Antibiotic use during the first 6 months of COVID-19 pandemic in Iran: A large-scale multi-centre study.

WHAT IS KNOWN AND OBJECTIVE: Although antibiotics are ineffective against viral infections, epidemiological studies have revealed that the COVID-19 pandemic resulted in the overuse of antibiotics and disruption of antimicrobial stewardship programmes. We investigated the pattern of antibiotic use during the first 6 months of the COVID-19 pandemic in Iran. METHODS: A multi-centre retrospective study was designed to investigate the use of 16 broad-spectrum antibiotics in 12 medical centres. The rate of antibiotic use was calculated and reported based on the Defined Daily Dose (DDD) per 100 hospital bed-days. The bacterial co-infection rate was also reported. RESULTS AND DISCUSSION: Totally, 43,791 hospitalized COVID-19 patients were recruited in this study. It was found that 121.6 DDD of antibiotics were used per 100 hospital bed-days, which estimated that each patient received approximately 1.21 DDDs of antibiotics every day. However, the bacterial co-infections were detected only in 14.4% of the cases. A direct correlation was observed between the rate of antibiotic use and mortality (r[142] = 0.237, p = 0.004). The rate of antibiotic consumption was not significantly different between the ICU and non-ICU settings (p = 0.15). WHAT IS NEW AND CONCLUSION: In this study, widespread antibiotic use was detected in the absence of the confirmed bacterial coinfection in COVID-19 patients. This over-consumption of broad-spectrum antibiotics may be associated with increased mortality in hospitalized COVID-19 patients, which can be an alarming finding.

Microleakage of five separated nickel-titanium rotary file systems in the apical portion of the root canal.

Background: The aim of this study was to evaluate the rate of apical microleakage following the fracture of five types of nickel-titanium rotary file systems (ProTaper Universal, Mtwo, RaCe, Revo-s, HeroShaper) in the apical one-third of the canal. Materials and Methods: In this laboratory experiment, 49 mandibular premolars were collected and randomly divided into seven groups. Root canal treatment was performed by five different rotary file systems with different cross-sections. All files, except in the control groups, were scratched at the 3-mm end by a handpiece. After separation of the apical end of the file in the root canal, the apical seal was measured, using the fluid infiltration technique. Data were analyzed in SPSS, using one-way ANOVA and Tamhane's T2 tests at P < 0.05. Results: The Hero Shaper and RaCe files showed the highest (3.14 µL/min) and the lowest (2.51 µL/min) rates of microleakage over time, respectively. There were significant differences between the Hero Shaper and RaCe files and between Hero Shaper and ProTaper files in terms of microleakage (Tamhane's T2 tests, P < 0.05). Conclusion: The presence of a separated file and its cross-section type affects the apical microleakage.

Hepatitis A Seroprevalence Among Patients with Chronic Hepatitis B Infection: A Cross-Sectional Study in Iran During 2016-2017.

INTRODUCTION: The aim of this study was to determine the prevalence of exposure to hepatitis A by means of serologic markers in chronic hepatitis B patients, with the secondary aim of finding the best prevention method for hepatitis A infection in susceptible groups of our setting. METHODS: During the period between 2016 and 2017, we recruited 403 hepatitis B patients aged more than 14 years and regularly attending the infectious diseases clinic at a referral university hospital, Tehran, Iran. A blood sample was collected from all the patients and tested for hepatitis A IgG. The data was analyzed by SPSS v.19. RESULTS: Although none of the patients had previously received hepatitis A vaccine, the results for serologic level of hepatitis A IgG, demonstrated positive results in 379 (94%) cases. The mean age of patients with negative and positive IgG was 29.17 and 42.46 years, respectively; the difference was statistically significant (P≤0.001). The majority of seronegative patients were young adults aged < 25 years and 25 to 35 years (P <0.001). CONCLUSION: Seroprevalence of hepatitis A in chronic HBV patients in Iran is high. As HBV infected patients younger than 35 years could be seronagative for HAV infection, evaluation of these patients for HAV infection and vaccination of seronegative patients would be a reasonable approach.