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1. It is time to define an organizational model for the prevention and management of infections along the surgical pathway: a worldwide cross-sectional survey

Author

Sartelli, M., Labricciosa, F. M., Coccolini, F., Coimbra, R., Abu-Zidan, F. M., Ansaloni, L., Al-Hasan, M. N., Ansari, S., Barie, P. S., Cainzos, M. A., Ceresoli, M., Chiarugi, M., Claridge, J. A., Cicuttin, E., Dellinger, E. P., Fry, D. E., Guirao, X., Hardcastle, T. C., Hecker, A., Leppaniemi, A. K., Litvin, A., Marwah, S., Maseda, E., Mazuski, J. E., Memish, Z. A., Kirkpatrick, A. W., Pagani, L., Podda, Maria Vittoria, Rasa, H. K., Sakakushev, B. E., Sawyer, R. G., Tumietto, F., Xiao, Y., Aboubreeg, W. F., Adamou, H., Akhmeteli, L., Akin, E., Alberio, M. G., Alconchel, F., Magagi, I. A., Arauz, A. B., Argenio, G., Atanasov, B. C., Atici, S. D., Awad, S. S., Baili, E., Bains, L., Bala, M., Baraket, O., Baral, S., Belskii, V. A., Benboubker, M., Ben-Ishay, O., Bordoni, P., Boumediene, A., Brisinda, Giuseppe, Cavazzuti, L., Chandy, S. J., Chiarello, M. M., Cillara, N., Clarizia, G., Cocuz, M. -E., Cocuz, I. G., Conti, L., Coppola, R., Cui, Y., Czepiel, J., D'Acapito, Fabrizio, Damaskos, D., Das, Anil Kumar, De Simone, B., Delibegovic, S., Demetrashvili, Z., Detanac, D. S., Dhingra, S., Di Bella, S., Dimitrov, E. N., Dogjani, A., D'Oria, M., Dumitru, I. M., Elmangory, M. M., Enciu, O., Fantoni, M., Filipescu, D., Fleres, F., Foghetti, D., Fransvea, Pietro, Gachabayov, M., Galeiras, R., Gattuso, G., Ghannam, W. M., Ghisetti, Valeria, Giraudo, G., Gonfa, K. B., Gonullu, E., Hamad, Y. T. E. Y., Hecker, M., Isik, A., Ismail, N., Ismail, A., Jain, S. A., Kanj, S. S., Kapoor, G., Karaiskos, I., Kavalakat, A. J., Kenig, J., Khamis, F., Khokha, V., Kiguba, R., Kim, J. I., Kobe, Y., Kok, K. Y. Y., Kovacevic, B. M., Kryvoruchko, I. A., Kuriyama, A., Landaluce-Olavarria, A., Lasithiotakis, K., Lohsiriwat, V., Lostoridis, E., Luppi, D., Vega, G. M. M., Maegele, M., Marinis, A., Martines, G., Martinez-Perez, A., Massalou, D., Mesina, C., Metan, G., Miranda-Novales, M. G., Mishra, S. K., Mohamed, M. I. H., Mohamedahmed, A. Y. Y., Mora-Guzman, I., Mulita, F., Musina, A. -M., Navsaria, P. H., Negoi, I., Nita, G. E., O'Connor, D. B., Ordonez, C. A., Pantalone, D., Panyko, A., Papadopoulos, A., Pararas, N., Pata, F., Patel, T., Pellino, Giuseppe, Perra, T., Perrone, G., Pesce, Antonio, Pintar, T., Popivanov, G. I., Porcu, A., Quiodettis, M. A., Rahim, R., Mitul, A. R., Reichert, M., Rems, M., Campbell, G. Y. R., Rocha-Pereira, N., Rodrigues, G., Villamil, G. E. R., Rossi, S., Sall, I., Kafil, H. S., Sasia, D., Seni, J., Seretis, C., Serradilla-Martin, M., Shelat, V. G., Siribumrungwong, B., Slavchev, M., Solaini, L., Tan, B. K., Tarasconi, A., Tartaglia, D., Toma, E. A., Tomadze, G., Toro, A., Tovani-Palone, M. R., van Goor, H., Vasilescu, A., Vereczkei, A., Veroux, M., Weckmann, S. A., Widmer, L. W., Yahya, A. I., Zachariah, S. K., Zakaria, A. D., Zubareva, N., Zuidema, W. P., Di Carlo, I., Cortese, Francesco, Baiocchi, G. L., Maier, R. V., Catena, F., Podda M. (ORCID:0000-0002-2779-8417), Brisinda G. (ORCID:0000-0001-8820-9471), D'Acapito F., Das K., Fransvea P. (ORCID:0000-0003-4969-3373), Ghisetti V., Pellino G., Pesce A., Cortese F., Sartelli, M., Labricciosa, F. M., Coccolini, F., Coimbra, R., Abu-Zidan, F. M., Ansaloni, L., Al-Hasan, M. N., Ansari, S., Barie, P. S., Cainzos, M. A., Ceresoli, M., Chiarugi, M., Claridge, J. A., Cicuttin, E., Dellinger, E. P., Fry, D. E., Guirao, X., Hardcastle, T. C., Hecker, A., Leppaniemi, A. K., Litvin, A., Marwah, S., Maseda, E., Mazuski, J. E., Memish, Z. A., Kirkpatrick, A. W., Pagani, L., Podda, Maria Vittoria, Rasa, H. K., Sakakushev, B. E., Sawyer, R. G., Tumietto, F., Xiao, Y., Aboubreeg, W. F., Adamou, H., Akhmeteli, L., Akin, E., Alberio, M. G., Alconchel, F., Magagi, I. A., Arauz, A. B., Argenio, G., Atanasov, B. C., Atici, S. D., Awad, S. S., Baili, E., Bains, L., Bala, M., Baraket, O., Baral, S., Belskii, V. A., Benboubker, M., Ben-Ishay, O., Bordoni, P., Boumediene, A., Brisinda, Giuseppe, Cavazzuti, L., Chandy, S. J., Chiarello, M. M., Cillara, N., Clarizia, G., Cocuz, M. -E., Cocuz, I. G., Conti, L., Coppola, R., Cui, Y., Czepiel, J., D'Acapito, Fabrizio, Damaskos, D., Das, Anil Kumar, De Simone, B., Delibegovic, S., Demetrashvili, Z., Detanac, D. S., Dhingra, S., Di Bella, S., Dimitrov, E. N., Dogjani, A., D'Oria, M., Dumitru, I. M., Elmangory, M. M., Enciu, O., Fantoni, M., Filipescu, D., Fleres, F., Foghetti, D., Fransvea, Pietro, Gachabayov, M., Galeiras, R., Gattuso, G., Ghannam, W. M., Ghisetti, Valeria, Giraudo, G., Gonfa, K. B., Gonullu, E., Hamad, Y. T. E. Y., Hecker, M., Isik, A., Ismail, N., Ismail, A., Jain, S. A., Kanj, S. S., Kapoor, G., Karaiskos, I., Kavalakat, A. J., Kenig, J., Khamis, F., Khokha, V., Kiguba, R., Kim, J. I., Kobe, Y., Kok, K. Y. Y., Kovacevic, B. M., Kryvoruchko, I. A., Kuriyama, A., Landaluce-Olavarria, A., Lasithiotakis, K., Lohsiriwat, V., Lostoridis, E., Luppi, D., Vega, G. M. M., Maegele, M., Marinis, A., Martines, G., Martinez-Perez, A., Massalou, D., Mesina, C., Metan, G., Miranda-Novales, M. G., Mishra, S. K., Mohamed, M. I. H., Mohamedahmed, A. Y. Y., Mora-Guzman, I., Mulita, F., Musina, A. -M., Navsaria, P. H., Negoi, I., Nita, G. E., O'Connor, D. B., Ordonez, C. A., Pantalone, D., Panyko, A., Papadopoulos, A., Pararas, N., Pata, F., Patel, T., Pellino, Giuseppe, Perra, T., Perrone, G., Pesce, Antonio, Pintar, T., Popivanov, G. I., Porcu, A., Quiodettis, M. A., Rahim, R., Mitul, A. R., Reichert, M., Rems, M., Campbell, G. Y. R., Rocha-Pereira, N., Rodrigues, G., Villamil, G. E. R., Rossi, S., Sall, I., Kafil, H. S., Sasia, D., Seni, J., Seretis, C., Serradilla-Martin, M., Shelat, V. G., Siribumrungwong, B., Slavchev, M., Solaini, L., Tan, B. K., Tarasconi, A., Tartaglia, D., Toma, E. A., Tomadze, G., Toro, A., Tovani-Palone, M. R., van Goor, H., Vasilescu, A., Vereczkei, A., Veroux, M., Weckmann, S. A., Widmer, L. W., Yahya, A. I., Zachariah, S. K., Zakaria, A. D., Zubareva, N., Zuidema, W. P., Di Carlo, I., Cortese, Francesco, Baiocchi, G. L., Maier, R. V., Catena, F., Podda M. (ORCID:0000-0002-2779-8417), Brisinda G. (ORCID:0000-0001-8820-9471), D'Acapito F., Das K., Fransvea P. (ORCID:0000-0003-4969-3373), Ghisetti V., Pellino G., Pesce A., and Cortese F.

Abstract

Background: The objectives of the study were to investigate the organizational characteristics of acute care facilities worldwide in preventing and managing infections in surgery; assess participants’ perception regarding infection prevention and control (IPC) measures, antibiotic prescribing practices, and source control; describe awareness about the global burden of antimicrobial resistance (AMR) and IPC measures; and determine the role of the Coronavirus Disease 2019 pandemic on said awareness. Methods: A cross-sectional web-based survey was conducted contacting 1432 health care workers (HCWs) belonging to a mailing list provided by the Global Alliance for Infections in Surgery. The self-administered questionnaire was developed by a multidisciplinary team. The survey was open from May 22, 2021, and June 22, 2021. Three reminders were sent, after 7, 14, and 21 days. Results: Three hundred four respondents from 72 countries returned a questionnaire, with an overall response rate of 21.2%. Respectively, 90.4% and 68.8% of participants stated their hospital had a multidisciplinary IPC team or a multidisciplinary antimicrobial stewardship team. Local protocols for antimicrobial therapy of surgical infections and protocols for surgical antibiotic prophylaxis were present in 76.6% and 90.8% of hospitals, respectively. In 23.4% and 24.0% of hospitals no surveillance systems for surgical site infections and no monitoring systems of used antimicrobials were implemented. Patient and family involvement in IPC management was considered to be slightly or not important in their hospital by the majority of respondents (65.1%). Awareness of the global burden of AMR among HCWs was considered very important or important by 54.6% of participants. The COVID-19 pandemic was considered by 80.3% of respondents as a very important or important factor in raising HCWs awareness of the IPC programs in their hospital. Based on the survey results, the authors developed 15 statements for

Published
2022

2. It is time to define an organizational model for the prevention and management of infections along the surgical pathway: a worldwide cross-sectional survey

Author

Sartelli, M, Labricciosa, F, Coccolini, F, Coimbra, R, Abu-Zidan, F, Ansaloni, L, Al-Hasan, M, Ansari, S, Barie, P, Cainzos, M, Ceresoli, M, Chiarugi, M, Claridge, J, Cicuttin, E, Dellinger, E, Fry, D, Guirao, X, Hardcastle, T, Hecker, A, Leppaniemi, A, Litvin, A, Marwah, S, Maseda, E, Mazuski, J, Memish, Z, Kirkpatrick, A, Pagani, L, Podda, M, Rasa, H, Sakakushev, B, Sawyer, R, Tumietto, F, Xiao, Y, Aboubreeg, W, Adamou, H, Akhmeteli, L, Akin, E, Alberio, M, Alconchel, F, Magagi, I, Arauz, A, Argenio, G, Atanasov, B, Atici, S, Awad, S, Baili, E, Bains, L, Bala, M, Baraket, O, Baral, S, Belskii, V, Benboubker, M, Ben-Ishay, O, Bordoni, P, Boumediene, A, Brisinda, G, Cavazzuti, L, Chandy, S, Chiarello, M, Cillara, N, Clarizia, G, Cocuz, M, Cocuz, I, Conti, L, Coppola, R, Cui, Y, Czepiel, J, D'Acapito, F, Damaskos, D, Das, K, De Simone, B, Delibegovic, S, Demetrashvili, Z, Detanac, D, Dhingra, S, Di Bella, S, Dimitrov, E, Dogjani, A, D'Oria, M, Dumitru, I, Elmangory, M, Enciu, O, Fantoni, M, Filipescu, D, Fleres, F, Foghetti, D, Fransvea, P, Gachabayov, M, Galeiras, R, Gattuso, G, Ghannam, W, Ghisetti, V, Giraudo, G, Gonfa, K, Gonullu, E, Hamad, Y, Hecker, M, Isik, A, Ismail, N, Ismail, A, Jain, S, Kanj, S, Kapoor, G, Karaiskos, I, Kavalakat, A, Kenig, J, Khamis, F, Khokha, V, Kiguba, R, Kim, J, Kobe, Y, Kok, K, Kovacevic, B, Kryvoruchko, I, Kuriyama, A, Landaluce-Olavarria, A, Lasithiotakis, K, Lohsiriwat, V, Lostoridis, E, Luppi, D, Vega, G, Maegele, M, Marinis, A, Martines, G, Martinez-Perez, A, Massalou, D, Mesina, C, Metan, G, Miranda-Novales, M, Mishra, S, Mohamed, M, Mohamedahmed, A, Mora-Guzman, I, Mulita, F, Musina, A, Navsaria, P, Negoi, I, Nita, G, O'Connor, D, Ordonez, C, Pantalone, D, Panyko, A, Papadopoulos, A, Pararas, N, Pata, F, Patel, T, Pellino, G, Perra, T, Perrone, G, Pesce, A, Pintar, T, Popivanov, G, Porcu, A, Quiodettis, M, Rahim, R, Mitul, A, Reichert, M, Rems, M, Campbell, G, Rocha-Pereira, N, Rodrigues, G, Villamil, G, Rossi, S, Sall, I, Kafil, H, Sasia, D, Seni, J, Seretis, C, Serradilla-Martin, M, Shelat, V, Siribumrungwong, B, Slavchev, M, Solaini, L, Tan, B, Tarasconi, A, Tartaglia, D, Toma, E, Tomadze, G, Toro, A, Tovani-Palone, M, van Goor, H, Vasilescu, A, Vereczkei, A, Veroux, M, Weckmann, S, Widmer, L, Yahya, A, Zachariah, S, Zakaria, A, Zubareva, N, Zuidema, W, Di Carlo, I, Cortese, F, Baiocchi, G, Maier, R, Catena, F, Sartelli M., Labricciosa F. M., Coccolini F., Coimbra R., Abu-Zidan F. M., Ansaloni L., Al-Hasan M. N., Ansari S., Barie P. S., Cainzos M. A., Ceresoli M., Chiarugi M., Claridge J. A., Cicuttin E., Dellinger E. P., Fry D. E., Guirao X., Hardcastle T. C., Hecker A., Leppaniemi A. K., Litvin A., Marwah S., Maseda E., Mazuski J. E., Memish Z. A., Kirkpatrick A. W., Pagani L., Podda M., Rasa H. K., Sakakushev B. E., Sawyer R. G., Tumietto F., Xiao Y., Aboubreeg W. F., Adamou H., Akhmeteli L., Akin E., Alberio M. G., Alconchel F., Magagi I. A., Arauz A. B., Argenio G., Atanasov B. C., Atici S. D., Awad S. S., Baili E., Bains L., Bala M., Baraket O., Baral S., Belskii V. A., Benboubker M., Ben-Ishay O., Bordoni P., Boumediene A., Brisinda G., Cavazzuti L., Chandy S. J., Chiarello M. M., Cillara N., Clarizia G., Cocuz M. -E., Cocuz I. G., Conti L., Coppola R., Cui Y., Czepiel J., D'Acapito F., Damaskos D., Das K., De Simone B., Delibegovic S., Demetrashvili Z., Detanac D. S., Dhingra S., Di Bella S., Dimitrov E. N., Dogjani A., D'Oria M., Dumitru I. M., Elmangory M. M., Enciu O., Fantoni M., Filipescu D., Fleres F., Foghetti D., Fransvea P., Gachabayov M., Galeiras R., Gattuso G., Ghannam W. M., Ghisetti V., Giraudo G., Gonfa K. B., Gonullu E., Hamad Y. T. E. Y., Hecker M., Isik A., Ismail N., Ismail A., Jain S. A., Kanj S. S., Kapoor G., Karaiskos I., Kavalakat A. J., Kenig J., Khamis F., Khokha V., Kiguba R., Kim J. I., Kobe Y., Kok K. Y. Y., Kovacevic B. M., Kryvoruchko I. A., Kuriyama A., Landaluce-Olavarria A., Lasithiotakis K., Lohsiriwat V., Lostoridis E., Luppi D., Vega G. M. M., Maegele M., Marinis A., Martines G., Martinez-Perez A., Massalou D., Mesina C., Metan G., Miranda-Novales M. G., Mishra S. K., Mohamed M. I. H., Mohamedahmed A. Y. Y., Mora-Guzman I., Mulita F., Musina A. -M., Navsaria P. H., Negoi I., Nita G. E., O'Connor D. B., Ordonez C. A., Pantalone D., Panyko A., Papadopoulos A., Pararas N., Pata F., Patel T., Pellino G., Perra T., Perrone G., Pesce A., Pintar T., Popivanov G. I., Porcu A., Quiodettis M. A., Rahim R., Mitul A. R., Reichert M., Rems M., Campbell G. Y. R., Rocha-Pereira N., Rodrigues G., Villamil G. E. R., Rossi S., Sall I., Kafil H. S., Sasia D., Seni J., Seretis C., Serradilla-Martin M., Shelat V. G., Siribumrungwong B., Slavchev M., Solaini L., Tan B. K., Tarasconi A., Tartaglia D., Toma E. A., Tomadze G., Toro A., Tovani-Palone M. R., van Goor H., Vasilescu A., Vereczkei A., Veroux M., Weckmann S. A., Widmer L. W., Yahya A. I., Zachariah S. K., Zakaria A. D., Zubareva N., Zuidema W. P., Di Carlo I., Cortese F., Baiocchi G. L., Maier R. V., Catena F., Sartelli, M, Labricciosa, F, Coccolini, F, Coimbra, R, Abu-Zidan, F, Ansaloni, L, Al-Hasan, M, Ansari, S, Barie, P, Cainzos, M, Ceresoli, M, Chiarugi, M, Claridge, J, Cicuttin, E, Dellinger, E, Fry, D, Guirao, X, Hardcastle, T, Hecker, A, Leppaniemi, A, Litvin, A, Marwah, S, Maseda, E, Mazuski, J, Memish, Z, Kirkpatrick, A, Pagani, L, Podda, M, Rasa, H, Sakakushev, B, Sawyer, R, Tumietto, F, Xiao, Y, Aboubreeg, W, Adamou, H, Akhmeteli, L, Akin, E, Alberio, M, Alconchel, F, Magagi, I, Arauz, A, Argenio, G, Atanasov, B, Atici, S, Awad, S, Baili, E, Bains, L, Bala, M, Baraket, O, Baral, S, Belskii, V, Benboubker, M, Ben-Ishay, O, Bordoni, P, Boumediene, A, Brisinda, G, Cavazzuti, L, Chandy, S, Chiarello, M, Cillara, N, Clarizia, G, Cocuz, M, Cocuz, I, Conti, L, Coppola, R, Cui, Y, Czepiel, J, D'Acapito, F, Damaskos, D, Das, K, De Simone, B, Delibegovic, S, Demetrashvili, Z, Detanac, D, Dhingra, S, Di Bella, S, Dimitrov, E, Dogjani, A, D'Oria, M, Dumitru, I, Elmangory, M, Enciu, O, Fantoni, M, Filipescu, D, Fleres, F, Foghetti, D, Fransvea, P, Gachabayov, M, Galeiras, R, Gattuso, G, Ghannam, W, Ghisetti, V, Giraudo, G, Gonfa, K, Gonullu, E, Hamad, Y, Hecker, M, Isik, A, Ismail, N, Ismail, A, Jain, S, Kanj, S, Kapoor, G, Karaiskos, I, Kavalakat, A, Kenig, J, Khamis, F, Khokha, V, Kiguba, R, Kim, J, Kobe, Y, Kok, K, Kovacevic, B, Kryvoruchko, I, Kuriyama, A, Landaluce-Olavarria, A, Lasithiotakis, K, Lohsiriwat, V, Lostoridis, E, Luppi, D, Vega, G, Maegele, M, Marinis, A, Martines, G, Martinez-Perez, A, Massalou, D, Mesina, C, Metan, G, Miranda-Novales, M, Mishra, S, Mohamed, M, Mohamedahmed, A, Mora-Guzman, I, Mulita, F, Musina, A, Navsaria, P, Negoi, I, Nita, G, O'Connor, D, Ordonez, C, Pantalone, D, Panyko, A, Papadopoulos, A, Pararas, N, Pata, F, Patel, T, Pellino, G, Perra, T, Perrone, G, Pesce, A, Pintar, T, Popivanov, G, Porcu, A, Quiodettis, M, Rahim, R, Mitul, A, Reichert, M, Rems, M, Campbell, G, Rocha-Pereira, N, Rodrigues, G, Villamil, G, Rossi, S, Sall, I, Kafil, H, Sasia, D, Seni, J, Seretis, C, Serradilla-Martin, M, Shelat, V, Siribumrungwong, B, Slavchev, M, Solaini, L, Tan, B, Tarasconi, A, Tartaglia, D, Toma, E, Tomadze, G, Toro, A, Tovani-Palone, M, van Goor, H, Vasilescu, A, Vereczkei, A, Veroux, M, Weckmann, S, Widmer, L, Yahya, A, Zachariah, S, Zakaria, A, Zubareva, N, Zuidema, W, Di Carlo, I, Cortese, F, Baiocchi, G, Maier, R, Catena, F, Sartelli M., Labricciosa F. M., Coccolini F., Coimbra R., Abu-Zidan F. M., Ansaloni L., Al-Hasan M. N., Ansari S., Barie P. S., Cainzos M. A., Ceresoli M., Chiarugi M., Claridge J. A., Cicuttin E., Dellinger E. P., Fry D. E., Guirao X., Hardcastle T. C., Hecker A., Leppaniemi A. K., Litvin A., Marwah S., Maseda E., Mazuski J. E., Memish Z. A., Kirkpatrick A. W., Pagani L., Podda M., Rasa H. K., Sakakushev B. E., Sawyer R. G., Tumietto F., Xiao Y., Aboubreeg W. F., Adamou H., Akhmeteli L., Akin E., Alberio M. G., Alconchel F., Magagi I. A., Arauz A. B., Argenio G., Atanasov B. C., Atici S. D., Awad S. S., Baili E., Bains L., Bala M., Baraket O., Baral S., Belskii V. A., Benboubker M., Ben-Ishay O., Bordoni P., Boumediene A., Brisinda G., Cavazzuti L., Chandy S. J., Chiarello M. M., Cillara N., Clarizia G., Cocuz M. -E., Cocuz I. G., Conti L., Coppola R., Cui Y., Czepiel J., D'Acapito F., Damaskos D., Das K., De Simone B., Delibegovic S., Demetrashvili Z., Detanac D. S., Dhingra S., Di Bella S., Dimitrov E. N., Dogjani A., D'Oria M., Dumitru I. M., Elmangory M. M., Enciu O., Fantoni M., Filipescu D., Fleres F., Foghetti D., Fransvea P., Gachabayov M., Galeiras R., Gattuso G., Ghannam W. M., Ghisetti V., Giraudo G., Gonfa K. B., Gonullu E., Hamad Y. T. E. Y., Hecker M., Isik A., Ismail N., Ismail A., Jain S. A., Kanj S. S., Kapoor G., Karaiskos I., Kavalakat A. J., Kenig J., Khamis F., Khokha V., Kiguba R., Kim J. I., Kobe Y., Kok K. Y. Y., Kovacevic B. M., Kryvoruchko I. A., Kuriyama A., Landaluce-Olavarria A., Lasithiotakis K., Lohsiriwat V., Lostoridis E., Luppi D., Vega G. M. M., Maegele M., Marinis A., Martines G., Martinez-Perez A., Massalou D., Mesina C., Metan G., Miranda-Novales M. G., Mishra S. K., Mohamed M. I. H., Mohamedahmed A. Y. Y., Mora-Guzman I., Mulita F., Musina A. -M., Navsaria P. H., Negoi I., Nita G. E., O'Connor D. B., Ordonez C. A., Pantalone D., Panyko A., Papadopoulos A., Pararas N., Pata F., Patel T., Pellino G., Perra T., Perrone G., Pesce A., Pintar T., Popivanov G. I., Porcu A., Quiodettis M. A., Rahim R., Mitul A. R., Reichert M., Rems M., Campbell G. Y. R., Rocha-Pereira N., Rodrigues G., Villamil G. E. R., Rossi S., Sall I., Kafil H. S., Sasia D., Seni J., Seretis C., Serradilla-Martin M., Shelat V. G., Siribumrungwong B., Slavchev M., Solaini L., Tan B. K., Tarasconi A., Tartaglia D., Toma E. A., Tomadze G., Toro A., Tovani-Palone M. R., van Goor H., Vasilescu A., Vereczkei A., Veroux M., Weckmann S. A., Widmer L. W., Yahya A. I., Zachariah S. K., Zakaria A. D., Zubareva N., Zuidema W. P., Di Carlo I., Cortese F., Baiocchi G. L., Maier R. V., and Catena F.

Abstract

Background: The objectives of the study were to investigate the organizational characteristics of acute care facilities worldwide in preventing and managing infections in surgery; assess participants’ perception regarding infection prevention and control (IPC) measures, antibiotic prescribing practices, and source control; describe awareness about the global burden of antimicrobial resistance (AMR) and IPC measures; and determine the role of the Coronavirus Disease 2019 pandemic on said awareness. Methods: A cross-sectional web-based survey was conducted contacting 1432 health care workers (HCWs) belonging to a mailing list provided by the Global Alliance for Infections in Surgery. The self-administered questionnaire was developed by a multidisciplinary team. The survey was open from May 22, 2021, and June 22, 2021. Three reminders were sent, after 7, 14, and 21 days. Results: Three hundred four respondents from 72 countries returned a questionnaire, with an overall response rate of 21.2%. Respectively, 90.4% and 68.8% of participants stated their hospital had a multidisciplinary IPC team or a multidisciplinary antimicrobial stewardship team. Local protocols for antimicrobial therapy of surgical infections and protocols for surgical antibiotic prophylaxis were present in 76.6% and 90.8% of hospitals, respectively. In 23.4% and 24.0% of hospitals no surveillance systems for surgical site infections and no monitoring systems of used antimicrobials were implemented. Patient and family involvement in IPC management was considered to be slightly or not important in their hospital by the majority of respondents (65.1%). Awareness of the global burden of AMR among HCWs was considered very important or important by 54.6% of participants. The COVID-19 pandemic was considered by 80.3% of respondents as a very important or important factor in raising HCWs awareness of the IPC programs in their hospital. Based on the survey results, the authors developed 15 statements for

Published
2022

3. Evidence for action : a One Health learning platform on interventions to tackle antimicrobial resistance

Author

Wernli, D., Jørgensen, Peter S., Parmley, E. J., Troell, Max, Majowicz, S., Harbarth, S., Léger, A., Lambraki, I., Graells, T., Henriksson, Patrik J. G., Carson, C., Cousins, M., Skoog Ståhlgren, G., Mohan, C. V., Simpson, A. J. H., Wieland, B., Pedersen, K., Schneider, A., Chandy, S. J., Wijayathilaka, T. P., Delamare-Deboutteville, J., Vila, J., Stålsby Lundborg, C., Pittet, D., Wernli, D., Jørgensen, Peter S., Parmley, E. J., Troell, Max, Majowicz, S., Harbarth, S., Léger, A., Lambraki, I., Graells, T., Henriksson, Patrik J. G., Carson, C., Cousins, M., Skoog Ståhlgren, G., Mohan, C. V., Simpson, A. J. H., Wieland, B., Pedersen, K., Schneider, A., Chandy, S. J., Wijayathilaka, T. P., Delamare-Deboutteville, J., Vila, J., Stålsby Lundborg, C., and Pittet, D.

Published
2020
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4. Erratum: Antimicrobials: A global alliance for optimizing their rational use in intra-abdominal infections (AGORA). [World J Emerg Surg. 11, (2016) (33)] DOI: 10.1186/s13017-016-0089-y

Author

Sartelli, M., Weber, D. G., Ruppé, E., Bassetti, M., Wright, B. J., Ansaloni, L., Catena, F., Coccolini, F., Abu-Zidan, F. M., Coimbra, R., Moore, E. E., Moore, F. A., Maier, R. V., De Waele, J. J., Kirkpatrick, A. W., Griffiths, E. A., Eckmann, C., Brink, A. J., Mazuski, J. E., May, A. K., Sawyer, R. G., Mertz, D., Montravers, P., Kumar, A., Roberts, J. A., Vincent, J. L., Watkins, R. R., Lowman, W., Spellberg, B., Abbott, I. J., Adesunkanmi, A. K., Al-Dahir, S., Al-Hasan, M. N., Agresta, F., Althani, A. A., Ansari, S., Ansumana, R., Augustin, G., Bala, M., Balogh, Z. J., Baraket, O., Bhangu, A., Beltrán, M. A., Bernhard, M., Biffl, W. L., Boermeester, M. A., Brecher, S. M., Cherry-Bukowiec, J. R., Buyne, O. R., Cainzos, M. A., Cairns, K. A., Camacho-Ortiz, A., Chandy, S. J., Che Jusoh, A., Chichom-Mefire, A., Colijn, C., Corcione, F., Cui, Y., Curcio, D., Delibegovic, S., Demetrashvili, Z., De Simone, B., Dhingra, S., Diaz, J. J., Di Carlo, I., Dillip, A., Di Saverio, S., Doyle, M. P., Dorj, G., Dogjani, A., Dupont, H., Eachempati, S. R., Enani, M. A., Egiev, V. N., Elmangory, M. M., Ferrada, P., Fitchett, J. R., Fraga, G. P., Guessennd, N., Giamarellou, H., Ghnnam, W., Gkiokas, G., Goldberg, S. R., Gomes, C. A., Gomi, H., Guzmán-Blanco, M., Haque, M., Hansen, S., Hecker, A., Heizmann, W. R., Herzog, T., Hodonou, A. M., Hong, S. K., Kafka-Ritsch, R., Kaplan, L. J., Kapoor, G., Karamarkovic, A., Kees, M. G., Kenig, J., Kiguba, R., Kim, P. K., Kluger, Y., Khokha, V., Koike, K., Kok, K. Y., Kong, V., Knox, M. C., Inaba, K., Isik, A., Iskandar, K., Ivatury, R. R., Labbate, M., Labricciosa, F. M., Laterre, P. F., Latifi, R., Lee, J. G., Lee, Y. R., Leone, M., Leppaniemi, A., Li, Y., Liang, S. Y., Loho, T., Maegele, M., Malama, S., Marei, H. E., Martin-Loeches, I., Marwah, S., Massele, A., Mcfarlane, M., Melo, R. B., Negoi, I., Nicolau, D. P., Nord, C. E., Ofori-Asenso, R., Omari, A. H., Ordonez, C. A., Ouadii, M., Pereira Júnior, G. A., Piazza, D., Pupelis, G., Rawson, T. M., Rems, M., Rizoli, S., Rocha, C., Sakakushev, B., Sanchez-Garcia, M., Sato, N., Segovia Lohse, H. A., Sganga, G., Siribumrungwong, B., Shelat, V. G., Soreide, K., Soto, R., Talving, P., Tilsed, J. V., Timsit, J. F., Trueba, G., Trung, N. T., Ulrych, J., van Goor, H., Vereczkei, A., Vohra, R. S., Wani, I., Uhl, W., Xiao, Y., Yuan, K. C., Zachariah, S. K., Zahar, J. R., Zakrison, T. L., Corcione, A., Melotti, R. M., Viscoli, C., Viale, P., Sartelli, M., Weber, D. G., Ruppé, E., Bassetti, M., Wright, B. J., Ansaloni, L., Catena, F., Coccolini, F., Abu-Zidan, F. M., Coimbra, R., Moore, E. E., Moore, F. A., Maier, R. V., De Waele, J. J., Kirkpatrick, A. W., Griffiths, E. A., Eckmann, C., Brink, A. J., Mazuski, J. E., May, A. K., Sawyer, R. G., Mertz, D., Montravers, P., Kumar, A., Roberts, J. A., Vincent, J. L., Watkins, R. R., Lowman, W., Spellberg, B., Abbott, I. J., Adesunkanmi, A. K., Al-Dahir, S., Al-Hasan, M. N., Agresta, F., Althani, A. A., Ansari, S., Ansumana, R., Augustin, G., Bala, M., Balogh, Z. J., Baraket, O., Bhangu, A., Beltrán, M. A., Bernhard, M., Biffl, W. L., Boermeester, M. A., Brecher, S. M., Cherry-Bukowiec, J. R., Buyne, O. R., Cainzos, M. A., Cairns, K. A., Camacho-Ortiz, A., Chandy, S. J., Che Jusoh, A., Chichom-Mefire, A., Colijn, C., Corcione, F., Cui, Y., Curcio, D., Delibegovic, S., Demetrashvili, Z., De Simone, B., Dhingra, S., Diaz, J. J., Di Carlo, I., Dillip, A., Di Saverio, S., Doyle, M. P., Dorj, G., Dogjani, A., Dupont, H., Eachempati, S. R., Enani, M. A., Egiev, V. N., Elmangory, M. M., Ferrada, P., Fitchett, J. R., Fraga, G. P., Guessennd, N., Giamarellou, H., Ghnnam, W., Gkiokas, G., Goldberg, S. R., Gomes, C. A., Gomi, H., Guzmán-Blanco, M., Haque, M., Hansen, S., Hecker, A., Heizmann, W. R., Herzog, T., Hodonou, A. M., Hong, S. K., Kafka-Ritsch, R., Kaplan, L. J., Kapoor, G., Karamarkovic, A., Kees, M. G., Kenig, J., Kiguba, R., Kim, P. K., Kluger, Y., Khokha, V., Koike, K., Kok, K. Y., Kong, V., Knox, M. C., Inaba, K., Isik, A., Iskandar, K., Ivatury, R. R., Labbate, M., Labricciosa, F. M., Laterre, P. F., Latifi, R., Lee, J. G., Lee, Y. R., Leone, M., Leppaniemi, A., Li, Y., Liang, S. Y., Loho, T., Maegele, M., Malama, S., Marei, H. E., Martin-Loeches, I., Marwah, S., Massele, A., Mcfarlane, M., Melo, R. B., Negoi, I., Nicolau, D. P., Nord, C. E., Ofori-Asenso, R., Omari, A. H., Ordonez, C. A., Ouadii, M., Pereira Júnior, G. A., Piazza, D., Pupelis, G., Rawson, T. M., Rems, M., Rizoli, S., Rocha, C., Sakakushev, B., Sanchez-Garcia, M., Sato, N., Segovia Lohse, H. A., Sganga, G., Siribumrungwong, B., Shelat, V. G., Soreide, K., Soto, R., Talving, P., Tilsed, J. V., Timsit, J. F., Trueba, G., Trung, N. T., Ulrych, J., van Goor, H., Vereczkei, A., Vohra, R. S., Wani, I., Uhl, W., Xiao, Y., Yuan, K. C., Zachariah, S. K., Zahar, J. R., Zakrison, T. L., Corcione, A., Melotti, R. M., Viscoli, C., and Viale, P.

Subjects
Settore MED/18 - CHIRURGIA GENERALE, Surgery, Emergency Medicine
Published
2017

5. Antimicrobials: a global alliance for optimizing their rational use in intra-abdominal infections (AGORA) (vol 11, 33, 2016)

Author

Sartelli, M., Weber, D. G., Ruppe, E., Bassetti, M., Wright, B. J., Ansaloni, L., Catena, F., Coccolini, F., Abu-Zidan, F. M., Coimbra, R., Moore, E. E., Moore, F. A., Maier, R. V., De Waele, J. J., Kirkpatrick, A. W., Griffiths, E. A., Eckmann, C., Brink, A. J., Mazuski, J. E., May, A. K., Sawyer, R. G., Mertz, D., Montravers, P., Kumar, A., Roberts, J. A., Vincent, L., Watkins, R. R., Lowman, W., Spellberg, B., Abbott, I. J., Adesunkanmi, A. K., Al-Dahir, S., Al-Hasan, M. N., Agresta, F., Althani, A. A., Ansari, S., Ansumana, R., Augustin, G., Bala, M., Balogh, Z. J., Baraket, O., Bhangu, A., Beltrán, Anna Maria, Bernhard, M., Biffl, W. L., Boermeester, M. A., Brecher, S. M., Cherry-Bukowiec, J. R., Buyne, O. R., Cainzos, M. A., Cairns, K. A., Camacho-Ortiz, A., Chandy, S. J., Jusoh, A. Che, Chichom-Mefire, A., Colijn, C., Corcione, F., Cui, Y., Curcio, D., Delibegovic, S., Demetrashvili, Z., De Simone, B., Dhingra, S., Diaz, J. J., Di Carlo, I., Dillip, A., Di Saverio, S., Doyle, M. P., Dorj, G., Dogjani, A., Dupont, H., Eachempati, S. R., Enani, M. A., Egiev, V. N., Elmangory, M. M., Ferrada, P., Fitchett, J. R., Fraga, G. P., Guessennd, N., Giamarellou, H., Ghnnam, W., Gkiokas, G., Goldberg, S. R., Gomes, C. A., Gomi, H., Guzman-Blanco, M., Haque, M., Hansen, S., Hecker, A., Heizmann, W. R., Herzog, T., Hodonou, A. M., Hong, S. K., Kafka-Ritsch, R., Kaplan, L. J., Kapoor, G., Karamarkovic, A., Kees, M. G., Kenig, J., Kiguba, R., Kim, P. K., Kluger, Y., Khokha, V., Koike, K., Kok, K. Y., Kong, V., Knox, M. C., Inaba, K., Isik, A., Iskandar, K., Ivatury, R. R., Labbate, M., Labricciosa, F. M., Laterre, P. F., Latifi, R., Lee, J. G., Lee, Y. R., Leone, M., Leppaniemi, A., Li, Y., Liang, S. Y., Loho, T., Maegele, M., Malama, S., Marei, H. E., Martin-Loeches, I., Marwah, S., Massele, A., McFarlane, M., Melo, R. B., Negoi, I., Nicolau, D. P., Nord, C. E., Ofori-Asenso, R., Omari, A. H., Ordonez, C. A., Ouadii, M., Pereira Junior, G. A., Piazza, D., Pupelis, G., Rawson, T. M., Rems, M., Rizoli, S., Rocha, C., Sakakushev, B., Sanchez-Garcia, M., Sato, N., Segovia Lohse, H. A., Sganga, G., Siribumrungwong, B., Shelat, V. G., Soreide, K., Soto, R., Talving, P., Tilsed, J. V., Timsit, J. F., Trueba, G., Trung, N. T., Ulrych, J., Van Goor, H., Vereczkei, A., Vohra, R. S., Wani, I., Uhl, W., Xiao, Y., Yuan, K. C., Zachariah, S. K., Zahar, J. R., Zakrison, T. L., Corcione, A., Melotti, R. M., Viscoli, C., Viale, P., Universita 'La Sapienza' Roma (Istituto CNR), Università degli Studi di Roma 'La Sapienza' = Sapienza University [Rome] (UNIROMA), Universidade de Aveiro, Laboratoire matériaux et microélectronique de Provence (L2MP), Université Paul Cézanne - Aix-Marseille 3-Université de Provence - Aix-Marseille 1-Université de Toulon (UTLN)-Centre National de la Recherche Scientifique (CNRS), Institut Pasteur de Côte d'Ivoire, Réseau International des Instituts Pasteur (RIIP), National Defence University of Malaysia [Kuala Lumpur], Max Planck Institute for the Physics of Complex Systems (MPI-PKS), Max-Planck-Gesellschaft, Center for Plant Molecular Biology, Plant Physiology, and Biophysical Chemistry, University of Tübingen, Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR48, Institut des sciences biologiques (INSB-CNRS)-Institut des sciences biologiques (INSB-CNRS)-Centre National de la Recherche Scientifique (CNRS), Laboratoire de l'Accélérateur Linéaire (LAL), Université Paris-Sud - Paris 11 (UP11)-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Centre National de la Recherche Scientifique (CNRS), Dipartimento di Fisica 'Giuseppe Occhialini' = Department of Physics 'Giuseppe Occhialini' [Milano-Bicocca], Università degli Studi di Milano-Bicocca = University of Milano-Bicocca (UNIMIB), Atmospheric and Environmental Research, Inc. (AER), Zhejiang University, Università degli Studi di Roma 'La Sapienza' = Sapienza University [Rome], INSB-INSB-Centre National de la Recherche Scientifique (CNRS), Centre National de la Recherche Scientifique (CNRS)-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Université Paris-Sud - Paris 11 (UP11), Università degli Studi di Milano-Bicocca [Milano] (UNIMIB), and COMBE, Isabelle

Subjects
[SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, Carbapenems, Antimicrobial Resistance, Invasive Candidiasis, Methicillin Resistant Staphylococcus Aureus, Tigecycline, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

International audience; Intra-abdominal infections (IAI) are an important cause of morbidity and are frequently associated with poor prognosis, particularly in high-risk patients.The cornerstones in the management of complicated IAIs are timely effective source control with appropriate antimicrobial therapy. Empiric antimicrobial therapy is important in the management of intra-abdominal infections and must be broad enough to cover all likely organisms because inappropriate initial antimicrobial therapy is associated with poor patient outcomes and the development of bacterial resistance.The overuse of antimicrobials is widely accepted as a major driver of some emerging infections (such as C. difficile), the selection of resistant pathogens in individual patients, and for the continued development of antimicrobial resistance globally. The growing emergence of multi-drug resistant organisms and the limited development of new agents available to counteract them have caused an impending crisis with alarming implications, especially with regards to Gram-negative bacteria.An international task force from 79 different countries has joined this project by sharing a document on the rational use of antimicrobials for patients with IAIs. The project has been termed AGORA (Antimicrobials: A Global Alliance for Optimizing their Rational Use in Intra-Abdominal Infections). The authors hope that AGORA, involving many of the world's leading experts, can actively raise awareness in health workers and can improve prescribing behavior in treating IAIs.

Published
2017
Full Text
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6. Erratum to: Antimicrobials: a global alliance for optimizing their rational use in intra-abdominal infections (AGORA)

Author

Sartelli, M., primary, Weber, D. G., additional, Ruppé, E., additional, Bassetti, M., additional, Wright, B. J., additional, Ansaloni, L., additional, Catena, F., additional, Coccolini, F., additional, Abu-Zidan, F. M., additional, Coimbra, R., additional, Moore, E. E., additional, Moore, F. A., additional, Maier, R. V., additional, De Waele, J. J., additional, Kirkpatrick, A. W., additional, Griffiths, E. A., additional, Eckmann, C., additional, Brink, A. J., additional, Mazuski, J. E., additional, May, A. K., additional, Sawyer, R. G., additional, Mertz, D., additional, Montravers, P., additional, Kumar, A., additional, Roberts, J. A., additional, Vincent, J. L., additional, Watkins, R. R., additional, Lowman, W., additional, Spellberg, B., additional, Abbott, I. J., additional, Adesunkanmi, A. K., additional, Al-Dahir, S., additional, Al-Hasan, M. N., additional, Agresta, F., additional, Althani, A. A., additional, Ansari, S., additional, Ansumana, R., additional, Augustin, G., additional, Bala, M., additional, Balogh, Z. J., additional, Baraket, O., additional, Bhangu, A., additional, Beltrán, M. A., additional, Bernhard, M., additional, Biffl, W. L., additional, Boermeester, M. A., additional, Brecher, S. M., additional, Cherry-Bukowiec, J. R., additional, Buyne, O. R., additional, Cainzos, M. A., additional, Cairns, K. A, additional, Camacho-Ortiz, A., additional, Chandy, S. J., additional, Che Jusoh, A., additional, Chichom-Mefire, A., additional, Colijn, C., additional, Corcione, F., additional, Cui, Y., additional, Curcio, D., additional, Delibegovic, S., additional, Demetrashvili, Z., additional, De Simone, B., additional, Dhingra, S., additional, Diaz, J. J., additional, Di Carlo, I., additional, Dillip, A., additional, Di Saverio, S., additional, Doyle, M. P., additional, Dorj, G., additional, Dogjani, A., additional, Dupont, H., additional, Eachempati, S. R., additional, Enani, M. A., additional, Egiev, V. N., additional, Elmangory, M. M., additional, Ferrada, P., additional, Fitchett, J. R., additional, Fraga, G. P., additional, Guessennd, N., additional, Giamarellou, H., additional, Ghnnam, W., additional, Gkiokas, G., additional, Goldberg, S. R., additional, Gomes, C. A., additional, Gomi, H., additional, Guzmán-Blanco, M., additional, Haque, M., additional, Hansen, S., additional, Hecker, A., additional, Heizmann, W. R., additional, Herzog, T., additional, Hodonou, A. M., additional, Hong, S. K., additional, Kafka-Ritsch, R., additional, Kaplan, L. J., additional, Kapoor, G., additional, Karamarkovic, A., additional, Kees, M. G., additional, Kenig, J., additional, Kiguba, R., additional, Kim, P. K., additional, Kluger, Y., additional, Khokha, V., additional, Koike, K., additional, Kok, K. Y., additional, Kong, V., additional, Knox, M. C., additional, Inaba, K., additional, Isik, A., additional, Iskandar, K., additional, Ivatury, R. R., additional, Labbate, M., additional, Labricciosa, F. M., additional, Laterre, P. F., additional, Latifi, R., additional, Lee, J. G., additional, Lee, Y. R., additional, Leone, M., additional, Leppaniemi, A., additional, Li, Y., additional, Liang, S. Y., additional, Loho, T., additional, Maegele, M., additional, Malama, S., additional, Marei, H. E., additional, Martin-Loeches, I., additional, Marwah, S., additional, Massele, A., additional, McFarlane, M., additional, Melo, R. B., additional, Negoi, I., additional, Nicolau, D. P., additional, Nord, C. E., additional, Ofori-Asenso, R., additional, Omari, A. H., additional, Ordonez, C. A., additional, Ouadii, M., additional, Pereira Júnior, G. A., additional, Piazza, D., additional, Pupelis, G., additional, Rawson, T. M., additional, Rems, M., additional, Rizoli, S., additional, Rocha, C., additional, Sakakushev, B., additional, Sanchez-Garcia, M., additional, Sato, N., additional, Segovia Lohse, H. A., additional, Sganga, G., additional, Siribumrungwong, B., additional, Shelat, V. G., additional, Soreide, K., additional, Soto, R., additional, Talving, P., additional, Tilsed, J. V., additional, Timsit, J. F., additional, Trueba, G., additional, Trung, N. T., additional, Ulrych, J., additional, van Goor, H., additional, Vereczkei, A., additional, Vohra, R. S., additional, Wani, I., additional, Uhl, W., additional, Xiao, Y., additional, Yuan, K. C., additional, Zachariah, S. K., additional, Zahar, J. R., additional, Zakrison, T. L., additional, Corcione, A., additional, Melotti, R. M., additional, Viscoli, C., additional, and Viale, P., additional

Published
2017
Full Text
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7. A Global Declaration on Appropriate Use of Antimicrobial Agents across the Surgical Pathway

Author

Sartelli, M, Kluger, Y, Ansaloni, L, Carlet, J, Brink, A, Hardcastle, T, Khanna, A, Chicom-Mefire, A, Rodriguez-Bano, J, Nathwani, D, Mendelson, M, Watkins, R, Pulcini, C, Beovic, B, May, A, Itani, K, Mazuski, J, Fry, D, Coccolini, F, Rasxa, K, Montravers, P, Eckmann, C, Abbo, L, Abubakar, S, Abu-Zidan, F, Adesunkanmi, A, Al-Hasan, M, Althani, A, Ticas, J, Ansari, S, Ansumana, R, Da Silva, A, Augustin, G, Bala, M, Balogh, Z, Baraket, O, Bassetti, M, Bellanova, G, Beltran, M, Ben-Ishay, O, Biffl, W, Boermeester, M, Brecher, S, Bueno, J, Cainzos, M, Cairns, K, Camacho-Ortiz, A, Ceresoli, M, Chandy, S, Cherry-Bukowiec, J, Cirocchi, R, Colak, E, Corcione, A, Cornely, O, Cortese, F, Cui, Y, Curcio, D, Damaskos, D, Dasx, K, Delibegovic, S, Demetrashvili, Z, De Simone, B, De Souza, H, De Waele, J, Dhingra, S, Diaz, J, Di Carlo, I, Di Marzo, F, Di Saverio, S, Dogjani, A, Dorj, G, Dortet, L, Duane, T, Dupont, H, Egiev, V, Eid, H, Elmangory, M, El-Sayed Marei, H, Enani, M, Escandon-Vargas, K, Faro, M, Ferrada, P, Foghetti, D, Foianini, E, Fraga, G, Frattima, S, Gandhi, C, Gattuso, G, Giamarellou, E, Ghnnam, W, Gkiokas, G, Girardis, M, Goff, D, Gomes, C, Gomi, H, Gronerth, R, Guirao, X, Guzman-Blanco, M, Haque, M, Hecker, A, Hell, M, Herzog, T, Hicks, L, Kafka-Ritsch, R, Kao, L, Kanj, S, Kaplan, L, Kapoor, G, Karamarkovic, A, Kashuk, J, Kenig, J, Khamis, F, Khokha, V, Kiguba, R, Kirkpatrick, A, Korner, H, Koike, K, Kok, K, Kon, K, Kong, V, Inaba, K, Ioannidis, O, Isik, A, Iskandar, K, Labbate, M, Labricciosa, F, Lagrou, K, Lagunes, L, Latifi, R, Lasithiotakis, K, Laxminarayan, R, Lee, J, Leone, M, Leppaniemi, A, Li, Y, Liang, S, Liau, K, Litvin, A, Loho, T, Lowman, W, Machain, G, Maier, R, Manzano-Nunez, R, Marinis, A, Marmorale, C, Martin-Loeches, I, Marwah, S, Maseda, E, Mcfarlane, M, De Melo, R, Melotti, M, Memish, Z, Mertz, D, Mesina, C, Menichetti, F, Mishra, S, Montori, G, Moore, E, Moore, F, Naidoo, N, Napolitano, L, Negoi, I, Nicolau, D, Nikolopoulos, I, Nord, C, Ofori-Asenso, R, Olaoye, I, Omari, A, Ordonez, C, Ouadii, M, Ouedraogo, A, Pagani, L, Paiva, J, Parreira, J, Pata, F, Pereira, J, Pereira, N, Petrosillo, N, Picetti, E, Pintar, T, Ponce-De-Leon, A, Popovski, Z, Poulakou, G, Preller, J, Guerrero, A, Pupelis, G, Quiodettis, M, Rawson, T, Reichert, M, Reinhart, K, Rems, M, Rello, J, Rizoli, S, Roberts, J, Rubio-Perez, I, Ruppe, E, Sakakushev, B, Sall, I, Kafil, H, Sanders, J, Sato, N, Sawyer, R, Scalea, T, Scibe, R, Scudeller, L, Lohse, H, Sganga, G, Shafiq, N, Shah, J, Spigaglia, P, Suroowan, S, Tsioutis, C, Sifri, C, Siribumrungwong, B, Sugrue, M, Talving, P, Tan, B, Tarasconi, A, Tascini, C, Tilsed, J, Timsit, J, Tumbarello, M, Trung, N, Ulrych, J, Uranues, S, Velmahos, G, Vereczkei, A, Viale, P, Estape, J, Viscoli, C, Wagenlehner, F, Wright, B, Xiao, Y, Yuan, K, Zachariah, S, Zahar, J, Mergulhao, P, Catena, F, Sartelli M., Kluger Y., Ansaloni L., Carlet J., Brink A., Hardcastle T. C., Khanna A., Chicom-Mefire A., Rodriguez-Bano J., Nathwani D., Mendelson M., Watkins R. R., Pulcini C., Beovic B., May A. K., Itani K. M. F., Mazuski J. E., Fry D. E., Coccolini F., Rasxa K., Montravers P., Eckmann C., Abbo L. M., Abubakar S., Abu-Zidan F. M., Adesunkanmi A. K., Al-Hasan M. N., Althani A. A., Ticas J. E. A., Ansari S., Ansumana R., Da Silva A. R. A., Augustin G., Bala M., Balogh Z. J., Baraket O., Bassetti M., Bellanova G., Beltran M. A., Ben-Ishay O., Biffl W. L., Boermeester M. A., Brecher S. M., Bueno J., Cainzos M. A., Cairns K., Camacho-Ortiz A., Ceresoli M., Chandy S. J., Cherry-Bukowiec J. R., Cirocchi R., Colak E., Corcione A., Cornely O. A., Cortese F., Cui Y., Curcio D., Damaskos D., Dasx K., Delibegovic S., Demetrashvili Z., De Simone B., De Souza H. P., De Waele J., Dhingra S., Diaz J. J., Di Carlo I., Di Marzo F., Di Saverio S., Dogjani A., Dorj G., Dortet L., Duane T. M., Dupont H., Egiev V. N., Eid H. O., Elmangory M., El-Sayed Marei H., Enani M. A., Escandon-Vargas K., Faro M. P., Ferrada P., Foghetti D., Foianini E., Fraga G. P., Frattima S., Gandhi C., Gattuso G., Giamarellou E., Ghnnam W., Gkiokas G., Girardis M., Goff D. A., Gomes C. A., Gomi H., Gronerth R. I. G., Guirao X., Guzman-Blanco M., Haque M., Hecker A., Hell M., Herzog T., Hicks L., Kafka-Ritsch R., Kao L. S., Kanj S. S., Kaplan L. J., Kapoor G., Karamarkovic A., Kashuk J., Kenig J., Khamis F., Khokha V., Kiguba R., Kirkpatrick A. W., Korner H., Koike K., Kok K. Y. Y., Kon K., Kong V., Inaba K., Ioannidis O., Isik A., Iskandar K., Labbate M., Labricciosa F. M., Lagrou K., Lagunes L., Latifi R., Lasithiotakis K., Laxminarayan R., Lee J. G., Leone M., Leppaniemi A., Li Y., Liang S. Y., Liau K. -H., Litvin A., Loho T., Lowman W., Machain G. M., Maier R. V., Manzano-Nunez R., Marinis A., Marmorale C., Martin-Loeches I., Marwah S., Maseda E., McFarlane M., De Melo R. B., Melotti M. R., Memish Z., Mertz D., Mesina C., Menichetti F., Mishra S. K., Montori G., Moore E. E., Moore F. A., Naidoo N., Napolitano L., Negoi I., Nicolau D. P., Nikolopoulos I., Nord C. E., Ofori-Asenso R., Olaoye I., Omari A. H., Ordonez C. A., Ouadii M., Ouedraogo A. -S., Pagani L., Paiva J. A., Parreira J. G., Pata F., Pereira J., Pereira N. R., Petrosillo N., Picetti E., Pintar T., Ponce-De-Leon A., Popovski Z., Poulakou G., Preller J., Guerrero A. P., Pupelis G., Quiodettis M., Rawson T. M., Reichert M., Reinhart K., Rems M., Rello J., Rizoli S., Roberts J., Rubio-Perez I., Ruppe E., Sakakushev B., Sall I., Kafil H. S., Sanders J., Sato N., Sawyer R. G., Scalea T., Scibe R., Scudeller L., Lohse H. S., Sganga G., Shafiq N., Shah J. N., Spigaglia P., Suroowan S., Tsioutis C., Sifri C. D., Siribumrungwong B., Sugrue M., Talving P., Tan B. K., Tarasconi A., Tascini C., Tilsed J., Timsit J. -F., Tumbarello M., Trung N. T., Ulrych J., Uranues S., Velmahos G., Vereczkei A. G., Viale P., Estape J. V., Viscoli C., Wagenlehner F., Wright B. J., Xiao Y., Yuan K. -C., Zachariah S. K., Zahar J. R., Mergulhao P., Catena F., Sartelli, M, Kluger, Y, Ansaloni, L, Carlet, J, Brink, A, Hardcastle, T, Khanna, A, Chicom-Mefire, A, Rodriguez-Bano, J, Nathwani, D, Mendelson, M, Watkins, R, Pulcini, C, Beovic, B, May, A, Itani, K, Mazuski, J, Fry, D, Coccolini, F, Rasxa, K, Montravers, P, Eckmann, C, Abbo, L, Abubakar, S, Abu-Zidan, F, Adesunkanmi, A, Al-Hasan, M, Althani, A, Ticas, J, Ansari, S, Ansumana, R, Da Silva, A, Augustin, G, Bala, M, Balogh, Z, Baraket, O, Bassetti, M, Bellanova, G, Beltran, M, Ben-Ishay, O, Biffl, W, Boermeester, M, Brecher, S, Bueno, J, Cainzos, M, Cairns, K, Camacho-Ortiz, A, Ceresoli, M, Chandy, S, Cherry-Bukowiec, J, Cirocchi, R, Colak, E, Corcione, A, Cornely, O, Cortese, F, Cui, Y, Curcio, D, Damaskos, D, Dasx, K, Delibegovic, S, Demetrashvili, Z, De Simone, B, De Souza, H, De Waele, J, Dhingra, S, Diaz, J, Di Carlo, I, Di Marzo, F, Di Saverio, S, Dogjani, A, Dorj, G, Dortet, L, Duane, T, Dupont, H, Egiev, V, Eid, H, Elmangory, M, El-Sayed Marei, H, Enani, M, Escandon-Vargas, K, Faro, M, Ferrada, P, Foghetti, D, Foianini, E, Fraga, G, Frattima, S, Gandhi, C, Gattuso, G, Giamarellou, E, Ghnnam, W, Gkiokas, G, Girardis, M, Goff, D, Gomes, C, Gomi, H, Gronerth, R, Guirao, X, Guzman-Blanco, M, Haque, M, Hecker, A, Hell, M, Herzog, T, Hicks, L, Kafka-Ritsch, R, Kao, L, Kanj, S, Kaplan, L, Kapoor, G, Karamarkovic, A, Kashuk, J, Kenig, J, Khamis, F, Khokha, V, Kiguba, R, Kirkpatrick, A, Korner, H, Koike, K, Kok, K, Kon, K, Kong, V, Inaba, K, Ioannidis, O, Isik, A, Iskandar, K, Labbate, M, Labricciosa, F, Lagrou, K, Lagunes, L, Latifi, R, Lasithiotakis, K, Laxminarayan, R, Lee, J, Leone, M, Leppaniemi, A, Li, Y, Liang, S, Liau, K, Litvin, A, Loho, T, Lowman, W, Machain, G, Maier, R, Manzano-Nunez, R, Marinis, A, Marmorale, C, Martin-Loeches, I, Marwah, S, Maseda, E, Mcfarlane, M, De Melo, R, Melotti, M, Memish, Z, Mertz, D, Mesina, C, Menichetti, F, Mishra, S, Montori, G, Moore, E, Moore, F, Naidoo, N, Napolitano, L, Negoi, I, Nicolau, D, Nikolopoulos, I, Nord, C, Ofori-Asenso, R, Olaoye, I, Omari, A, Ordonez, C, Ouadii, M, Ouedraogo, A, Pagani, L, Paiva, J, Parreira, J, Pata, F, Pereira, J, Pereira, N, Petrosillo, N, Picetti, E, Pintar, T, Ponce-De-Leon, A, Popovski, Z, Poulakou, G, Preller, J, Guerrero, A, Pupelis, G, Quiodettis, M, Rawson, T, Reichert, M, Reinhart, K, Rems, M, Rello, J, Rizoli, S, Roberts, J, Rubio-Perez, I, Ruppe, E, Sakakushev, B, Sall, I, Kafil, H, Sanders, J, Sato, N, Sawyer, R, Scalea, T, Scibe, R, Scudeller, L, Lohse, H, Sganga, G, Shafiq, N, Shah, J, Spigaglia, P, Suroowan, S, Tsioutis, C, Sifri, C, Siribumrungwong, B, Sugrue, M, Talving, P, Tan, B, Tarasconi, A, Tascini, C, Tilsed, J, Timsit, J, Tumbarello, M, Trung, N, Ulrych, J, Uranues, S, Velmahos, G, Vereczkei, A, Viale, P, Estape, J, Viscoli, C, Wagenlehner, F, Wright, B, Xiao, Y, Yuan, K, Zachariah, S, Zahar, J, Mergulhao, P, Catena, F, Sartelli M., Kluger Y., Ansaloni L., Carlet J., Brink A., Hardcastle T. C., Khanna A., Chicom-Mefire A., Rodriguez-Bano J., Nathwani D., Mendelson M., Watkins R. R., Pulcini C., Beovic B., May A. K., Itani K. M. F., Mazuski J. E., Fry D. E., Coccolini F., Rasxa K., Montravers P., Eckmann C., Abbo L. M., Abubakar S., Abu-Zidan F. M., Adesunkanmi A. K., Al-Hasan M. N., Althani A. A., Ticas J. E. A., Ansari S., Ansumana R., Da Silva A. R. A., Augustin G., Bala M., Balogh Z. J., Baraket O., Bassetti M., Bellanova G., Beltran M. A., Ben-Ishay O., Biffl W. L., Boermeester M. A., Brecher S. M., Bueno J., Cainzos M. A., Cairns K., Camacho-Ortiz A., Ceresoli M., Chandy S. J., Cherry-Bukowiec J. R., Cirocchi R., Colak E., Corcione A., Cornely O. A., Cortese F., Cui Y., Curcio D., Damaskos D., Dasx K., Delibegovic S., Demetrashvili Z., De Simone B., De Souza H. P., De Waele J., Dhingra S., Diaz J. J., Di Carlo I., Di Marzo F., Di Saverio S., Dogjani A., Dorj G., Dortet L., Duane T. M., Dupont H., Egiev V. N., Eid H. O., Elmangory M., El-Sayed Marei H., Enani M. A., Escandon-Vargas K., Faro M. P., Ferrada P., Foghetti D., Foianini E., Fraga G. P., Frattima S., Gandhi C., Gattuso G., Giamarellou E., Ghnnam W., Gkiokas G., Girardis M., Goff D. A., Gomes C. A., Gomi H., Gronerth R. I. G., Guirao X., Guzman-Blanco M., Haque M., Hecker A., Hell M., Herzog T., Hicks L., Kafka-Ritsch R., Kao L. S., Kanj S. S., Kaplan L. J., Kapoor G., Karamarkovic A., Kashuk J., Kenig J., Khamis F., Khokha V., Kiguba R., Kirkpatrick A. W., Korner H., Koike K., Kok K. Y. Y., Kon K., Kong V., Inaba K., Ioannidis O., Isik A., Iskandar K., Labbate M., Labricciosa F. M., Lagrou K., Lagunes L., Latifi R., Lasithiotakis K., Laxminarayan R., Lee J. G., Leone M., Leppaniemi A., Li Y., Liang S. Y., Liau K. -H., Litvin A., Loho T., Lowman W., Machain G. M., Maier R. V., Manzano-Nunez R., Marinis A., Marmorale C., Martin-Loeches I., Marwah S., Maseda E., McFarlane M., De Melo R. B., Melotti M. R., Memish Z., Mertz D., Mesina C., Menichetti F., Mishra S. K., Montori G., Moore E. E., Moore F. A., Naidoo N., Napolitano L., Negoi I., Nicolau D. P., Nikolopoulos I., Nord C. E., Ofori-Asenso R., Olaoye I., Omari A. H., Ordonez C. A., Ouadii M., Ouedraogo A. -S., Pagani L., Paiva J. A., Parreira J. G., Pata F., Pereira J., Pereira N. R., Petrosillo N., Picetti E., Pintar T., Ponce-De-Leon A., Popovski Z., Poulakou G., Preller J., Guerrero A. P., Pupelis G., Quiodettis M., Rawson T. M., Reichert M., Reinhart K., Rems M., Rello J., Rizoli S., Roberts J., Rubio-Perez I., Ruppe E., Sakakushev B., Sall I., Kafil H. S., Sanders J., Sato N., Sawyer R. G., Scalea T., Scibe R., Scudeller L., Lohse H. S., Sganga G., Shafiq N., Shah J. N., Spigaglia P., Suroowan S., Tsioutis C., Sifri C. D., Siribumrungwong B., Sugrue M., Talving P., Tan B. K., Tarasconi A., Tascini C., Tilsed J., Timsit J. -F., Tumbarello M., Trung N. T., Ulrych J., Uranues S., Velmahos G., Vereczkei A. G., Viale P., Estape J. V., Viscoli C., Wagenlehner F., Wright B. J., Xiao Y., Yuan K. -C., Zachariah S. K., Zahar J. R., Mergulhao P., and Catena F.

Abstract

This declaration, signed by an interdisciplinary task force of 234 experts from 83 different countries with different backgrounds, highlights the threat posed by antimicrobial resistance and the need for appropriate use of antibiotic agents and antifungal agents in hospitals worldwide especially focusing on surgical infections. As such, it is our intent to raise awareness among healthcare workers and improve antimicrobial prescribing. To facilitate its dissemination, the declaration was translated in different languages.

Published
2017

8. Food Marketing towards Children : Brand Logo Recognition, Food-Related Behavior and BMI among 3-13-Year-Olds in a South Indian Town

Author

Ueda, P., Tong, L., Viedma, Cristobal, Chandy, S. J., Marrone, G., Simon, A., Stålsby Lundborg, C., Ueda, P., Tong, L., Viedma, Cristobal, Chandy, S. J., Marrone, G., Simon, A., and Stålsby Lundborg, C.

Abstract

Objectives: To assess exposure to marketing of unhealthy food products and its relation to food related behavior and BMI in children aged 3-13, from different socioeconomic backgrounds in a south Indian town. Methods: Child-parent pairs (n = 306) were recruited at pediatric clinics. Exposure to food marketing was assessed by a digital logo recognition test. Children matched 18 logos of unhealthy food (high in fat/sugar/salt) featured in promotion material from the food industry to pictures of corresponding products. Children's nutritional knowledge, food preferences, purchase requests, eating behavior and socioeconomic characteristics were assessed by a digital game and parental questionnaires. Anthropometric measurements were recorded. Results: Recognition rates for the brand logos ranged from 30% to 80%. Logo recognition ability increased with age (p<0.001) and socioeconomic level (p<0.001 comparing children in the highest and lowest of three socioeconomic groups). Adjusted for gender, age and socioeconomic group, logo recognition was associated with higher BMI (p = 0.022) and nutritional knowledge (p<0.001) but not to unhealthy food preferences or purchase requests. Conclusions: Children from higher socioeconomic groups in the region had higher brand logo recognition ability and are possibly exposed to more food marketing. The study did not lend support to a link between exposure to marketing and poor eating behavior, distorted nutritional knowledge or increased purchase requests. The correlation between logo recognition and BMI warrants further investigation on food marketing towards children and its potential role in the increasing burden of non-communicable diseases in this part of India., QC 20121205

Published
2012
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11. A six-hour extrapolated sampling strategy for monitoring mycophenolic acid in renal transplant patients in the Indian subcontinent.

Author

Fleming, D. H., Mathew, B. S., John, G. T., Chandy, S. J., Manivannan, J., and Jeyaseelan, V.

Subjects
DRUG monitoring, PHARMACOLOGY, THERAPEUTICS, SERUM, IMMUNOSUPPRESSIVE agents
Abstract

Background: Therapeutic drug monitoring for mycophenolic acid (MPA) is increasingly being advocated. The present therapeutic range relates to the 12-hour area under the serum concentration time profile (AUC). However, this is a cumbersome, tedious, cost restricting procedure. Is it possible to reduce this sampling period? Aim: To compare the AUC from a reduced sampling strategy with the full 12-hour profile for MPA. Settings and Design: Clinical Pharmacology Unit of a tertiary care hospital in South India. Retrospective, paired data. Materials and Methods: Thirty-four 12-hour profiles from post-renal transplant patients on Cellcept® were evaluated. Profiles were grouped according to steroid and immunosuppressant co-medication and the time after transplant. MPA was estimated by high performance liquid chromatography with UV detection. From the 12-hour profiles the AUC up to only six hours was calculated by the trapezoidal rule and a correction factor applied. These two AUCs were then compared. Statistical Analysis: Linear regression, intra-class correlations (ICC) and a two-tailed paired t-test were applied to the data. Results: Comparing the 12-hour AUC with the paired 6-hour extrapolated AUC, the ICC and linear regression (r²) were very good for all three groups. No statistical difference was found by a two-tailed paired t-test. No bias was seen with a Bland Altman plot or by calculation. Conclusion: For patients on Cellcept® with prednisolone ± cyclosporine the 6-hour corrected is an accurate measure of the full 12-hour AUC. [ABSTRACT FROM AUTHOR]

Published
2006

12. Stability Issues of Mycophenolic Acid in Plasma: From Patient to Laboratory.

Author

MATHEW, B. S., JOHN, G. T., CHANDY, S. J., and FLEMING, D. H.

Subjects
MYCOPHENOLIC acid, DRUG monitoring, HIGH performance liquid chromatography, PHARMACOLOGY, METABOLITES
Abstract

Although mycophenolate is widely prescribed in India, therapeutic drug monitoring of mycophenolic acid is not performed in most centers. This could be due to many factors such as the large investment and expertise required for high performance liquid chromatography, or the high costs involved as specialized refrigeration is required when transporting patient specimens to the laboratories with the facility to analyze MPA. The Clinical Pharmacology unit of the Christian Medical College Hospital routinely monitors the area under the curve of MPA. In order to determine if this unit could act as a central laboratory for MPA monitoring, the stability of MPA in plasma under a series of storage and transport conditions was assessed. The procedures involved the analysis of plasma specimens from patients on mycophenolate mofetil and blank plasma spiked with MPA reference standard. A range of low and high concentrations were separately analyzed to confirm long term and short term stability. The measured concentrations of MPA showed no significant change over 5 months when stored at -20° or over five days under conditions encountered during transport. [ABSTRACT FROM AUTHOR]

Published
2009

16. Role of active surveillance in improving hospital adverse drug event monitoring.

Author

Subbanna, Prasanna Kumar T. and Chandy, S .J.

Subjects
*DRUG monitoring, *DRUG advertising, *DRUG marketing, *HOSPITAL care
Abstract

The article focuses on the significance of active surveillance in ameliorating the hospital-based adverse drug event (ADE) monitoring in India. It was found out that active surveillance is more effective in detecting the adverse events to newly marketed drugs than through the spontaneous reporting (SR) system. It has been suggested that SR-based hospital ADE monitoring system should be added to the active surveillance system to supervise the safety profile of newly marketed drugs at hospitals.

Published
2006
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17. Antibiotic use for febrile illness in rural paediatric population: Questions?

Author

Mathew, B. S., Fleming, D. H., Chandy, S. J., and Balraj, Vinohar

Subjects
*LETTERS to the editor, *HIGH performance liquid chromatography
Abstract

A response by B. S. Mathew, D. H. Fleming, S. J. Chandy and Vinohar Balraj to a letter to the editor about their article "An Objective Measure of Antibiotic Use for Febrile Illness in a Rural Paediatric Population Using High Performance Liquid Chromatography," in the 2010 issue is presented.

Published
2010

18. An objective measure of antibiotic use for febrile illness in a rural paediatric population using high performance liquid chromatography.

Author

Mathew, B. S., Fleming, D. H., Gupta, Madhu, Kumar, Rajesh, Kumar, Dinesh, Chandy, S. J., and Balraj, Vinohar

Subjects
*LETTERS to the editor, *ANTIBIOTICS
Abstract

A letter to the editor is presented about an objective method for measuring antibiotic use for febrile illness in a rural paediatric population using high performance liquid chromatography.

Published
2010

19. Antimicrobial prescription patterns for common acute infections in some rural & urban health facilities of India.

Author

S KI, Chandy SJ, Jeyaseelan L, Kumar R, and Suresh S

Subjects
India, Rural Health statistics & numerical data, Urban Health statistics & numerical data, Anti-Infective Agents therapeutic use, Infections drug therapy, Practice Patterns, Physicians' statistics & numerical data, Prescriptions statistics & numerical data, Public Health Practice statistics & numerical data
Abstract

Background & Objectives: Irrational use of antimicrobials is a key factor behind rapidly spreading antimicrobial resistance in microorganisms. This study was undertaken to determine the rate and pattern of antimicrobial prescribing in patients with uncomplicated acute respiratory infections, fever and diarrhoea attending a few rural and urban health settings., Methods: The study was done in primary and secondary health care facilities of public/government and private settings at four sites in India. Patients with fever, cough, diarrhoea or ear, nose or throat infections of < 7 days were included. Pregnant women, lactating mothers, infants, seriously ill patients and patients with bloody diarrhoea or purulent nasal or ear discharge were excluded., Results: Overall antimicrobial prescription rate was 69.4 per cent (95% CI 67.1, 71.7). Wide variation was observed (Thiruvananthapuram 47.6%, Lucknow 81.8%, Chennai 73.1% and Vellore 76.5%). Physicians practicing in rural and public/government settings prescribed antimicrobials more frequently than those in urban and private settings (83.8, 81.9, 68.3 and 68.2% respectively). Antimicrobials were more frequently prescribed for patients presenting with fever. Highest rate was noticed for children aged between 6 and 18 yr. Patients of the high-income group received antimicrobials more frequently (72.7%). In both public/ government and private settings, for patients who purchased medicines, the rate was higher (82.4 and 68.9% respectively), vs. those receiving free medicines (70.2 and 46.2% respectively). Two third of all antimicrobials prescribed were penicillins and co-trimoxazole, and > 40 per cent of prescriptions from private sector were quinolones and cephalosporins., Interpretation & Conclusions: Our findings showed that prescription of antimicrobials for acute respiratory infections and diarrhoea was extremely common and warrants interventional strategies.

Published
2008

20. Acenocoumarol and phenytoin toxicity in the presence of CYP2C9 mutation.

Author

Jose L, Binila C, Chandy SJ, Mathews JE, and Mathews KP

Subjects
Adult, Cytochrome P-450 CYP2C9, Drug Interactions, Female, Humans, Pharmacogenetics, Polymorphism, Genetic, Pregnancy, Pregnancy Complications, Hematologic prevention & control, Seizures drug therapy, Acenocoumarol adverse effects, Anticoagulants adverse effects, Anticonvulsants poisoning, Aryl Hydrocarbon Hydroxylases genetics, Mutation, Phenytoin poisoning, Pregnancy Complications drug therapy
Abstract

This case report describes a rare interaction between therapeutic doses of phenytoin and acenocoumarol resulting in both acute phenytoin toxicity and increased international normalized ratio (INR). Interactions between these drugs are due to the pharmacokinetics and the common metabolising pathway by hepatic cytochrome P450 isoenzyme-CYP2C9. Our patient was detected to be homozygous for CYP2C9*3 by PCR-RFLP analysis resulting in markedly decreased metabolism of both the drugs. Given that these two drugs are often given concomitantly in the medical out patient department, and that CYP2C9 polymorphisms are not uncommon, clinicians should be aware of this interaction and suspect this in patients with toxicity to these drugs.

Published
2008

21. A prospective evaluation of leflunomide therapy for cytomegalovirus disease in renal transplant recipients.

Author

John GT, Manivannan J, Chandy S, Peter S, Fleming DH, Chandy SJ, Balakrishnan N, Krishnamurthy K, Kirubakaran MG, and Jacob CK

Subjects
Adult, Antiviral Agents therapeutic use, Female, Humans, Leflunomide, Male, Middle Aged, Prospective Studies, Treatment Outcome, Cytomegalovirus Infections drug therapy, Isoxazoles therapeutic use, Kidney Transplantation, Postoperative Complications drug therapy, Postoperative Complications virology
Abstract

Aim: A preliminary observation suggests leflunomide is effective in the treatment of cytomegalovirus (CMV) disease in renal transplant recipients. A prospective evaluation was conducted in renal transplant recipients to study the efficacy of leflunomide in the treatment of CMV disease., Patients and Methods: With prior approval and informed consent for therapy and follow-up, 17 consecutive consenting renal transplant recipients with proven CMV disease were treated with leflunomide. CMV disease was defined as a clinical syndrome of fever and/or symptoms of organ involvement, leukopenia, and a positive nested CMV quantitative PCR test at 0.001 microg/5 microL template input, with or without histologic evidence of tissue invasion. Leflunomide metabolite concentrations (A77 1726) were monitored., Results: Of the 17 patients, 14 patients were treated for 6 months for CMV disease the first time; the remaining 3 received leflunomide treatment for relapse after ganciclovir treatment, for a year. Seven patients had fever with viremia and no organ involvement, nine had viremia with involvement of gastrointestinal tract, and one had fever with CMV inclusions in the allograft, with no demonstrable viremia. The three patients with relapse treated with leflunomide responded. Overall, 15 patients (88%) clinically responded to leflunomide therapy and with viral clearance from blood and healing of involved organs. The cost of therapy with intravenous ganciclovir (Cymevene, Roche) for 2 weeks was US 721 dollars while that of leflunomide (Cleft, Cipla Ltd) for 6 months was US 64 dollars., Conclusion: Leflunomide treatment for CMV disease in renal transplant recipients is effective, simple, and economical.

Published
2005
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