Acid-suppression medications and bacterial gastroenteritis: a population-based cohort study.

Aims: To investigate whether acid-suppression medicines (ASMs) increase the risk of bacterial gastroenteritis.

Methods: A population-based, propensity-score matched cohort study using a record-linkage database in Tayside, UK. The study consisted of 188 323 exposed to ASMs (proton-pump inhibitors and histamine-2 receptor antagonists) and 376 646 controls (a propensity-score matched cohort from the rest of population who were not exposed to ASMs) between 1999 and 2013.

Hospital-acquired pneumonia incidence and diagnosis in older patients.

Background: hospital-acquired pneumonia poses a hazard to older people who are hospitalised, yet few data exist on the incidence or risk factors in non-intensive care patients. This study aimed to determine the incidence of hospital-acquired pneumonia (HAP) in a sample of hospitalised older people.

Methods: prospective survey of hospitalised older patients (>65 years) at a single centre over a 12-month period.

Comparison of strategies to reduce meticillin-resistant Staphylococcus aureus rates in surgical patients: a controlled multicentre intervention trial.

Objective: To compare the effect of two strategies (enhanced hand hygiene vs meticillin-resistant Staphylococcus aureus (MRSA) screening and decolonisation) alone and in combination on MRSA rates in surgical wards.

Design: Prospective, controlled, interventional cohort study, with 6-month baseline, 12-month intervention and 6-month washout phases.

Setting: 33 surgical wards of 10 hospitals in nine countries in Europe and Israel.

Optimal management of urinary tract infections in older people.

Urinary tract infections (UTI) occur frequently in older people. Unfortunately, UTI is commonly overdiagnosed and overtreated on the basis of nonspecific clinical signs and symptoms. The diagnosis of a UTI in the older patient requires the presence of new urinary symptoms, with or without systemic symptoms.

Severity assessment of skin and soft tissue infections: cohort study of management and outcomes for hospitalized patients.

Background: Skin and soft tissue infections (SSTIs) are caused by bacterial invasion of the skin and underlying soft tissues and can present with a wide spectrum of signs, symptoms and illness severity. They are a common indication for antimicrobial therapy. However, there are few data on treatment outcomes or the validity of clinical severity scores.

Distribution of meticillin-resistant Staphylococcus aureus spa types isolated from health-care workers and patients in a Scottish university teaching hospital.

Our study was aimed at comparing the meticillin-resistant Staphylococcus aureus (MRSA) strains isolated from an anonymous group of health-care workers (HCWs) with those obtained from patient samples during a 3-month time interval. We employed spa typing and virulence gene profiling to characterize the MRSA strains. Our data revealed that a total of 14 discrete spa types were circulating in both patients and HCWs.

Cranberry or trimethoprim for the prevention of recurrent urinary tract infections? A randomized controlled trial in older women.

Objectives: To compare the effectiveness of cranberry extract with low-dose trimethoprim in the prevention of recurrent urinary tract infections (UTIs) in older women.

Patients And Methods: One hundred and thirty-seven women with two or more antibiotic-treated UTIs in the previous 12 months were randomized to receive either 500 mg of cranberry extract or 100 mg of trimethoprim for 6 months.

Results: Thirty-nine of 137 participants (28%) had an antibiotic-treated UTI (25 in the cranberry group and 14 in the trimethoprim group); difference in proportions relative risk 1.

Does ingestion of cranberry juice reduce symptomatic urinary tract infections in older people in hospital? A double-blind, placebo-controlled trial.

Background: cranberry juice is often given to older people in hospital to prevent urinary tract infection (UTI), although there is little evidence to support its use.

Objective: to assess whether cranberry juice ingestion is effective in reducing UTIs in older people in hospital.

Design: randomised, placebo-controlled, double-blind trial.

Outcomes of an intervention to improve hospital antibiotic prescribing: interrupted time series with segmented regression analysis.

Objectives: To evaluate an intervention to reduce inappropriate use of key antibiotics with interrupted time series analysis.

Methods: The intervention is a policy for appropriate use of Alert Antibiotics (carbapenems, glycopeptides, amphotericin, ciprofloxacin, linezolid, piperacillin-tazobactam and third-generation cephalosporins) implemented through concurrent, patient-specific feedback by clinical pharmacists. Statistical significance and effect size were calculated by segmented regression analysis of interrupted time series of drug use and cost for 2 years before and after the intervention started.