An open-label, multicentre, randomized comparative study of efficacy, safety and tolerability of the 5 plant - extract BNO 1012 in the Delayed Antibiotic Prescription Method in children, aged 6 to 11 years with acute viral and post-viral rhinosinusitis.

Acute rhinosinusitis (ARS) can be characterized as bacterial (ABRS) and require antibiotic therapy only in 0.5-5% of cases. In most cases, the disease is in a viral and post-viral form, which requires pathogenetic and symptomatic treatment. The study objective was to determine the efficacy of BNO 1012 extract in the technology of delayed antibiotic prescribing in children with acute rhinosinusitis. METHODS: 292 children aged 6 to 11 years with ARS were randomized in the multicenter, comparative study. They received an extract of five medicinal plants in addition to standard symptomatic therapy or standard therapy only. EVALUATION CRITERIA: reduction of the sinusitis severity according to a 4-point medical assessment scale (nasal congestion, severity of anterior and posterior rhinorrhea) at each visit, dynamics of self-scoring of rhinorrhea and headache (according to a 10-point visual analogue scale), "therapeutic benefit" in days, frequency of antibiotic prescriptions due to the use of an extract of five plants. RESULTS: The use of the 5-plant extract BNO 1012 in addition to the standard symptomatic treatment of acute rhinosinusitis provides a clinically significant, adequate reduction in the severity of rhinorrhea, nasal congestion and post-nasal drip, assessed by a physician at V2 (p < 0.005). Significant differences are noted in the patient's self-scoring of rhinorrhea on the second or third day in viral RS, and from the fourth to the eighth day in post-viral RS. Symptoms of similar intensity in control group were observed at V3. Thus, in the first week of treatment, the treatment group compared to the control one showed a "therapeutic benefit" of three days. The use of BNO 1012 in patients with acute rhinosinusitis can 1.81-fold reduce the prescription of antibacterial drugs. CONCLUSION: The combination of five medicinal plants is effective for the treatment of acute rhinosinusitis in children aged 6 to 11 years. Its use provides a significant "therapeutic benefit" when administered in addition to standard symptomatic therapy, reducing the need for antibiotic use.

Postpartum mastitis in the breastfeeding women and antimicrobial resistance of responsible pathogens in ukraine: results a multicenter study.

OBJECTIVE: The aim: To obtain the prevalence of mastitis in the breastfeeding women and antimicrobial resistance of responsible pathogens in Ukraine. PATIENTS AND METHODS: Materials and methods: A retrospective multicenter cohort study was based on surveillance data for Postpartum Mastitis and included 18,427 breastfeeding women's who gave birth in 11 regional hospitals of Ukraine. RESULTS: Results: 22.6% breastfeeding women's were found to have breast infections. Among these patients, 11.6% breast abscess and 88.4% mastitis were observed. Of the total cases breast infections, 74.8% were detected after hospital discharge. The rate of healthcare-associated mastitis was 8.6%. The predominant pathogens were: Staphylococcus aureus (23.6%), Escherichia coli (19.4%), Enterobacter spp. (11.9%), Staphylococcus epidermidis (10.7%), Klebsiella spp. (8.7%), Pseudomonas aeruginosa (4.8%), Enterococcus faecalis (4.8%), and Proteus mirabilis (4.6%). The overall proportion of methicillin-resistance was observed in 27.9% of S. aureus (MRSA) and 24.3% of S. epidermidis (MRSE). Of the total methicillin-resistance strains, 74.8% of MRSA and 82.1% of MRSE is community-acquired, were detected after hospital discharge. Vancomycin resistance was observed in 9.2% of isolated enterococci. Carbapenem resistance was identified in 7.3% of P.aeruginosa isolates. Resistance to third-generation cephalosporins was observed in 8.8% Klebsiella spp. and E.coli 9.1% isolates. CONCLUSION: Conclusions: Mastitis in the breastfeeding women in Ukraine requires medical attention it is common, and a lot of cases are caused by pathogens resistant to antibiotics. Optimizing the management and empirical antimicrobial therapy may reduce the burden of mastitis, but prevention is the key element.

Bloodstream infections and antimicrobial resistance of responsible pathogens in Ukraine: results of a multicenter study (2013-2015).

OBJECTIVE: Introduction: Bloodstream infections (BSIs) are associated with high morbidity and mortality worldwide. However data of BSI from Ukraine are scarce. The aim: To obtain the first national estimates of the current incidence of BSI and antimicrobial resistance of responsible pathogens, and associated mortality in Ukraine. PATIENTS AND METHODS: Materials and methods: A retrospective multicenter cohort study was conducted at the 14 hospitals of Ukraine between January 2013 to December 2015. Definitions of BSIs were adapted from the CDC. The identification and antimicrobial susceptibility of cultures were determined, using automated microbiology analyzer. Some antimicrobial susceptibility test used Kirby - Bauer antibiotic testing. RESULTS: Results: Among 20,544 patients, 3816 (18.6%) BSIs were observed. The rate of health care associated BSI was 92.4%. Death was reported in 68.4% BSI cases. The predominant pathogens were: Klebsiella pneumoniae (25.1%), Escherichia coli (17.5%), Staphylococcus aureus (9.9%), Pseudomonas aeruginosa (8.9%), and Acinetobacter spp.(8.5%). The overall proportion of extended spectrum beta-lactamase (ESBL) production among Enterobacteriaceae was 24.8% and of methicillin-resistance in S. aureus (MRSA) 38.2%. Vancomycin resistance was observwd in 9.2% of isolated enterococci (VRE). Carbapenem resistance was identified in 33.1% of P.aeruginosa isolates and 63.2% of A. baumannii isolates. Resistance to third-generation cephalosporins was observed in 14.2% K. pneumoniae and E.coli 55% isolates. CONCLUSION: Conclusions: Healthcare-associated BSIs and antimicrobial resistance of responsible pathogens together with their associated impact on mortality, presents a significant burden to the Ukraine hospital system. Surveillance of BSIs may help to delineate the requirements for infection prevention and control.