Acne antibiotic prescription pattern in Colombia.

BACKGROUND: Bacterial resistance to antibiotics has been growing exponentially. Acne is the most common outpatient complains in dermatology, and involve the use of antibiotics for treatment. METHODS: We conducted a drug utilization study, with a retrospective and descriptive design, in order to evaluated the antibiotic prescription pattern for acne vulgaris patients who were cared for the first time in 2015, and were prescribed with an antibiotic, no matter if it was topical, oral or both, and compared it against the Colombian clinical practice guidelines valid for that year in our country. RESULTS: Three hundred sixty-nine patients were randomly collected, 221 women and 148 men. There were a correct adherence to guidelines in election of an antibiotic, its dosage, and time of use in 51.7%, 94.85%, and 76.1%, respectively. 37.1% of patients has being correctly prescribe globally, taking into consideration the three previously describe variables. CONCLUSIONS: A no adherent antibiotic prescription was documented for less than half of the patients. In almost a quarter of the patients it was not prescribed for the right time and in most patients the correct dose was chosen. It is important to know the prescription pattern as it allows decisions to be made that lead to an adequate use of antibiotics, and thus prevent the development of antimicrobial resistance.

Clinical and parasitological factors in parasite persistence after treatment and clinical cure of cutaneous leishmaniasis.

BACKGROUND: The determinants of parasite persistence or elimination after treatment and clinical resolution of cutaneous leishmaniasis (CL) are unknown. We investigated clinical and parasitological parameters associated with the presence and viability of Leishmania after treatment and resolution of CL caused by L. Viannia. METHODS: Seventy patients who were treated with meglumine antimoniate (n = 38) or miltefosine (n = 32) and cured, were included in this study. Leishmania persistence and viability were determined by detection of kDNA and 7SLRNA transcripts, respectively, before, at the end of treatment (EoT), and 13 weeks after initiation of treatment in lesions and swabs of nasal and tonsillar mucosa. RESULTS: Sixty percent of patients (42/70) had evidence of Leishmania persistence at EoT and 30% (9/30) 13 weeks after treatment initiation. A previous episode of CL was found to be a protective factor for detectable Leishmania persistence (OR: 0.16, 95%CI: 0.03-0.92). kDNA genotyping could not discern differences between parasite populations that persisted and those isolated at diagnosis. CONCLUSIONS: Leishmania persist in skin and mucosal tissues in a high proportion of patients who achieved therapeutic cure of CL. This finding prompts assessment of the contribution of persistent infection in transmission and endemicity of CL, and in disease reactivation and protective immunity.