How Necessary Is Empirical Antibiotic Therapy in COVID-19 Patients before ICU infections develop? An Observational Study

Introduction: There have been few studies reporting empirical antibiotic use in Covid-19 patients, particularly in those admitted to the intensive care unit (ICU). This study evaluated empirical antibiotic use in patients admitted to the ICU with Covid-19 Methods: This two-center retrospective study included 79 consecutive patients who were admitted to the ICU due to Covid-19 infection between October 1 and December 31, 2020, and received empirical antibiotics. The patients were classified into two groups: those who developed ICU infections after 48 hours of ICU admission despite empirical antibiotic therapy (Group 1), and those who received empirical antibiotic therapy during the ICU stay, but were free of ICU infections (Group 2). Results: In Group 1, 37 patients (46.8%) developed ICU infections after a median of 12 days (IQR 5.5-15.5) of ICU stay. The cumulative antibiotic use until the detection ICU infections was 395 antibiotic days corresponding to 1070 DOTs/1000 hospital days. The median antibiotic use was 9 days (IQR 4-15.5). In Group 2, 42 patients (53.2%) received empirical antibiotic therapy for a median of 5 ICU days (IQR 3-8.3) and for a total of 256 antibiotic days (1051 DOTs/1000 hospital days). Twenty–three patients received empirical antibiotic therapy during the entire ICU stay. The median ICU stay was 6.5 days (IQR 4-10) and the median antibiotic use was 5 days (IQR 3-8.2). Discussion and Conclusion: Our findings are alarming and raise doubt about the potential role of antibiotics in the initial therapy of Covid-19 patients at the time of ICU admission and suggest the need to narrow or tailor antibiotic use based on clear laboratory and radiologic indications

Learning and reasoning styles of pre service teachers': inductive or deductive reasoning on science and mathematics related to their learning style

The purpose of this study is to determine the relationship between reasoning styles and learning styles of pre service teachers. In this research, science and mathematics reasoning were examined in order to propose suggestions to reduce gaps between mathematics and science education curriculums. The data was collected through two open ended-reasoning questions and "Learning Styles Inventory" developed by Kolb (1984). Participants were pre-service teachers who are training on science, mathematics and primary school in two different faculty of education (Uludag University in Bursa and Istanbul University). (C) 2009 Elsevier Ltd. All rights reserve

Evaluation of Risk Factors in Nosocomial Vancomycin-Resistant Enterococci Colonization and Infection

Introduction: Vancomycin-resistant enterococci (VRE) have recently been observed as an increasingly responsible agent among nosocomial infections. In our study, we aimed to investigate the possible risk factors for VRE colonization and infection. Materials and Methods: This study was conducted prospectively in the hematology, oncology and bone marrow transplantation departments between September 2004 and April 2005. Rectal swab culture was obtained on admission day and once a week from patients who had been hospitalized in these departments. A follow-up form was completed for each patient. Stata version 8.0 was used for statistical analysis. Results: A total of 462 rectal swab samples were obtained in the seven-month period. VRE was isolated in 13 patients. All these patients were from the hematology department. Female gender, long duration of hospitalization, prolonged neutropenia, total parenteral nutrition, sucralfate usage, central venous catheterization, and duration of antibiotic usage (third- and fourth- generation cephalosporins, metronidazole, amikacin, glycopeptides, macrolides, carbapenems, quinolones) were found as risk factors with univariate analysis. In multivariate analysis, long duration of hospitalization was found as an independent risk factor. Conclusion: Establishing the risk factors for colonization and infection with VRE can contribute to the implementation of effective infection control measures