Monday, January 1, 2018

WHO first-ever list of antibiotic-resistant “priority” pathogens

  • A new study by researchers at Harvard University of all 48 million Americans aged 65 and older on Medicare found people were dying after just a single day of breathing air that met federal standards, but was somewhat dirty. The study was published Tuesday in JAMA. Environmental Protection Agency sets safety standards and if pollution is below that standard, everyone is safe but the same is not correct. There is no safe level of exposure to either pollutant.
  • Decades of research, including a new study published December 26 in JAMA has failed to find substantial evidence that vitamins and supplements do any significant good.
  • Delhi LG gave a nod to three big health schemes of the Delhi government – treatment for road and fire accident and acid attack victims, outsourcing of high-end diagnostic tests and surgeries. He has given a nod to the amendment in the Delhi Arogya Kosh (DAK), which would help pay for the free diagnostic tests and surgeries. LG, however, asked the government to maintain an income ceiling for the people who would be allowed to avail the benefits of the scheme “so that the resources of the government are used to help the poor and the needy and the poor are not crowded out by the well-to-do”. With recent cases of medical negligence and malpractices in private hospitals, the LG also urged the government to have a mechanism to penalize institutions in case of malpractice or even poor quality of services.
  • Nabarangpur: A district consumer forum has ordered a doctor of the Christian Hospital here to pay a compensation of Rs 20 lakh for “deficiency of service and medical negligence”, which left a pregnant woman paralysed on the lower part of her body (paraplegia), seven years ago. Sabina, a Bachelor of Physiotherapy was administered anesthesia as many as seven times by Dr Nag on May 19, 2010 while performing cesarean delivery, even though the latter was not qualified as MD (Anesthetist) and did so after her repeated refusal.
  • In a shocking case from Argentina, doctors accidentally tore off an infant’s head during a delivery. The incident occurred as they were trying to deliver a premature baby when the child got stuck inside.
  • WHO published its first ever list of antibiotic-resistant "priority pathogens" – a catalogue of 12 families of bacteria that pose the greatest threat to human health. The WHO list is divided into three categories according to the urgency of need for new antibiotics: critical, high and medium priority. The most critical group of all includes multidrug resistant bacteria that pose a particular threat in hospitals, nursing homes, and among patients whose care requires devices such as ventilators and blood catheters. They include Acinetobacter, Pseudomonas and various Enterobacteriaceae (including Klebsiella, E. coli, Serratia, and Proteus). They can cause severe and often deadly infections such as bloodstream infections and pneumonia. These bacteria have become resistant to a large number of antibiotics, including carbapenems and third generation cephalosporins – the best available antibiotics for treating multi-drug resistant bacteria. The second and third tiers in the list – the high and medium priority categories – contain other increasingly drug-resistant bacteria that cause more common diseases such as gonorrhea and food poisoning caused by salmonella.
  • Drugs banned in 2017: Fixed dose combinations of nimesulide + levocetirizine; fixed dose combinations of ofloxacin + ornidazole injection; fixed dose combinations of gemifloxacin + ambroxol; fixed dose combinations of glucosamine + ibuprofen and fixed dose combinations of etodolac + paracetamol.
  • In a new essay publishing 28 December in the open access journal PLos Biology, Kristofer Wollein Waldetoft and Sam P. Brown of Georgia Institute of Technology propose that development of alternative therapies for mild infections could help slow the development and spread of antibiotic resistance, thereby preserving the drugs' effectiveness for use in severe infections.
  • Do not routinely administer prophylactic antibiotics in low-risk laparoscopic procedures: The use of prophylactic antibiotics in women undergoing gynecologic surgery is often inconsistent with published guidelines. Although the appropriate use of antibiotic prophylaxis for hysterectomy is high, antibiotics are increasingly being administered to women who are less likely to receive benefit. The potential results are significant resource use and facilitation of antimicrobial resistance.
  • Avoid the unaided removal of endometrial polyps without direct visualization when hysteroscopic guidance is available and can be safely performed: Endometrial polyps are a common gynecologic disease. Though conservative management may be appropriate in some patients, hysteroscopic polypectomy is the mainstay of treatment. Removal without the aid of direct visualization should be avoided due to its low sensitivity and negative predictive value of successful removal compared to hysteroscopy and guided biopsy.

Dr KK Aggarwal
Padma Shri Awardee
Vice President CMAAO
Group Editor-in-Chief IJCP Group
President Heart Care Foundation of India

Immediate Past National President IMA

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