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A special issue of Antibiotics (ISSN 2079-6382). This special issue belongs to the section "Antibiotic Therapy in Infectious Diseases".

Deadline for manuscript submissions: closed (15 March 2022) | Viewed by 27509

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Special Issue Editors

Dr. Francesco Di Gennaro

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Respiratory Infectious Diseases Unit, National Institute for Infectious Diseases “L. Spallanzani” IRCCS, 00149 Rome, Italy
Interests: infectious diseases; respiratory infectious diseases; pulmonary tuberculosis; COVID-19 pneumonia; antibiotic use and resistance
Special Issues, Collections and Topics in MDPI journals

Dr. Gina Gualano

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Respiratory Infectious Diseases Unit, National Institute for Infectious Diseases “L. Spallanzani” IRCCS, 00149 Rome, Italy
Interests: infectious diseases; respiratory infectious diseases; pulmonary tuberculosis; COVID-19 pneumonia; antibiotic use and resistance; NTM
Special Issues, Collections and Topics in MDPI journals

Dr. Fabrizio Palmieri

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Director of Respiratory Infectious Diseases Unit, National Institute for Infectious Diseases “L. Spallanzani” IRCCS, 00149 Rome, Italy
Interests: infectious diseases; respiratory infectious diseases; pulmonary tuberculosis; COVID-19 pneumonia; antibiotic use and resistance
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Infectious respiratory diseases (IRD) remain among the most important causes of morbidity and mortality worldwide and, in the era of the COVID-19 pandemic, they have come into major focus in the scientific world and the global health approach. They can have a viral, bacterial, parasitic, and opportunistic origin; however, indiscriminate use of antibiotics in their treatment has led to the development of antimicrobial resistance. Effective management of respiratory infectious diseases to reduce their burden and to avoid overuse of antibiotics has become a great therapeutic and public health challenge. Manuscripts covering all aspects of research relating to IRD prevention, diagnosis, management, and treatment are welcome.

In addition, manuscripts covering these areas of interest are welcome:

Bacterial host resistance and antimicrobial resistance;
HAP (hospital-acquired pneumonia), VAP (ventilator-associated pneumonia), CAP (community-acquired pneumonia);
Tuberculosis and nontuberculous mycobacteria (NTM);
Viral pneumonia and SARS CoV2 interstitial pneumonia;
Educational on antimicrobial resistance and antimicrobial prescription;
Pneumonia infection in immunocompetent and immunosuppressed patients.

Dr. Francesco Di Gennaro
Dr. Gina Gualano
Dr. Fabrizio Palmieri
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Antibiotics is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

infectious respiratory diseases
pulmonary tuberculosis
COVID-19 pneumonia
antibiotic use and resistance
gram negative
gram positive
pneumonia opportunistic infection
multidrug resistance (MDR)

Published Papers (10 papers)

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Editorial

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2 pages, 177 KiB

Open AccessEditorial

Antibiotics and Infectious Respiratory Diseases

by Francesco Di Gennaro, Gina Gualano and Fabrizio Palmieri

Antibiotics 2022, 11(7), 859; https://doi.org/10.3390/antibiotics11070859 - 27 Jun 2022

Viewed by 1277

Abstract

Respiratory infectious diseases (rIDs) remain among the most significant causes of morbidity and mortality worldwide, and, in the era of COVID-19, they have come into major focus in the scientific world and global health approaches [...] Full article

(This article belongs to the Special Issue Antibiotics and Infectious Respiratory Diseases)

Research

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10 pages, 1223 KiB

Open AccessArticle

Multidisciplinary Approach in the Treatment of Descending Necrotizing Mediastinitis: Twenty-Year Single-Center Experience

by Angela De Palma, Mirko Girolamo Cantatore, Francesco Di Gennaro, Francesca Signore, Teodora Panza, Debora Brascia, Giulia De Iaco, Doroty Sampietro, Rosatea Quercia, Marcella Genualdo, Ondina Pizzuto, Giuseppe Garofalo, Fabio Signorile, Davide Fiore Bavaro, Gaetano Brindicci, Nicolò De Gennaro, Annalisa Saracino, Nicola Antonio Adolfo Quaranta, Gianfranco Favia and Giuseppe Marulli

Antibiotics 2022, 11(5), 664; https://doi.org/10.3390/antibiotics11050664 - 16 May 2022

Cited by 10 | Viewed by 1953

Abstract

Descending necrotizing mediastinitis (DNM) is an acute, rare, severe condition with high mortality, but the optimal management protocol is still controversial. We retrospectively analyzed the results of multidisciplinary management in patients treated for DNM at our center over the last twenty years. Fifteen male patients, mean age 49.07 ± 14.92 years, were treated: 9 with cervico-pharyngeal etiopathogenesis, 3 peri-tonsillar/tonsillar, 2 odontogenic, 1 post-surgical; 6 with DNM type I, 6 with type IIA, and 3 with type IIB (Endo’s classification). Mean time between diagnosis and treatment was 2.24 ± 1.61 days. In all cases, mediastinum drainage via thoracotomy was performed after neck drainage via cervicotomy, associated with tooth treatment in two; one required re-operation; tracheostomy was necessary in 9, temporary intensive care unit stay in 4; 6 developed complications, without post-operative mortality. Main isolated germs were Staphylococci and Candida; 7 had polymicrobial infection. The most used antibiotics were meropenem, metronidazole, teicoplanin, third-generation cephalosporins and clyndamicin; anti-fungal drugs were fluconazole, caspofungin and anidulafungin. On multivariate analysis, presence of cardiovascular disease was statistically significantly associated with longer chest tube duration and hospital stay. DNM requires early diagnosis and treatment to reduce mortality and morbidity. The most effective treatment should provide a multidisciplinary approach, combining cervicotomy and thoracotomy to drain all infectious collections with administration and monitoring of the proper antimicrobial therapy. Full article

(This article belongs to the Special Issue Antibiotics and Infectious Respiratory Diseases)

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19 pages, 2097 KiB

Open AccessArticle

The Role of Point-of-Care C-Reactive Protein Testing in Antibiotic Prescribing for Respiratory Tract Infections: A Survey among Swiss General Practitioners

by Nahara Anani Martínez-González, Andreas Plate, Levy Jäger, Oliver Senn and Stefan Neuner-Jehle

Antibiotics 2022, 11(5), 543; https://doi.org/10.3390/antibiotics11050543 - 19 Apr 2022

Cited by 6 | Viewed by 2175

Abstract

Understanding the decision-making strategies of general practitioners (GPs) could help reduce suboptimal antibiotic prescribing. Respiratory tract infections (RTIs) are the most common reason for inappropriate antibiotic prescribing in primary care, a key driver of antibiotic resistance (ABR). We conducted a nationwide prospective web-based survey to explore: (1) The role of C-reactive protein (CRP) point-of-care testing (POCT) on antibiotic prescribing decision-making for RTIs using case vignettes; and (2) the knowledge, attitudes and barriers/facilitators of antibiotic prescribing using deductive analysis. Most GPs (92–98%) selected CRP-POCT alone or combined with other diagnostics. GPs would use lower CRP cut-offs to guide prescribing for (more) severe RTIs than for uncomplicated RTIs. Intermediate CRP ranges were significantly wider for uncomplicated than for (more) severe RTIs (p = 0.001). Amoxicillin/clavulanic acid was the most frequently recommended antibiotic across all RTI case scenarios (65–87%). Faced with intermediate CRP results, GPs preferred 3–5-day follow-up to delayed prescribing or other clinical approaches. Patient pressure, diagnostic uncertainty, fear of complications and lack of ABR understanding were the most GP-reported barriers to appropriate antibiotic prescribing. Stewardship interventions considering CRP-POCT and the barriers and facilitators to appropriate prescribing could guide antibiotic prescribing decisions at the point of care. Full article

(This article belongs to the Special Issue Antibiotics and Infectious Respiratory Diseases)

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10 pages, 264 KiB

Open AccessArticle

Increased Association of Pulmonary Thromboembolism and Tuberculosis during COVID-19 Pandemic: Data from an Italian Infectious Disease Referral Hospital

by Virginia Di Bari, Gina Gualano, Maria Musso, Raffaella Libertone, Carla Nisii, Stefania Ianniello, Silvia Mosti, Annelisa Mastrobattista, Carlotta Cerva, Nazario Bevilacqua, Fabio Iacomi, Annalisa Mondi, Simone Topino, Delia Goletti, Enrico Girardi, Fabrizio Palmieri and on behalf of the TB-INMI Working Group

Antibiotics 2022, 11(3), 398; https://doi.org/10.3390/antibiotics11030398 - 16 Mar 2022

Cited by 3 | Viewed by 2109

Abstract

Pulmonary thromboembolism (PTE) has been associated with tuberculosis (TB), but the true incidence is unknown. The aim of our study was to retrospectively evaluate the PTE prevalence in TB patients hospitalized at the National Institute for Infectious Diseases L. Spallanzani during the January 2016–December 2021 period. Retrospective data collection and evaluation were conducted. Among 1801 TB patients, 29 (1.61%) exhibited PTE. Twenty (69%) had comorbidities; eleven (37.9%) had predisposing factors for PTE. Nineteen (65.5%) had extensive TB disease. The commonest respiratory symptoms were cough (37.9%), dyspnea (31%), chest pain (10.3%), and hemoptysis (6.9%). Twenty-five (86.2%) had elevated serum D-dimer levels. An increased prevalence of PTE from 0.6% in the pre-COVID-19 pandemic period to 4.6% in the pandemic period was found. Acute respiratory failure and extensive TB disease increased significantly in the pandemic period. The increase in PTE could be explained by the increased severity of TB in patients in the pandemic period and by increased clinical suspicion and, consequently, increased requests for D-dimer testing, including in patients with non-COVID-19 pneumonia. Patients with extensive pulmonary disease are at high risk of developing PTE. Clinicians should be aware of this potentially life-threatening complication of TB, and patients should receive a thromboembolism risk assessment. Full article

(This article belongs to the Special Issue Antibiotics and Infectious Respiratory Diseases)

16 pages, 1876 KiB

Open AccessArticle

Efficacy and Safety of Remdesivir over Two Waves of the SARS-CoV-2 Pandemic

by Mariacristina Poliseno, Crescenzio Gallo, Donatella Concetta Cibelli, Graziano Antonio Minafra, Irene Francesca Bottalico, Serena Rita Bruno, Maria Luca D’Errico, Laura Montemurro, Marianna Rizzo, Lucia Barbera, Giacomo Emanuele Custodero, Antonella La Marca, Donatella Lo Muzio, Anna Miucci, Teresa Antonia Santantonio and Sergio Lo Caputo

Antibiotics 2021, 10(12), 1477; https://doi.org/10.3390/antibiotics10121477 - 01 Dec 2021

Cited by 5 | Viewed by 2093

Abstract

The aim of this study is to describe the features, the outcomes, and the clinical issues related to Remdesivir administration of a cohort of 220 patients (pts) with COVID-19 hospitalized throughout the last two pandemic waves in Italy. One hundred and nine pts were enrolled from 1 September 2020, to 28 February 2021 (Group A) and 111 from 1 March to 30 September 2021 (Group B). Notably, no differences were reported between the two groups neither in the timing of hospitalization. nor in the timing of Remdesivir administration from symptoms onset. Remarkably, a higher proportion of pts with severe COVID-19 was observed in Group B (25% vs. 10%, p < 0.001). At univariate and multivariate analysis, rather than the timing of Remdesivir administration, age, presence of coexisting conditions, D-dimers, and O2 flow at admission correlated positively to progression to non-invasive ventilation, especially for patients in Group B. However, the rate of admission in the Intensive Care Unit and/or death was comparable in the two groups (7% vs. 4%). Negligible variations in serum GOT, GPT, GGT, and eGFR levels were detected. A mean reduction in heart rate was noticed within the first three days of antiviral treatment (p < 0.001). Low rate of ICU admission, high rate of clinical recovery, and good drug safety were observed in COVID-19 patients treated with Remdesivir during two diverse pandemic waves. Full article

(This article belongs to the Special Issue Antibiotics and Infectious Respiratory Diseases)

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14 pages, 3729 KiB

Open AccessArticle

Screening for Tuberculosis in Migrants: A Survey by the Global Tuberculosis Network

by Lia D’Ambrosio, Rosella Centis, Claudia C. Dobler, Simon Tiberi, Alberto Matteelli, Justin Denholm, Dominik Zenner, Seif Al-Abri, Fatma Alyaquobi, Marcos Abdo Arbex, Evgeny Belilovskiy, François-Xavier Blanc, Sergey Borisov, Anna Cristina C. Carvalho, Jeremiah Muhwa Chakaya, Nicola Cocco, Luigi Ruffo Codecasa, Margareth Pretti Dalcolmo, Keertan Dheda, Anh Tuan Dinh-Xuan, Susanna R. Esposito, José-María García-García, Yang Li, Selene Manga, Valentina Marchese, Marcela Muñoz Torrico, Emanuele Pontali, Adrián Rendon, Denise Rossato Silva, Rupak Singla, Ivan Solovic, Giovanni Sotgiu, Martin van den Boom, Nguyen Viet Nhung, Jean-Pierre Zellweger and Giovanni Battista Migliori Show full author list Hide full author list

Antibiotics 2021, 10(11), 1355; https://doi.org/10.3390/antibiotics10111355 - 05 Nov 2021

Cited by 5 | Viewed by 2962

Abstract

Tuberculosis (TB) does not respect borders, and migration confounds global TB control and elimination. Systematic screening of immigrants from TB high burden settings and—to a lesser degree TB infection (TBI)—is recommended in most countries with a low incidence of TB. The aim of the study was to evaluate the views of a diverse group of international health professionals on TB management among migrants. Participants expressed their level of agreement using a six-point Likert scale with different statements in an online survey available in English, French, Mandarin, Spanish, Portuguese and Russian. The survey consisted of eight sections, covering TB and TBI screening and treatment in migrants. A total of 1055 respondents from 80 countries and territories participated between November 2019 and April 2020. The largest professional groups were pulmonologists (16.8%), other clinicians (30.4%), and nurses (11.8%). Participants generally supported infection control and TB surveillance established practices (administrative interventions, personal protection, etc.), while they disagreed on how to diagnose and manage both TB and TBI, particularly on which TBI regimens to use and when patients should be hospitalised. The results of this first knowledge, attitude and practice study on TB screening and treatment in migrants will inform public health policy and educational resources. Full article

(This article belongs to the Special Issue Antibiotics and Infectious Respiratory Diseases)

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10 pages, 518 KiB

Open AccessEditor’s ChoiceArticle

Management of Common Infections in German Primary Care: A Cross-Sectional Survey of Knowledge and Confidence among General Practitioners and Outpatient Pediatricians

by Peter Konstantin Kurotschka, Elena Tiedemann, Dominik Wolf, Nicola Thier, Johannes Forster, Johannes G. Liese and Ildiko Gagyor

Antibiotics 2021, 10(9), 1131; https://doi.org/10.3390/antibiotics10091131 - 20 Sep 2021

Cited by 2 | Viewed by 2370

Abstract

Outpatient antibiotic use is closely related to antimicrobial resistance and in Germany, almost 70% of antibiotic prescriptions in human health are issued by primary care physicians (PCPs). The aim of this study was to explore PCPs, namely General Practitioners’ (GPs) and outpatient pediatricians’ (PDs) knowledge of guideline recommendations on rational antimicrobial treatment, the determinants of confidence in treatment decisions and the perceived need for training in this topic in a large sample of PCPs from southern Germany. Out of 3753 reachable PCPs, 1311 completed the survey (overall response rate = 34.9%). Knowledge of guideline recommendations and perceived confidence in making treatment decisions were high in both GPs and PDs. The two highest rated influencing factors on prescribing decisions were reported to be guideline recommendations and own clinical experiences, hence patients’ demands and expectations were judged as not influencing treatment decisions. The majority of physicians declared to have attended at least one specific training course on antibiotic use, yet almost all the participating PCPs declared to need more training on this topic. More studies are needed to explore how consultation-related and context-specific factors could influence antibiotic prescriptions in general and pediatric primary care in Germany beyond knowledge. Moreover, efforts should be undertaken to explore the training needs of PCPs in Germany, as this would serve the development of evidence-based educational interventions targeted to the improvement of antibiotic prescribing decisions rather than being focused solely on knowledge of guidelines. Full article

(This article belongs to the Special Issue Antibiotics and Infectious Respiratory Diseases)

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20 pages, 3372 KiB

Open AccessArticle

Bibliometric Analysis on Tuberculosis and Tuberculosis-Related Research Trends in Africa: A Decade-Long Study

by Aboi Igwaran and Chiedu Epiphany Edoamodu

Antibiotics 2021, 10(4), 423; https://doi.org/10.3390/antibiotics10040423 - 12 Apr 2021

Cited by 26 | Viewed by 3357

Abstract

Tuberculosis is one of the oldest known diseases and the leading communicable cause of deaths worldwide. Although several studies have been carried out on tuberculosis, no research has examined the publication trends in this area. Hence, this study aimed to fill the gap by conducting a bibliometric study in publications trends on tuberculosis and tuberculosis-related studies in Africa from 2010–2019 and explore the hotspots. Information in published documents on tuberculosis and its related studies from 2010 to 2019 were retrieved from the Web of Science (WoS) database. The bibliometric tool biblioshiny and Microsoft Excel 2016 were used to analyse the top leading journals, top cited documents, authors’ country production, country collaboration networks, most relevant authors, authors’ impacts, most relevant authors by corresponding author, most cited countries, university collaborations, most relevant affiliations, conceptual structural maps, title word co-occurrence networks, collaboration and significance of individual sources, university, country and keyword relations. A total of 3945 published documents were retrieved. The analyses showed that European Respiratory Journal was the leading journal in publications on tuberculosis studies with a total of 452 published articles, the WHO 2012 report was the most cited document with 2485 total citations while South Africa was the most productive country in tuberculosis publications as well as the leading country with the highest co-authorship collaboration. Analysis of top relevant authors revealed that Anonymous (133) and Dheda (44) were the two topmost relevant authors of tuberculosis publications, South Africa was the most relevant country by corresponding authors and the topmost cited country for tuberculosis publications. Furthermore, analysis of the university collaborations network showed that the University of Cape Town was the topmost university in Africa with the highest collaboration network, tuberculosis as a word had the highest co-occurrence network while the Three Field Plot diagram revealed the relations between universities, keywords and countries. This study provides a quantitative and qualitative analyses of the leading journals, most cited published articles, title word occurrences, and most relevant authors in published documents on tuberculosis and tuberculosis related studies from 2010–2019. Full article

(This article belongs to the Special Issue Antibiotics and Infectious Respiratory Diseases)

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Review

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16 pages, 319 KiB

Open AccessReview

Potential Role of Vitamins A, B, C, D and E in TB Treatment and Prevention: A Narrative Review

by Giulia Patti, Carmen Pellegrino, Aurelia Ricciardi, Roberta Novara, Sergio Cotugno, Roberta Papagni, Giacomo Guido, Valentina Totaro, Giuseppina De Iaco, Federica Romanelli, Stefania Stolfa, Maria Letizia Minardi, Luigi Ronga, Ilenia Fato, Rossana Lattanzio, Davide Fiore Bavaro, Gina Gualano, Loredana Sarmati, Annalisa Saracino, Fabrizio Palmieri and Francesco Di Gennaro Show full author list Hide full author list

Antibiotics 2021, 10(11), 1354; https://doi.org/10.3390/antibiotics10111354 - 05 Nov 2021

Cited by 11 | Viewed by 4122

Abstract

(1) Background: Tuberculosis (TB) is one of the world’s top infectious killers, in fact every year 10 million people fall ill with TB and 1.5 million people die from TB. Vitamins have an important role in vital functions, due to their anti-oxidant, pro-oxidant, anti-inflammatory effects and to metabolic functions. The aim of this review is to discuss and summarize the evidence and still open questions regarding vitamin supplementation as a prophylactic measure in those who are at high risk of Mycobacterium tuberculosis (MTB) infection and active TB; (2) Methods: We conducted a search on PubMed, Scopus, Google Scholar, EMBASE, Cochrane Library and WHO websites starting from March 1950 to September 2021, in order to identify articles discussing the role of Vitamins A, B, C, D and E and Tuberculosis; (3) Results: Supplementation with multiple micronutrients (including zinc) rather than vitamin A alone may be more beneficial in TB. The WHO recommend Pyridoxine (vitamin B6) when high-dose isoniazid is administered. High concentrations of vitamin C sterilize drug-susceptible, MDR and extensively drug-resistant MTB cultures and prevent the emergence of drug persisters; Vitamin D suppresses the replication of mycobacterium in vitro while VE showed a promising role in TB management as a result of its connection with oxidative balance; (4) Conclusions: Our review suggests and encourages the use of vitamins in TB patients. In fact, their use may improve outcomes by helping both nutritionally and by interacting directly and/or indirectly with MTB. Several and more comprehensive trials are needed to reinforce these suggestions. Full article

(This article belongs to the Special Issue Antibiotics and Infectious Respiratory Diseases)

Other

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7 pages, 228 KiB

Open AccessBrief Report

Cefiderocol for Severe Carbapenem-Resistant A. baumannii Pneumonia: Towards the Comprehension of Its Place in Therapy

by Emanuele Rando, Francesco Vladimiro Segala, Joel Vargas, Cristina Seguiti, Gennaro De Pascale, Rita Murri and Massimo Fantoni

Antibiotics 2022, 11(1), 3; https://doi.org/10.3390/antibiotics11010003 - 21 Dec 2021

Cited by 19 | Viewed by 3696

Abstract

Cefiderocol use in A. baumannii pneumonia still represents an important matter of debate. The aim of this study is to describe 13 cases of carbapenem-resistant A. baumannii (CRAB) pneumonia treated with cefiderocol in real-life practice. We retrospectively included patients with CRAB pneumonia hospitalized at Fondazione Policlinico Universitario Agostino Gemelli Hospital treated with cefiderocol either in the general ward or the intensive care unit. A total of 11 patients out of 13 had ventilator-associated pneumonia caused by CRAB, and 12/13 patients had polymicrobial infection. We found a 30-day success rate of 54%. Cefiderocol may have a role when facing severe XDR A. baumannii pneumonia. Future studies are warranted to better define its place in therapy in CRAB infections. Full article

(This article belongs to the Special Issue Antibiotics and Infectious Respiratory Diseases)

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