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Older respondents, who tend to have greater comorbidity, were also more opposed to the delayed antibiotic option.
In this study, azithromycin 1.5% ophthalmic solution, a topical antibiotic option recently approved in Europe for the treatment of bacterial conjunctivitis and trachomatous conjunctivitis 12, was tested in children as young as a few days old.
We used cafazolin in this model because cefalosporins are a recommended antibiotic option in open fractures, and previous experience with cafazolin in similar animal models reduced the model development work required to design this study.
The Infectious Diseases Society of America IDSAA) guidelines for the management of MRSA infections recognize daptomycin as an antibiotic option for the treatment of osteomyelitis [ 21] and the IDSA guidelines for the management of prosthetic joint infections also recommend daptomycin as an alternative to oxacillin and vancomycin [ 22].
When asked about their infections and antibiotic use in the past 12 months, 65% (1052) respondents reported that they had an infection, 34% (449) reported being prescribed antibiotics, 10% (172) reported asking a GP or nurse for antibiotics and 4% (CI±1.2%, n=65) reported that they had been offered a delayed antibiotic option (14% of those prescribed an antibiotic (CI±1%, n=65) (figure 2).
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Current antibiotic options are limited and possess severe practical limitations and potential adverse environmental impacts.
Table 3 Suggested empiric antibiotic options for Lemierre's syndrome Metronidazole Ampicillin – sulbactam Clindamycin Ticarcillin – clavulanate Penicillin plus metronidazole Imipenem.
Oxytocics and magnesium sulphate were not available in the majority of heath centres, and antibiotic options were inadequate.
At many government hospitals in Malawi, including Kamuzu Central Hospital (KCH), limited laboratory data and antibiotic options are barriers to providing appropriate antibiotics to patients.
We also review inhaled antibiotic options currently in development for the treatment of pneumonia in patients who are intubated and mechanically ventilated.
Suggested empiric antibiotic options for the treatment of Lemierre's syndrome are listed in Table 3 [2, 8, 14, 18, 19, 25, 27].
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