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Permanent URI for this collectionhttps://hdl.handle.net/11443/932
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Item Comparison of pediatric and adult antibiotic-associated diarrhea and Clostridium difficile infections(BAISHIDENG PUBLISHING GROUP INC, 2016-01-01) McFarland, Lynne Vernice; Ozen, Metehan; Dinleyici, Ener Cagri; Goh, ShanAntibiotic-associated diarrhea (AAD) and Clostridum difficile infections (CDI) have been well studied for adult cases, but not as well in the pediatric population. Whether the disease process or response to treatments differs between pediatric and adult patients is an important clinical concern when following global guidelines based largely on adult patients. A systematic review of the literature using databases PubMed (June 3, 1978-2015) was conducted to compare AAD and CDI in pediatric and adult populations and determine significant differences and similarities that might impact clinical decisions. In general, pediatric AAD and CDI have a more rapid onset of symptoms, a shorter duration of disease and fewer CDI complications (required surgeries and extended hospitalizations) than in adults. Children experience more community-associated CDI and are associated with smaller outbreaks than adult cases of CDI. The ribotype NAP1/027/BI is more common in adults than children. Children and adults share some similar risk factors, but adults have more complex risk factor profiles associated with more co-morbidities, types of disruptive factors and a wider range of exposures to C. difficile in the healthcare environment. The treatment of pediatric and adult AAD is similar (discontinuing or switching the inciting antibiotic), but other treatment strategies for AAD have not been established. Pediatric CDI responds better to metronidazole, while adult CDI responds better to vancomycin. Recurrent CDI is not commonly reported for children. Prevention for both pediatric and adult AAD and CDI relies upon integrated infection control programs, antibiotic stewardship and may include the use of adjunctive probiotics. Clinical presentation of pediatric AAD and CDI are different than adult AAD and CDI symptoms. These differences should be taken into account when rating severity of disease and prescribing antibiotics.Item Frequency of antibiotic use in the end-of-life cancer patients(BAYRAKOL MEDICAL PUBLISHER, 2021-01-01) Urvay, Semiha; Karagoz, HaticeAim: Making decisions about how to maintain general medical care and manage complications for patients in the last stage of advanced cancer is difficult. The benefits and necessity of antibiotic use in the last period of life are controversial. In this study, we aimed to investigate the frequency of antibiotic use in terminal stage cancer patients followed up with palliative care and died during their hospitalization. Material and Methods: One hundred twenty-one patients from January 2015 to June 2020 were included. Results: Among the 121 patients, 104 (86\%) received antibiotics. Eighty-five (81.7\%) patients received antibiotics until death. The mean duration of antibiotic treatment was 8.9 days. Antibiotic treatment was started 1 week before death in 88 (84.6\%) of 104 patients who used antibiotics. The number of patients whose antibiotic treatment was discontinued was 3 (15.7\%) in hospital wards and 16 (84.2\%) in the intensive care unit. Discussion: This is the first study on the frequency of antibiotic use in the end-of-life cancer patients in our country, and we found that the antibiotic prescription rate is high in dying cancer patients. It is questionable whether such care has positive effects on survival or quality of life. Guidelines on antibiotic use and discontinuation in patients with end-stage cancer should be developed.