The clinical problem that will be addressed for the purpose of the critical appraisal is the use of probiotics to prevent antibiotic-associated diarrhea. The prevalence of diarrhea related to use antibiotic usage is a commonly acknowledge the adverse effect in patients. Therefore, further understanding into what can prevent such an adverse effect can be of significant benefit.
Antibiotic-associated diarrhea is defined as inexplicable diarrhea that is present in connection with the use of antibiotics. It is typically caused by alterations in the microflora of the stomach (Beaugerie & Petit, 2004). The rate of this associated complication is related often to the type of antibiotic that is used. This change to the microflora create the opportunity
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The study trial clearly focused on the effectiveness that S. boulardii had on the prevention of AAD and Clostridium difficile-associated diarrhea (CDAD) the use of the probiotics to prevent this. The population focus was hospitalized adults. A total of fifteen hospitals were included in the trial. Two thousand four hundred and forty-four patients were initially screen to participate in this study. 1976 participants were deemed to be ineligible, unwilling to participate in the study or there were ethical or operational limitations that resulted in patients not participating. This has the potential to significantly impact external validity. Since the participants were all from large teaching hospitals, the comorbidities and illness of the patient were more complex, therefore it led to issues in the recruitment process. The eligibility criteria could have resulted in only healthy participants being included within the study. The assignment of patients to the intervention group occurred using blocked randomization. An allocation ratio of 1:1 was implemented through a computer method. The sequence for allocation into the groups using a separate statistician and the results were hidden from the participants or the investigators. The trials were stopped early due to futility was noted after four hundred and forty-six patients. A total of four hundred and seventy-seven patients were randomized into …show more content…
The use of antibiotics had discontinued due to adverse effects that presented in the patient, such as abdominal cramping, nausea, increase temperature, or rash. The results of the study concluded that when patients received a systemic antibiotic, S. Boulardii did not prevent ADD within the adult, hospitalized population. The experiential group and the intervention group were treated equally. The trial medication or a matching placebo was administered twice daily. Each group would start in phase one, and would receive the dose concurrently with the antibiotic. The duration of administration of the trial drug varied. When the antibiotic was discontinued, phase two of the study commenced and the drug as given for an additional seven days. If an antibiotic was reinitiated, then phase one would be restarted. After phase two ended, the participants in each group where monitored for a total of six weeks. The consistency of stool was documented by the participant in the study and then the data was gathered each week by the researchers. This lead to complications within the study since it was found that the participants were not consistent on how they kept the records of their stool amount and consistency or simply forgot. A total of one hundred and eighty-five participants did not document their daily bowel movements. The study also concluded that the frequency of loose stools per day was increased in the
BACKGROUND – E. coli is a food-borne bacterium that inhabits the bowels of warm blooded creatures such as humans and animals. If the individual is infected by E. coli, some symptoms can be “diarrhea, gas, abdominal cramping, fatigue, fever and vomiting.” (Pietrangelo”) If someone is infected with this bacterium, anti-biotics, which is explained by Oxford Dictionaries as “A medicine (such as penicillin or its derivatives) that inhibits the growth of or destroys microorganisms” can successfully treat the disease if it is outside of the digestive tract.
Mindy Perkins is 48 year old woman who presents to the ED with 10- 15 loose, liquid stools daily for the past 2 days. She completed a course of oral Amoxicillin seven days ago for a dental infection. In addition to loose stools, she complains of lower abdominal pain that began 2 days ago as well. She has not noted any blood in the stool. She denies vomiting, fever, or chills. She is on Prednisone for Crohn’s disease as well as Pantoprazole (Protonix) for severe GERD.
Nausea, vomiting, and oral thrush can occur with repeated or prolonged usage. Other side effects of antibiotics can be diarrhea. The diarrhea may also be a sign of a new infection such as, clostridium difficile. Anti-diarrheal medications are not indicated unless instructed by your provider (rxlist, n.d.).
Health experts know that most antibiotic products interfere with the immune system and the digestive system. Most of these products quell probiotic bacteria
Clostridium difficile was discovered and isolated from neonates in 1935. It was initially considered a component of the fecal flora of newborns and not thought to be pathogenic (Keessen, Gaastra, & Lipman, 2010). The history of C. diff and other antibiotic resistant pathogens are closely related with the history of antibiotics. The first antibiotic discovered was penicillin by Alexander Fleming while working with Staphylococcus. With this discovery, a surge of natural and synthetic drugs was discovered to treat bacterial infections. During the 1970s, clindamycin and cephalosporins were highly used as an effective antibiotic against bacterial infection but at the same time disrupted the normal, healthy bowel flora, allowing C.
Dr. Gumma mentioned that in prescribing antibiotic, it is very important to determine the patient’s allergy to
Bousvaros, & E. (2005). A Randomized, Double-blind Trial of Lactobacillus GG Versus Placebo in Addition to Standard Maintenance Therapy for Children with Crohn’s Disease. http://www.hmphanmi.com.cn/hmp/upload/event/study_4/9.pdf
Imagine walking out towards the White House in Washington D.C. and seeing the American flag burn in flames. Seeing people act irrational. How would you react? In the document “American Flag stands for tolerance” and imagine them burning the flag. Just think how people accepted the fact of the burning the flag, because they didn’t accept it.
Meanwhile, the quality improvement team selected potential subjects and added their medical record numbers to the database. The team decided to utilize a quality improvement toolbox technique to create surveys for physicians to complete on a daily basis. The survey form requested patient demographics along with the patient’s medical history. The physicians were asked to estimate the patient’s risk of ARTI complications due to chronic illnesses such as diabetes or cardiovascular disease. Finally, the physician recorded the patient’s final diagnosis and the type of antibiotic prescribed. The data collected from the physician forms was entered into a database (REDCaps) for statistical analysis. The working hypothesis stated that the overall antibiotic prescription rate would be reduced by 5% through education and intervention. Overall, their final results support their hypothesis, all of their stated goals met expectations. The overall prescription rate was reduced from 69% to 55%, and broad spectrum antibiotic prescriptions fell from 68% to 59%. The interventions also reduced antibiotic use in otherwise healthy patients and delayed treatment with antibiotics from a baseline of 8.3 days to 9.7 days (Grover DO, et al.,
While everybody nowadays receives a good education, not all are taught to the highest standard. The education system, for a long time, has remained unadapted to modern life; this principle remains true. As part of the national wakeup call on America’s scrambled and varying education standards across the nation, Davis Guggenheim’s Waiting for Superman raises thoughtful consideration to the subject of educating youth. Throughout the film, Guggenheim utilizes the stories of children in poorer areas to appeal to the audience’s emotional side, or pathos. Effectively showcasing the lives of lower-income families and the disadvantages faced- like not getting into a school that efficiently teaches children and permits them to consequently receive an even higher education, potentially breaking the cycle of poverty- Guggenheim offers evidence based on the success rates of charter schools. Displaying the most successful charter schools, and the most prosperous students out of those, puts charter schools into the
In the last decade, the number of prescriptions for antibiotics has increases. Even though, antibiotics are helpful, an excess amount of antibiotics can be dangerous. Quite often antibiotics are wrongly prescribed to cure viruses when they are meant to target bacteria. Antibiotics are a type of medicine that is prone to kill microorganisms, or bacteria. By examining the PBS documentary Hunting the Nightmare Bacteria and the article “U.S. government taps GlaxoSmithKline for New Antibiotics” by Ben Hirschler as well as a few other articles can help depict the problem that is of doctors prescribing antibiotics wrongly or excessively, which can led to becoming harmful to the body.
A couple times a year local and national mass media put the spotlight on problems connected to antibiotic overuse. Some people consider those problems to be real and serious, and others think that the discussed topics are nothing more than new “fashionable” subjects to talk about, distracting people from “real” problems, such as climbing gas prices or war expenses. Meanwhile, antibiotic overuse continues as a common practice among US doctors and agribusinesses for the last 20 years. The practice of antibiotic overuse has put patient’s health at risk, contributed to antibiotic resistance and increased bacterial mutation to a new, stronger level; as well as it hitting the economy with new costly expenses in health care. It is time to stop
Gold standard procedures should be implemented with the aim of providing timely and accurate results. (Schentag) The culture result should be accompanied by its clinical significance, selective reporting of susceptibility testing results in accordance with hospital antimicrobial therapy guidelines and suggested management. (Schentag) This encourages appropriate prescribing and minimises unnecessary use of antimicrobials. The clinical microbiology team should also provide reports to AMS regarding resistant organisms.
Driving in Montana is at high risk for teen drivers without any statewide laws against distracted driving. According to research done by Virginia Tech Transportation Institute in 2009, “…Text messaging on a cell phone was associated with the highest risk of all cell phone related tasks.” The study was conducted by observing continuously drivers for over six million miles of driving. The major focus was done on eye glance analyses. The assessment of where drivers looked when involved in driving events which were critical for safety, and how cell phone usage impacted the driver was analyzed. The tasks, which drew the driver’s eyes away from forward focus and attention, created the highest
bacterial urinary tract infection, which is the most common side effect, may occur.21 Other patients