Resistencia a antibióticos: Diferenzas entre revisións

A resistencia a antibióticos increméntase coa duración do tratamento; por tanto, con tal de que se manteña o mínimo efectivo, os tratamentos curtos con antibióticos é probable que diminúan as taxas de resistencia, reduzan os custos, e teñan mellores resultados e menores complicacións.<ref name=NPS2013/> Hai tratamentos curtos para a [[pneumonía adquirida na comunidade]]<ref>{{Cita publicación periódica |vauthors=Li JZ, Winston LG, Moore DH, Bent S | title = Efficacy of short-course antibiotic regimens for community-acquired pneumonia: a meta-analysis | journal = Am. J. Med. | volume = 120 | issue = 9 | pages = 783–90 | date = September 2007 | pmid = 17765048 | doi = 10.1016/j.amjmed.2007.04.023 | ref = harv }}</ref> [[peritonite bacteriana espontánea]],<ref>{{Cita publicación periódica |vauthors=Runyon BA, McHutchison JG, Antillon MR, Akriviadis EA, Montano AA | title = Short-course versus long-course antibiotic treatment of spontaneous bacterial peritonitis. A randomized controlled study of 100 patients | journal = Gastroenterology | volume = 100 | issue = 6 | pages = 1737–42 | date = June 1991 | pmid = 2019378 }}</ref> infeccións pulmonares en coidados intensivos,<ref>{{Cita publicación periódica |vauthors=Singh N, Rogers P, Atwood CW, Wagener MM, Yu VL | title = Short-course Empiric Antibiotic Therapy for Patients with Pulmonary Infiltrates in the Intensive Care Unit A Proposed Solution for Indiscriminate Antibiotic Prescription | journal = Am. J. Respir. Crit. Care Med. | volume = 162 | issue = 2 | pages = 505–511 | date = 1 August 2000 | pmid = 10934078 | doi = 10.1164/ajrccm.162.2.9909095 }}</ref> o denominado [[abdome agudo]],<ref>{{Cita publicación periódica |vauthors=Gleisner AL, Argenta R, Pimentel M, Simon TK, Jungblut CF, Petteffi L, de Souza RM, Sauerssig M, Kruel CD, Machado AR | title = Infective complications according to duration of antibiotic treatment in acute abdomen | journal = International Journal of Infectious Diseases | volume = 8 | issue = 3 | pages = 155–162 | date = 30 April 2004 | pmid = 15109590 | doi = 10.1016/j.ijid.2003.06.003 }}</ref> infeccións do oído medio, sinusite e infeccións de garganta,<ref>{{Cita publicación periódica |vauthors=Pichichero ME, Cohen R | title = Shortened course of antibiotic therapy for acute otitis media, sinusitis and tonsillopharyngitis | journal = The Pediatric Infectious Disease Journal | volume = 16 | issue = 7 | pages = 680–95 | year = 1997 | pmid = 9239773 | doi = 10.1097/00006454-199707000-00011 }}</ref> e lesións intestinasis penetrantes.<ref>{{Cita publicación periódica |vauthors=Dellinger EP, Wertz MJ, Lennard ES, Oreskovich MR | title = Efficacy of Short-Course Antibiotic Prophylaxis After Penetrating Intestinal Injury | journal = Archives of Surgery | volume = 121 | issue = 1 | pages = 23–30 | year = 1986 | pmid = 3942496 | doi = 10.1001/archsurg.1986.01400010029002 }}</ref><ref>{{Cita publicación periódica |vauthors=Perez-Gorricho B, Ripoll M | title = Does short-course antibiotic therapy better meet patient expectations? | journal = International Journal of Antimicrobial Agents | volume = 21 | issue = 3 | pages = 222–8 | year = 2003 | pmid = 12636982 | doi = 10.1016/S0924-8579(02)00360-6 }}</ref> Nalgunhas situacións un tratamento curto pode que non cure a [[infeción]] pero tampouco un tratamento longo.<ref>{{Cita publicación periódica |vauthors=Keren R, Chan E | title = A Meta-analysis of Randomized, Controlled Trials Comparing Short- and Long-Course Antibiotic Therapy for Urinary Tract Infections in Children | journal = Pediatrics | volume = 109 | issue = 5 | pages = E70–0 | year = 2002 | pmid = 11986476 | doi = 10.1542/peds.109.5.e70 }}</ref><ref>{{Cita publicación periódica |vauthors=McCormack J, Allan GM | title = A prescription for improving antibiotic prescribing in primary care | journal = [[British Medical Journal]] | volume = 344 | pages = d7955 | year = 2012 | pmid = 22302779 | doi = 10.1136/bmj.d7955 }}</ref> Como o paciente pode sentirse mellor antes de que a infección sexa erradicda, os médicos poden darlle instrucións para que saiba cando é seguro deixar de tomalos. Algúns investigadores avogan porque os médicos usen tratamentos curtos con antibióticos, e reavalíen o paciente uns días despois, e paren o tratamento se xa non hai síntomas de infección.<ref>Marc Bonten, MD; Eijkman-Winkler Institute for Medical Microbiology, Utrecht, the Netherland | [http://hicsigwiki.asid.net.au/images/4/41/Should_you_stop_an_antibiotic_course_early_if_you_feel_better_R._Everts.pdf Infectious Diseases, and Inflammation] {{Webarchive|url=https://web.archive.org/web/20130517042502/http://hicsigwiki.asid.net.au/images/4/41/Should_you_stop_an_antibiotic_course_early_if_you_feel_better_R._Everts.pdf |date=17 de maio de 2013 }}</ref>

 

 

Certos factores que se dan en unidades de coidados intensivos como a aplicacion de ventilación mecánica e múltiples enfermidades subxacentes tamén parecen contribuír á resistencia baceriana cando se usan antibióticos.<ref>{{Cita publicación periódica |vauthors=Thomas JK, Forrest A, Bhavnani SM, Hyatt JM, Cheng A, Ballow CH, Schentag JJ | title = Pharmacodynamic Evaluation of Factors Associated with the Development of Bacterial Resistance in Acutely Ill Patients during Therapy | journal = Antimicrob. Agents Chemother. | volume = 42 | issue = 3 | pages = 521–7 | date = March 1998 | pmid = 9517926 | pmc = 105492 | ref = harv }}</ref> Unha mala hixiene do persoal do hospital foi asociada co espallamento de organismos resistentes.<ref>{{Cita publicación periódica |vauthors=Girou E, Legrand P, Soing-Altrach S, Lemire A, Poulain C, Allaire A, Tkoub-Scheirlinck L, Chai SH, Dupeyron C, Loche CM | title = Association between hand hygiene compliance and methicillin-resistant Staphylococcus aureus prevalence in a French rehabilitation hospital | journal = Infect Control Hosp Epidemiol | volume = 27 | issue = 10 | pages = 1128–30 | date = October 2006 | pmid = 17006822 | doi = 10.1086/507967 | ref = harv }}</ref><ref>{{Cita publicación periódica |vauthors=Swoboda SM, Earsing K, Strauss K, Lane S, Lipsett PA | title = Electronic monitoring and voice prompts improve hand hygiene and decrease nosocomial infections in an intermediate care unit | journal = Crit. Care Med. | volume = 32 | issue = 2 | pages = 358–63 | date = February 2004 | pmid = 14758148 | doi = 10.1097/01.CCM.0000108866.48795.0F | ref = harv }}</ref>

 

==== ''Streptococcus'' e ''Enterococcus'' ====

 

A resistencia de ''[[Streptococcus pneumoniae]]'' á penicilina e outros beta-lactámicos estase incrementando en todo o mundo. O principal mecanismo de resistencia implica a introdución de mutacións en xenes que codifican proteínas que se unen á penicilina. Crese que a presión selectiva xoga un importante papel, e o uso de antibióticos beta-lactámicos foi consderado un factor de risco para a infección e colonización. ''S. pneumoniae'' é responsable de [[pneumonía]], [[bacteremia]], [[otite media]], [[meninxite]], [[sinusite]], [[peritonite]] e [[artrite]].<ref name="pmid15109426"/>

* [http://www.reactgroup.org/ ReAct Action on Antibiotic Resistance]

* [https://web.archive.org/web/20160826193122/http://apua.org/ Alliance for the Prudent Use of Antibiotics]

* [http://www.extendingthecure.org/ Extending the Cure: Policy Research to Extend Antibiotic Effectiveness ]

* [https://web.archive.org/web/20071214142631/http://www.fda.gov/oc/antimicrobial/questions.html 2003 New Guidance for Industry on Antimicrobial Drugs for Food Animals Questions and Answers, U.S. FDA]