The use of phages for treating bacterial pathogens has recently been advocated as an alternative to antibiotic therapy. Here, we test a hypothesis that bacteria treated with phages may show more limited evolution of antibiotic resistance as the fitness costs of resistance to phages may add to those of antibiotic resistance, further reducing the growth performance of antibiotic-resistant bacteri...

Remarkable shifts in antibiotic resistance have occurred in many important human pathogens over the last decade and a half. While some resistance types have declined in prevalence, others have accumulated sharply over the same timeframe. The implications for antibiotic therapy are significant and worrisome; infections due to multi-resistant strains are more difficult to treat and are not covere...

OBJECTIVES Complicated intra-abdominal infection (cIAI) is infection that extends beyond the hollow viscus of origin into the peritoneal space, and is associated with either abscess formation or peritonitis. There are few studies that have assessed the actual costs and outcomes associated with failure of initial antibiotic therapy for cIAI. The aims of this study were to evaluate risk factors a...

The worldwide epidemic of antibiotic resistance is in danger of ending the golden age of antibiotic therapy. Resistance impacts on all areas of medicine, and is making successful empirical therapy much more difficult to achieve. Antibiotic choices are often severely restricted, and the pipeline of new antibiotics is almost dry. Resistance cannot be prevented, but its development and spread can ...

The prospective clinical examination of 80 patients with the verified carcinoma of the colon and rectum was performed at the Clinic of General and Vascular Surgery of the M.M.A. in the period 1989-1990 with the aim to evaluate efficacy and justified use of antibiotic prophylaxis or prophylaxis and antibiotic therapy after elective surgical intervention. The preoperative mechanical preparation w...

Inappropriate initial antibiotic therapy in nosocomial pneumonia is associated with higher mortality, longer hospital stays and increased healthcare costs. The key pathogens associated with these adverse outcomes include Pseudomonas aeruginosa, methicillin-resistant Staphylococcus aureus and Acinetobacter baumannii. Due to the increasing rates of resistance, a new paradigm is needed for treatin...

As part of the Monoclonal Anti-TNF: A Randomized Controlled Sepsis (MONARCS) trial, which enrolled patients with suspected sepsis, we sought to determine whether adequate antibiotic therapy was associated with a decreased mortality rate. The study enrolled 2634 patients, 91% of whom received adequate antibiotic therapy. The mortality rate among patients given adequate antibiotic treatment was 3...

the empiric antibiotic therapy can result in antibiotic overuse, development of bacterial resistance and increasing costs in critically ill patients. the aim of the present study was to evaluate the effect of procalcitonin (pct) guide treatment on antibiotic use and clinical outcomes of patients admitted to intensive care unit (icu) with systemic inflammatory response syndrome (sirs).  a total ...

In patients with ventilator-associated pneumonia (VAP), guidelines recommend antibiotic therapy adjustment according to microbiology results after 72 h. Circulating procalcitonin levels may provide evidence that facilitates the reduction of antibiotic therapy. In a multicentre, randomised, controlled trial, 101 patients with VAP were assigned to an antibiotic discontinuation strategy according ...

INTRODUCTION The development of resistance by bacterial species is a compelling issue to reconsider indications and administration of antibiotic treatment. Adequate indications and duration of therapy are particularly important for the use of highly potent substances in the intensive care setting. Until recently, no laboratory marker has been available to differentiate bacterial infection from ...