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Information for health professionals
Antibiotic resistance is an increasing public health threat all
over the world. To reduce this problem the use of antibiotics
has to be balanced, meaning that antibiotics should be used
only when they are needed and justified for therapeutic
reasons, and not otherwise.

Antibiotic resistance is causing increased illness and
preventable deaths, and the growth of infections from
resistant bacteria in health care settings is a major concern.
Every year in the European Union, Iceland and Norway,
an estimated 25 000 patients die from a serious resistant
bacterial infection, most of them in hospital. This number
covers only about half of the 53 Member States of the
WHO European Region: variable diagnostic capacity and
incomplete data in the rest of the Region mean that the
overall number is not known.

The increasing development of resistance is not only a threat
to the outcome of treating bacterial infections but a serious
risk to the success of some surgical interventions such as
colon surgery, transplants and hip replacements, as well as
many minimally invasive diagnostic interventions that take
place under antibiotic prophylaxis.

If you are a doctor, veterinarian, or dentist, and prescribe
drugs, you are responsible for using these life-saving drugs
wisely to cure patients, and thus keep antibiotics effective.
Overuse and misuse of antibiotics increase the risk of
resistant bacterial strains developing by selective pressure or
mutation. The transmission and spread of resistant bacteria
between people, food animals, products or the environment
can further contribute to the increased risk of antibiotic drug
failure, leading to severe disease, deaths and increased costs.
What doctors and dentists can do

Prescribe antibiotics only when needed and only as indicated by treatment protocols for the disease. Antibiotics do not cure viral infections – influenza, coughs and colds – and over-prescribing them inappropriately increases the emergence and possible spread of resistance.
Contribute to preventing infections
Do not sell antibiotics without prescriptions, nor in insufficient • All health care workers, particularly nurses, should promote quantities to complete a course of treatment. Make sure that the patient has full instructions on how they should be taken and for how long, and understands that the entire course must be • Preventing infections is the key to the efficient control of resistant bacteria. In hospitals or clinics, this means a rigorous infection control programme. • Establishing antibiotic and infection prevention committees in Discuss the correct use of antibiotics with patients and make sure health care settings allows better detection and reaction to they take them according to the instructions, particularly finishing hospital-acquired infections and effective treatment of them. the course. Help to enforce rigorous infection control measures, to stop the spread of resistance.
• National recommendations from a national antimicrobial resistance committee may give guidance for the prudent use Veterinarians
of antibiotics, whether in hospitals or outside. The use of antibiotics as a growth promoter is already banned • If you are involved in teaching, use the opportunity to speak in the European Union and other countries should consider this. about the prudent use of antibiotics and the dangers that lie Use antibiotics wisely in the veterinary sector and avoid giving antibiotics to healthy animals wherever possible. What to say to patients
Some facts on antibiotic resistance
Many patients think they need an antibiotic to feel better, even Ninety per cent of antibiotic prescriptions for people are issued though they have a viral infection. This puts pressure on you. As a at the primary care level and given for common infections such health professional, it is important to talk about the illness with the as urinary tract, respiratory tract or skin infections. Many upper patient and discuss whether an antibiotic is the right treatment. respiratory tract infections are not caused by bacteria and antibiotics will not benefit the patient.
Explain that antibiotics do not treat viruses and can make the patient more vulnerable.
Methicillin-resistant Staphylococcus aureus (MRSA) often affects • Recommend symptomatic relief and common practices patients in hospitals and health care settings, leading to life- for fever, influenza, runny noses, headaches and other threatening situations, and in some countries over 25% of S. symptoms that go hand in hand with common illnesses and aureus samples are resistant.
Evidence indicates that when low doses of antibiotics, such as Tell patients what you find on examination, such as clear tetracycline, are used in healthy chickens as a growth promoter, lungs or no signs of ear inflammation, to allay some of their this quickly (within 36 hours) leads to the excretion of resistant Escherichia coli, a common bacterial cause of infections in • Explain your diagnosis and how common infections develop and usually improve within 72 hours. Give advice on how to recognize more severe symptoms.
Of the 440 000 estimated multidrug-resistant tuberculosis (MDR-TB) patients per year in the world, 81 000 are estimated to be in If you do prescribe antibiotics
the WHO European Region (20% of the global burden). • Follow national treatment protocols if they exist to ensure Points to remember
the appropriate treatment regimen and dose to prevent the Antibiotic resistance could take us back to the pre-antibiotic era. Resistant disease-causing bacteria (or genes that induce • Make sure the patient understands the importance of resistance) are emerging and can spread rapidly between people, following the prescription exactly, and completing the animals, products and the environment. Currently, very few new antibiotics are in the development pipeline.
• If dealing with life-threatening infections in hospital, the use Antibiotic resistance increases health care costs. If illnesses of antibiotic drugs should ideally be based on culture results. last longer and treatment is more complex, costs rise. This also • Remember that for certain medical and surgical places a heavier financial burden on families and societies. The interventions, bacterial prophylaxis with antibiotics can in European Centre for Disease Prevention and Control estimates that resistant bacterial infections cost European Union countries Veterinarians should not prescribe antibiotics as promoters of animal growth. Only use antibiotics when needed. Definitions: antibiotics and antibiotic resistance
Antibiotics are a subclass of antimicrobial agents that are active
only against bacteria. They can either be naturally derived from
bacteria or moulds (fungi) or produced synthetically. Scientifically,
“antibiotic” refers only to naturally produced antimicrobial
agents, but this text uses the term to mean all drugs or agents
against bacterial infections.
The emergence of resistance to antibiotics is a natural biological phenomenon that occurs when antibiotics are used. Antibiotic resistance results from the ability of bacteria to withstand attack by antibiotics, which can develop either through mutation or by acquiring resistance genes from other bacteria that are already resistant. The main drivers of antibiotic resistance are the use of antibiotics, especially overuse (but also misuse and underuse) and the transmission and spread of already resistant bacterial strains or genes that carry the information on resistance.
For more information, see the web site of the WHO Regional Office for Europe For further information on antibiotic
For further information and
resistance, please contact:
interview requests, please contact:
Senior Adviser, Antimicrobial Resistance, Scherfigsvej 8, DK-2100 Copenhagen Ø, Denmark


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