Guideline recommendations and antimicrobial resistance: the need for a change.

OBJECTIVE
antimicrobial resistance has become a global burden of inappropriate use of antimicrobials is an important contributing factor. Any decisions on the selection of antibiotic use should take into account the effect on antimicrobial resistance. The purpose of this study was to assess the extent to which the guidelines prescribe antibiotic resistance patterns have been considered when making recommendations for the five syndrome is a very common infection.


METHOD
We used Medline search engines equipped with extensive use of the web to identify the empirical treatment guidelines for community-acquired pneumonia, urinary tract infections, acute otitis media, rhinosinusitis and pharyngitis. We collect microbiology and resistance patterns and categories of patterns of discrete identified. We assess the extent to which the recommendation was considered a resistance, in addition to safety and efficacy, as recommended antibiotics.


RESULTS
We identified 135 guidelines, which reported a total of 251 recommendations. The majority (103/135, 79%) come from developed countries. Community-acquired pneumonia is mostly represented syndrome (51, 39%). In only 16 (6.4%) recommendation, the selection of empiric antibiotics discussed in terms of endurance and certain microbiological data. In a further 69 (27.5%) recommendations were made in relation to the reference resistance, but the effort was not consistent. In syndrome, 12 of resistance patterns with implications on the recommendation observed. 50% to 75% of the recommendations are not trying to recommendation set in the context of these patterns.


CONCLUSION
There is consistent evidence that the guidelines for the use of empirical antibiotic resistance is not routinely consider in their recommendations. Decision makers must analyze and report on the extent to which local resistance patterns to enable better decision-making. the abundance of viruses in soil can range from below detection limit in the desert heat for more than 1 billion per gram in wetlands. Abundance seems strongly influenced by water availability and temperature, but the lack of standards of information makes it difficult to cross-study analysis.

Guideline recommendations and antimicrobial resistance: the need for a change.
Guideline recommendations and antimicrobial resistance: the need for a change.

Soil diversity of viruses is very underrated and undersampled, despite the measures currently higher viral richness to the ground than the aquatic ecosystem. Both morphometric analysis and metagenomic have raised questions about the prevalence of nontailed, ssDNA viruses in soil. Land complex and important for terrestrial biodiversity and human civilization, but the impact of viral activity in the soil ecosystem services are poorly understood. Information from aquatic systems and medical microbiology virus shows potential effect on nutrient cycling, food web interactions, gene transfer, and other key processes in the soil, very little empirical data available. To understand virome ground, still a lot of work.

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