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OBJECTIVES: Korean red ginseng (KRG) has hypoglycemic, antioxidant, antithrombotic, and other beneficial effects in human. The present study evaluate the therapeutic effects of KRG on hearing recovery and glucocorticoid-induced hyperglycemia in patients with idiopathic sudden sensorineural hearing loss (SSNHL) undergoing systemic steroid therapy. METHODS: The patients were divided into 2 groups: the steroid, and the combination of steroid and red ginseng. Pure tone averages (PTA) were assessed at the first visit and 2-month follow-up. All patients underwent fasting blood glucose analyses just before and on the fifth day of treatment. Both groups were treated with a 10-day course of oral methylprednisolone at tapering doses starting from a daily dose of 48 mg. To the combination group, KRG extract was administered by mouth at a daily dose of 3 g for 20 days in addition to methylprednisolone. Hearing gain was calculated comparing the initial PTA and PTA at 2 months' follow-up. Treatment responses were classified according to Siegel's criteria. RESULTS: Pretreatment conditions were similar between the steroid (n=37) and combination groups (n=36). At 2 months after the treatment, PTA improved significantly in both groups, but there was no significant difference in the mean hearing gain & recovery rate. The non-diabetic subjects in the steroid group (n=27) exhibited a 24% increase in the mean blood glucose level during the systemic steroid therapy, while those in the combination group (n=34) showed no changes. CONCLUSION: Although the KRG did not provide greater therapeutic effects on hearing recovery, we suggest that red ginseng can be a useful adjuvant to the current steroid therapy to normalize glucocorticoid-induced hyperglycemia in non-diabetic patients during the treatment of SSNHL.
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OBJECTIVES: This ambidirectional intervention study was performed to examine the impact of a change in antibiotic policy on extended-spectrum beta-lactamase (ESBL) prevalence in a children's hospital with a high prevalence of ESBL production among Escherichia coli and Klebsiella pneumoniae. METHODS: The use of extended-spectrum cephalosporins was restricted and use of beta-lactam/ beta-lactamase inhibitor combinations was encouraged from 2002. All strains of E. coli and K. pneumoniae isolated from sterile body fluids from 1999 to 2005 were analysed for beta-lactamase production and the prevalences of ESBL production were compared at three periods; pre-intervention (1999-2001), transitional period (2002-03) and post-intervention (2004-05). RESULTS: Comparing the pre- and post-intervention periods, overall piperacillin/tazobactam use increased from 2.2 to 108.0 days on antibiotics/1000 patient admission days/year (AD) (P for trend < 0.001), whereas extended-spectrum cephalosporin use decreased from 175.0 to 96.9 AD (P for trend < 0.001). Among 252 strains of E. coli (n = 128) and K. pneumoniae (n = 124), the overall prevalence of ESBL producers decreased from 39.8% (41/103) to 22.8% (18/79) (P for trend = 0.018). This decreasing trend of ESBL production was more evident for K. pneumoniae (64.1% to 25.6%; P for trend < 0.001) than E. coli (25.0% to 19.4%; P for trend = 0.514). The mortality rates of invasive disease caused by E. coli or K. pneumoniae remained unchanged. CONCLUSIONS: The substitution of piperacillin/tazobactam for extended-spectrum cephalosporins successfully decreased the prevalence of ESBL production of K. pneumoniae and E. coli in an institute for children where ESBLs were endemic. The impact of change in antibiotic policy was more evident in K. pneumoniae than E. coli.