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Medical Management of Crs
Published in R James A England, Eamon Shamil, Rajeev Mathew, Manohar Bance, Pavol Surda, Jemy Jose, Omar Hilmi, Adam J Donne, Scott-Brown's Essential Otorhinolaryngology, 2022
Mikkel Alanin, Richard Harvey, Claire Hopkins
Long-term use of macrolide antibiotics is associated with macrolide resistance, and gastrointestinal side effects are relatively common. Therefore, use should be directed at those patients most likely to benefit (i.e. CRSsNP, normal IgE levels). Macrolides interact with many other drugs and may prolong the QT interval; a careful medical history should be taken prior to usage.
Antimicrobials during Pregnancy
Published in “Bert” Bertis Britt Little, Drugs and Pregnancy, 2022
Macrolide antibiotics are effective in treatment of a range of aerobic organisms, but have poor activity against most Gram-negative organisms. The major antibiotics in this group are erythromycin, azithromycin, clarithromycin, spiramycin, and telithromycin.
Urolithiasis
Published in Manit Arya, Taimur T. Shah, Jas S. Kalsi, Herman S. Fernando, Iqbal S. Shergill, Asif Muneer, Hashim U. Ahmed, MCQs for the FRCS(Urol) and Postgraduate Urology Examinations, 2020
Thomas Johnston, James Armitage, Oliver Wiseman
Penicillin, cephalosporin and macrolide antibiotics are considered safe to use in pregnancy. Nitrofurantoin is also safe for most of pregnancy but should be avoided towards term due to an increased risk of neonatal haemolysis. Trimethoprim is a folate antagonist and should be avoided, especially in the first trimester during organogenesis. There is a risk of auditory or vestibular nerve damage with gentamicin and therefore should not be used in pregnancy. There is limited information on tazocin or carbapenems with manufactures advising to use only if the potential benefit outweighs the risk in more severe infections.
Throat infections and use of streptococcal antigen test and antibiotic treatment in general practice; a web-based survey
Published in Scandinavian Journal of Primary Health Care, 2022
Hanne Puntervoll, Pål Jenum, Sigurd Høye, Mette Tollånes
In our survey, most of the GPs (95%) would prescribe beta-lactamase-sensitive penicillin. This is in accordance with guidelines, which recommend phenoxymethylpenicillin as first-line treatment for most respiratory tract infections when antibiotic therapy is indicated. Approximately 4–5% of the GPs indicated that they would offer broad-spectrum antibiotics. Macrolides were also suggested by a few GPs. Treatment of upper respiratory tract infections with second-choice antibiotics is almost always unnecessary. Hence, treatment with broad-spectrum antibiotics in cases 1 and 2 would not be in accordance with guidelines. These findings are consistent with previous reports showing that macrolides and penicillin with extended-spectrum are used more often than recommended [18,19]. The use of macrolide antibiotics is particularly problematic as they may trigger microbial resistance [20].
An outbreak of Legionnaires’ disease in newborns in Serbia
Published in Paediatrics and International Child Health, 2022
Zorana Djordjevic, Marko Folic, Ivana Petrovic, Sanja Zornic, Andjelka Stojkovic, Ana Miljanovic, Sladjana Randjelovic, Snezana Jovanovic, Milica Jovanovic, Slobodan Jankovic
Two newborns had L. pneumophila and both were infected after admission to the Paediatric Clinic in the University Clinical Centre in Kragujevac. The first of the two cases was an infant boy born on 14 February 2022 in the maternity ward of the General Hospital in Arandjelovac; he weighed 4050 g, had an Apgar score of 10, and was discharged healthy from the maternity ward after 2 days. On Day 7 of life, he was admitted to the Paediatric Clinic in Kragujevac with a high fever, crying and refusal to feed, and pneumonia was detected radiologically with diffuse consolidation zones in the right lung and in the left lung apex and hilum. Laboratory parameters of inflammation were as follows: white cell count was 11.7×109/L (4–10), C-reactive protein 219 mg/L (<10) and procalcitonin 83 ng/mL (<0.25). Immediately on arrival, a tracheal aspirate was taken and sent for microbiological analysis by RT-PCR which demonstrated the presence of L. pneumophila. A urine sample was positive for L. pneumophila antigen. The child was treated with macrolide antibiotics which led to a complete recovery.
The financial burden of treating patients presenting with acute and chronic cough
Published in Current Medical Research and Opinion, 2021
Surinder S. Birring, Craig J. Currie, Sarah E. Holden, Sara Jenkins-Jones, Ellen R. Berni, Bethan Jones, Thomas R. Berni, Haya Langerman
Around half the drug prescriptions in the 2 months following an episode of CC were for an antibiotic, whether for the incident episode or a subsequent episode. Penicillin, macrolide antibiotics (e.g. erythromycin, clarithromycin, azithromycin), and tetracycline were the most frequently prescribed, in agreement with recent data from Public Health England22. The use of antibiotics seemed particularly high in this study and suggests that they are frequently used as treatment for CC. While this study cannot determine the proportion of antibiotic prescribing that is in accordance with antimicrobial prescribing guidance23, recent research from Public Health England reported that no clinical justification for prescribing could be determined in 31% of all antibiotic prescriptions22.