The purpose of this study was to quantify the antibiotics prescribed in the outpatient setting of all primary health care professionals in Catalonia during 1992-2007. We calculated prescribed defined daily doses per 1,000 inhabitants and day (DID) from data provided by the Catalonian Health Service. The antibiotics analysed belonged to the J01 group (ATC/DDD classification). The overall prescribing of antibacterials has decreased by 11.9% during this period (1992: 16.75 DID, 2007: 14.75 DID). During this 16-year period, an increase was observed for penicillins (from 46.1% in 1992 to 59.6% in 2007) and for quinolones (from 13.3% to 15.7%). The prescription of cephalosporins remained steady and, conversely, a decrease in macrolides was found (from 14.8% to 12.2%). The leading antibiotic prescribed in 2007 was amoxicillin plus clavulanic acid (5.15 DID), followed by amoxicillin (2.95 DID). The former has increased by 84.4% since 2002. Penicillin V prescribing reached a peak in 2007 with 0.034 DID. There has been a slight reduction in antibiotic prescription in this 16-year study, with an increase of penicillins, mainly at the expense of those of broader antibacterial spectrum. Awareness of the rational use of antibiotics is mandatory, basically aimed at reducing the overall prescribing of antibiotics and encouraging those with a narrower spectrum.

Peritonitis is a serious infection and early diagnosis and treatment is mandatory. A variety of microorganisms are identified in these cases and during recent years a new one was included, Pantoea agglomerans. In this case report, a female patient on continuous ambulatory peritoneal dialysis therapy with a peritonitis episode caused by this organism is described. The source of infection was thought to be due to contact of catheter with non-sterile surfaces. In microbiologic culture, this organism was identified and the patient successfully treated with a three week course of gentamicin therapy. The number of reported cases with this organism has increased in last years and various infection localizations and clinical progress patterns have been identified. In peritoneal dialysis patients presenting with peritonitis, this organism must be kept in mind.

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Introduction: Cardiovascular, respiratory, and cerebrovascular diseases and malignancies are responsible for morbidity and mortality in acromegaly. Also these diseases are associated with chronic inflammation. The neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) are currently gaining interest as new markers of inflammation. Moreover, increased morbidity and mortality are positively correlated with the presence of diabetes and levels of insulin-like growth factor 1 (IGF-1) in acromegaly. The objective of the present study was to investigate the relationship between these markers and acromegaly according to plasma glucose status and serum IGF-1 levels. Materials and Methods: We retrospectively analyzed data from 61 acromegaly patients who were in a newly diagnosed period (35 male, 26 female; mean age 38.13 ± 13.98). Patients with normal plasma glucose ( n = 27), impaired fasting glucose ( n = 18), and diabetes mellitus ( n = 16) were categorized into three different groups. NLR and PLR were compared between the study groups and were evaluated according to IGF-1 levels. Results: There were no statistically significant differences in NLR and PLR measurements among the study groups ( p > 0.05). However, there were significant positive correlations between NLR and IGF-1 levels and between PLR and IGF-1 levels when all patients were evaluated ( r = 0.334, p = 0.011 and r = 0.277, p = 0.035, respectively). Conclusions: This is the first report studying the relationship of NLR and PLR with glucose status and IGF-1 levels in acromegaly patients. Our study results suggest that subclinical inflammation may play a role in increased incidence of mortality and morbidity, which depends on uncontrolled IGF-1 levels in patients with acromegaly.