Incredible Thriving Power Of Bafilomycin A1

In our hospital, more than 1300 ICTs are performed each year. Taking duplicate and unnecessary ICTs into account (8% and 57%, respectively), we estimated a surplus cost of��22?000 per year. The ICT allowed the aetiological diagnosis in an additional 17% of the patients who had pneumonia with no S.?pneumoniae-positive cultures. This number is comparable to that obtained in other studies [14,16]. There are differences in the adherence to guidelines as reported in published studies [17�C19]. In the pneumonia group of this study, although a positive ICT result led to a greater proportion of patients being treated with amoxycillin (45% vs. 7%, p?Selleckchem PF-06463922 fairly poor adherence to the national guidelines for the management of pneumonia, which advocate the use of amoxycillin in pneumococcal pneumonia [2,3]. Overall, the impact of an ICT on changing the antibiotic regimen appeared to be low in this study (Table?3), because a positive ICT result did not lead to the use of a narrow-spectrum antibiotic such as amoxycillin. Other reports have found that blood culture results have a limited impact on changing the antibiotic regimen in cases of pneumonia, even when FMO5 they are positive [20,21]. These findings raise the question of the usefulness of microbiological examinations in non-severe pneumonia [2], as there is limited impact on the adaptation of therapy. This can be explained by the reluctance of physicians to prescribe narrow-spectrum antibiotics and to change a ��winning team�� [22]. However, this habit could lead to the alteration of the human bacterial flora and the selection of resistant microorganisms. This study has several limitations. First, it was conducted in one single centre, and Bafilomycin A1 order generalization could therefore be problematic, as prescription habits could be different elsewhere. Second, during the study, we established direct contact with the physicians in charge of the patients soon after receipt of the ICT result. Therefore, even in the absence of any therapeutic advice, an influence on antibiotic prescription practices was possible, and the effect of the ICT in clinical practice could actually be much lower. Another potential limitation was that the majority of the patients were from the emergency department, and diagnosing pneumonia could be a way of justifying hospitalization or antibiotic use. However, we did not find any difference in the percentages of pneumonia patients between the emergency department (118 of 308, 38%) and overall (77 of 203, 38%). Finally, we did not evaluate the clinical impact of any antibiotic regimen modification in terms of mortality, morbidity or length of hospital stay. Therefore, no conclusions can be drawn concerning the safety of the adaptation of the antibiotic regimen and the true clinical implications of a positive ICT result.