Search

Aim: To describe trends in antibiotic (AB) prescriptions in children in primary care over 11 years, using a large data warehouse. Methods: A retrospective cohort study assessed outpatient AB prescriptions 2007‐2017, using the Massachusetts Health Disparities Repository. The evolution of paediatric outpatient AB prescriptions was assessed using time‐series analyses through annual per cent change (APC) for the population and for children with or without comorbid condition. Results: About 25 000 children were followed in primary care with 31 248 AB prescriptions reported in the data warehouse. The youngest children had more AB prescriptions. Penicillins were prescribed most frequently (46%), then macrolides (28%). One third of children had comorbid conditions, receiving significantly more antibiotics (30.3 vs 21.0 AB/100 child‐years, relative risk: 1.43, 95% CI: 1.40, 1.46). Overall AB prescription decreased over the period (APC = −5.34%, 95% CI: −7.10, −3.54), with similar trends for penicillins (APC = −5.49; 95% CI: −8.27, −2.62) and macrolides (APC = −6.46; 95% CI: −8.37, −4.58); antibiotic prescribing declined more in children with comorbid conditions. Conclusion: Outpatient AB prescribing decline was gradual and consistent in paediatrics over the period. Prescription differences persisted between age groups, conditions and indication. The availability of routine care data through data warehouse fosters the surveillance automation, providing inexpensive fast tools to design appropriate antimicrobial stewardship. [ABSTRACT FROM AUTHOR]

Purpose: To investigate a new noninvasive method to assess central venous pressure (CVP) in hemodialysis patients, based on the ultrasonographic measurement of the collapsing point of the internal jugular vein (CVPni).Materials and Methods: In this preliminary, noninterventional, single center study, we enrolled 22 dialyzed patients with an indwelling jugular catheter. CVPni was compared to the gold-standard invasive measurement of CVP using the central venous catheter (CVPi). Agreement between CVPi and CVPni was assessed by Bland and Altman Method. Correlation was assessed by linear regression.Results: A strong correlation was observed between CVPi and CVPni (OR = 3.47 [2.96; 4.07], P < .0001). For overloaded patients, the area under the curve for the operating characteristic curve was 0.971 (IC95: 0.915; 1.000). For under-loaded patients, area under the curve was 0.971 (IC95: 0.917; 1.000). The mean bias between intra-individual CVPi and CVPni measures was 0.57 cm H2 O (SD: 3.1 cm H2 O).Conclusion: CVPni appears as a noninvasive and reliable technique. Further studies are required to confirm these results and to assess the direct clinical impact of this new method. [ABSTRACT FROM AUTHOR]