In Situ Raman Monitoring of Trace Antibiotics in Different Harsh Water Environments

In situ surface-enhanced Raman scattering(SERS)is a widely used operando analytical technique,while facing numerous complex factors in applications under aqueous environment,such as low detection sensitivity,poor anti-interference capability,etc.,resulting in unreliable detectability.To address these issues,herein a new hydrophobic SERS strategy has been attempted.By comprehensively designing and researching a SERS-active structure of superhydrophobic ZnO/Ag nanowires,we demonstrate that hydrophobicity can not only draw analytes from water onto substrate,but also adjust"hottest spot"from the bottom of the nanowires to the top.As a result,the structure can simultaneously concentrate the dispersed molecules in water and the enhanced electric field in structure into a same zone,while perfecting its own anti-interference ability.The underwater in situ analytical enhancement factor of this platform is as high as 1.67×10^(11),and the operando limited of detection for metronidazole(MNZ)reaches to 10^(-9)M.Most importantly,we also successfully generalized this structure to various real in situ detection scenarios,including on-site detection of MNZ in corrosive urine,real-time warning of wrong dose of MNZ during intravenous therapy,in situ monitoring of MNZ in flowing wastewater with particulate interference,etc.,demonstrating the great application potential of this hydrophobic platform.This work realizes a synergistic promotion for in situ SERS performance under aqueous environment,and also provides a novel view for improving other in situ analytical techniques.

Prescription of Antibiotics in Oral-Dental Practice: Case of the Dental Practice at the Coyah Prefectoral Hospital in the Republic of Guinea 2019-2020

Introduction: Antibiotics are medications that have the property of destroying bacteria or preventing their proliferation. The aim of this study is to evaluate antibiotic prescriptions in oral practice: case of the dental office of the Coyah prefectural hospital. Methods: This is a descriptive cross-sectional study which took place from August 2019 to January 2020 inclusive, i.e. a duration of six (6) months, during which 400 patients were identified. Results: Our results revealed a frequency of 70% of antibiotic prescriptions. The 16 - 25-year-old age group was the most dismayed, at 47.25% and with an average age of 27.78 years. Men represent 55% compared to 45% of women, i.e. sex ratio of 1.22. Pulp gangrene was the most common pathology in 55% of cases. The most prescribed family was Betalactamine or 61.71% and the most represented molecules were Amoxicillin with 56.10% followed by Metronidazole or 34.16%. And the favorable prognosis was observed in 99% of cases. Conclusion: Prescription should always be based on the benefit-risk ratio. This prescription by practitioners aims to prevent or eradicate infections and pain in order to obtain a good therapeutic result.

Antimicrobial Activity of Some Commercial Toothpastes and Antibiotics on Two Oral Pathogenic Bacteria—An in-Vitro Study

Oral health problems such as periodontal diseases, dental caries, and endodontic infections have a significant negative impact on oral health and impose a substantial financial burden on the global population. The prevalence of these issues is increasing due to the buildup of bacterial plaque and the growing resistance of bacteria to antimicrobial treatments. The aims of this study to evaluate the anti-bacterial activity of four types of antibiotics (Amoxicillin, Augmentin, Azithromycin and Metronidazole) and four types of toothpastes (Sensodyne, ipana, denta and cariax Gingival Kin) on two oral pathogenic bacteria (Streptococcus mutans and Staphylococcus epidermidis). Bacterial samples of previously isolated Streptococcus mutans and Staphylococcusepidermidis were used as test organisms and the Kirby-Bauer disc diffusion method was employed to assess the antibacterial efficacy of various antibiotics and evaluate the impact of different toothpastes using a filter paper disc agar measurement technique. Each filter disc was saturated with toothpaste solution in a test tube for approximately 30 to 40 seconds, after which they were placed on Mueller-Hinton broth bacterial cultures in petri dishes. These Petri dishes were then incubated at 37°C for 24 hours, and the clear zone’s diameter (inhibition zone in mm) was subsequently measured and the results were recorded. The results demonstrated that Sensodyne toothpaste and Metronidazole antibiotic were ineffective against both types of bacteria, while Augmentin and Amoxicillin were effective by high diameter inhibition zones of growth against S. mutans and Azithromycine against S. epidermidis. Also Ipana, Denta, and Cariax Gingival Kin toothpastes exhibited a moderate effect against the two bacteria. This study suggests that certain antibiotics and toothpastes can effectively inhibit the growth of harmful oral bacteria, but not all of them are effective.

Single flow treatment degradation of antibiotics in water using falling-film dielectric barrier discharge

The environmental contamination caused by antibiotics is increasingly conspicuous due to their widespread manufacture and misuse. Plasma has been employed in recent years for the remediation of antibiotic pollution in the environment. In this work, a falling-film dielectric barrier discharge was used to degrade the antibiotic tetracycline(TC) in water. The reactor combined the gas-liquid discharge and active gas bubbling to improve the TC degradation performance. The discharge characteristics, chemical species’ concentration, and degradation rates at different parameters were systematically studied. Under the optimized conditions(working gas was pure oxygen, liquid flow rate was 100 mL/min, gas flow rate was 1 L/min,voltage was 20 kV, single treatment), TC was removed beyond 70% in a single flow treatment with an energy efficiency of 145 mg/(kW·h). The reactor design facilitated gas and liquid flow in the plasma area to produce more ozone in bubbles after a single flow under pure oxygen conditions, affording fast TC degradation. Furthermore, long-term stationary experiment indicated that long-lived active species can sustain the degradation of TC. Compared with other plasma treatment systems, this work offers a fast and efficient degradation method, showing significant potential in practical industrial applications.

Simultaneous Degradation, Dehalogenation, and Detoxification of Halogenated Antibiotics by Carbon Dioxide Radical Anions

Despite the extensive application of advanced oxidation processes(AOPs)in water treatment,the efficiency of AOPs in eliminating various emerging contaminants such as halogenated antibiotics is constrained by a number of factors.Halogen moieties exhibit strong resistance to oxidative radicals,affecting the dehalogenation and detoxification efficiencies.To address these limitations of AOPs,advanced reduction processes(ARPs)have been proposed.Herein,a novel nucleophilic reductant—namely,the carbon dioxide radical anion(CO_(2)^(·-))—is introduced for the simultaneous degradation,dehalogenation,and detoxification of florfenicol(FF),a typical halogenated antibiotic.The results demonstrate that FF is completely eliminated by CO_(2)^(·-),with approximately 100%of Cland 46%of Freleased after 120 min of treatment.Simultaneous detoxification is observed,which exhibits a linear response to the release of free inorganic halogen ions(R^(2)=0.97,p<0.01).The formation of halogen-free products is the primary reason for the superior detoxification performance of this method,in comparison with conventional hydroxyl-radical-based AOPs.Products identification and density functional theory(DFT)calculations reveal the underlying dehalogenation mechanism,in which the chlorine moiety of FF is more susceptible than other moieties to nucleophilic attack by CO_(2)^(·-).Moreover,CO_(2)^(·-)-based ARPs exhibit superior dehalogenation efficiencies(>75%)in degrading a series of halogenated antibiotics,including chloramphenicol(CAP),thiamphenicol(THA),diclofenac(DLF),triclosan(TCS),and ciprofloxacin(CIP).The system shows high tolerance to the pH of the solution and the presence of natural water constituents,and demonstrates an excellent degradation performance in actual groundwater,indicating the strong application potential of CO_(2)^(·-)-based ARPs in real life.Overall,this study elucidates the feasibility of CO_(2)^(·-)for the simultaneous degradation,dehalogenation,and detoxification of halogenated antibiotics and provides a promising method for their regulation during water or wastewater treatment.

A novel Ag/ZnO core-shell structure for efficient sterilization synergizing antibiotics and subsequently removing residuals

The massive use of antibiotics has led to the aggravation of bacterial resistance and also brought environmental pollution problems.This poses a great threat to human health.If the dosage of antibiotics is reduced by increasing its bactericidal performance,the emergence of drug resistance is certainly delayed,so that there's not enough time for developing drug resistance during treatment.Therefore,we selected typical representative materials of metal Ag and semiconductor ZnO nano-bactericides to design and synthesize Ag/ZnO hollow core-shell structures(AZ for short).Antibiotics are grafted on the surface of AZ through rational modification to form a composite sterilization system.The research results show that the antibacterial efficiency of the composite system is significantly increased,from the sum(34.7%+22.8%-57.5%)of the antibacterial efficiency of AZ and gentamicin to 80.2%,net synergizes 22.7%,which fully reflects the effect of 1+1>2.Therefore,the dosage of antibiotics can be drastically reduced in this way,which makes both the possibility of bacterial resistance and medical expenses remarkably decrease.Subsequently,residual antibiotics can be degraded under simple illumination using AZ-self as a photocatalyst,which cuts off the path of environmental pollution.In short,such an innovative route has guiding significance for drug resistance.

Indication of conservative treatment by antibiotics for uncomplicated and complicated acute appendicitis

BACKGROUND Acute appendicitis is one of the most common emergency abdominal disease,and recent studies have evaluated conservative treatment using antibiotics for uncomplicated appendicitis.Although the efficacy of conservative treatment for uncomplicated appendicitis is known,its efficacy for complicated appendicitis remains unknown,so are risk factors for the conservative treatment of appendi-citis.In our institution,conservative treatment has long been the first choice for most appendicitis cases,except for perforation.Therefore,this novel study inves-tigated the outcomes of conservative treatment for uncomplicated and compli-cated acute appendicitis and the risk factors associated with conservative treat-ment.treatment.The significant and independent predictors of resistance to conservative treatment were body temperature≥37.3℃,appendicolith and Douglas sinus fluid visible on computed tomography(CT).The rate of resistance to conservative treatment was 66.7%(6/9)for patients with the above three factors,22.9%(8/35)for patients with two factors(appendicolith and body temperature≥37.3℃),16.7%(2/12)for patients with two factors(Douglas sinus fluid and appendicolith)and 11.1%(1/9)for patients with two factors(Douglas sinus fluid and body temperature≥37.3℃).CONCLUSION A temperature≥37.3℃,appendicolith and Douglas sinus fluid on CT might be clinical risk factors of resistance to conservative treatment for acute appendicitis.

Early clinical outcomes of two regimens of prophylactic antibiotics in cardiac surgical patients with delayed sternal closure

BACKGROUND Delayed sternal closure(DSC)can be a lifesaving approach for certain patients who have undergone cardiac surgery.The value of the type of prophylactic antibiotics in DSC is still debatable.AIM To investigate clinical outcomes of different prophylactic antibiotic regimens in patients who had DSC after cardiac surgery.METHODS This was a retrospective observational single-center study.Fifty-three consecutive patients who underwent cardiac surgery and had an indication for DSC were included.Patients were subjected to two regimens of antibiotics:Narrow-spectrum and broad-spectrum regimens.RESULTS The main outcome measures were length of hospital and intensive care unit(ICU)stay,duration of mechanical ventilation,and mortality.Of the 53 patients,12(22.6%)received narrow-spectrum antibiotics,and 41(77.4%)received broad-spectrum antibiotics.The mean age was 59.0±12.1 years,without significant differences between the groups.The mean duration of antibiotic use was significantly longer in the broad-spectrum than the narrowspectrum group(11.9±8.7 vs 3.4±2.0 d,P<0.001).The median duration of open chest was 3.0(2.0-5.0)d for all patients,with no difference between groups(P=0.146).The median duration of mechanical ventilation was significantly longer in the broad-spectrum group[60.0(Δinterquartile range(IQR)170.0)h vs 50.0(ΔIQR 113.0)h,P=0.047].Similarly,the median length of stay for both ICU and hospital were significantly longer in the broadspectrum group[7.5(ΔIQR 10.0)d vs 5.0(ΔIQR 5.0)d,P=0.008]and[27.0(ΔIQR 30.0)d vs 19.0(ΔIQR 21.0)d,P=0.031].Five(9.8%)patients were readmitted to the ICU and 18(34.6%)patients died without a difference between groups.CONCLUSION Prophylactic broad-spectrum antibiotics did not improve clinical outcomes in patients with DSC post-cardiac surgery but was associated with longer ventilation duration,length of ICU and hospital stays vs narrow-spectrum antibiotics.

Current trends in nanomaterials-mediated biosensing platforms and signal amplification strategies for antibiotics detection in dairy products

Dairy products have become one of the most prevalent daily foods worldwide,but safety concerns are rising.In dairy farming,unscrupulous traders misuse antibiotics to treat some diseases such as mastitis in cows,leading to antibiotic residues in dairy products.Rapid,sensitive,and simple detection methods for antibiotic residues are particularly important for food safety in dairy products.Traditional detection technology can effectively detect antibiotics,but there are defects such as complicated pre-treatment and high cost.Biosensors are widely used in food safety due to fast detection speed,low detection cost,strong anti-interference ability,and suitability for the field application.Nevertheless,these sensors often fail to trigger the signal conversion output due to low target concentration.To cope with this issue,some high-efficiency signal amplification systems can be introduced to improve the detection sensitivity and linear range of biosensors.In this review,we focused on:(i)Sources and toxicity of major antibiotics in animal-derived foods.(ii)Nanomaterial-mediated biosensors for real-time detection of target antibiotics in animal-derived foods.(iii)Signal amplification techniques to increase the sensitivity of biosensors.Finally,future prospects and challenges in this research field are discussed.

Evaluation of Beta-Lactam Antibiotics on the Regeneration of Peanut Plants and Their Inhibitory Effect on Agrobacterium Growth

The effect of beta-lactam antibiotics on shoot induction and plantlet regeneration from cotyledonary nodes was tested using two peanut cultivars.The culture media contained 4 mg/L 6-benzylaminopurine(BAP)as the main growth regulator.Various concentrations(100–600 mg/L)of cefotaxime,carbenicillin,and timentin were applied in the culture media.In all the tested media,there were no significant differences in the shoot induction as compared to the control.However,little phytotoxic effect was observed at higher concentrations of these antibiotics in the shoot elongation media.Under shoot elongation medium,shoots turned brownish and partly died at higher concentrations where shooting rates were not affected by the treatments.In cefotaxime,timentin,and carbenicillin-containing media,levels of antibiotics greater than 400,300,and 200 mg/L,respectively resulted in the brown coloration of plantlets.Moreover,the mean shoot number and shoot weight significantly decreased as their dosage increased.The results indicate that maximum levels of antibiotics have an adverse effect on the growth and development of peanuts.Also,cefotaxime(100–300 mg/L)and timentin(100–300 mg/L)will be sufficient in controlling Agrobacterium growth in the culture media with the least phytotoxic effect on the peanut plants.

Optimal mode of capillary electrophoresis for the impurity analysis of β-lactam antibiotics

In order to determine the optimal mode of capillary electrophoresis for the impurity control of β-lactam antibiotics, different modes and various electrophoresis conditions for the separation of impurities were compared.The results showed that micellar electrokinetic capillary chromatography（MEKC） was the optimal separation mode for the impurity profiling of β-lactam antibiotics.In MEKC,not only the common R and S isomers,Δ-2 andΔ-3 isomers,and Z and E isomers,but also the impurities of β-lactam antibiotics could be well separated compared with the capillary zone electrophoresis.Therefore,MECK is the first choice for the separation of impurities of β-lactam antibiotics with capillary electrophoresis（CE）.The optimal separation could be achieved in MEKC by optimizing the pH and the concentrations of buffered saline,micelles and organic solvent（methanol） in running buffer.

Simultaneous determination of 14β-lactam antibiotics in cosmetic products by liquid chromatography tandem mass spectrometry method

In this study,a simple and rapid high-performance liquid chromatography-tandem mass spectrometry（HPLC-MS/MS） method was established and validated to determine the 14β-lactam antibiotics in cosmetic products,including 1（ceftazidime）,2（cefaclor）, 3（cefdinir）,4（ampicillin）,5（cefalexin）,6（ceftezole）,7（cefotaxim）,8（cefradine）,9（cefuroxime）,10（cephazoline）,11 （cefathiamidine）,12（cefoperazone）,13（cafalotin）,14（piperacillin）.

The effect of prophylactic antibiotics in acute upper gastrointestinal bleeding patients in the emergency department

BACKGROUND: Currently, prophylactic antibiotics are recommended only for cirrhotic patients with acute upper gastrointestinal bleeding(AUGIB);however, the benefit for other AUGIB patients remains undetermined. We aimed to compare the clinical outcomes between patients with AUGIB with and without prophylactic antibiotics to identify the population that requires this therapy.METHODS: Patients with AUGIB admitted between 1st January 2019 and 31st December 2021 in the Emergency Department of Peking Union Medical College Hospital were enrolled. Patients were divided into the antibiotic and non-antibiotic groups. The primary outcome was in-hospital mortality, and the secondary outcome was the onset of new infection. The risk factors for mortality and infection were analyzed, and stratification analysis of prophylactic antibiotics was performed. Continuous data were analyzed using the t-test or nonparametric rank sum test, and categorical data were analyzed using the Chi-square test or Fisher's exact test. Indicators with significant differences between the groups were included for logistic regression analysis. A P-value <0.05 was considered statistically significant. RESULTS: A total of 392 individuals were included, among them, 281 patients received prophylactic antibiotics, and 111 patients did not receive prophylactic antibiotics. The mortality rates were significantly lower in the antibiotic group than in the non-antibiotics group(6.41% vs. 17.12%, P=0.001). The risk factors for infection were varicose veins(P=0.045) and endotracheal intubation(P=0.005) in the prophylactic antibiotic group, and endoscopic treatment(P=0.010) in the non-prophylactic antibiotic group. Stratified analyses showed that patients with age ≥ 65 years, endotracheal intubation, endoscopic treatment, and AUGIB of variceal etiologies benefited from prophylactic antibiotics.CONCLUSION: AUGIB patients may benefit from prophylactic antibiotics to decrease mortality, especially those aged ≥ 65 years and those with endotracheal intubation, endoscopic treatment, and variceal etiologies.

Photocatalytic removal of heavy metal ions and antibiotics in agricultural wastewater:A review

In recent years,the treatment of agricultural wastewater has been an important aspect of environmental protection.The purpose of photocatalytic technology is to degrade pollutants by utilizing solar light energy to stimulate the migration of photocarriers to the surface of photocatalysts and occur reduction-oxidation reaction with pollutants in agricultural wastewater.Photocatalytic technology has the characteristics of high efficiency,sustainability,low-energy and free secondary pollution.It is an environmental and economical method to recover water quality that only needs sunlight.In this paper,the mechanism and research progress of photocatalytic removal of heavy metal ions and antibiotics from agricultural water pollution were reviewed by combining photocatalytic degradation process with agricultural treatment technology.The mechanism of influencing factors of photocatalytic degradation efficiency was discussed in detail and corresponding strategies were proposed,which has certain reference value for the development of photocatalytic degradation.

Hypericin enhances β-lactam antibiotics activity by inhibiting sarA expression in methicillinresistant Staphylococcus aureus

Bacteremia is a life-threating syndrome often caused by methicillin-resistant Staphylococcus aureus(MRSA).Thus,there is an urgent need to develop novel approaches to successfully treat this infection.Staphylococcal accessory regulator A(SarA),a global virulence regulator,plays a critical role in pathogenesis andβ-lactam antibiotic resistance in Staphylococcus aureus.Hypericin is believed to act as an antibiotic,antidepressant,antiviral and non-specific kinase inhibitor.In the current study,we investigated the impact of hypericin onβ-lactam antibiotics susceptibility and mechanism(s)of its activity.We demonstrated that hypericin significantly decreased the minimum inhibitory concentrations ofβ-lactam antibiotics(e.g.,oxacillin,cefazolin and nafcillin),biofilm formation and fibronectin binding in MRSA strain JE2.In addition,hypericin significantly reduced sarA expression,and subsequently decreased mecAy and virulence-related regulators(e.g.,agr RNAIII)and genes(e.g.,fnbA and hla)expression in the studied MRSA strain.Importantly,the in vitro synergistic effect of hypericin withβ-lactam antibiotic(e.g.,oxacillin)translated into in vivo therapeutic outcome in a murine MRSA bacteremia model.These findings suggest that hypericin plays an important role in abrogation ofβ-lactam resistance againstMRSA through sarA inhibition,and may allow us to repurpose the use ofβ-lactam antibiotics,which are normally ineffective in the treatment of MRSA infections(e.g.,oxacillin).

In vitro and in vivo activity of D-serine in combination with β-lactam antibiotics against methicillin-resistant Staphylococcus aureus

As D-amino acids play important roles in the physiological metabolism of bacteria,combination of D-amino acids with antibiotics may provide synergistic antibacterial activity. The aim of the study was to evaluate in vitro and in vivo activity of D-serine alone and in combination withβ-lactams against methicillin-resistant Staphylococcus aureus(MRSA) strains, and to explore the possible sensitization mechanisms. The activity of D-serine, β-lactams alone and in combinations was evaluated both in vitro by standard MICs, time–kill curves and checkerboard assays, and in vivo by murine systemic infection model as well as neutropenic thigh infection model. An in vitro synergistic effect was demonstrated with the combination of D-serine and β-lactams against MRSA standard and clinical strains.Importantly, the combinations enhanced the therapeutic efficacy in the animal models as compared toβ-lactam alone groups. Initial mechanism study suggested possible revision of D-alanine-D-alanine residue to D-alanine-D-serine in peptidoglycan by adding of D-alanine in the medium, which may cause decreased affinity to PBPs during transpeptidation. In conclusion, D-serine had synergistic activity in combination with β-lactams against MRSA strains both in vitro and in vivo. Considering the relatively good safety of D-serine alone or in combination with β-lactams, D-serine is worth following up as new anti-MRSA infection strategies.

The Mechanism of Resistance of Pseudomonas Aeruginosa toβ-lactam Antibiotics and Clinical Significance

To study the resistant mechanism and clinical significance of pseudomonas aeruginosa toβ- lactam antibiotics,the outer mem brane permeability rate of30 P.aeruginosa strains to5 β- lactam antibiotics was m easured and their production ofβ- lactamase and theβ- lactam ase genes they carried detected. Furthermore,the relationship between the perm eability,β- lactam ase and the clinical effects ofβ- lactam antibiotics was observed. By using 1 4C- penicillin and liquid- scintillant isotope assay,the affinity of penicillin binding proteins(PBPs) was m easured and their roles in the resistant m echanism studied.Itwas revealed thatthe perm eability rate was higher in sensitive strains than in resistantones(P<0 .0 5 ) .All strains harbored1- 4 β- lactamase genes and produced β- lactam ase.Higher permeability rate and higher degree of stability toβ- lactamase indicated better clinical therapeutic effects. The affinity of PBPs changed little without regard to the perm eability andβ- lactam ase. These results suggested that the permeability of outer mem brane andβ- lacta- mase,but not PBPs,played im portant roles in the resistant mechanism of P. aeruginosa toβ- lac- tam antibiotics and affected the clinical therapeutic effectiveness of som e patients.

Microbial Contents and Antibiotics Susceptibilities from Hand Washing Stations during COVID-19 Pandemic in Lagos, Nigeria

The COVID-19 pandemic put every government in the globe on red alert;safety protocol and long-standing infection prevention and control (IPC) measures such as hand and oral hygiene, social/ physical distancing, use of face mask were rigorously enforced. This study evaluated microbial (bacterial, fungal) contents of rinsate, bowl water, water from tap, and the neighborhood drainage in selected hand washing stations in Agege, Alimosho, Mainland, Island and Shomolu local government areas (LGAs) in Lagos, Nigeria. The identities of bacterial isolates were confirmed with 16S rRNA sequencing while the fungi were identified by colonial appearances. The antibiotics susceptibility testing (AST) of the bacteria against structurally unrelated antibiotics was performed and interpreted according to standard guidelines. Sixty-seven (67) bacterial and fifty-one (51) fungal isolates were recovered from mainly water bucket with tap and rinsates across all the LGAs. There were marked microbial loads (some too numerous to count at 10-3 dilution) across Alimosho, Lagos Island and Mainland. Forty (40) representative bacterial isolates were selected for 16S rRNA sequencing. The occurrence of microbial isolates in the samples was at varying degrees;Klebsiella spp. (37.5%), Bacillus spp. (32.5%), Enterobacter spp. (17.5%), were the predominant bacteria while Aspergillus spp. (46.2%), yeasts (34.6%), Sporothrix schenckii (11.5%) and Penicillium spp. (7.7%) constituted the fungal isolates. The biological weapon, B. anthracis was recovered from a water bucket with tap in Alimosho. The antibiotics susceptibility testing of the bacteria showed high degrees of resistance profile;45 (69.2%) to ampicillin, 41.5% amoxicillin/clavulanate while 47.6% were resistant to two (2) or more antibiotics. This study demonstrated high microbial load during the pandemic at the study LGAs, presence of environmental commensals reputed for debilitating opportunistic infections in man and risk of passing heavy load of these potential pathogens to the public.

Essential Oils as an Alternative to Antibiotics to Reduce the Incidence and Severity of Necrotic Enteritis in Broiler Chickens: A Short Review

Due to the removal of antibiotic growth promoters (AGPs) and consumer pressure for antibiotic-free (ABF) or no antibiotics ever (NAE) poultry production, there is a need for sustainable alternatives to prevent disease in commercial poultry operations. Without AGPs, there has been a rise in diseases that were traditionally controlled by subtherapeutic levels of antibiotics in the diet. This has impacted the health of commercial poultry and has been a significant cost to poultry producers. To mitigate this, the industry has started to investigate alternatives to antibiotics to treat these forthcoming health issues, such as necrotic enteritis (NE). NE is an enteric disease caused by an over proliferation of toxigenic Clostridium perfringens (CP) in the gastrointestinal tract. Although CP is a commensal in the avian intestinal tract, dysbiosis caused by inflammation and impaired intestinal integrity facilitates uncontrolled replication of CP. Infectious agents, such as Eimeria maxima, appear to be a predominant predisposing factor that promotes NE. However, non-infectious stressors, including dietary changes, have also been associated with NE to some degree. As a result of increased pressure to restrict the use of antibiotics, there is a need for research evaluating the efficacy of alternatives, such as plant-derived essential oils, as potential tools to mitigate NE in commercial poultry flocks. The aim of this study is to review the effects of essential oils as an alternative to antibiotics to reduce the incidence and severity of necrotic enteritis in broiler chickens.

The Impact of Behavioural Insights on Effective Prescription of Antibiotics by Doctors: A Case Study from Latifa Hospital for Women and Children, Dubai Health Authority

Introduction: Wise prescription of antibiotics is an ethical duty of physicians in view of rising antimicrobial resistance in the community, it should be balanced between the health requirements of the patients and resulting long-term antibiotics resistance. Overuse of antimicrobials is a major cause of emerging resistance to antimicrobials. There are multiple factors in the community that influence the physician’s antibiotic prescriptions. Methods: This is a systematic case-control study on antibiotics prescription for paediatric patients attending Latifa Hospital for Women and Children (LWCH), Dubai Health Authority, to know the effects of behavioral interventions on rates of inappropriate antimicrobials prescription by doctors in the Paediatric Emergency Department. Results: The results of our study showed the effectiveness of behavioral insights by peer comparison in antibiotic use among paediatricians in Latifa Hospital had a statistical significance (P = 0.0038). The rate of the prescription decreased from 41% to 21%, a difference of 20%. Conclusion: The study concluded behavioural intervention is an effective measure in reducing the improper prescription of antibiotics in the hospital setting.