Animal Bite Infections

Seventy to ninety three percent of animal bites are caused by dogs whereas 3-15 % by cats. The delay in wound management or puncture wounds increase the risk of infection. The infecting microorganism of bite wounds arise from the oral flora of the animal, skin flora of the victim and from the environment. Staphylococcus spp., streptococcus spp., anaerobes and Pasteurella multocida are the most frequently isolated bacteriae. Besides medical and surgical management of bite wounds, tetanus and rabies prophylaxis should be performed when needed

In vitro Activity of Trovafloxacin Against Various Microorganisms

In vitro activity of a new fluoroquinolone, trovafloxacin, was tested against 512 aerobic microorganisms by agar dilution method. Methicillin-susceptible Staphylococcus aureus (MSSA), Escherichia coli, Proteus, Salmonella and Shigella species were isolated from patients hospitalized in various clinics. Klebsiella spp., Pseudomonas aeruginosa and methicillin-resistant Staphylococcus aureus (MRSA) were mainly the isolates of intensive care units. Minimum inhibitory concentration 50 and 90 (MIC50/MIC90) values for methicillin-sensitive Staphylococcus aureus (MSSA) and methicillin-resistant Staphylococcus aureus (MRSA) were ≤ 0.03/0.06 µg/mL and 1/2 µg/mL, respectively. The same values for gram negative aerobic bacteria were as follows; Klebsiella spp. 0.12/4 µg/mL. P. aeruginosa 2/ ≥ 16 µg/mL, E. coli ≤ 0.03/0.25 µg/mL, Proteus spp. 0.12/0.25 µg/mL, Salmonella and Shigella spp. ≤ 0.03/ ≤ 0.03 µg/mL. Our results of the in vitro activity of trovafloxacin which will be used in our country in the near future are compared with those of other studies

The Antibiotic Usage Before and After a Nationwide Antibiotic Restriction Policy at a University Hospital

There is a growing concern on wisely use of antimicrobial agents. Some nationwide restrictions on antibiotic usage have been settled via a regulation released by Turkish government in February 2003. We conducted a study to assess the impact of this nationwide antibiotic restriction policy (NARP) at a university hospital. All hospitalized patients were visited on 18th February 2003 (before the regulation) and on 15th September 2003 (after the regulation). For each patient receiving antibiotic treatment, demographic data, diagnosis, results from microbiological specimens, details of antibiotic administration, indication for treatment or prophylaxis, dosage, dose frequency and administration route were recorded on individual forms. The appropriateness of antimicrobial treatments were assessed by two infectious disease specialists and infectious disease proffessors according to the local and international guidelines. On the first prevalence day and on the second prevalence day 20.8% of patients were receiving antimicrobial treatment. Before and after NARP, 36% and 29% of antimicrobial treatments were judged inappropriate, respectively (p= 0.131). There was not any difference between surgical and medical wards. The rate of antibiotic usage without any clinical indication was significantly decreased after NARP (p= 0.03). After NARP, 42% of the empirical treatments was begun after infectious disease consultation, while it was 14% (p< 0.001) before NARP. Fourty-four percent and 36% of antimicrobial regimens used for surgical prophylaxis was inappropriate before and after NARP, respectively (p= 0.39). The daily cost of inappropriate antibiotic usage was 2661 and 2187 dollars in February and September, respectively (p= 0.77). We conclude that, NARP has a good but unsatisfactory impact on antibiotic usage and cost. Other interventions should be implemented for an optimal outcome