Adding zinc to antibiotic treatment helps young children recover more quickly from severe pneumonia

2004 ◽  
Vol 8 (6) ◽  
pp. 402-403
Keyword(s):  
Young Children ◽  
Antibiotic Treatment ◽  
Severe Pneumonia

Methods of early diagnostics of severe pneumonia in children

2020 ◽  
Vol 03 (04) ◽  
pp. 43-46
Author(s):  
Sabir Nurgalam Amiraliev ◽  
Keyword(s):  
Young Children ◽  
Key Words ◽  
Lung Tissue ◽  
Tissue Damage ◽  
Severe Pneumonia ◽  
Early Diagnostics ◽  
Key Words Pneumonia ◽  
Pneumonia Severity ◽  
Acute Pneumonia ◽  
Lung Tissue Damage

Studies have shown that the severity and outcome of acute pneumonia largely depends on the prevalence of the focus of inflammation in the lung tissue, which is determined radiologically. We analyzed and determined a statistically significant effect of the degree of lung tissue damage on the severity and prognosis of pneumonia in young children, taking into account the conditions of infection. In pneumonia, χ² = 47.13 (p <0.001), indicates that the greater the degree of damage, the greater the likelihood of a severe course and unfavorable outcome of pneumonia. Key words: pneumonia, severity of the course, outcome, young children

scholarly journals The Diagnosis of Urinary Tract infection in Young children (DUTY): a diagnostic prospective observational study to derive and validate a clinical algorithm for the diagnosis of urinary tract infection in children presenting to primary care with an acute illness

2016 ◽  
Vol 20 (51) ◽  
pp. 1-294 ◽  
Author(s):  
Alastair D Hay ◽  
Kate Birnie ◽  
John Busby ◽  
Brendan Delaney ◽  
Harriet Downing ◽  
...  
Keyword(s):  
Primary Care ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Cost Effectiveness ◽  
Tract Infection ◽  
Young Children ◽  
Clinical Diagnosis ◽  
Antibiotic Treatment ◽  
Clinical Judgement ◽  
Index Tests

BackgroundIt is not clear which young children presenting acutely unwell to primary care should be investigated for urinary tract infection (UTI) and whether or not dipstick testing should be used to inform antibiotic treatment.ObjectivesTo develop algorithms to accurately identify pre-school children in whom urine should be obtained; assess whether or not dipstick urinalysis provides additional diagnostic information; and model algorithm cost-effectiveness.DesignMulticentre, prospective diagnostic cohort study.Setting and participantsChildren < 5 years old presenting to primary care with an acute illness and/or new urinary symptoms.MethodsOne hundred and seven clinical characteristics (index tests) were recorded from the child’s past medical history, symptoms, physical examination signs and urine dipstick test. Prior to dipstick results clinician opinion of UTI likelihood (‘clinical diagnosis’) and urine sampling and treatment intentions (‘clinical judgement’) were recorded. All index tests were measured blind to the reference standard, defined as a pure or predominant uropathogen cultured at ≥ 105colony-forming units (CFU)/ml in a single research laboratory. Urine was collected by clean catch (preferred) or nappy pad. Index tests were sequentially evaluated in two groups, stratified by urine collection method: parent-reported symptoms with clinician-reported signs, and urine dipstick results. Diagnostic accuracy was quantified using area under receiver operating characteristic curve (AUROC) with 95% confidence interval (CI) and bootstrap-validated AUROC, and compared with the ‘clinician diagnosis’ AUROC. Decision-analytic models were used to identify optimal urine sampling strategy compared with ‘clinical judgement’.ResultsA total of 7163 children were recruited, of whom 50% were female and 49% were < 2 years old. Culture results were available for 5017 (70%); 2740 children provided clean-catch samples, 94% of whom were ≥ 2 years old, with 2.2% meeting the UTI definition. Among these, ‘clinical diagnosis’ correctly identified 46.6% of positive cultures, with 94.7% specificity and an AUROC of 0.77 (95% CI 0.71 to 0.83). Four symptoms, three signs and three dipstick results were independently associated with UTI with an AUROC (95% CI; bootstrap-validated AUROC) of 0.89 (0.85 to 0.95; validated 0.88) for symptoms and signs, increasing to 0.93 (0.90 to 0.97; validated 0.90) with dipstick results. Nappy pad samples were provided from the other 2277 children, of whom 82% were < 2 years old and 1.3% met the UTI definition. ‘Clinical diagnosis’ correctly identified 13.3% positive cultures, with 98.5% specificity and an AUROC of 0.63 (95% CI 0.53 to 0.72). Four symptoms and two dipstick results were independently associated with UTI, with an AUROC of 0.81 (0.72 to 0.90; validated 0.78) for symptoms, increasing to 0.87 (0.80 to 0.94; validated 0.82) with the dipstick findings. A high specificity threshold for the clean-catch model was more accurate and less costly than, and as effective as, clinical judgement. The additional diagnostic utility of dipstick testing was offset by its costs. The cost-effectiveness of the nappy pad model was not clear-cut.ConclusionsClinicians should prioritise the use of clean-catch sampling as symptoms and signs can cost-effectively improve the identification of UTI in young children where clean catch is possible. Dipstick testing can improve targeting of antibiotic treatment, but at a higher cost than waiting for a laboratory result. Future research is needed to distinguish pathogens from contaminants, assess the impact of the clean-catch algorithm on patient outcomes, and the cost-effectiveness of presumptive versus dipstick versus laboratory-guided antibiotic treatment.FundingThe National Institute for Health Research Health Technology Assessment programme.

scholarly journals Legionella pneumophila infection and antibiotic treatment engenders a highly disturbed pulmonary microbiome with decreased microbial diversity

2019 ◽  
Author(s):  
Ana Elena Pérez-Cobas ◽  
Christophe Ginevra ◽  
Christophe Rusniok ◽  
Sophie Jarraud ◽  
Carmen Buchrieser
Keyword(s):  
Antibiotic Treatment ◽  
Legionella Pneumophila ◽  
Severe Pneumonia ◽  
Resistant Bacteria ◽  
Rrna Gene ◽  
Microbial Composition ◽  
Bacterial Composition ◽  
Lung Microbiome ◽  
The Impact ◽  
Healthy Lung

ABSTRACTBackgroundLung microbiome analyses have shown that the healthy lung is not sterile but it is colonized like other body sites by bacteria, fungi and viruses. However, little is known about the microbial composition of the lung microbiome during infectious diseases such as pneumonia and how it evolves during antibiotic therapy. To better understand the impact of the composition of the pulmonary microbiome on severity and outcome of pneumonia we analysed the composition and evolution of the human lung microbiome during pneumonia caused by the bacterium Legionella pneumophila.ResultsWe collected 10 bronchoalveolar lavage (BAL) samples from three patients during long-term hospitalisation due to severe pneumonia and performed a longitudinal in-depth study of the composition of their lung microbiome by high-throughput Illumina sequencing of the 16S rRNA gene (bacteria and archaea), ITS region (fungi) and 18S rRNA gene (eukaryotes). We found that the composition of the bacterial lung microbiome during pneumonia is hugely disturbed containing a very high percentage of the pathogen, a very low bacterial diversity, and an increased presence of opportunistic microorganisms such as species belonging to Staphylococcaceae and Streptococcaceae. The microbiome of antibiotic treated patients cured from pneumonia represented a different perturbation state with a higher abundance of resistant bacteria (mainly Firmicutes) and a significantly different bacterial composition as that found in healthy individuals. In contrast, the mycobiome remains more stable during pneumonia and antimicrobial therapy. Interestingly we identified possible cooperation within and between both communities. Furthermore, archaea (Methanobrevibacter) and protozoa (Acanthamoeba and Trichomonas) were detected.ConclusionsBacterial pneumonia leads to a collapse of the healthy microbiome and a strongly disturbed bacterial composition of the pulmonary microbiome that is dominated by the pathogen. Antibiotic treatment allows some bacteria to regrow or recolonize the lungs but the restoration of a healthy lung microbiome composition is only regained a certain time after the antibiotic treatment. Archaea and protozoa should also be considered, as they might be important but yet overseen members of the lung microbiome. Interactions between the micro- and the mycobiome might play a role in the restoration of the microbiome and the clinical evolution of the disease.

scholarly journals Cost of management of severe pneumonia in young children: systematic analysis

2016 ◽  
Vol 6 (1) ◽  
Author(s):  
Shanshan Zhang ◽  
Peter M. Sammon ◽  
Isobel King ◽  
Ana Lucia Andrade ◽  
Cristiana M. Toscano ◽  
...  
Keyword(s):  
Young Children ◽  
Severe Pneumonia ◽  
Systematic Analysis

scholarly journals Antibiotic treatment of diarrhoea is associated with decreased time to the next diarrhoea episode among young children in Vellore, India

2015 ◽  
Vol 44 (3) ◽  
pp. 978-987 ◽  
Author(s):  
Elizabeth T Rogawski ◽  
Daniel J Westreich ◽  
Sylvia Becker-Dreps ◽  
Linda S Adair ◽  
Robert S Sandler ◽  
...  
Keyword(s):  
Young Children ◽  
Antibiotic Treatment ◽  
Diarrhoea Episode
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