Outpatient Parenteral Antimicrobial Treatment for Non-Cystic Fibrosis Bronchiectasis Exacerbations: A Prospective Multicentre Observational Cohort Study

Respiration ◽  
2019 ◽  
Vol 98 (4) ◽  
pp. 294-300 ◽  
Author(s):  
Luis Eduardo López-Cortés ◽  
Rut Ayerbe-García ◽  
Laura Carrasco-Hernández ◽  
Elena Fraile-Ramos ◽  
Juan Manuel Carmona-Caballero ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Cohort Study ◽  
Antimicrobial Treatment ◽  
Observational Cohort Study ◽  
Observational Cohort

scholarly journals An Observational Cohort Study Evaluating Antimicrobial Use in Peripartum Sepsis: A Tendency towards Overdiagnosis?

Pharmacy ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 211
Author(s):  
Nouf Abutheraa ◽  
June Grant ◽  
Alexander B. Mullen
Keyword(s):  
Cohort Study ◽  
Group B Streptococcus ◽  
Positive Culture ◽  
Medication Administration ◽  
Antimicrobial Treatment ◽  
Observational Cohort Study ◽  
Clinical Markers ◽  
Clinical Specimens ◽  
Sepsis Diagnosis ◽  
Observational Cohort

(1) Background: Sepsis is the leading cause of maternal death in 11–15% of women worldwide. This emphasises the importance of administrating timely and appropriate antibiotic therapy to women with sepsis. We aimed to evaluate the appropriateness of antimicrobial prescribing in women diagnosed with peripartum sepsis. (2) Method: A prospective observational cohort study in a single Scottish health region with 12,233 annual live births. Data were collected on women diagnosed with sepsis in the peripartum period using physical and electronic medical records, drug Kardex® (medication administration) and ward handover records. (3) Results: A sepsis diagnosis was concluded in 89 of the 2690 pregnancy cases reviewed, with a median hospital stay of four days. Good overall adherence to the local guidelines for the empiric antimicrobial treatment of sepsis was observed. Group B Streptococcus was associated with 20.8% of maternal sepsis cases, whilst in 60% of clinical specimens tested no causative pathogen was isolated. (4) Conclusion: The lack of specific and sensitive clinical markers for sepsis, coupled with their inconsistent clinical application to inform diagnosis, hindered effective antimicrobial stewardship. This was further exacerbated by the lack of positive culture isolates from clinical specimens, which meant that patients were often continued on broader-spectrum empiric treatment.

scholarly journals An observational cohort study of bacterial co-infection and implications for empirical antibiotic therapy in patients presenting with COVID-19 to hospitals in North West London

2020 ◽  
Author(s):  
Liyang Wang ◽  
Amit K Amin ◽  
Priya Khanna ◽  
Adnan Aali ◽  
Alastair McGregor ◽  
...  
Keyword(s):  
Cohort Study ◽  
Antibiotic Treatment ◽  
Inflammatory Markers ◽  
White Cell Count ◽  
Antimicrobial Treatment ◽  
Observational Cohort Study ◽  
North West ◽  
Empirical Antibiotic Treatment ◽  
Significant Difference ◽  
Observational Cohort

Abstract Objectives To describe the prevalence and nature of bacterial co-infections in COVID-19 patients within 48 hours of hospital admission and assess the appropriateness of empirical antibiotic treatment they received. Methods In this retrospective observational cohort study, we included all adult non-pregnant patients who were admitted to two acute hospitals in North West London in March and April 2020 and confirmed to have COVID-19 infection within 2 days of admission. Results of microbiological specimens taken within 48 hours of admission were reviewed and their clinical significance was assessed. Empirical antibiotic treatment of representative patients was reviewed. Patient age, gender, co-morbidities, inflammatory markers at admission, admission to ICU and 30 day all-cause in-hospital mortality were collected and compared between patients with and without bacterial co-infections. Results Of the 1396 COVID-19 patients included, 37 patients (2.7%) had clinically important bacterial co-infection within 48 hours of admission. The majority of patients (36/37 in those with co-infection and 98/100 in selected patients without co-infection) received empirical antibiotic treatment. There was no significant difference in age, gender, pre-existing illnesses, ICU admission or 30 day all-cause mortality in those with and without bacterial co-infection. However, white cell count, neutrophil count and CRP on admission were significantly higher in patients with bacterial co-infections. Conclusions We found that bacterial co-infection was infrequent in hospitalized COVID-19 patients within 48 hours of admission. These results suggest that empirical antimicrobial treatment may not be necessary in all patients presenting with COVID-19 infection, although the decision could be guided by high inflammatory markers.

scholarly journals Phenotyping adults with non-cystic fibrosis bronchiectasis: A prospective observational cohort study

2013 ◽  
Vol 107 (7) ◽  
pp. 1001-1007 ◽  
Author(s):  
G.A. Anwar ◽  
M.J. McDonnell ◽  
S.A. Worthy ◽  
S.C. Bourke ◽  
G. Afolabi ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Cohort Study ◽  
Observational Cohort Study ◽  
Prospective Observational Cohort Study ◽  
Observational Cohort

scholarly journals KMBARC registry: protocol for a multicentre observational cohort study on non-cystic fibrosis bronchiectasis in Korea

BMJ Open ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. e034090 ◽  
Author(s):  
Hyun Lee ◽  
Hayoung Choi ◽  
Yun Su Sim ◽  
Shinhee Park ◽  
Woo Jin Kim ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Cohort Study ◽  
Cohort Studies ◽  
Large Scale ◽  
Research Collaboration ◽  
Medical Center ◽  
Observational Cohort Study ◽  
Institutional Review ◽  
Study Results ◽  
Observational Cohort

IntroductionDespite the significant disease burden of bronchiectasis in Korea, no large-scale, representative prospective cohort studies have been conducted to evaluate the clinical characteristics of Korean patients with bronchiectasis, indicating an urgent need for cohort studies on bronchiectasis.Methods and analysisThe Korean Multicenter Bronchiectasis Audit and Research Collaboration (KMBARC) is a prospective, non-interventional observational cohort study on bronchiectasis in Korea. The inclusion criteria of this registry are as follows: (1) adult patients (aged ≥18 years) with or without respiratory symptoms (cough, chronic sputum and/or recurrent respiratory infection) and chest computed tomography revealing bronchiectasis affecting one or more lobes and (2) stable status at the time of registration: patients with bronchiectasis who were admitted for a respiratory aetiology can be enrolled at least 4 weeks after hospital discharge. The exclusion criteria are as follows: (1) bronchiectasis due to cystic fibrosis; (2) traction bronchiectasis associated with interstitial lung disease; (3) patients actively being treated for pneumonia, pulmonary tuberculosis or non-tuberculous mycobacterial infection; (4) patients who are unable or unwilling to provide informed consent; and (5) pregnant patients. Although the KMBARC questionnaires for baseline and annual follow-up data are similar to the European Multicentre Bronchiectasis Audit and Research Collaboration questionnaires, KMBARC has distinctive features such as use of Bronchiectasis Health Questionnaires, measurement with fatigue and depression scales, blood tests, use of consensus definition of exacerbations and information on emergency room or hospitalisation.We aim to recruit at least 1200 patients over the study period from more than 26 hospitals in South Korea. Patients will undergo a detailed baseline and yearly assessment for up to 5 years. The study objectives of the KMBARC registry are as follows: (1) uncovering the natural course of bronchiectasis; (2) aiding in establishing evidence-based bronchiectasis guidelines in Korea; and (3) encouraging and facilitating studies on bronchiectasis in Korea.Ethics and disseminationThis study received necessary approval from the Institutional Review Boards of all participating institutions. The Asan Medical Center Institutional Review Board gave overall approval for the study. Results will be disseminated via peer-reviewed publications and conference presentations.Trial registration numberKCT0003088.

scholarly journals The Efficacy of MRI in the diagnostic workup of cystic fibrosis-associated liver disease: A clinical observational cohort study

2018 ◽  
Vol 29 (2) ◽  
pp. 1048-1058 ◽  
Author(s):  
Sarah Poetter-Lang ◽  
Katharina Staufer ◽  
Pascal Baltzer ◽  
Dietmar Tamandl ◽  
Dina Muin ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Cohort Study ◽  
Liver Disease ◽  
Observational Cohort Study ◽  
Diagnostic Workup ◽  
Observational Cohort

scholarly journals Non cystic fibrosis bronchiectasis: A longitudinal retrospective observational cohort study of Pseudomonas persistence and resistance

2015 ◽  
Vol 109 (6) ◽  
pp. 716-726 ◽  
Author(s):  
Melissa J. McDonnell ◽  
Hannah R. Jary ◽  
Audrey Perry ◽  
James G. MacFarlane ◽  
Katy L.M. Hester ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Cohort Study ◽  
Observational Cohort Study ◽  
Observational Cohort ◽  
Retrospective Observational Cohort Study
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