Current evidence on hospital antimicrobial stewardship objectives: a systematic review and meta-analysis.

Background: Antimicrobial stewardship is advocated to improve the quality of antimicrobial use. We did a systematic review and meta-analysis to assess whether antimicrobial stewardship objectives had any effects in hospitals and long-term care facilities on four predefined patients' outcomes: clinical outcomes, adverse events, costs, and bacterial resistance rates.

Methods: We identified 14 stewardship objectives and did a separate systematic search for articles relating to each one in Embase, Ovid MEDLINE, and PubMed.

The Effect of Roux-en-Y Gastric Bypass Surgery in Morbidly Obese Patients on Pharmacokinetics of (Acetyl)Salicylic Acid and Omeprazole: the ERY-PAO Study.

Background: Data on the absorption of orally administered drugs following Roux-en-Y gastric bypass (RYGB) surgery in obese patients are limited and inconclusive. As it is difficult to predict changes in absorption, studies on frequently used drugs in this population are necessary. Acetylsalicylic acid (ASA) and omeprazole are two commonly prescribed drugs in obese patients.

The metabolism and biopharmaceutics of spironolactone in man.

Spironolactone, a competitive aldosterone antagonist, has been used for almost 30 years in those disorders associated with primary or secondary hyperaldosteronism. This review is confined to its metabolism and biopharmaceutics in man. Spironolactone undergoes extensive metabolism with no unchanged drug appearing in the urine.

Influence of food on the bioavailability of spironolactone.

Nine healthy volunteers received a single oral dose of 200 mg spironolactone, once during fasting conditions and once immediately after a standardized breakfast. Serum concentrations of spironolactone and its metabolites 7 alpha-thiomethylspirolactone, 6 beta-hydroxy-7 alpha-thiomethylspirolactone, and canrenone were determined by HPLC for 24 hours after dosing. By taking spironolactone with food, the mean (+/- SD) AUC (0 to 24 hours) of the parent drug increased from 288 +/- 138 (empty stomach) to 493 +/- 105 ng X ml-1 X hr (P less than 0.

New insights into the pharmacokinetics of spironolactone.

Four healthy men took a single oral dose of 200 mg spironolactone after a standardized breakfast. Blood samples were drawn until 24 hours after dosing. A specific HPLC method was used to determine the serum concentrations of spironolactone and its metabolites 7 alpha-thiomethylspirolactone, 6 beta-hydroxy-7 alpha-thiomethylspirolactone, and canrenone.

[Differential diagnostic and therapeutic measures after aspiration of foreign bodies].

While aspiration is extremely rare, it must be considered as a possibility. Its prompt consideration is already half of the diagnosis, and the patient is protected from avoidable complications. The patient should be admitted to a hospital or department where routine bronchoscopic examinations are carried out and where personnel and equipment are available for immediate foreign body extraction.

[Aspiration accidents in dental practice].

Lack of symptoms does not necessarily mean that a small foreign body has been swallowed. Symptoms may not be present after aspiration of a foreign body which lodges in the bronchial tract. In any case, the event must be clarified roentgenologically.

[Persistency and resistance of streptococci isolated from periodontal pockets].

Intradermal injection of cell walls or cell wall constituents (Peptidoglycane) of Streptococcus sanguis II in experimental animals caused a similarly severe inflammatory reaction as with Streptococcus A. The three "viridans" species of streptococci proved to be resistant to complement (active serum) as well as to lysozyme and were superior to Streptococcus A in their capacity for resistance to another type of muralytic enzyme isolated from Streptomyces albus. The new acylureido penicillins (Mezlocillin, Azlocillin) had an almost equally inhibitory effect on the growth of the various species of bacteria.

[Intensive drug therapy of the marginal periodontium].

Two composite pastes composed of iodoformglycerin-tween 80 and tribromphenol-bismuth-glycerin were examined using the results of microbiologic studies. Because of their broad antimicrobial spectrum and their easy application, both pastes are suitable for primary control of bacteria in periodontal pockets, particularly when the complete picture of an inflammation is present. The application period for the therapeutic use of corticosteroids should be limited.