5/31/2023 0 Comments Nvalt 2018Antimicrobial susceptibility tests were identified using the disc diffusion method. The bacterial isolates were identified using conventional biochemical tests and then confirmed using a commercial biochemical test kit (MICROBACT) according to the manufacturer's instructions. The samples were all screened for significant bacterial growth using standard microbiological techniques. ![]() Three hundred and fifty sputum samples were collected from consented patients with the symptoms of LRTI attending six different hospitals in Kebbi State. This study was designed to determine the antimicrobial susceptibility pattern of bacteria isolated from patients with lower respiratory tract infection (LRTI) attending some Kebbi State, Nigeria hospitals. The rise in antibiotic resistance could be a growing public health concern among agents of respiratory tract infection, which is liable for morbidity, mortality, and costs in Africa. Our multidisciplinary committee formulated evidence-based recommendations for the empiric antibacterial therapy of adults with sepsis in The Netherlands. We also established recommendations on timing and duration of antibacterial treatment. Other new topics included empirical antibacterial therapy in patients with a reported penicillin allergy and the role of pharmacokinetics and pharmacodynamics to guide dosing in sepsis. One important revision was the distinction between low, increased and high risk of infection with Enterobacterales resistant to third generation cephalosporins (3GRC-E) to guide the choice of empirical therapy. ![]() Recommendations on empiric antibacterial therapy choices were differentiated for sepsis according to the source of infection, the potential causative pathogen and its resistance pattern. When evidence could not be obtained, recommendations were provided based on expert opinion and experience (good practice statements).įifty-five recommendations on the antibacterial therapy of sepsis were generated. In structured consensus meetings, the committee formulated recommendations as strong or weak. The quality of evidence for clinically relevant outcomes was graded from high to very low. For each question, a literature search was performed to obtain the best available evidence and assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. Our multidisciplinary guideline committee generated ten population, intervention, comparison, and outcome (PICO) questions relevant for adult patients with sepsis. The Dutch Working Party on Antibiotic Policy (SWAB) in collaboration with relevant professional societies, has updated their evidence-based guidelines on empiric antibacterial therapy of sepsis in adults. Corticosteroids are not recommended as adjunctive therapy for CAP. For these patients (with CURB-65 score >2 or Pneumonia Severity Index score of 5) empirical therapy with a 2nd/3rd generation cephalosporin is recommended, because of the relatively high incidence of Gram-negative bacteria, and to a lesser extent S. Coverage for atypical microorganisms is no longer recommended in empirical treatment of severe CAP in the non-intensive care setting. A pneumococcal urine antigen test is now recommended for all patients presenting with severe CAP a positive test result can help streamline therapy once clinical stability has been reached and no other pathogens have been detected. Low-dose CT scanning may ultimately replace the conventional chest X-ray however, at present, there is insufficient evidence to advocate the use of CT scanning as the new standard in patients evaluated for CAP. Apart from the Q fever outbreak in the Netherlands (2007-2010) no other shifts in the most common causative agents of CAP or in their resistance patterns were observed in the last five years. ![]() Other parts overlap with the 2011 guideline. This 2016 update focuses on new data on the aetiological and radiological diagnosis of CAP, severity classification methods, initial antibiotic treatment in patients with severe CAP and the role of adjunctive corticosteroids. The Dutch Working Party on Antibiotic Policy in collaboration with the Dutch Association of Chest Physicians, the Dutch Society for Intensive Care and the Dutch College of General Practitioners have updated their evidence-based guidelines on the diagnosis and treatment of community-acquired pneumonia (CAP) in adults who present to the hospital.
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