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  • PREVALENCE  (2)
  • ACID SUPPRESSION  (1)
Keywords
  • 1
    Keywords: AGENTS ; Germany ; EPIDEMIOLOGY ; SAMPLES ; PATIENT ; culture ; PATTERNS ; HUMANS ; resistance ; PREVALENCE ; ADULT ; methods ; drug therapy ; pharmacology ; FECES ; female ; Male ; ANTIBIOTICS ; RESISTANT ; E ; microbiology ; Aged ; Middle Aged ; isolation & purification ; Ampicillin ; Anti-Bacterial Agents ; Ciprofloxacin ; Doxycycline ; drug effects ; Drug Resistance,Multiple,Bacterial ; Enterococcus faecalis ; Enterococcus faecium ; Gram-Positive Bacterial Infections ; growth & development ; Microbial Sensitivity Tests
    Abstract: PURPOSE: The aim of the study was to assess the prevalence and determinants of antibiotic-resistant Enterococci in a large group of outpatients in Southern Germany. METHODS: Stool samples were collected from 497 unselected patients aged 40-75 years attending general practitioners. Enterococcus faecium (E. faecium) and Enterococcus faecalis (E. faecalis) were cultured and minimal inhibitory concentrations of antibiotics used inside and outside the clinical sector were tested. RESULTS: E. faecium and E. faecalis could be identified and cultured in 60 (12.4%) and 205 (41.2%) of the stool samples, respectively. Under non-selective culture conditions no vancomycin-resistant Enterococcus (VRE) isolate was found. Only E. faecium isolates showed resistance to fluoroquinolones, 40% were resistant to ciprofloxacin. The prevalences of E. faecium resistance to ampicillin and doxycycline were 3.3% and 13.3%, respectively, whereas 0.5% and 29.6% of the E. faecalis isolates were resistant to ampicillin and doxycycline, respectively. Antibiotic use during the last 3 months was significantly associated with antibiotic resistance (to either ampicillin, imipenem, or doxycycline) of E. faecalis isolates (OR: 2.9; CI: 1.2-6.8). CONCLUSIONS: Prevalences of resistance were generally lower than and patterns of resistance were quite different from previous investigations in the clinical setting. Recent antibiotic use was associated with increased colonization with resistant strains
    Type of Publication: Journal article published
    PubMed ID: 16287198
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  • 2
    Keywords: THERAPY ; PHARMACOKINETICS ; GASTROESOPHAGEAL-REFLUX DISEASE ; ACID SUPPRESSION
    Abstract: Purpose We investigated the association between conditions of proton pump inhibitor (PPI) treatment failure and food intake in an elderly ambulatory population. Methods Our data originate from a large population-based cohort study. During a home visit done by a trained study physician, patients were asked for each medication to state whether it was taken in relation to a meal (before, concurrently with, and after) or independent of a meal. This information was analyzed for all patients taking a PPI daily and correlated to markers of PPI failure. Results Out of 2717 patients participating in a home visit and taking at least one medication, 383 took a PPI daily (14.1%). A PPI intake independent of meals was defined as incorrect and was observed in 64 patients, whereas 319 patients took their PPI in relation to a meal, which was defined as the correct intake. Treatment failure was observed in 10 out of 64 (15.6%) PPI users with incorrect intake and in 18 out of 319 (5.6%) PPI users with correct intake. The risk of treatment failure was threefold higher in patients taking their PPI independent of meals (OR 3.35; 95% CI 1.44-7.76). Conclusion The higher risk for PPI failure in patients taking PPIs independent of meals suggests that synchronized PPI administration with meals is indeed essential, and better counseling of patients is needed.
    Type of Publication: Journal article published
    PubMed ID: 24723311
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  • 3
    Keywords: BLOOD ; Germany ; COHORT ; DISEASE ; DISEASES ; EPIDEMIOLOGY ; RISK ; SAMPLE ; DRUG ; HEART ; PATIENT ; primary ; RISK-FACTORS ; ASSOCIATION ; NO ; prevention ; lifestyle ; DESIGN ; AGE ; risk factors ; smoking ; lipids ; BLOOD-PRESSURE ; HYPERTENSION ; PREVALENCE ; MANAGEMENT ; GUIDELINES ; CARDIOVASCULAR RISK-FACTORS ; MELLITUS ; ADULT ; ADULTS ; REGRESSION ; POPULATION-BASED COHORT ; RE ; DETERMINANTS ; PHYSICAL-ACTIVITY ; CORONARY-HEART-DISEASE ; LEVEL ; elderly ; pharmacology ; RECOMMENDATIONS ; RISK-FACTOR ; population-based ; ENGLAND ; Diabetes Mellitus ; cardiovascular ; heart disease ; ANTIHYPERTENSIVE MEDICATION ; CARE CLINICS ; MICROVASCULAR COMPLICATIONS
    Abstract: Objective To evaluate the management of cardiovascular risk factors in a population-based cohort of adults with diabetes mellitus in Germany. Design and Measurements For the 9953 participants (50-74 years of age) of the ESTHER study, diabetes mellitus, hypertension, dyslipidemia and the respective medication were documented at baseline by their primary care physician. Blood pressure was taken and lipid levels were determined from a blood sample drawn at recruitment. Lifestyle factors (smoking, BMI, physical activity) were documented by the participants. Prevalence of pharmacotherapy for and control of hypertension and dyslipidemia among diabetic patients with these diagnoses were assessed and determinants were evaluated by multiple logistic regression. Results Diabetes mellitus was present in 1375 participants (14.2%). Almost 78% of diabetic participants had physician diagnosed hypertension, 86.0% received pharmacotherapy, but only 12.8% of those with anti-hypertensive medication achieved blood pressure levels below 130/85 mmHg. Obese participants were more likely to receive anti-hypertensive pharmacotherapy than non-obese ones: adjusted odds ratio (OR, 95% confidence interval (CI): 3.58 (1.86-6.87). Gender had no influence on anti-hypertensive pharmacotherapy. Older diabetic patients with hypertension were less likely to have sufficient blood pressure control than younger ones. Dyslipidemia was documented in 50% of diabetic patients. Diabetic participants with coronary heart disease or hypertension were more likely to receive lipid-lowering pharmacotherapy than those without these conditions (adjusted OR 1.85 (95%CI 1.19-2.89) and 2.59 (95%CI 1.41-4.74), respectively). Conclusions For most elderly with diabetes cardiovascular risk factor management continues to be not in line with recommendations. Copyright (C) 2008 John Wiley & Sons, Ltd
    Type of Publication: Journal article published
    PubMed ID: 18383562
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