Parents’ expectation of antibiotic prescriptions for respiratory infections in children: a systematic review and meta-analysis

Objectives: Despite most childhood infections being self-limiting, children are among the leading consumers of antibiotics. Little is known about parental expectations of antibiotics for childhood infections. A comprehensive systematic review and meta-analysis was conducted to explore the nature and extent of parental expectations of antibiotic prescriptions for children with respiratory infections. Design: Systematic review and meta-analysis. Methods: An extensive literature search using six major scientific databases was conducted for all published articles until 7 December 2022. Primary studies reporting parents’ expectations of antibiotics for children with upper respiratory tract infections were included after assessment for quality. Heterogeneity between the studies was assessed using the I 2 statistic and publication bias was analyzed using funnel plots and Egger regression tests. The primary outcome was a summary estimate of the percentage of parents who expect antibiotics from their physicians when their child presents with an upper respiratory tract infection. Results: From a total of 4510 studies found in the initial searches, a final pool of 19 eligible studies with 15,664 individuals was included in this meta-analysis. Nine of the 19 studies were from the United States or Saudi Arabia. The pooled prevalence of parental expectations of antibiotics in the population reviewed was 55.78% (95% CI = 44.60–66.41). There was significant heterogeneity between the studies, but funnel plot and meta-regression did not detect any publication bias. Conclusion: More than half of parents expect antibiotics for their children during consultation for upper respiratory tract infections. Such practices may cause undue side effects among children, contribute to the growing burden of antibiotic resistance, and lead to treatment failure for many common infections in the future. To optimize efforts to tackle antimicrobial resistance, shared decision-making and education emphasizing the proper and judicious use of antibiotics are much needed in pediatric healthcare settings. This can also help to manage parents’ expectations when seeking antibiotics for their children. Despite pressure from parents, pediatric healthcare providers should continue to advocate for antibiotic use only when warranted and help improve knowledge and awareness amongst parents. Registration: The protocol has been registered with PROSPERO (CRD42022364198

AIDS-related Cryptococcus neoformans choroiditis

We describe a case of Cryptococcal choroiditis in a person with advanced HIV/AIDS. A 29-year-old male with AIDS presented with fever, photophobia, and ataxia secondary to cryptococcal and toxoplasma meningoencephalitis. Dilated fundoscopic examination revealed bilateral and multifocal posterior infiltrates consistent with cryptococcal choroiditis. Treatment with parenteral and intravitreal liposomal amphotericin B, oral flucytosine, and oral trimethoprim-sulfamethoxazole led to resolution of his symptoms and improvement in his vision. Our case documents a rare, intraocular opportunistic infection and highlights the importance of ophthalmologic examination in immunocompromised hosts with visual symptoms and invasive fungal infection. We discuss diagnostic and treatment considerations in cryptococcal choroiditis

Yellow fever reemergence in Venezuela – Implications for international travelers and Latin American countries during the COVID-19 pandemic

Fundación Universitaria Autónoma de las Américas. Faculty of Medicine. Grupo de Investigacíon Biomedicina. Pereira, Risaralda, Colombia / Colombian Association of Infectious Diseases. Committe on Tropical Medicine, Zoonoses and Travel Medicine. Bogota, Colombia / Fundación Universitaria Autónoma de las Américas. Grupo de Investigacíon GISCA. Semillero de Zoonosis. Sede Pereira, Pereira, Risaralda, Colombia / Instituto para la Investigación en Ciencias Biomédicas. Emerging Infectious Diseases and Tropical Medicine Research Group. Pereira, Risaralda, Colombia / Pan-American Association of Infectious Diseases. Committe on Travel Medicine. Panama City, Panama / Universidad Cientifica del Sur. Master of Clinical Epidemiology and Biostatistics. Lima, Peru / Institución Universitaria Visión de las Américas. Faculty of Medicine. Grupo de Investigacón Biomedicina. Pereira, Risaralda, Colombia / Institución Universitaria Visión de las Américas. Grupo de Investigación GISCA. Semillero de Zoonosis. Sede Pereira, Pereira, Risaralda, Colombia.Colombian Association of Infectious Diseases. Committe on Tropical Medicine, Zoonoses and Travel Medicine. Bogota, Colombia / Fundación Universitaria Autónoma de las Américas. Grupo de Investigacíon GISCA. Semillero de Zoonosis. Sede Pereira, Pereira, Risaralda, Colombia / Instituto para la Investigación en Ciencias Biomédicas. Emerging Infectious Diseases and Tropical Medicine Research Group. Pereira, Risaralda, Colombia / Institución Universitaria Visión de las Américas. Grupo de Investigación GISCA. Semillero de Zoonosis. Sede Pereira, Pereira, Risaralda, Colombia.Pan-American Association of Infectious Diseases. Committe on Travel Medicine. Panama City, Panama / Instituto Conmemorativo Gorgas de Estudios de la Salud. Clinical Research Deparment. Investigador SNI Senacyt Panama. Panama City, Panama.Pan-American Association of Infectious Diseases. Committe on Travel Medicine. Panama City, Panama / University of Colorado Anschutz Medical Center. Department of Medicine. Division of Infectious Diseases. Aurora, CO, USA / Hospital Infantil de México. Federico Góomez, Méexico City, Mexico.Biomedical Research and Therapeutic Vaccines Institute. Ciudad Bolivar, Venezuela.Colombian Association of Infectious Diseases. Committe on Tropical Medicine, Zoonoses and Travel Medicine. Bogota, Colombia / Universidad de Cordoba. Instituto de Investigaciones Biológicas del Trópico. Colombia.Colombian Association of Infectious Diseases. Committe on Tropical Medicine, Zoonoses and Travel Medicine. Bogota, Colombia / Pan-American Association of Infectious Diseases. Committe on Travel Medicine. Panama City, Panama / Hospital Universitario de Sincelejo. Infectious Diseases and Infection Control Research Group. Sincelejo, Sucre, Colombia / Universidad del Atlático. SUE Caribe. Programa del Doctorado de Medicina Tropical. Barranquilla, Colombia.Colombian Association of Infectious Diseases. Committe on Tropical Medicine, Zoonoses and Travel Medicine. Bogota, Colombia / Universidad Cooperativa de Colombia. Grupo de Investigación en Ciencias Animales. Bucaramanga, Colombia.Fundación Universitaria Autónoma de las Américas. Faculty of Medicine. Grupo de Investigacíon Biomedicina. Pereira, Risaralda, Colombia / Colombian Association of Infectious Diseases. Committe on Tropical Medicine, Zoonoses and Travel Medicine. Bogota, Colombia / Instituto para la Investigación en Ciencias Biomédicas. Emerging Infectious Diseases and Tropical Medicine Research Group. Pereira, Risaralda, Colombia / Pan-American Association of Infectious Diseases. Committe on Travel Medicine. Panama City, Panama / Fundación Universitaria Autónoma de las Américas. Faculty of Medicine. Semillero de Investigación en Infecciones Emergentes y Medicina Tropical. Pereira, Risaralda, Colombia / Institución Universitaria Visión de las Américas. Faculty of Medicine. Grupo de Investigacón Biomedicina. Pereira, Risaralda, Colombia.Instituto Médico La Floresta. Caracas, Venezuela.Universidad del Norte and Hospital Universidad del Norte. Department of Medicine, Health Sciences Division. Barranquilla, Colombia.Pan-American Association of Infectious Diseases. Committe on Travel Medicine. Panama City, Panama / Universidad Central de Venezuela. Faculty of Medicine. Caracas, Venezuela.Institute of Infectious Diseases Emilio Ribas, São Paulo, SP, Brazil.Universidad Estatal del Sur de Manabí. Carrera de Laboratorio Clínico. Cantón Jipijapa, Ecuador.Universidad Católica del Maule. Vicerrectoría de Investigación y Postgrado. Chile.Universidad Central de Venezuela. Faculty of Medicine. Hospital Universitario de Caracas. Department of Internal Medicine. Cardiology Division. Caracas, Venezuela.Hospital José María Vargas. La Guaira, Vargas, Venezuela.Universidad Castilla La Mancha. Facultad de Medicina. Complejo Hospitalario Universitario de Albacete. Servicio de Anatomía Patológica. Albacete, Spain.International Airport Camilo Daza. Health Care Service. Cúcuta, Norte de Santander, Colombia.Universidade de São Paulo. Faculdade de Saúde Pública. Departamento de Epidemiologia. São Paulo, SP, Brazil.Universidad Técnica de Ambato. Ambato, Ecuador.Hospital Transfrontalier Cerdayna. Catalonia, Spain.University of Illinois. Department of Internal Medicine. Division of Infectious Diseases. Chicago, IL, USA.Hospital Evangélico de Montevideo. Montevideo, Uruguay.Universidad Cooperativa de Colombia. Grupo de Investigación en Ciencias Animales. Bucaramanga, Colombia.Instituto Nacional de Salud del Niño San Borja. Infectious Diseases Division. Lima, Peru / Universidad Privada de Tacna. Facultad de Ciencias de la Salud. Tacna, Peru.Hospital Universitario Departamental de Nariño. Pasto, Nariño, Colombia.Universidad de Manizales. School of Medicine. Coordination of Microbiology. Manizales, Caldas, Colombia / Grupo de Resistencia Antibiótica de Manizales. Manizales, Caldas, Colombia.Clínica San Josée. Cúcuta, Norte de Santander, Colombia / Hospital Universitario Erasmo Meoz. Cúcuta, Norte de Santander, Colombia.Hospital de Niños J. M. de Los Ríos. Division of Infectious Diseases. Caracas, Venezuela / Venezuelan Society of Infectious Diseases. Executive Board. Caracas, Venezuela.University of Colorado Anschutz Medical Center. Department of Medicine. Division of Infectious Diseases. Aurora, CO, USA.Universidad Industrial de Santander. Department of Internal Medicine. Bucaramanga, Santander, Colombia.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil / aq Universidade Federal do Para. Faculdade de Medicina. Belém, PA, Brasil.Hospital de Infecciosas F. Muñíz. Buenos Aires, Argentina.GSK Vaccines. Clinical Research & Development and Medical Affairs. Rio de Janeiro, RJ, Brazil.Hospital de Trauma y Emergencias Federico Abete. Buenos Aires, Argentina.Hospital Británico de Buenos Aires. Buenos Aires, Argentina.Pontificia Universidad Católica de Chile. School of Medicine. Department of Pediatric Infectious Diseases and Immunology. Santiago de Chile, Chile.Hospital de Infecciosas F. Muñíz. Buenos Aires, Argentina.Hospital de Infecciosas F. Muñíz. Buenos Aires, Argentina / Universidad de Buenos Aires. Buenos Aires, Argentina.Latin American Society for Travel Medicine. Panel of Sports and Travel. Buenos Aires, Argentina.Universidad Internacional SEK. Health Sciences Faculty. Research Group of Emerging Diseases, Ecoepidemiology and Biodiversity. Quito, Ecuador / Universidad Central de Venezuela. Facultad de Ciencias. Instituto de Zoología y Ecología Tropical. Caracas, Venezuela.Pan-American Association of Infectious Diseases. Committe on Travel Medicine. Panama City, Panama / Instituto de Investigaciones Biomédicas. Clínica IDB Cabudare. Department of Infectious Diseases and Tropical Medicine. Lara, Venezuela / Venezuelan Science Incubator and the Zoonosis and Emerging Pathogens Regional Collaborative Network. Infectious Diseases Research Branch. Lara, Venezuela / Instituto de Estudios Avanzados. Laboratorio de Señalización Celular y Bioquímica de Parásitos. Caracas, Caracas, Venezuela / Academia Nacional de Medicina. Caracas, Venezuela / The Mount Sinai Hospital-Icahn School of Medicine at Mount Sinai. Department of Pathology, Molecular and Cellbased Medicine. Direction of Microbiology. New York, USA

Overall survival in the OlympiA phase III trial of adjuvant olaparib in patients with germline pathogenic variants in BRCA1/2 and high-risk, early breast cancer

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