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Antibiotics
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Antibiotics and Respiratory Tract Infections
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Antibiotics and Respiratory Tract Infections

A special issue of Antibiotics (ISSN 2079-6382).

Deadline for manuscript submissions: closed (31 August 2013) | Viewed by 52204

Special Issue Editor

Dr. Kenny Kung

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Guest Editor
Division of Family Medicine, 4/F, The Jockey Club School of Public Health and Primary Care, Prince of Wales Hospital, Shatin, NT, Hong Kong
Interests: respiratory tract infections; antibiotic use; doctor training; health services improvement

Special Issue Information

Dear Colleagues,

Respiratory tract infection continues to be one of the commonest conditions encountered in primary care. Despite the efforts made in many healthcare systems, inappropriate antibiotic prescription with ensuing resistance remains a global issue. 
"Antibiotics" will be issuing a special issue focusing on antibiotic usage among patients with respiratory tract infections. We invite submissions of high quality research related to this topic. Priority will be given to trials that:

  • advance the evidence-base for appropriate antibiotic use in the management of respiratory tract infections (particularly on humans)
  • look into the factors leading to antibiotic resistance among respiratory pathogens
  • look into the behavior of antibiotic use (clinician and patient perspective), including qualitative studies

Dr. Kenny Kung
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Antibiotics is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • respiratory tract infection
  • antibiotic resistance
  • antibiotic prescription
  • prescribing behavior

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Further information on MDPI's Special Issue polices can be found here.

Published Papers (5 papers)

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Research

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510 KiB  
Article
Antibiotic Usage Prior and During Hospitalization for Clinical Severe Pneumonia in Children under Five Years of Age in Rabat, Morocco
by Imane Jroundi, Rachid Benmessaoud, Chafiq Mahraoui, Cinta Moraleda, Houssain Tligui, Myriam Seffar, Badr Sououd Benjelloun, Jordi Vila, Joaquim Ruiz, Pedro L. Alonso and Quique Bassat
Antibiotics 2013, 2(4), 450-464; https://doi.org/10.3390/antibiotics2040450 - 26 Sep 2013
Cited by 6 | Viewed by 7166
Abstract
Scarce and limited epidemiological, clinical and microbiological data are available regarding pediatric respiratory tract infections in the Kingdom of Morocco, a middle-income country in Northwestern Africa. Data on antibiotic usage for such infections are also scarce. A good understanding of pre-admission and intra-hospital [...] Read more.
Scarce and limited epidemiological, clinical and microbiological data are available regarding pediatric respiratory tract infections in the Kingdom of Morocco, a middle-income country in Northwestern Africa. Data on antibiotic usage for such infections are also scarce. A good understanding of pre-admission and intra-hospital usage of antibiotics in children with respiratory infections linked with an adequate surveillance of the antibiotic susceptibility from circulating pathogens could help policy makers improve their recommendations on management of respiratory infections. We hereby present data on antibiotic usage prior and during admission and antibiotic susceptibility of major circulating respiratory pathogens in children under five years of age admitted to the Hôpital d’Enfants de Rabat, Morocco, with a diagnosis of clinical severe pneumonia (using World Health Organization (WHO) standardized case definitions) during a period of 14 months (November 2010–December 2011), as part of a larger hospital-based surveillance study designed to understand the etiology and epidemiology of severe pneumonia cases among children. Full article
(This article belongs to the Special Issue Antibiotics and Respiratory Tract Infections)
145 KiB  
Article
“How Do You Feel about Antibiotics for This?” A Qualitative Study of Physician Attitudes towards a Context-Rich Communication Skills Method
by Jochen W. L. Cals, Mirjam E. Van Leeuwen, Fleur H. F. Chappin, Eefje G. P. M. De Bont, Geert-Jan Dinant and Christopher C. Butler
Antibiotics 2013, 2(3), 439-449; https://doi.org/10.3390/antibiotics2030439 - 16 Sep 2013
Cited by 4 | Viewed by 6360
Abstract
To explore experiences with and views of general practitioners (GPs) on a physician communication training method in primary care and its applicability and implementation in daily practice, we performed a semi-structured qualitative study of GPs’ experience of training in and implementing a communication [...] Read more.
To explore experiences with and views of general practitioners (GPs) on a physician communication training method in primary care and its applicability and implementation in daily practice, we performed a semi-structured qualitative study of GPs’ experience of training in and implementing a communication skills training program for managing lower respiratory tract infection (LRTI) which included a seminar, simulated patient consultation together with providing and receiving feedback on ones own transcript, and a seminar in a structured approach to the LRTI consultation. Seventeen out of 20 eligible GPs who had participated in the IMPAC3T trial and were allocated to receiving enhanced physician communication training for managing lower respiratory tract infection participated. GPs’ experiences with the physician communication training method and its specific components were positive. The method gave GPs additional tools for managing LRTI consultations and increased their sense of providing evidence-based management. During the study, GPs reported using almost all communication items covered in the training, but some GPs stated that the communication skills diluted over time, and that they continued to use a selected set of the skills. The general communication items were most regularly used. Implementation of the method in daily practice helped GPs to prescribe fewer antibiotics in LRTI with the only perceived disadvantage being time-pressure. This study suggests that GPs felt positive about the physician communication training method for enhanced management of LRTI in primary care. GPs continued to use some of the communication items, of which general communication items were the most common. Furthermore, GPs believed that implementation of the communication skills in daily practice helped them to prescribe fewer antibiotics. The context-rich communication method could have wider application in common conditions in primary care. Full article
(This article belongs to the Special Issue Antibiotics and Respiratory Tract Infections)
365 KiB  
Communication
Prescriber and Patient Responsibilities in Treatment of Acute Respiratory Tract Infections — Essential for Conservation of Antibiotics
by Alike Van der Velden, Martin G. Duerden, John Bell, John S. Oxford, Attila Altiner, Roman Kozlov, Aurelio Sessa, Antonio C. Pignatari and Sabiha Y. Essack
Antibiotics 2013, 2(2), 316-327; https://doi.org/10.3390/antibiotics2020316 - 4 Jun 2013
Cited by 35 | Viewed by 13007
Abstract
Inappropriate antibiotic use in normally self-limiting acute respiratory tract infections (RTIs), such as sore throat and the common cold, is a global problem and an important factor for increasing levels of antibiotic resistance. A new group of international experts—the Global Respiratory Infection Partnership [...] Read more.
Inappropriate antibiotic use in normally self-limiting acute respiratory tract infections (RTIs), such as sore throat and the common cold, is a global problem and an important factor for increasing levels of antibiotic resistance. A new group of international experts—the Global Respiratory Infection Partnership (GRIP)—is committed to addressing this issue, with the interface between primary care practitioners and their patients as their core focus. To combat the overuse of antibiotics in the community, and facilitate a change from prescribing empiric antibiotic treatment towards cautious deferment combined with symptomatic relief, there is a need to introduce and enhance evidence-based dialogue between primary care practitioners and their patients. Communication with patients should focus on the de-medicalisation of self-limiting viral infections, which can be achieved via a coherent globally endorsed framework outlining the rationale for appropriate antibiotic use in acute RTIs in the context of antibiotic stewardship and conservancy. The planned framework is intended to be adaptable at a country level to reflect local behaviours, cultures and healthcare systems, and has the potential to serve as a model for change in other therapeutic areas. Full article
(This article belongs to the Special Issue Antibiotics and Respiratory Tract Infections)
915 KiB  
Article
Efficacy and Safety of Procalcitonin-Guided Antibiotic Therapy in Lower Respiratory Tract Infections
by Daniel Drozdov, Frank Dusemund, Beat Müller and Werner C. Albrich
Antibiotics 2013, 2(1), 1-10; https://doi.org/10.3390/antibiotics2010001 - 22 Jan 2013
Cited by 5 | Viewed by 15615
Abstract
Background: In 14 randomized controlled studies to date, a procalcitonin (PCT)-based algorithm has been proven to markedly reduce the use of antibiotics along with an unimpaired high safety and low complication rates in patients with lower respiratory tract infections (LRTIs). However, compliance with [...] Read more.
Background: In 14 randomized controlled studies to date, a procalcitonin (PCT)-based algorithm has been proven to markedly reduce the use of antibiotics along with an unimpaired high safety and low complication rates in patients with lower respiratory tract infections (LRTIs). However, compliance with the algorithm and safety out of controlled study conditions has not yet been sufficiently investigated. Methods: We performed a prospective international multicenter observational post-study surveillance of consecutive adults with community-acquired LRTI in 14 centers (Switzerland (n = 10), France (n = 3) and the United States (n = 1)). Results: Between September 2009 and November 2010, 1,759 patients were enrolled (median age 71; female sex 44.4%). 1,520 (86.4%) patients had a final diagnosis of LRTI (community-acquired pneumonia (CAP), 53.7%; acute exacerbation of chronic obstructive pulmonary disease (AECOPD), 17.1%; and acute bronchitis, 14.4%). Compliance with the PCT-guided therapy (overall 68.2%) was highest in patients with bronchitis (81.0% vs. AECOPD, 70.1%; CAP, 63.7%; p < 0.001), outpatients (86.1% vs. inpatients, 65.9%; p < 0.001) and algorithm-experienced centers (82.5% vs. algorithm-naive, 60.1%; p < 0.001) and showed significant geographical differences. The initial decision about the antibiotic therapy was based on PCT value in 72.4%. In another 8.6% of patients, antibiotics were administered despite low PCT values but according to predefined criteria. Thus, the algorithm was followed in 81.0% of patients. In a multivariable Cox hazard ratio model, longer antibiotic therapy duration was associated with algorithm-non-compliance, country, hospitalization, CAP vs. bronchitis, renal failure and algorithm-naïvety of the study center. In a multivariable logistic regression complications (death, empyema, ICU treatment, mechanical ventilation, relapse, and antibiotic-associated side effects) were significantly associated with increasing CURB65-Score, CAP vs. bronchitis, multilobar pneumonia, but not with algorithm-compliance. Discussion: Cultural and geographic differences in antibiotic prescribing affected the compliance with our PCT-guided algorithm. Efforts to reinforce compliance are needed. Antibiotic stewardship with PCT is possible, effective and safe without increasing the risk of complications in real-life conditions. Full article
(This article belongs to the Special Issue Antibiotics and Respiratory Tract Infections)
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Review

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353 KiB  
Review
Empirical Antibiotic Therapy for Ventilator-Associated Pneumonia
by Joseph M. Swanson and Diana L. Wells
Antibiotics 2013, 2(3), 339-351; https://doi.org/10.3390/antibiotics2030339 - 4 Jul 2013
Cited by 18 | Viewed by 9364
Abstract
Ventilator-associated pneumonia (VAP) is the most common infectious complication in the intensive care unit. It can increase duration of mechanical ventilation, length of stay, costs, and mortality. Improvements in the administration of empirical antibiotic therapy have potential to reduce the complications of VAP. [...] Read more.
Ventilator-associated pneumonia (VAP) is the most common infectious complication in the intensive care unit. It can increase duration of mechanical ventilation, length of stay, costs, and mortality. Improvements in the administration of empirical antibiotic therapy have potential to reduce the complications of VAP. This review will discuss the current data addressing empirical antibiotic therapy and the effect on mortality in patients with VAP. It will also address factors that could improve the administration of empirical antibiotics and directions for future research. Full article
(This article belongs to the Special Issue Antibiotics and Respiratory Tract Infections)
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