scholarly journals Psoriasis and wound healing outcomes: A retrospective cohort study examining wound complications and antibiotic use

2017 ◽  
Vol 23 (11) ◽  
Author(s):  
Paulina M Young ◽  
Kory K Parsi ◽  
Clayton W Schupp ◽  
April W Armstrong
Keyword(s):  
Wound Healing ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Antibiotic Use ◽  
Wound Complications

scholarly journals Empiric Antibiotic Use and Susceptibility in Infants With Bacterial Infections: A Multicenter Retrospective Cohort Study

2017 ◽  
Vol 7 (8) ◽  
pp. 427-435 ◽  
Author(s):  
Elana A. Feldman ◽  
Russell J. McCulloh ◽  
Angela L. Myers ◽  
Paul L. Aronson ◽  
Mark I. Neuman ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Bacterial Infections ◽  
Antibiotic Use ◽  
Empiric Antibiotic

scholarly journals Antibiotic Use and Bacterial Infection Among Inpatients in the First Wave of COVID-19: A Retrospective Cohort Study of 64,691 Patients

2021 ◽  
Author(s):  
Jonathan D. Baghdadi ◽  
KC Coffey ◽  
Timileyin Adediran ◽  
Katherine E. Goodman ◽  
Lisa Pineles ◽  
...  
Keyword(s):  
Cohort Study ◽  
Bacterial Infection ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Bacterial Infections ◽  
Secondary Infection ◽  
Antibiotic Use ◽  
Healthcare Database ◽  
Secondary Infections ◽  
Present On Admission

Background: Hospitalized patients with SARS-CoV-2 infection (COVID-19) often receive antibiotics for suspected bacterial co-infection. We estimated the incidence of bacterial co-infection and secondary infection in COVID-19 using clinical diagnoses to determine how frequently antibiotics are administered when bacterial infection is absent. Methods: We performed a retrospective cohort study of inpatients with COVID-19 present on admission to hospitals in the Premier Healthcare Database between April – June 2020. Bacterial infections were defined using ICD-10-CM diagnosis codes and associated “present on admission” coding. Co-infections were defined by bacterial infection present on admission, while secondary infections were defined by bacterial infection that developed after admission. Co-infection and secondary infection were not mutually exclusive. Results: 18.5% of 64,961 COVID-19 patients (n=12,040) presented with bacterial infection at admission, 3.8% (n=2,506) developed secondary infection after admission, and 0.9% (n=574) had both. 76.3% (n=49,551) received an antibiotic while hospitalized, including 71% of patients who had no diagnosis of bacterial infection. Secondary bacterial infection occurred in 5.7% patients receiving steroids in the first 2 days of hospitalization, 9.9% receiving tocilizumab in the first 2 days of hospitalization, and 10.3% patients receiving both. After adjusting for patient and hospital characteristics, bacterial co-infection (aRR 1.15; 95% CI, 1.11 – 1.20) and secondary infection (aRR 1.93; 95% CI, 1.82 – 2.04) were both independently associated with increased mortality. Conclusions: Though 1 in 5 inpatients with COVID-19 present with bacterial infection, secondary infections in the hospital are uncommon. Most inpatients with COVID-19 receive antibiotic therapy, including 71% of those not diagnosed with bacterial infection.

scholarly journals Broad-Spectrum Antibiotic Use and Disease Progression in Early-Stage Melanoma Patients: A Retrospective Cohort Study

Cancers ◽  
2021 ◽  
Vol 13 (17) ◽  
pp. 4367
Author(s):  
Mahip Acharya ◽  
Thomas Kim ◽  
Chenghui Li
Keyword(s):  
Cohort Study ◽  
Broad Spectrum ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Index Date ◽  
Early Stage ◽  
Antibiotic Use ◽  
Prior Treatment ◽  
Broad Spectrum Antibiotic ◽  
Melanoma Progression

Animal studies and a few clinical studies have reported mixed findings on the association between antibiotics and cancer incidence. Antibiotics may inhibit tumor cell growth, but could also alter the gut-microbiome-modulated immune system and increase the risk of cancer. Studies that assess how antibiotics affect the progression of cancer are limited. We evaluated the association between broad-spectrum antibiotic use and melanoma progression. We conducted a retrospective cohort study using IQVIA PharMetrics® Plus data (2008–2018). We identified patients with malignant melanoma who underwent wide local excision or Mohs micrographic surgery within 90 days of first diagnosis. Surgery date was the index date. Patients were excluded if they had any other cancer diagnosis or autoimmune disorders in 1 year before the index date (“baseline”). Exposure to broad-spectrum antibiotics was identified in three time windows using three cohorts: 3 months prior to the index date, 1 month after the index date, and 3 months after the index date. The covariates were patients’ demographic and clinical characteristics identified in the 1-year baseline period. The patients were followed from the index date until cancer progression, loss of enrollment, or the end of 2 years after the index date. Progression was defined as: (i) any hospice care after surgery, (ii) a new round of treatment for melanoma (surgery, chemotherapy, immunotherapy, targeted therapy, or radiotherapy) 180 days after prior treatment, or (iii) a metastasis diagnosis or a diagnosis of a new nonmelanoma primary cancer at least 180 days after first melanoma diagnosis or prior treatment. A high-dimensional propensity score approach with inverse weighting was used to adjust for the patients’ baseline differences. Cox proportional hazard regression was used for estimating the association. The final samples included 3930, 3831, and 3587 patients (mean age: 56 years). Exposure to antibiotics was 16% in the prior-3-months, 22% in the post-1-month, and 22% in the post-3-months. In the pre-3-months analysis, 9% of the exposed group and 9% of the unexposed group had progressed. Antibiotic use was not associated with melanoma progression (HR: 0.81; 95% CI: 0.57–1.14). However, antibiotic use in subsequent 1 month and subsequent 3 months was associated with 31% reduction (HR: 0.69; 95% CI: 0.51–0.92) and 32% reduction (HR: 0.68; 95% CI: 0.51–0.91) in progression, respectively. In this cohort of patients with likely early-stage melanoma cancer, antibiotic use in 1 month and 3 months after melanoma surgery was associated with a lower risk of melanoma progression. Future studies are warranted to validate the findings.

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