Our findings (Table 4) also showed that some plants extracts investigated in this study (i.e. Dekker ARJ, Verheij TJM, van der Velden AW. This study suggests the need for regulatory guidelines on the use of antimicrobial herbs. Salmonella enterica serovar Typhimurium genetic variants isolated after lethal treatment with Thymbra capitata essential oil (TCO) showed increased resistance to TCO in milk. Acute gastroenteritis is followed by an increased risk of inflammatory bowel disease. Patients who were 0 and 1â4âyears old (1.7% and 5%, respectively) were less frequently treated with antibiotics than older (>4âyears) patients (between 8.1% and 11.4%, Pâ<â0.05) (Figure 2a).
Conceptualization, The authors also wish to thank Suliat A. Abdulsalam (Microbiology Department, Faculty of Science, University of Ilorin) for technical support and Chris Randall, University of Leeds, for his helpful comments on the manuscript. Gastroenteritis is an infection of the stomach and intestine that is usually caused by a virus. Furthermore, for each gastrointestinal pathogen species detected through DFT, we assessed the proportion of infections treated with antibiotics. Empirical treatment was more frequent compared with targeted treatment and was mostly with non-CPG-recommended antibiotics. Prescription rates differed significantly between months of the year (Pâ=â0.003) (Figure 2b). Multiple GP contacts for GE within a 60âday period were counted as one episode. Gastroenteritis is most often a self limiting disease, and most authorities are of the opinion that stool cultures should be restricted to patients who are severely dehydrated, toxic, or immunocompromised. We found that GPs prescribe antibiotic treatment in 1 in 11 patients who presented with a GE episode in primary care. Acute diarrhea with blood: diagnosis and drug treatment†. Pathogen-specific antibiotic treatment for GE and accordance with first- and second-choice CPG-recommended antibiotics. Gastroenteritis, also known as infectious diarrhea and gastro, is inflammation of the gastrointestinal tract—the stomach and intestine. Acute gastritis treatment options according to latest American College of Gastroenterology (ACG) guidelines are shown. Treatment can involve use of unregulated herbal medication and antibiotics. Routine DFT testing identified a total of 1437 potential GE-causative enteropathogens in 2429 GE episodes. Acute Gastroenteritis Therapy Based on Degree of Dehydration. As GPs did not regard post hoc antibiotic treatment necessary in these patients, it remains unclear what the actual indication for the diagnostic testing was. About half of antibiotic treatment for GE is prescribed on an empirical basis, without microbiological test results available. However, treatment based upon DFT results followed CPG recommendations. PLoS ONE 16(10): Kwara State is located within the North-central geopolitical zone of the Federal Republic of Nigeria. food handlers or healthcare professionals).4,16 DFT results were retrieved from Saltro Diagnostic Center, the main regional primary care laboratory, and linked to the JGPN cohort by a pseudonymization procedure performed by a âtrusted third partyâ in accordance with privacy regulations. Antibiotic therapy is not necessary for acute diarrhea in children, as rehydration is the key treatment and symptoms resolve generally without specific therapy. These figures obtained from primary healthcare facilities could be extrapolated to indicate high levels of antimicrobial use within the larger society, and in particular, the common usage of antibiotics. The evaluation of the child with acute gastroenteritis . Methodology, After DFT confirmation, GPs refrain from antibiotic treatment in most patients with bacterial infections, but they do treat the majority of patients with parasitic infections. others) for prescription among respondents (Fig 1F). It is clear that young children presenting with acute watery diarrhoea to healthcare centres in Abakaliki are likely to be prescribed antibiotics, despite there being no obvious reason that this treatment is appropriate. (b) Monthly (nâ=â24) antibiotic prescription for patients with GE cases (nâ=â13217). https://doi.org/10.1371/journal.pone.0257837.t004. We assessed the proportion of episodes treated with any antibiotic and for each antimicrobial agent. Found insidePediatric patients (n = 76) aged 5 months to 6 years treated with antibiotics (amoxycillin or co-amoxiclav) were ... of yogurt in the treatment of acute gastroenteritis in hospital settings had similar conclusions based on four studies. To determine the MIC of plant extracts, antibacterial assays were carried out within 96-well microtitre plates, using two-fold dilutions for each plant extract from 0.625mg/ml to 100 mg/ml. We calculated the incidence rate of GP consultation for GE in the population by dividing the total number of GE episodes by the person-years of observation. For both empirical and targeted treatment we assessed whether the prescribed antibiotic was in accordance with the recommendations described in the Dutch CPGs4,16 (Table S2). 19 From our findings, some herbs were mainly used as single course medications such as Agbo iba, âAgbo jedi-jediâ, Dutchmanâs pipe, Akintola leaf (Chromolaena odorata), Mango leaf (Mangifera indica), Drumstick tree leaves and Bitter leaf (Vernonia amygdalina). Searching for the etiology of gastroenteritis is not usually needed; however, it may be necessary if antimicrobial treatment is considered. Writing â original draft, There's not usually any specific treatment and your child should start feeling better in a few days. Competing interests: The authors have declared that no competing interests exist. Treatment. Gastroenteritis refers to inflammation of the gastrointestinal tract, meaning the stomach and the intestines. Project administration, We observed that of the users of antibiotics, metronidazole was more common across all courses of prescriptions (Table 2). No, Is the Subject Area "Leaves" applicable to this article? Plates were covered with Parafilm and incubated at 37°C with shaking at 140 rpm for 18 hours. We hereby reported an interesting case with the above adverse events after Pfizer-BioNTech COVID-19 vaccination and review the relevant literatures. These were sourced from local traditional herbalists and taxonomically identified (S1 Table and S1 Fig). The same holds for the assessment of CPG adherence to prescribe no, empirical or targeted antibiotic treatment. Gastroenteritis is a descriptive term to describe inflammation of the stomach or intestines that is manifested as nausea, vomiting or diarrhea and is considered acute in nature if the duration has been less than two weeks. It can be caused by infection with bacteria, viruses, or parasites, medications, or even new foods. New emerging diseases, new diagnostic modalities for resource-poor settings, new vaccine schedules ... all significant, recent developments in the fast-changing field of tropical medicine. This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (. (E) Source of herbal prescription for treatment of symptoms reported. INTRODUCTION. Although often considered a benign disease, acute gastroenteritis remains a major cause of morbidity and mortality in children around the world, accounting for 1.34 million deaths annually in children younger than 5 years, or roughly 15% of all child deaths. This may be due to abundance of active compounds, which is likely to vary between individual plants of the same species. Additional symptoms include thirst, lightheadedness, vomiting, and decreased urine output. No, Is the Subject Area "Herbs" applicable to this article? The management of prolonged diarrhea is complex and should take into consideration the age of the patient, clinical and epidemiological factors, and the nutritional status and should always include a search for enteric pathogens. Yes Metronidazole is most frequently prescribed, followed by azithromycin and ciprofloxacin. The following list of medications are in some way related to, or used in the treatment of this condition. In agreement with this, the antidiarrheal properties of A. indica [48], C. odorata [26], M. charantia [32] and A. ringens [49] have been reported elsewhere. The management and therapy of acute gastroenteritis is discussed in two epidemiological settings: community-acquired diarrhoea and travellers' diarrhoeal illness. However, among these antibacterial herbal extracts, Igi Odan, was reported by only one respondent. Writing â review & editing, Roles Among children in the United States, acute diarrhea accounts for >1.5 million outpatient visits, 200,000 hospitalizations, and approximately 300 deaths/year. Management guidelines for acute infective diarrhoea / gastroenteritis in infants. Metronidazole was most frequently prescribed (nâ=â646, 4.9% of all GE episodes), accounting for more than half of the antibiotic treatment courses for GE, followed by azithromycin (nâ=â254, 1.9% of all GE episodes), ciprofloxacin (nâ=â184, 1.4%), co-trimoxazole (nâ=â59, 0.4%) and clioquinol (nâ=â57, 0.4%) (Table 2). Diagnoses during these contacts are coded according to the International Classification of Primary Care (ICPC)12 and antibiotic prescriptions are registered according to the WHO guidelines for Anatomical Therapeutic Chemical (ATC) classification.13 GPs of participating practices are trained in correct use of ICPC coding and have on average 10âyears experience in systematic coding of disease episodes.14, We selected patients with at least one GE episode that presented to GPs participating in the JGPN between 2013 and 2014. You are currently offline. Searching for the etiology of gastroenteritis is not usually needed; however, it may be necessary if antimicrobial treatment is considered. In most cases of acute gastroenteritis, the infections resolve on their own. As a narrow spectrum nucleic acid inhibitor, Metronidazole is active against enteropathogenic bacteria and protozoans [40] with growing concerns about Metronidazole-resistant organisms [41, 42]. Conceptualization, However, few respondents reported the use of A. indica alone for the management of AGE. However, issues of toxicity continue to raise valid concerns owing to the handed-down tradition of self-prescription [10], erroneous use of incorrect plant species [11] and the lack of regulations on usage [12]. This volume covers a wide range of topics that support wellness in infants through the prevention and treatment of infectious diseases, malnutrition, and developmental and genetic abnormalities. E. Africana, F. capensis, M. indica, S. alata and V. amygdalina) inhibited bacterial growth at relatively low concentrations (<6.25 mg/ml), irrespective of bacterial species, while others did not. Leaf extracts of O. gratisimum as well as sheath extracts of S. bicolor showed non-inhibitory effects against two-third of the Gram-negative bacterial agents of AGE investigated. No, PLOS is a nonprofit 501(c)(3) corporation, #C2354500, based in San Francisco, California, US, Corrections, Expressions of Concern, and Retractions, https://doi.org/10.1371/journal.pone.0257837, https://doi.org/10.1007/978-1-4615-0059-9_26, https://kwarastate.gov.ng/discover-kwara/history-society/, http://www.academia.edu/31425727/Quantitative_and_Qualitative_Assessment_of_Seleceted_Herbal_Remedies_Marketed_in_Nigeria. More elaborate information on the study design and population can be found in the study design statement.15. For permissions, please email: journals.permissions@oup.com. Results: To treat uncontrolled diarrhea at home, antibiotic therapy was initiated in 36.7% of patients in the DH group without any valid prescription, whereas only 7.5% of patients in the EH group, DOI: 10.21276/sjams.2019.7.1.2 Abstract: Introduction: There are multiple etiologies responsible for infectious gastroenteritis causing acute diarrhea which are often under diagnosed. to first- and second-choice antibiotics is widespread and considered to be a substantial public health problem.7â11.
Internationally, AMR of Salmonella spp., Shigella spp. Data Availability: All relevant data are within the manuscript and its Supporting Information files. It is usually self-limited, but improper management of an acute infection can lead to a protracted course. The antibiotic choice for targeted treatment was in accordance with CPG recommendations in 99% (nâ=â529) of GE episodes with targeted antibiotics. Describes increased stool frequency, volume, and water content x 2 days. Travelers' diarrhea is self-limiting and generally resolves within 5 days; however, antibiotic treatment significantly reduces symptom severity and duration of illness. Prepares you for certification and recertification with more than 400 board review-style questions, answers, and rationales – 30% new to this edition. The principal treatment of gastroenteritis is . A written informed consent for voluntary participation in the study was obtained from each participant (or parents or guardians of underage participants) before enlistment in the study. A p-value of <0.05 was considered statistically significant. The parts of plants that were prescribed were harvested, washed, dried at 16°C for 4 days and transferred to 45°C for 1 day prior to pulverisation. The 2003 Red Book, 26th Edition advances the Red Book's mission for the 21st century, with the most current information on clinical manifestations, etiology, epidemiology, diagnosis, and treatment of more than 200 childhood infectious ... Acute diarrhea antibiotic treatment recommendations. here. The findings from this study emphasise the need for further research on traditional and herbal medication, including investigation of anti-viral effects on viral agents of gastroenteritis.
Citation: Adeyemi OO, Alabi AS, Adeyemi OA, Talabi OT, Abidakun OM, Joel IY, et al. Antibiotic therapy is not necessary for acute diarrhea in children, as rehydration is the key treatment and symptoms resolve generally without specific therapy. …hypercoagulable state and compression of the mesenteric veins by the enlarged uterus. Blastocystis and Dientamoeba were relatively often treated with antibiotics, in 52% (nâ=â234) and 60% (nâ=â292) of the positive patients, respectively. No, Is the Subject Area "Antibacterials" applicable to this article? https://doi.org/10.1371/journal.pone.0257837.s001. The database contains detailed information on all patient contacts (telephone and practice consultations and home visits) of the participating GPs during office hours. AST results suggest that almost all Campylobacter and Salmonella infections in patients with DFT are susceptible to the antibiotics currently recommended by CPGs. African Traditional worshippers) [21]. Conclusion. Neither patients nor emergency clinicians want unnecessary testing or antibiotics. The typical symptoms are nausea, vomiting, and diarrhea. It highlights a high level of antibiotic and herbal medicine use during the study period that are likely to have little benefit to patients with viral disease. Of the recruited respondents, 386 completed the survey. Found inside – Page 5265Chemotherapy 23 ( 1 ) : 315-23 , Jan 77 J Am Dent Assoc 94 ( 3 ) : 429 , Mar 77 and concentration of antibiotic in sputum . McCrae WM , Treatment of acute and subacute gonococcal urethritis with Antibiotic prophylaxis for endocarditis ... When should I contact my doctor? What symptoms signal an emergency? Mayo Clinic Book of Home Remedies clearly defines these questions with regard to your health concerns and guides you to choose the appropriate and most effective response. Leaf extracts of Neem tree (A. indica) constitute a vital component of the popular concoction, Agbo-iba, which is commonly used as a febrile prophylactic especially in the treatment of malaria [24], and recently reported to have antiviral effects on type-2 Dengue virus [51] and group B coxsackie viruses known to cause gastroenteritis [52].
Resources, Affiliation By definition the diagnosis of gastroenteritis should be supported by historical components of both vomiting and diarrhea. Discover a faster, simpler path to publishing in a high-quality journal. The recommendation of this guideline was developed regarding the f … (F) Age group distribution of traditional herbal medicine users. You can look after your child at home if they have diarrhoea and vomiting. We performed a retrospective cohort study using the routine primary care data from the Julius General Practitioner Network (JGPN), containing pseudonymized routine primary care data from 45 general practices (with 160 GPs and â¼290000 patients) in the academic primary care network of Utrecht, the Netherlands. Targeted treatment is, in nearly all cases, in agreement with CPG recommendations. Department of Microbiology, Faculty of Life Sciences, Ajayi Crowther University, Oyo, Nigeria, Roles Correcting water and electrolytes deficits that occur, because they are lost in the stools and vomitus, is best done with an oral rehydration solution. Ethanolic extracts of selected herbal plants reported (i.e. It can be argued that, if no clear indication for treatment exists, DFT has no direct clinical value and can be withheld in these patients. Number of isolates (for nââ¥â20) tested for antimicrobial resistance and proportion of resistant isolates for each bacterial species, Indicated in bold are the first- and second-choice antibiotics recommended by the Dutch CPGs for treatment of infectious GE.4,16, Resistance to erythromycin tends to correspond with cross-resistance to other macrolides, such as azithromycin.20. Previous studies, using castor oil-induced diarrhoea in Wistar rats, have reported antidiarrheal properties of a number of herbal extracts [26, 30, 32, 48â50]. Investigation, Yes Antimicrobial treatment should be considered in severely sick children, in those who have chronic conditions or…. others; 13.8%), healthcare workers (~1%), and undisclosed sources (i.e. School of Molecular and Cellular Biology and Astbury Centre for Structural Molecular Biology, Garstang Building, Faculty of Biological Sciences, University of Leeds, Leeds, United Kingdom, Roles Looking after a child with gastroenteritis. Nonetheless, there are certain conditions and circumstances that warrant more than just reassurance and advice to drink more fluids: Root extracts of A. ringens was not a popular herbal option among respondents (Table 3), however, locally used in the management of a wide range of unrelated conditions that cut across inflammatory and noninflammatory anomalies as well as infectious and non-infectious diseases [53]. As treatment of these parasites may not always be clinically beneficial22â25 and in many cases even ineffective,24,26,27 further research needs to evaluate the role of antibiotics in the treatment of these parasites and identify when antibiotic treatment of primary care patients with GE is appropriate. Treatment of patients with acute salmonella gastroenteritis with either chloramphenicol or ampicillin prolonged the period of postconvalescent excretion of salmonellae. Additionally, Roscoe was mainly used as the third of three herbal medication options (Table 3). Plates were incubated at 37°C with shaking at 140 rpm for 18 hours. Furthermore, it reveals inadequacies in the laboratory diagnosis and poor management of AGE in primary healthcare facilities. Our data further showed that Ocimum gratisimum, Sorghum bicolor and Terminalia avicennioides showed weak inhibitory properties across bacterial species tested. Here, a descriptive cross-sectional survey was carried out to investigate local practices in the management of AGE in Kwara state, Nigeria, which include the use of antibiotics and traditional herbal medications. Bacterial gastroenteritis is a digestive problem caused by bacteria. • Acute gastroenteritis is a common infectious disease syndrome, causing a combination of nausea, vomiting, diarrhea, and abdominal pain. Together, approximately 88% of respondents had no record of which antibiotics were prescribed by the health personnel, while 3% respondents did not know which antibiotics, they had self-prescribed (Table 2). In this study, two locally common fig tree species (i.e. In addition to extracts of O. gratisimum, âAgbo jedi-jediâ [24] also includes S. bicolour and the more potent antibacterial, V. amygdalina (discussed below); thus suggesting its potential effectiveness against bacterial gastroenteritis. The most common etiology is viral gastroenteritis, a self-limited disease. Found inside – Page 1858Table 187.3 Guide to a drug treatment in acute gastroenteritis Infants and children should not be treated with antidiarrheal agents Antidiarrheal Antibiotics Patients with invasive S. typhi, Shigella, amebiasis, Isospora, and giardiasis ... If an adult with gastroenteritis has a specific microbiological cause confirmed after stool culture and sensitivity testing: Seek advice from the local health protection team regarding the need for antibiotic treatment or stool testing for microbiological clearance, if there is any uncertainty:. acute gastroenteritis, hepatitis, pneumonitis, myocarditis and pericarditis) has not been reported previously.
Acute gastroenteritis is defined as diarrheal disease (three or more times per day or at least 200 g of stool per…. In total, 13217 episodes of GE were recorded in the database, resulting in an overall incidence rate of primary care consultations for GE of 26 per 1000 person-years (Figure 1). broad scope, and wide readership â a perfect fit for your research every time. Campylobacteriosis. • Recent antibiotic treatment (C-difficile) • Diarrhea after exposure to a known community bacterial outbreak • Concern for Hemolytic Uremic Syndrome (E coli 07H157) 5. Found insideAntibiotics are rarely indicated in the empirical treatment of acute gastroenteritis, for many reasons. Viruses remain the most common causes of acute gastroenteritis in the general population, and these infections resolve without ... Antibiotic treatment of GE in primary care is relatively infrequent, with 1 in 11 episodes treated. Formulation of traditional and herbal medicine is often undertaken by herbalists and the use of such remedies often relies on self-prescription. Antibiotic therapy is not necessary for acute diarrhea in children, as rehydration is the key treatment and symptoms resolve generally without specific therapy. Antibacterial properties of the selected plant extracts were investigated using samples of bacteria known to be causative agents of gastroenteritis. While some herbal medications are mixtures of various antimicrobial compounds, others are standalone herbs with complex antimicrobial properties. This book is a comprehensive overview of invited contributions on Helicobacter pylori infection in gastritis and gastric carcinogenesis. However, severe cases with serious dehydration such as those caused by RV infection can be life-threatening. O. gratisimum is a common plant ingredient of two commonly used herbal mixtures, âAgbo ibaâ and âAgbo jedi-jediâ [24]. In-office consultations, home visits and telephone consultations per GE episode. Their religious beliefs included Islam (52.33%), Christianity (36.27%), African Traditional Religion (2.33%) and the non-religious (9.07%). Metronidazole (nâ=â205, 32%) and ciprofloxacin (nâ=â165, 26%) were also prescribed frequently, even though they are not recommended for empirical treatment (Table 2). Duplicate wells of sterile flat bottom 96-well microtitre plates were seeded with 216.5 μl nutrient broth, 8.5 μl bacterial inoculum and 25 μl plant ethanolic (EtOH) extract to a final concentration of 100 mg/ ml in a total volume of 250 μl per well. Bacterial stocks were grown in nutrient broth (10 g/L Tryptone, 10 g/L NaCl and 5 g/L yeast extract) for 24 hours with shaking at 160 rpm and bacterial colonies were enumerated on nutrient agar using the pour plate method. Furthermore, approximately 19% of the respondents combined the use of antibiotics and herbal medication and 23% used no medication. [Medline] . Approach to acute abdominal/pelvic pain in pregnant and postpartum patients. In these CPGs, empirical treatment of patients with suspected parasitic GE is not recommended.4,16 Targeted treatment was defined as an antibiotic prescription for a GE episode where a presumed causal pathogen was identified through DFT. We speculate that variation in the composition of Igi Odan may suggest why it was unpopular among respondents. . Azithromycin, which is the recommended choice for empirical treatment according to the CPGs, was prescribed in 30% (nâ=â191) of the empirically treated patients. These patients had fewer GP contacts and lower specialist referral rates compared with patients with targeted treatment, suggesting a benign and self-limiting course of GE. Supervision, Figure shows (A) Image of Aristolochia ringens root (B) Upper and lower images of Azadirachta indica leaf (C) Upper and lower images of Chromolaena odorata leaf (D) Upper and lower images of Etanda africana leaf (E) Upper and lower of Ficus capensis leaf (F) Upper and lower images of Ficus vogelii (syn. School of Molecular and Cellular Biology and Astbury Centre for Structural Molecular Biology, Garstang Building, Faculty of Biological Sciences, University of Leeds, Leeds, United Kingdom. Campylobacter isolates were tested for resistance to ciprofloxacin, erythromycin and tetracycline; other bacteria were tested for resistance to ciprofloxacin, co-trimoxazole, amoxicillin and amoxicillin/clavulanic acid. 18, 19 For example, antibiotic treatment is prescribed in 55% of the patients with acute otitis media antibiotic treatment is prescribed, and 14% of the episodes with acute upper respiratory tract infections. For each episode, data on patient characteristics, DFT results including antimicrobial resistance testing, and antibiotic prescriptions were collected. F. lutea) leaf (G) Upper and lower images of Mangifera indica leaf (H) Upper and lower images of Momordica charantia leaf (I) Upper and lower images of Ocimum gratisimum leaf (J) Upper and lower images of Senna alata (K) Images of Sorghum bicolor sheath (L) Upper and lower images of Vernonia amygdalina leaf. However, treatment based upon DFT results followed CPG recommendations. A relatively high resistance rate to prescribed antibiotics for children indicates that the selection of high-cost antibiotics, including ceftriaxone, vancomycin, and meropenem should be based on antimicrobial sensitivity tests. Our findings further showed that extracts of E. Africana, Igi Odan (F. capensis), M. indica and V. amygdalina were strong inhibitors of all bacterial samples investigated. Acute gastroenteritis is defined as a diarrheal disease of rapid onset, with or without nausea, vomiting, fever, or abdominal pain. (D) Age group distribution of antibiotic users. Infectious Diseases Emergencies is a succinct guide to the infectious disease processes most commonly seen in practice. Antibiotic susceptibility testing is important for treatment of bacterial gastroenteritis while viral gastroenteritis should be carefully managed.
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