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[PMID]:29505509
[Au] Autor:Xu L; Zhu Y; Yu J; Deng M; Zhu X
[Ad] Endereço:Department of Children's Critical Care Medicine, Xin-Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
[Ti] Título:Nursing care of a boy seriously infected with Steven-Johnson syndrome after treatment with azithromycin: A case report and literature review.
[So] Source:Medicine (Baltimore);97(1):e9112, 2018 Jan.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Stevens-Johnson syndrome (SJS) is an acute blistering disease of the skin and mucous membranes. SJS in children is not common but potentially serious disease. But the epidemiology of SJS in China is not well defined. PATIENT CONCERNS: A 6-year-old boy was initially diagnosed as pneumonia admitted to hospital after admission, and the body appears red rash with blisters, skin damage, lip debaucjed, repeated high fever, and rapid progression. DIAGNOSES: SJS often results from an allergy reaction response to a range of drugs. It is a clinical diagnosis suggested by fever and malaise followed by an extensive painful, nonblanching, macular rash that commonly progresses to blistering or sloughing, and mucositis. INTERVENTIONS: The boy was treated with continuous renal replacement therapy, anti-infection therapy, high-dose glucocorticoid treatment, and symptomatic treatment. OUTCOMES: The patient was recovered after 33 days of treatment. LESSONS: The current treatment is mainly symptomatic treatment, and for the patient, it is important to make skin care related well, included early out blisters at effusion, reducing skin ulceration of the mucosa area, keeping skin clean, removing mucosa secretion and blood clots, doing eye care related, preventing the complications, ensuring adequate intake of nutrition and warm and so on.
[Mh] Termos MeSH primário: Antibacterianos/efeitos adversos
Azitromicina/efeitos adversos
Higiene da Pele/enfermagem
Síndrome de Stevens-Johnson/enfermagem
[Mh] Termos MeSH secundário: Criança
Seres Humanos
Masculino
Pneumonia/tratamento farmacológico
Síndrome de Stevens-Johnson/etiologia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 83905-01-5 (Azithromycin)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180306
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009112


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[PMID]:29377957
[Au] Autor:Yang D; Chen L; Chen Z
[Ad] Endereço:Zhejiang University School of Medicine, Hangzhou, Zhejiang, P.R. China.
[Ti] Título:The timing of azithromycin treatment is not associated with the clinical prognosis of childhood Mycoplasma pneumoniae pneumonia in high macrolide-resistant prevalence settings.
[So] Source:PLoS One;13(1):e0191951, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Mycoplasma pneumoniae infection is a major cause of community-acquired pneumonia in children. We performed a retrospective study to evaluate the clinical impact of the timing of azithromycin treatment in children with Mycoplasma pneumoniae pneumonia in high macrolide-resistant prevalence settings. METHODS AND FINDINGS: A total of 623 patients were enrolled in this study and were divided into 2 groups according to the timing of azithromycin therapy. Children who received azithromycin within 3 days (72 hours) after the onset of Mycoplasma pneumoniae pneumonia were classified into the early azithromycin treatment group (n = 174), whereas the late azithromycin treatment group (n = 449) comprised children treated with azithromycin more than 72 hours after symptom onset. We evaluated clinical prognosis according to demographic, clinical and laboratory characteristics. Although the early azithromycin treatment group exhibited a longer fever duration after azithromycin administration (7.17±4.12 versus 4.82±3.99 days, P<0.01), the total fever duration exhibited no significant difference (9.02±4.58 versus 9.57±4.91 days, P = 0.212). After azithromycin therapy, the two groups exhibited no significant differences with respect to improvements in the laboratory and radiological findings (all P>0.05). CONCLUSION: The timing of azithromycin treatment is not associated with the clinical prognosis of Mycoplasma pneumoniae pneumonia in children in high macrolide-resistant Mycoplasma pneumoniae prevalence settings.
[Mh] Termos MeSH primário: Antibacterianos/uso terapêutico
Azitromicina/uso terapêutico
Macrolídeos/uso terapêutico
Pneumonia Bacteriana/tratamento farmacológico
[Mh] Termos MeSH secundário: Adolescente
Criança
Pré-Escolar
Farmacorresistência Bacteriana
Feminino
Seres Humanos
Lactente
Masculino
Pneumonia Bacteriana/patologia
Prognóstico
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (Macrolides); 83905-01-5 (Azithromycin)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180130
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0191951


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[PMID]:29031188
[Au] Autor:Vermillion Maier ML; Tjeerdema RS
[Ad] Endereço:Department of Environmental Toxicology, College of Agricultural and Environmental Sciences, University of California, One Shields Avenue, Davis, CA 95616-8588, USA. Electronic address: mlmaier@ucdavis.edu.
[Ti] Título:Azithromycin sorption and biodegradation in a simulated California river system.
[So] Source:Chemosphere;190:471-480, 2018 Jan.
[Is] ISSN:1879-1298
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Azithromycin (AZ) is a widely-used macrolide antibiotic that is continually deposited into natural waterways by sewage effluent. Though recognized as an emerging contaminant of concern, little is known about its fate and transport in aquatic systems. American River soils and water were used to determine degradation of AZ in microcosms simulating flooded (anaerobic) and non-flooded (aerobic) California watershed conditions. Under aerobic conditions the degradation rate constant (k=0.0084 ± 0.0039 day ) and DT (82.52 ± 56.54 days) were calculated, as AZ disappearance indicated potential degradation. However, based on concurrent product appearance, less than one percent of the parent degraded over 150 days. Throughout the experiment microbial growth was observed by culturing in tryptic soy broth despite antibiotic addition and soil being autoclaved. Sorption likely contributes to AZ recalcitrance, thus the soil-water partition coefficient (log K = 2.18 Lkg ), Freundlich sorption and desorption coefficients (log K = 1.90 ± 0.14 and log K = 2.51 ± 0.30, respectively), and organic-carbon-normalized distribution coefficient (log K = 4.25 Lkg ) were also calculated. Based on these results, AZ degradation in aquatic systems will likely be very limited and transport will fluctuate based on the extent of soil-water saturation or bulk movement of sediment.
[Mh] Termos MeSH primário: Azitromicina/química
Rios/química
Poluentes do Solo/análise
Poluentes Químicos da Água/análise
[Mh] Termos MeSH secundário: Adsorção
Antibacterianos/química
Biodegradação Ambiental
California
Simulação por Computador
Cinética
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (Soil Pollutants); 0 (Water Pollutants, Chemical); 83905-01-5 (Azithromycin)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180228
[Lr] Data última revisão:
180228
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171015
[St] Status:MEDLINE


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[PMID]:29443773
[Au] Autor:Cai X; Zhou H; Xie Y; Yu D; Wang Z; Ren H
[Ad] Endereço:Department of Pediatrics, West China Second University Hospital.
[Ti] Título:Anti-N-methyl-D-aspartate receptor encephalitis associated with acute Toxoplasma gondii infection: A case report.
[So] Source:Medicine (Baltimore);97(7):e9924, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis has been recognized as the most frequent autoimmune encephalitis in children. Several infectious agents have been implicated in anti-NMDA encephalitis. PATIENT CONCERNS: A previously healthy immunocompetent 9-year-old girl first presented with seizures, headaches and vomiting. Cerebrospinal fluid and brain magnetic resonance imaging were normal. After one week onset, the patient gradually developed unexplained personality and behavior changes, accompanied by fever and seizures again. Repeated CSF analysis revealed a slightly lymphocytic predominant pleocytosis and positive anti-NMDAR antibody. A variety of pathogenic examinations were negative, except for positive toxoplasma IgM and IgG. DIAGNOSES: The patient was diagnoses for anti-NMDA encephalitis associated with acute acquired toxoplasma gondii infection. INTERVENTIONS: The patient received 10 days azithromycin for treatment of acquired toxoplasma infection. The parents refuse immunotherapy because substantial recovery from clinical symptoms. OUTCOMES: The patient was substantially recovered with residual mild agitation after therapy for acquired toxoplasma gondii infection. Two months later, the patient was completely devoid of symptoms, and the levels of serum IgM and IgG of toxoplasma gondii were decreased. LESSONS: Acquired toxoplasma gondii infection may trigger anti-NMDAR encephalitis in children, which has not been reported previously. Clinicians should assess the possibility of toxoplasma gondii infection when evaluating a patient with anti-NMDA encephalitis.
[Mh] Termos MeSH primário: Encefalite Antirreceptor de N-Metil-D-Aspartato/diagnóstico
Encefalite Antirreceptor de N-Metil-D-Aspartato/parasitologia
Toxoplasmose Cerebral/diagnóstico
[Mh] Termos MeSH secundário: Encefalite Antirreceptor de N-Metil-D-Aspartato/tratamento farmacológico
Antiprotozoários/uso terapêutico
Azitromicina/uso terapêutico
Criança
Feminino
Seres Humanos
Imunoglobulina G/sangue
Imunoglobulina M/sangue
Toxoplasma/imunologia
Toxoplasmose Cerebral/tratamento farmacológico
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antiprotozoal Agents); 0 (Immunoglobulin G); 0 (Immunoglobulin M); 83905-01-5 (Azithromycin)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180220
[Lr] Data última revisão:
180220
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180215
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009924


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[PMID]:29384912
[Au] Autor:Han B; Sheng Y; Wang L; Feng H; Hou X; Li Y
[Ad] Endereço:Centre for Reproductive Medicine.
[Ti] Título:Intrahepatic cholestasis of pregnancy or azithromycin-induced intrahepatic cholestasis: A case report.
[So] Source:Medicine (Baltimore);96(52):e9346, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Azithromycin-induced liver injury has been rarely reported in adult individuals, let alone in a pregnant woman. Here, we describe the clinical features and outcomes of azithromycin-induced liver injury in a pregnant woman. PATIENT CONCERNS: A 30-year-old pregnant woman presented with generalized pruritus and elevated serum bile acid level (123.6 µmol/L) on day 4 of azithromycin administration. A diagnosis of intrahepatic cholestasis of pregnancy was made, and cesarean section was performed immediately. Interestingly, the alanine aminotransferase level (ALT) reached 211.2 U/L on day 9 after azithromycin administration. DIAGNOSIS: Therefore, drug-induced intrahepatic cholestasis was considered. INTERVENTIONS: (1) Azithromycin withdrawal after the patient hospitalized. (2) Termination of pregnancy by cesarean section was performed inmmediately to protect the fetus. (3) Silymarin capsules and bifendate are used to protect the liver after liver enzymes elevation was discovered. OUTCOMES: The liver enzymes recovered within 4 weeks without any symptoms after treatment with silymarin capsules and bifendate, which helps reduce ALT level and protects the liver from further injury. LESSIONS: A pregnant woman developed azithromycin-induced intrahepatic cholestasis. Physicians should be aware of this side effect of azithromycin, which is widely prescribed.
[Mh] Termos MeSH primário: Antibacterianos/efeitos adversos
Azitromicina/efeitos adversos
Colestase Intra-Hepática/induzido quimicamente
Colestase Intra-Hepática/diagnóstico
Complicações na Gravidez/induzido quimicamente
Complicações na Gravidez/diagnóstico
[Mh] Termos MeSH secundário: Adulto
Cesárea
Colestase Intra-Hepática/terapia
Feminino
Seres Humanos
Gravidez
Complicações na Gravidez/terapia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 83905-01-5 (Azithromycin)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180209
[Lr] Data última revisão:
180209
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180201
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009346


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[PMID]:29248446
[Au] Autor:Sanchez Garcia D; Sjödin M; Hellstrandh M; Norinder U; Nikiforova V; Lindberg J; Wincent E; Bergman Å; Cotgreave I; Munic Kos V
[Ad] Endereço:Swetox, Karolinska Institutet, Unit of Toxicology Sciences, Forskargatan 20, SE-151 36 Södertälje, Sweden.
[Ti] Título:Cellular accumulation and lipid binding of perfluorinated alkylated substances (PFASs) - A comparison with lysosomotropic drugs.
[So] Source:Chem Biol Interact;281:1-10, 2018 Feb 01.
[Is] ISSN:1872-7786
[Cp] País de publicação:Ireland
[La] Idioma:eng
[Ab] Resumo:Many chemicals accumulate in organisms through a variety of different mechanisms. Cationic amphiphilic drugs (CADs) accumulate in lysosomes and bind to membranes causing phospholipidosis, whereas many lipophilic chemicals target adipose tissue. Perfluoroalkyl substances (PFASs) are widely used as surfactants, but many of them are highly bioaccumulating and persistent in the environment, making them notorious environmental toxicants. Understanding the mechanisms of their bioaccumulation is, therefore, important for their regulation and substitution with new, less harmful chemicals. We compared the highly bioaccumulative perfluorooctanesulfonic acid PFOS to its three less bioaccumulative alternatives perfluorooctanoic acid (PFOA), perfluorohexanoic acid (PFHxA) and perfluorobutane sulfonic acid (PFBS), in their ability to accumulate and remain in lung epithelial cells (NCI-H292) and adipocytes (3T3-L1K) in vitro. As a reference point we tested a set of cationic amphiphilic drugs (CADs), known to highly accumulate in cells and strongly bind to phospholipids, together with their respective non-CAD controls. Finally, all compounds were examined for their ability to bind to neutral lipids and phospholipids in cell-free systems. Cellular accumulation and retention of the test compounds were highly correlated between the lung epithelial cells and adipocytes. Interestingly, although an anion itself, intensities of PFOS accumulation and retention in cells were comparable to those of CAD compounds, but PFOS failed to induce phospholipidosis or alter lysosomal volume. Compared to other lipophilicity measures, phospholipophilicity shows the highest correlation (Rˆ2 = 0.75) to cellular accumulation data in both cell types and best distinguishes between high and low accumulating compounds. This indicates that binding to phospholipids may be the most important component in driving high cellular accumulation in lung epithelial cells, as well as in adipocytes, and for both CADs and bioaccumulating PFASs. Obtained continuous PLS models based on compound's affinity for phospholipids and neutral lipids can be used as good prediction models of cellular accumulation and retention of PFASs and CADs.
[Mh] Termos MeSH primário: Ácidos Alcanossulfônicos/metabolismo
Fluorcarbonetos/metabolismo
Lisossomos/metabolismo
Preparações Farmacêuticas/metabolismo
Fosfolipídeos/metabolismo
[Mh] Termos MeSH secundário: Adipócitos/citologia
Adipócitos/metabolismo
Ácidos Alcanossulfônicos/química
Animais
Azitromicina/química
Azitromicina/metabolismo
Caproatos/química
Caproatos/metabolismo
Caprilatos/química
Caprilatos/metabolismo
Cátions/química
Linhagem Celular
Sobrevivência Celular
Células Epiteliais/citologia
Células Epiteliais/metabolismo
Fluorcarbonetos/química
Seres Humanos
Análise dos Mínimos Quadrados
Modelos Lineares
Lipídeos/química
Camundongos
Preparações Farmacêuticas/química
Fosfolipídeos/química
Ácidos Sulfônicos/química
Ácidos Sulfônicos/metabolismo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Alkanesulfonic Acids); 0 (Caproates); 0 (Caprylates); 0 (Cations); 0 (Fluorocarbons); 0 (Lipids); 0 (Pharmaceutical Preparations); 0 (Phospholipids); 0 (Sulfonic Acids); 0 (perfluorobutanesulfonic acid); 83905-01-5 (Azithromycin); 947VD76D3L (perfluorooctanoic acid); 9H2MAI21CL (perfluorooctane sulfonic acid); ZP34Q2220R (perfluorohexanoic acid)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180129
[Lr] Data última revisão:
180129
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171218
[St] Status:MEDLINE


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[PMID]:29226307
[Au] Autor:Romero L; Huerfano C; Grillo-Ardila CF
[Ad] Endereço:Department of Obstetrics and Gynecology, Faculty of Medicine, Universidad Nacional de Colombia, Bogota, Colombia.
[Ti] Título:Macrolides for treatment of Haemophilus ducreyi infection in sexually active adults.
[So] Source:Cochrane Database Syst Rev;12:CD012492, 2017 Dec 11.
[Is] ISSN:1469-493X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Chancroid is a genital ulcerative disease caused by Haemophilus ducreyi. This microorganism is endemic in Africa, where it can cause up to 10% of genital ulcers. Macrolides may be an effective alternative to treat chancroid and, based on their oral administration and duration of therapy, could be considered as first line therapy. OBJECTIVES: To assess the effectiveness and safety of macrolides for treatment of H ducreyi infection in sexually active adults. SEARCH METHODS: We searched the Cochrane STI Group Specialized Register, CENTRAL, MEDLINE, Embase, LILACS, WHO ICTRP, ClinicalTrials.gov and Web of Science to 30 October 2017. We also handsearched conference proceedings and reference lists of retrieved studies. SELECTION CRITERIA: Randomized controlled trials (RCTs) comparing macrolides in different regimens or with other therapeutic alternatives for chancroid. DATA COLLECTION AND ANALYSIS: Two review authors independently assessed trials for inclusion, extracted data and assessed risk of bias. We resolved disagreements through consensus. We used the GRADE approach to assess the quality of the evidence. MAIN RESULTS: Seven RCTs (875 participants) met our inclusion criteria, of which four were funded by industry. Five studies (664 participants) compared macrolides with ceftriaxone, ciprofloxacin, spectinomycin or thiamphenicol. Low quality evidence suggested there was no difference between the groups after treatment in terms of clinical cure (risk ratio (RR) 1.09, 95% confidence interval (CI) 0.97 to 1.21; 2 studies, 340 participants with syndromic approach and RR 1.06, 95% CI 0.98 to 1.15; 5 studies, 348 participants with aetiological diagnosis) or improvement (RR 0.89, 95% CI 0.52 to 1.52; 2 studies, 340 participants with syndromic approach and RR 0.80, 95% CI 0.42 to 1.51; 3 studies, 187 participants with aetiological diagnosis). Based on low and very low quality evidence, there was no difference between macrolides and any other antibiotic treatments for microbiological cure (RR 0.93, 95% CI 0.74 to 1.16; 1 study, 45 participants) and minor adverse effects (RR 1.34, 95% CI 0.24 to 7.51; 3 studies, 412 participants).Two trials (269 participants) compared erythromycin with any other macrolide type. Low quality evidence suggested that, compared with azithromycin or rosaramicin, long courses of erythromycin did not increase clinical cure (RR 1.00, 95% CI 0.91 to 1.10; 2 studies, 269 participants with syndromic approach and RR 1.04, 95% CI 0.93 to 1.16; 2 studies, 211 participants with aetiological diagnosis), with a similar frequency of minor adverse effects between the groups (RR 1.14, 95% CI 0.63 to 2.06; 1 trial, 101 participants). For this comparison, subgroup analysis found no difference between HIV-positive participants (RR 1.02, 95% CI 0.73 to 1.43; 1 study, 38 participants) and HIV-negative participants (RR 1.04, 95% CI 0.94 to 1.14; 1 study, 89 participants). We downgraded the quality of evidence to low, because of imprecision, some limitations on risk of bias and heterogeneity.None of the trials reported serious adverse events, cost effectiveness and participant satisfaction. AUTHORS' CONCLUSIONS: At present, the quality of the evidence on the effectiveness and safety of macrolides for treatment of H ducreyi infection in sexually active adults is low, implying that we are uncertain about the estimated treatment effect. There is no statistically significant difference between the available therapeutic alternatives for the treatment of sexually active adults with genital ulcers compatible with chancroid. Low quality evidence suggests that azithromycin could be considered as the first therapeutic alternative, based on their mono-dose oral administration, with a similar safety and effectiveness profile, when it is compared with long-term erythromycin use.Due to sparse available evidence about the safety and effectiveness of macrolides to treat H ducreyi infection in people with HIV, these results should be taken with caution.
[Mh] Termos MeSH primário: Antibacterianos/uso terapêutico
Cancroide/tratamento farmacológico
Haemophilus ducreyi
Macrolídeos/uso terapêutico
[Mh] Termos MeSH secundário: Adolescente
Adulto
Azitromicina/uso terapêutico
Eritromicina/efeitos adversos
Eritromicina/uso terapêutico
Seres Humanos
Leucomicinas/uso terapêutico
Macrolídeos/efeitos adversos
Meia-Idade
Ensaios Clínicos Controlados Aleatórios como Assunto
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (Leucomycins); 0 (Macrolides); 63937KV33D (Erythromycin); 83905-01-5 (Azithromycin); E907BNQ7SH (rosaramicin)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180123
[Lr] Data última revisão:
180123
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171212
[St] Status:MEDLINE
[do] DOI:10.1002/14651858.CD012492.pub2


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[PMID]:28746259
[Au] Autor:Fleming-Dutra KE; Demirjian A; Bartoces M; Roberts RM; Taylor TH; Hicks LA
[Ad] Endereço:From the *Office of Antibiotic Stewardship, Division of Healthcare Quality Promotion, National Center for Emerging and Infectious Diseases, Centers for Disease Control and Prevention, †Epidemic Intelligence Service, Centers for Disease Control and Prevention, ‡Respiratory Diseases Branch, Division of Bacterial Diseases, National Center for Immunizations and Respiratory Diseases, Centers for Disease Control and Prevention, and §Division of Laboratory Systems, Center for Surveillance, Epidemiology and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, Georgia.
[Ti] Título:Variations in Antibiotic and Azithromycin Prescribing for Children by Geography and Specialty-United States, 2013.
[So] Source:Pediatr Infect Dis J;37(1):52-58, 2018 Jan.
[Is] ISSN:1532-0987
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Using antibiotics appropriately is critical to slow spread of antibiotic resistance, a major public health problem. Children, especially young children, receive more antibiotics than other age groups. Our objective was to describe antibiotic use in children in the United States and use of azithromycin, which is recommended infrequently for pediatric conditions. METHODS: We used QuintilesIMS Xponent 2013 data to calculate the number and rate of oral antibiotic prescriptions for children by age (0-2, 3-9 and 10-19 years) and agent. We used log-binomial regression to calculate adjusted prevalence ratios and 95% confidence intervals to determine if specialty and patient age were associated with azithromycin selection when an antibiotic was prescribed. RESULTS: In 2013, 66.8 million antibiotics were prescribed to US children ≤19 years of age (813 antibiotic prescriptions per 1000 children). Amoxicillin and azithromycin were the 2 most commonly prescribed agents (23.1 million courses, 35% of all antibiotics; 12.2 million, 18%, respectively). Most antibiotics for children were prescribed by pediatricians (39%) and family practitioners (15%). Family practitioners were more likely to select azithromycin when an antibiotic was prescribed in all age groups than pediatricians (for children 0-2 years of age: prevalence ratio: 1.79, 95% confidence interval: 1.78-1.80; 3-9 years: 1.40, 1.40-1.40 and 10-19 years: 1.18, 1.18-1.18). CONCLUSION: Despite infrequent pediatric recommendations, variations in pediatric azithromycin use may suggest inappropriate antibiotic selection. Public health interventions focused on improving antibiotic selection in children as well as reducing antibiotic overuse are needed.
[Mh] Termos MeSH primário: Antibacterianos/uso terapêutico
Azitromicina/uso terapêutico
Prescrições de Medicamentos/estatística & dados numéricos
Medicina/estatística & dados numéricos
[Mh] Termos MeSH secundário: Adolescente
Adulto
Gestão de Antimicrobianos
Criança
Pré-Escolar
Feminino
Seres Humanos
Lactente
Recém-Nascido
Masculino
Padrões de Prática Médica/estatística & dados numéricos
Estados Unidos/epidemiologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 83905-01-5 (Azithromycin)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180110
[Lr] Data última revisão:
180110
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170727
[St] Status:MEDLINE
[do] DOI:10.1097/INF.0000000000001708


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[PMID]:29279924
[Au] Autor:Bergeron A; Bondeelle L; Chevret S
[Ad] Endereço:Service de Pneumologie, AP-HP, Hôpital Saint-Louis, Paris, France.
[Ti] Título:Azithromycin and Survival After Hematopoietic Stem Cell Transplant-Reply.
[So] Source:JAMA;318(24):2492, 2017 12 26.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Azitromicina
Transplante de Células-Tronco Hematopoéticas
[Mh] Termos MeSH secundário: Seres Humanos
Estudos Retrospectivos
[Pt] Tipo de publicação:LETTER; COMMENT
[Nm] Nome de substância:
83905-01-5 (Azithromycin)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180101
[Lr] Data última revisão:
180101
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171228
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2017.17236


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[PMID]:29279920
[Au] Autor:Fuji S
[Ad] Endereço:Department of Hematology, Osaka International Cancer Institute, Osaka, Japan.
[Ti] Título:Azithromycin and Survival After Hematopoietic Stem Cell Transplant.
[So] Source:JAMA;318(24):2492, 2017 12 26.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Azitromicina
Transplante de Células-Tronco Hematopoéticas
[Mh] Termos MeSH secundário: Seres Humanos
Estudos Retrospectivos
[Pt] Tipo de publicação:LETTER; COMMENT
[Nm] Nome de substância:
83905-01-5 (Azithromycin)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180101
[Lr] Data última revisão:
180101
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171228
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2017.17228



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