years), live in non-local cities (vs. local cities), never married (vs. married), have a high monthly income (vs. no income and 1-599 USD), use versatile positions during anal intercourse (vs. top or bottom), and have inadequate HIV-related prevention knowledge (vs. adequate). As the number of RDs used in the previous 6 months increased, the prevalence of HIV-related high-risk behaviors increased (P < 0.05 for all). The odds of recent HIV infection were higher among those who used one type (aOR = 2.2, 95% CI: 1.5-3.0) or two types of RD (aOR=2.3, 95% CI: 1.0-5.2) in the previous 6 months compared to the odds among those who did not use RDs.ConclusionThe level and pattern of multiple RD use among Chinese MSM were different from high-income countries. MSM who used more RDs are more likely to engage in high-risk sexual behaviors, and these behaviors may be associated with increases in new HIV infections.
| S-EPMC7885486 | biostudies-literature
Project description:This cross-sectional study aims to assess parents' knowledge, attitude, and practices on antibiotic use for children with URTIs symptoms in Greece in the era of the COVID-19 pandemic. We distributed a questionnaire to a random sample of parents who visited primary health care centers in Patras, Greece. Out of 412 participants, 86% believed that most infections with common cold or flu symptoms were caused by viruses, although 26.9% believed that antibiotics may prevent complications. Earache was the most common symptom for which antibiotics were needed. Most of them (69%) declare being considerably anxious about their children's health during the COVID-19 pandemic. The majority (85%) knew that COVID-19 was of viral origin, yet half of them declared uncertain whether antibiotics were needed. All demographic characteristics, except for gender, were found to have a significant effect on parents' knowledge, attitude, and practices on antibiotic use for URTIs and COVID-19. Factor analysis revealed six groups of parents with common characteristics associated with misuse of antibiotics. Our findings highlight the need to decrease misconceptions regarding antibiotic use by providing relevant education for parents targeting particular characteristics, especially during the COVID-19 pandemic. Continuous education of healthcare providers in the field is also of paramount importance.
| S-EPMC8300644 | biostudies-literature
Project description:Small-molecule drugs may complement antibody-based therapies in an immune-oncology setting, yet systematic methods for the identification and characterization of the immunomodulatory properties of these entities are lacking. We surveyed the immumomodulatory potential of 1,402 small chemical molecules, as defined by their ability to alter the cell-cell interactions among peripheral mononuclear leukocytes ex vivo, using automated microscopy and population-wide single-cell image analysis. Unexpectedly, ∼10% of the agents tested affected these cell-cell interactions differentially. The results accurately recapitulated known immunomodulatory drug classes and revealed several clinically approved drugs that unexpectedly harbor the ability to modulate the immune system, which could potentially contribute to their physiological mechanism of action. For instance, the kinase inhibitor crizotinib promoted T cell interactions with monocytes, as well as with cancer cells, through inhibition of the receptor tyrosine kinase MSTR1 and subsequent upregulation of the expression of major histocompatibility complex molecules. The approach offers an attractive platform for the personalized identification and characterization of immunomodulatory therapeutics.
| S-EPMC5438060 | biostudies-literature
Project description:Atherosclerotic changes can be measured as changes in common carotid intima media thickness (CIMT). It is hypothesised that repeated infection-associated inflammatory responses in childhood contribute to the atherosclerotic process. We set out to determine whether the frequency of infectious diseases in childhood is associated with CIMT in adolescence. The study is part of the Prevention and Incidence of Asthma and Mite Allergy (PIAMA) population-based birth cohort. At age 16 years, common CIMT was measured. We collected general practitioner (GP) diagnosed infections and prescribed antibiotics. Parent-reported infections were retrieved from annual questionnaires. Linear regression analysis assessed the association between number of infections during the first 4 years of life and common CIMT. Common CIMT measurement, GP and questionnaire data were available for 221 participants. No association was observed between the infection measures and CIMT. In a subgroup analysis, significant positive associations with CIMT were observed in participants with low parental education for 2-3 or ⩾7 GP diagnosed infections (+26.4 µm, 95% CI 0.4-52.4 and +26.8 µm, 95% CI 3.6-49.9, respectively) and ⩾3 antibiotic prescriptions (+35.5 µm, 95%CI 15.8-55.3). Overall, early childhood infections were not associated with common CIMT in adolescence. However, a higher number of childhood infections might contribute to the inflammatory process of atherosclerosis in subgroups with low education, this needs to be confirmed in future studies.
| S-EPMC6518654 | biostudies-literature
Project description:ObjectiveTo describe help seeking behaviour from a medical doctor and antimicrobial use for common infections among rural residents of Anhui province, China.DesignA cross-sectional retrospective household survey.Setting12 administrative villages from rural Anhui, China.Participants2760 rural residents selected through cluster-randomised sampling using an interviewer administered questionnaire.MethodLogistic regression models were used to estimate associations between exposures (health insurance and antimicrobial-related knowledge), adjusted for confounders (sex, age and education), and help-seeking behaviour from a medical doctor and antimicrobial use following common infections, including acute respiratory tract infections (ARTIs), gastrointestinal tract infections (GTIs) and urinary tract infections (UTIs).ResultsIn total 2611 (94.6%) rural residents completed the questionnaire. Help seeking from a medical doctor was highest for ARTIs (59.4%) followed by GTIs (42.1%), and UTIs (27.8%). Around two-thirds (82.3% for ARTIs, 87.0% for GTIs and 66.0% for UTIs) of respondents sought help within 3 days following symptom onset and over three quarters (88% for ARTIs, 98% for GTIs and 77% for UTIs) reported complete recovery within 7 days. Of the help-seeking respondents, 94.5% with ARTI symptoms recalled being prescribed either oral or intravenous antimicrobials (GTIs 81.7% and UTIs 70.4%). Use of antimicrobials bought from medicine shops without prescriptions ranged from 8.8% for GTIs to 17.2% for ARTIs; while use of antimicrobials leftover from previous illnesses or given by a relative ranged from 7.6% for UTIs to 13.4% for ARTIs. Multivariate logistic regression analysis revealed that respondents with a higher antimicrobial-related knowledge score and lack of insurance were associated with lower levels of help-seeking for ARTIs; while respondents with a higher antimicrobial-related knowledge score were less likely to be prescribed either oral or intravenous antimicrobials.ConclusionsExcessive antimicrobial use in the studied primary care settings is still prevalent.
| S-EPMC6500192 | biostudies-literature
Project description:BackgroundAssociations between adverse childhood experiences (ACEs) and common psychiatric disorders among older Chinese individuals have not been well reported. The objectives of this study are to examine the prevalence of ACEs and the associations of ACEs with common psychiatric disorders among older adults in China.MethodsThe study used data from the China Mental Health Survey (CMHS), a nationally representative epidemiological survey, which used computer-assisted personal interviewing (CAPI), logistic regression models were used to examine community-based adult psychiatric disorders and associated risk factors. Finally, 2,317 individuals aged 60 years or over were included in the CMHS. The national prevalence of ACEs in older adults were estimated and logistic regression were used to analyse the association between ACEs and past-year psychiatric disorders.ResultsPrevalence of ACEs among older adults in China was 18.1%. The three most common types of ACEs were neglect (11.6%), domestic violence (9.2%), and parental loss (9.1%). This study proved the association between ACEs and common past-year psychiatric disorders in older adults. ACEs increased the risk of past-year psychiatric disorders in older adults. After adjustment for age, sex, marital status, employment status, education, rural or urban residence, region, and physical diseases, the association between ACEs and past-year psychiatric disorders were still significant.ConclusionsACEs are linked to an increased risk for past-year psychiatric disorders in older adults. ACEs may have long-term effects on older adults' mental well-being. Preventing ACEs may help reduce possible adverse health outcomes in later life.
| S-EPMC10619228 | biostudies-literature
Project description:In recent years, high frequencies of trimethoprim resistance in urinary tract infections (UTIs) caused by E. coli are have been reported. Co-resistance to other antimicrobial drugs may play a role in this increase. Therefore, we investigated whether previous use of other antimicrobial drugs was associated with trimethoprim resistance. We conducted a nested case-control study with urinary cultures with E. coli from participants of the Rotterdam Study sent in by general practitioners to the regional laboratory between 1 January 2000 and 1 April 2016. Multivariable logistic regression analysis was performed to study the association between prior prescriptions of several antimicrobial drug groups and trimethoprim resistance using individual participant data. Urinary cultures of 1264 individuals with a UTI caused by E. coli were included. When adjusted for previous other antimicrobial drug use, a history of > 3 prescriptions of extended-spectrum penicillins (OR 1.68; 95% CI 1.10-2.55) was significantly associated with trimethoprim resistance of E. coli as was the use of > 3 prescriptions of sulfonamides and trimethoprim (OR 2.22; 95% CI 1.51-3.26). The use of > 3 prescriptions of nitrofuran derivatives was associated with a lower frequency of trimethoprim resistance (OR 0.60; 95% CI 0.39-0.92), after adjustment for other antimicrobial drug prescriptions. We found that previous use of extended-spectrum penicillins is associated with trimethoprim resistance. On the contrary, previous nitrofurantoin use was associated with a lower frequency of trimethoprim resistance. Especially in individuals with recurrent UTI, co-resistance should be taken into account and susceptibility testing before starting trimethoprim should be considered.
| S-EPMC6858404 | biostudies-literature