Thanks to penicillin the chicken is cheap Dag Berild 2014.
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Transcript of Thanks to penicillin the chicken is cheap Dag Berild 2014.
Thanks to penicillin the chicken is cheap
Dag Berild 2014
Dag Berild 2014
Evolution of resistance in tuberculosis
Resitance Year Number of cases
Monoresistant TB 1950-60 ?
Multi drug resistant TB 1990? 9-32% new pts>50% previously treated
Extensively resistant TB 2006, now in 84 countries 630 000, East-Europe, Asia
Totally resistant TB 2012 India, Iran, Poland
Dag Berild 2014
Intervention to reduce macrolides
Dag Berild 2014
But, good things are happening i Norway too
Dag Berild 2014
Dag Berild 2014
Penetrerende abdominale skader 1. verdenskrig
• ”During World War I battlefield surgeons were reluctant to operate on the abdominal cavity when active sepsis was present. The accepted procedure for treating a penetrating abdominal wound was to use morphine for pain, prayers for the soul, and watchful waiting for the peritonitis to resolve.”
• Gorbach SL. Abdominal infections. Clin Infect Dis 1993; 17: 961–7.
Dag Berild 2014
Doses the impact of interventions sustain?
Dag Berild 2014
Until now, no visionary political leadership
Dag Berild 2014
Adjust therapy according to blood cultures Berild D, Jensenius M, Ringertz SH, Mohseni A. JAC 2006;57:326-30
354 episodesof positive
blood cultures
226 episodes of true bacteraemia Guidelines recommended adjustment of antibiotics
in 166 episodes
In 36 episodes the patients diedor were discharged before
the results of blood cultures
92 episodes with CNSand other contaminants
Treatment adjusted in 146 (88%) episodes
Not adjusted in 20 episodes
Appropriate antibiotic therapycontinued in 60 episodes
Cost reduction 19800 EUR (21%)
Dag Berild 2014
Dag Berild 2014
Dag Berild 2014
Clinical successes
Dag Berild 2014
Pneumococcal infections
Dag Berild 2014
Serumterapi (hesteserum)
Dag Berild 2014