Expert Review of Anti-infective Therapy最新文献_第9页

Diagnosis and treatment of congenital toxoplasmosis: an updated overview. 先天性弓形虫病的诊断和治疗：最新综述。

IF 4.6 2区医学

Expert Review of Anti-infective Therapy Pub Date : 2026-05-01 Epub Date: 2026-05-13 DOI: 10.1080/14787210.2026.2673215

Truong Giang Nguyen, Cécile Garnaud, Marie-Pierre Brenier-Pinchart, Marie Gladys Robert

{"title":"Diagnosis and treatment of congenital toxoplasmosis: an updated overview.","authors":"Truong Giang Nguyen, Cécile Garnaud, Marie-Pierre Brenier-Pinchart, Marie Gladys Robert","doi":"10.1080/14787210.2026.2673215","DOIUrl":"10.1080/14787210.2026.2673215","url":null,"abstract":"Introduction: Toxoplasmosis is a widespread protozoan infection that exhibits increased pathogenicity in its congenital form. The diagnosis and management of this condition require high accuracy and rapid intervention throughout the maternal-fetal and neonatal periods.Areas covered: The aim of this review is to provide an updated overview of screening and diagnostic confirmation strategies for congenital toxoplasmosis, covering prenatal screening, neonatal assessment and long-term follow-up. It also examines therapeutic options for prenatal treatment based on gestational age.Expert opinion: Diagnostic strategies for congenital toxoplasmosis remain highly heterogeneous worldwide, ranging from intensive prenatal screening to a complete absence of systematic testing. When implemented, screening programs promote early diagnosis and treatment, with a positive impact on transmission and disease severity. The recent withdrawal of various key serological tests has forced laboratories to adopt and validate alternative diagnostic algorithms in complex situations. Pyrimethamine-sulfonamide is the cornerstone of treatment, but its toxicity profile remains a major limitation of current management. Cotrimoxazole appears to be a better-tolerated alternative that warrants consideration, although studies are still scarce.","PeriodicalId":12213,"journal":{"name":"Expert Review of Anti-infective Therapy","volume":" ","pages":"501-516"},"PeriodicalIF":4.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147867258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Surgical antibiotic prophylaxis in clean elective upper limb soft-tissue surgery in a resource-limited setting: a randomized, double-blind, placebo-controlled trial. 在资源有限的情况下，清洁选择性上肢软组织手术中的外科抗生素预防：一项随机、双盲、安慰剂对照试验

IF 3.8 2区医学

Expert Review of Anti-infective Therapy Pub Date : 2026-05-01 Epub Date: 2026-05-18 DOI: 10.1080/14787210.2026.2672549

Marcos Felipe Marcatto-Abreu, Pedro Henrique de Magalhães Tenório, Maurício Etchebehere

{"title":"Surgical antibiotic prophylaxis in clean elective upper limb soft-tissue surgery in a resource-limited setting: a randomized, double-blind, placebo-controlled trial.","authors":"Marcos Felipe Marcatto-Abreu, Pedro Henrique de Magalhães Tenório, Maurício Etchebehere","doi":"10.1080/14787210.2026.2672549","DOIUrl":"10.1080/14787210.2026.2672549","url":null,"abstract":"Routine surgical antibiotic prophylaxis (SAP) is frequently used to prevent surgical site infections, although its benefit in clean elective upper limb soft-tissue surgery remains questionable due to the low baseline risk of infection. This issue is particularly relevant in resource-limited settings, where concerns about infection and limited locally generated evidence often sustain routine antibiotic use. This study evaluated whether SAP provides clinical benefit in this context using a randomized, double-blind, placebo-controlled design. A total of 110 adult patients undergoing clean outpatient upper limb surgery were allocated to receive either a single preoperative dose of antibiotics or placebo. Surgical site infection rates were low and equivalent in both groups (1.8%), with no meaningful differences in postoperative wound complications. These findings suggest that routine SAP does not improve outcomes in this setting and support more judicious, evidence-based antibiotic use in low-risk surgical procedures, even in environments where perceived infection risk remains a concern.Trial registration: ClinicalTrials.gov NCT05990842.","PeriodicalId":12213,"journal":{"name":"Expert Review of Anti-infective Therapy","volume":" ","pages":"465-473"},"PeriodicalIF":3.8,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147948259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Typical and atypical clinical profiles in syphilis patients: will genotyping of syphilis agents and patients help to explain symptom differences? 梅毒患者的典型和非典型临床特征：梅毒病原体和患者的基因分型是否有助于解释症状差异？

IF 4.6 2区医学

Expert Review of Anti-infective Therapy Pub Date : 2026-05-01 Epub Date: 2026-05-20 DOI: 10.1080/14787210.2026.2675011

David Šmajs, Filip Skokan

{"title":"Typical and atypical clinical profiles in syphilis patients: will genotyping of syphilis agents and patients help to explain symptom differences?","authors":"David Šmajs, Filip Skokan","doi":"10.1080/14787210.2026.2675011","DOIUrl":"10.1080/14787210.2026.2675011","url":null,"abstract":"Introduction: Syphilis, caused by Treponema pallidum subsp. pallidum, is a chronic sexually transmitted infection resulting in a broad spectrum of clinical manifestations showing a rising incidence at the global level. A high proportion of syphilis patients have atypical manifestations that may complicate clinical recognition and lead to diagnostic uncertainty and delays in treatment, thereby increasing the risk of syphilis transmission.Areas covered: We performed bibliographical searches of online databases to provide an overview of the clinical profiles observed in patients with syphilis. We also reviewed published correlations between clinical symptomatology and genotypes of the T. pallidum and syphilis patients.Expert opinion: T. pallidum strains analyzed in vitro revealed differences in growth characteristics and clinical T. pallidum isolates showed differences in the epidemiological success of individual allelic profiles. In addition, genetic differences in the clinical isolates were found with respect to syphilis stage at the time of diagnosis, multiple primary lesions and other patient characteristics. Moreover, first examples of human genomic polymorphisms involved in syphilis susceptibility and progress of infection were discovered. These findings suggest that both genetic background of a treponemal strain and a patient contribute to the different clinical outcome of syphilis infection.","PeriodicalId":12213,"journal":{"name":"Expert Review of Anti-infective Therapy","volume":" ","pages":"517-528"},"PeriodicalIF":4.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147948227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Precision antibiotic treatment in intensive care unit-acquired lower respiratory tract infections (ICU-LRTIs): contemporary concepts and future directions. 重症监护病房获得性下呼吸道感染（ICU-LRTIs）的精确抗生素治疗：当代概念和未来方向。

IF 4.6 2区医学

Expert Review of Anti-infective Therapy Pub Date : 2026-04-01 Epub Date: 2026-04-22 DOI: 10.1080/14787210.2026.2663102

Ignacio Martín-Loeches, Marc Leone, Luis Felipe Reyes, Andrew Conway-Morris, Lene Russell, Tee Keat Teoh, Alejandro Rodríguez

{"title":"Precision antibiotic treatment in intensive care unit-acquired lower respiratory tract infections (ICU-LRTIs): contemporary concepts and future directions.","authors":"Ignacio Martín-Loeches, Marc Leone, Luis Felipe Reyes, Andrew Conway-Morris, Lene Russell, Tee Keat Teoh, Alejandro Rodríguez","doi":"10.1080/14787210.2026.2663102","DOIUrl":"10.1080/14787210.2026.2663102","url":null,"abstract":"Introduction: Intensive care unit-acquired lower respiratory tract infections (ICU-LRTIs), including ventilator-associated pneumonia (VAP), ventilator-associated tracheobronchitis (VAT), and hospital-acquired pneumonia (vHAP) requiring invasive ventilation, remain among the most frequent and complex infections in critical care. Their management is challenged by diagnostic uncertainty, overlapping syndromes, and rising antimicrobial resistance. Despite advances in diagnostic and therapeutic tools, empirical broad-spectrum antibiotics remain the cornerstone of treatment, often started without microbiological confirmation.Areas covered: This narrative review examines current approaches to ICU-LRTIs, with a focus on the growing role of bronchoscopy, molecular diagnostics, host biomarkers, and therapeutic drug monitoring (TDM). The need for harmonized definitions, such as ventilator-associated lower respiratory tract infection (VA-LRTI), is discussed to address diagnostic variability. The review also considers combined therapies, including nebulized antibiotics, novel antimicrobials targeting multidrug-resistant pathogens, and real-time TDM to optimize treatment in complex ICU cases.Expert opinion: Management of VA-LRTIs is moving toward precision-guided care. Integrating bronchoscopy, molecular testing, and host-response profiling into routine practice can enable earlier, targeted therapy. Real-time TDM and local resistance surveillance should be standard to optimize antimicrobial use and prevent resistance. A shift from rigid syndromic classifications toward phenotype-driven management is needed to improve patient outcomes.","PeriodicalId":12213,"journal":{"name":"Expert Review of Anti-infective Therapy","volume":" ","pages":"381-392"},"PeriodicalIF":4.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147722351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Dengue in a warming world: changing epidemiology, vaccines, and therapeutic developments. 全球变暖中的登革热：流行病学变化、疫苗和治疗发展。

IF 4.6 2区医学

Expert Review of Anti-infective Therapy Pub Date : 2026-04-01 Epub Date: 2026-04-23 DOI: 10.1080/14787210.2026.2662312

Francesca F Norman, Ralph Huits, Lin H Chen

{"title":"Dengue in a warming world: changing epidemiology, vaccines, and therapeutic developments.","authors":"Francesca F Norman, Ralph Huits, Lin H Chen","doi":"10.1080/14787210.2026.2662312","DOIUrl":"10.1080/14787210.2026.2662312","url":null,"abstract":"Introduction: Dengue has emerged as the most widespread and rapidly increasing vector-borne disease globally and is currently a global public health threat. Geographical, environmental, host and/or vector-specific factors can act as drivers of dengue epidemics globally.Areas covered: The current dengue virus distribution and the geographical expansion of competent Aedes spp. vectors are reviewed. Recent advances in vaccine development and novel treatment options under evaluation are highlighted, including novel antivirals and monoclonal antibodies.Expert opinion: Climate change and human-related factors are driving the global expansion of dengue risk, including in temperate regions. While licensed vaccines offer new prevention opportunities, limitations remain, especially for vulnerable populations. Continued research into effective antivirals and innovative vaccines is critical. A multidisciplinary approach integrating vector control, vaccination, and emerging therapies is essential to address the growing dengue burden in a warming world.","PeriodicalId":12213,"journal":{"name":"Expert Review of Anti-infective Therapy","volume":" ","pages":"363-380"},"PeriodicalIF":4.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147697710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Unmet targets: evaluating vancomycin use and predictive factors of target attainment in hemodialysis patients. 未达到目标：评估血液透析患者万古霉素的使用和目标达到的预测因素。

IF 4.6 2区医学

Expert Review of Anti-infective Therapy Pub Date : 2026-04-01 Epub Date: 2026-04-28 DOI: 10.1080/14787210.2026.2665224

Van Dong Nguyen, Philip Ouimet, Alice Dion-Laplante, Stéphanie Crête, Sarah Dabouz, France Dion, Vlad Alexandru Rosu, Marie-Ève Legris, Amélie Marsot

{"title":"Unmet targets: evaluating vancomycin use and predictive factors of target attainment in hemodialysis patients.","authors":"Van Dong Nguyen, Philip Ouimet, Alice Dion-Laplante, Stéphanie Crête, Sarah Dabouz, France Dion, Vlad Alexandru Rosu, Marie-Ève Legris, Amélie Marsot","doi":"10.1080/14787210.2026.2665224","DOIUrl":"10.1080/14787210.2026.2665224","url":null,"abstract":"Background: Vancomycin is commonly prescribed in hemodialysis (HD) patients, who are highly susceptible to infections. Although HD-specific dosing targets have recently emerged, considerable practice variability persists, highlighting the need to standardize vancomycin therapeutic drug monitoring (TDM).Research design and methods: This multicenter retrospective study describes local practice of vancomycin dosing and monitoring, measures attainment of vancomycin target concentration range (trough: 15-20 mg/L), and identifies predictors of attainment of TDM target in HD patients. Data was collected from patients on chronic intermittent high-flux HD who received vancomycin in two Canadian health centers from 1 January 2019 to 31 December 2022.Results: 453 treatment courses, corresponding to 261 patients, were analyzed. Target attainment varied in both centers. The median (IQR) target attainment during a treatment course was 16.7% (0-50%) across all courses. Residual diuresis (OR = 0.48, 95% CI [0.28, 0.83]) and shorter treatment duration (OR = 0.91, 95% CI [0.87, 0.97]) were associated with worse target attainment.Conclusions: This study highlights the high rate of 0% target trough concentration attainment per treatment course in our centers and identifies patients with residual diuresis and/or early stages of treatment (less than 7 days) as populations that may benefit from closer vancomycin TDM.","PeriodicalId":12213,"journal":{"name":"Expert Review of Anti-infective Therapy","volume":" ","pages":"449-459"},"PeriodicalIF":4.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147766607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Efficacy and safety of gepotidacin versus standard of-care antibiotics for the treatment of uncomplicated urogenital infections in adults and adolescents: a systematic review and meta-analysis. Gepotidacin与标准护理抗生素治疗成人和青少年无并发症泌尿生殖器感染的疗效和安全性：一项系统回顾和荟萃分析。

IF 4.6 2区医学

Expert Review of Anti-infective Therapy Pub Date : 2026-04-01 Epub Date: 2026-05-06 DOI: 10.1080/14787210.2026.2667361

Mounika Reddy, Vishakha Jain, Madhavi Eerike, Manasa Reddy, Debasis Bisoi, Vahini Golla, Gerard Marshall Raj

{"title":"Efficacy and safety of gepotidacin versus standard of-care antibiotics for the treatment of uncomplicated urogenital infections in adults and adolescents: a systematic review and meta-analysis.","authors":"Mounika Reddy, Vishakha Jain, Madhavi Eerike, Manasa Reddy, Debasis Bisoi, Vahini Golla, Gerard Marshall Raj","doi":"10.1080/14787210.2026.2667361","DOIUrl":"10.1080/14787210.2026.2667361","url":null,"abstract":"Background: Gepotidacin, a novel oral antibacterial targeting bacterial DNA gyrase and topoisomerase IV, exhibits potent activity against Escherichia coli and Neisseria gonorrhoeae resistant strains. This systematic review and meta-analysis assessed the efficacy and safety of gepotidacin compared with standard-of-care antibiotics in adults and adolescents with uncomplicated urogenital infections.Methods: Randomized controlled trials comparing gepotidacin with standard antibiotic regimens for uncomplicated urinary tract infections or urogenital gonorrhea were included. Pooled risk ratios (RRs) with 95% confidence intervals (CIs) were calculated for microbiological success, clinical cure, and serious adverse events (SAEs). Risk of bias and certainty of evidence were assessed using the Cochrane RoB2 tool and GRADE approach, respectively.Results: Three phase 3 trials (EAGLE-1, EAGLE-2, EAGLE-3; n = 3,757) were included. Gepotidacin achieved comparable microbiological success (RR = 1.10; 95% CI: 0.96-1.27; p = 0.17) and clinical cure rates (RR = 1.04; 95% CI: 0.95-1.13; p = 0.39) versus standard antibiotics. SAEs were rare and balanced (RR = 0.98; 95% CI: 0.37-2.58; p = 0.96). Overall risk of bias was low.Conclusions: Gepotidacin demonstrates non-inferior efficacy and comparable safety to standard antibiotics, supporting its role as a promising oral agent against resistant E. coli and N. gonorrhoeae.","PeriodicalId":12213,"journal":{"name":"Expert Review of Anti-infective Therapy","volume":" ","pages":"425-434"},"PeriodicalIF":4.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147766585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Interplay between the arachidonic acid/cyclooxygenase 2/prostaglandin E₂ pathway and RNA viral infections. 花生四烯酸/环氧合酶2/前列腺素E2途径与RNA病毒感染的相互作用。

IF 4.6 2区医学

Expert Review of Anti-infective Therapy Pub Date : 2026-04-01 Epub Date: 2026-04-29 DOI: 10.1080/14787210.2026.2665216

Areli J Navarro, Ignacio A Pasten-Ferrada, Felipe A Cancino, Hernán F Peñaloza, Alexis M Kalergis, Leandro J Carreño, Pablo A González

{"title":"Interplay between the arachidonic acid/cyclooxygenase 2/prostaglandin E2 pathway and RNA viral infections.","authors":"Areli J Navarro, Ignacio A Pasten-Ferrada, Felipe A Cancino, Hernán F Peñaloza, Alexis M Kalergis, Leandro J Carreño, Pablo A González","doi":"10.1080/14787210.2026.2665216","DOIUrl":"10.1080/14787210.2026.2665216","url":null,"abstract":"Introduction: Viruses manipulate cellular pathways to support their replication, often leading to inflammatory responses through the arachidonic acid (AA)/cyclooxygenase (COX)/prostaglandin E2 (PGE2) axis. Given the potential impact of this pathway on viral pathogenesis and disease severity, defining its role during infection warrants attention.Areas covered: This review examines the roles of COX-2 and its primary metabolite, PGE2, in RNA virus infections, highlighting their context-dependent effects on viral replication, pathogenesis, and host immunity. It also covers the therapeutic potential of selective COX-2 inhibitors over these processes. The review is based on articles retrieved during 2000-2025 through a systematic search in PubMed and the web.Expert opinion: Emerging evidence suggests that the AA/COX-2/PGE2 axis exerts significant, yet context-dependent antiviral effects during RNA virus infections. Critical gaps remain in understanding the tissue-specific effects of this pathway during RNA virus infections, including the contributions of COX-2-derived metabolites and their molecular mechanisms of action. In vivo studies and clinical trials are needed to evaluate the therapeutic potential of targeting the AA/COX-2/PGE2 axis, with available safe COX-2-inhibiting drugs approved for human use that allow such approaches. Knowledge derived from these assays could yield impactful therapeutic applications that significantly improve clinical outcomes in RNA virus infections.","PeriodicalId":12213,"journal":{"name":"Expert Review of Anti-infective Therapy","volume":" ","pages":"393-412"},"PeriodicalIF":4.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147766646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Difficile to treat: advanced management strategies in difficult to treat Clostridioides difficile infections. 难辨梭菌的治疗：难辨梭菌感染的先进治疗策略。

IF 4.6 2区医学

Expert Review of Anti-infective Therapy Pub Date : 2026-04-01 Epub Date: 2026-04-15 DOI: 10.1080/14787210.2026.2659725

Sahil Khanna, Patricia P Bloom

{"title":"Difficile to treat: advanced management strategies in difficult to treat Clostridioides difficile infections.","authors":"Sahil Khanna, Patricia P Bloom","doi":"10.1080/14787210.2026.2659725","DOIUrl":"10.1080/14787210.2026.2659725","url":null,"abstract":"Introduction: Clostridioides difficile infection (CDI) remains a leading cause of healthcare-associated infectious diarrhea, with a major burden driven by recurrences and severe or even fulminant disease in vulnerable hosts. The therapeutic landscape has shifted toward fidaxomicin-based antibiotic regimens and microbiota restoration strategies, including standardized microbiota-based products.Areas covered: Recent international guidelines, outcome studies, and pivotal trials focused on difficult-to-treat phenotypes such as refractory or fulminant CDI, multiply recurrent CDI, and CDI in high-risk populations (immunocompromised, inflammatory bowel disease, critical illness) were reviewed. A PubMed search was supplemented by hand-searching additional references, guidelines and regulatory documents. Evidence is summarized for optimized antibiotic regimens, bezlotoxumab, conventional fecal microbiota transplantation (FMT), FDA-approved microbiota-based products, and salvage strategies including intracolonic therapy and surgery.Expert opinion: Advanced CDI management is moving from repeated antibiotic cycling toward individualized recurrence prevention and microbiota restoration strategies. Implementation requires diagnostic stewardship, early recognition of recurrences, clear pathways for microbiota-based therapy access, and multidisciplinary care for fulminant infection. Over the next five years, standardized microbiota therapeutics and better risk tools should shift care toward earlier, more durable recurrence prevention.","PeriodicalId":12213,"journal":{"name":"Expert Review of Anti-infective Therapy","volume":" ","pages":"413-424"},"PeriodicalIF":4.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147662351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Non-prescription antibiotic dispensing and counseling practices in Iraqi community pharmacies: implications for antimicrobial stewardship and resistance containment. 伊拉克社区药房的非处方抗生素分发和咨询做法：对抗菌素管理和耐药性控制的影响。

IF 4.6 2区医学

Expert Review of Anti-infective Therapy Pub Date : 2026-04-01 Epub Date: 2026-04-21 DOI: 10.1080/14787210.2026.2663104

Omeed Darweesh, Brian Godman, Amanj Kurdi

{"title":"Non-prescription antibiotic dispensing and counseling practices in Iraqi community pharmacies: implications for antimicrobial stewardship and resistance containment.","authors":"Omeed Darweesh, Brian Godman, Amanj Kurdi","doi":"10.1080/14787210.2026.2663104","DOIUrl":"10.1080/14787210.2026.2663104","url":null,"abstract":"Background: To assess the prevalence, characteristics, dispensing practices, and counseling behavior of non-prescription antibiotic dispensing among Iraqi community pharmacies to inform antimicrobial stewardship (AMS) policy.Research design and methods: A cross-sectional simulated client study was conducted among 696 pharmacies across five Iraqi provinces. Standardized scenarios of upper respiratory tract infection were used to evaluate dispensing behavior, counseling quality (defined as whether staff provided key counseling components including enquiry about symptoms, allergy status, dosage instructions, and treatment duration), and antibiotic class distribution according to the WHO-AWaRe framework. Data were analyzed using descriptive and multivariable logistic regression.Results: Antibiotics were dispensed without prescription in 80.6% (95%CI:77.6-83.5%) of the visits. Access antibiotics accounted for 60.8% (95%CI:56.9-65.0%) and Watch agents for 39.2% (95%CI:34.9-43.1%), with amoxicillin-(26.4%), amoxicillin-clavulanate-(30.7%), and azithromycin-(25.5%) most common. Counseling was poor; only 15% (95%CI:12.3-18.3%) of the providers asked any clinical question and only 7.7% (95%CI:5.5-9.9%) enquired about allergy history. Non-pharmacist staff (nurses) were significantly more likely to dispense antibiotics without prescription compared with pharmacists (OR = 5.7; 95%CI:3.2-10.1).Conclusions: Non-prescription antibiotic dispensing and minimal counseling remain widespread in Iraqi pharmacies. Effective AMS in Iraq will require phased, system-level approaches, including strengthened regulatory enforcement, workforce support addressing all pharmacy personnel, and integration of community pharmacies into national AMR strategies.","PeriodicalId":12213,"journal":{"name":"Expert Review of Anti-infective Therapy","volume":" ","pages":"435-448"},"PeriodicalIF":4.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147716394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0