Inappropriate Use of Antibiotics and the Risk for Delayed Admission and Masked Diagnosis of Infectious Diseases

Abstract

Use of antimicrobial drugs before coming to an emergency department was associated with a significantly increased risk for delayed and masked or missed diagnoses of infectious diseases and missed diagnosis of noninfectious diseases.

Non-prescription antimicrobial use worldwide: a systematic review

“…93 In support of this assumption, more widespread antimicrobial use was identified with urine sampling than with patient selfreport. 97,[115][116][117][118] Expansion of internet commerce provides virtual worldwide access to non-prescription antimicrobials; those available on the internet are diverse and generally seem to originate in countries in which non-prescription antimicrobials are available. 86 Non-prescription use of antimicrobials is inherently associated with little guidance regarding appropriate antimicrobial selection for individual syndromes and safe practices to minimise adverse drug effects (even when provided by a pharmacist).…”

“…126 Inappropriate antimicrobial use by patients with true bacterial infections is associated with treatment failure and masking of the underlying clinical syndrome. 97 In patients treated inappropriately, either because they do not have an underlying bacterial infection or receive an inappropriate drug or suboptimum duration of treatment, patients are exposed to the risks of an antimicrobial without benefit. Although widely perceived as low-risk drugs, antimicrobials are the second most common cause of adverse drug events in the USA, 103 and nonprescription antimicrobial use has been associated with severe adverse events including death.…”

“…In Taiwan, patients admitted to hospital through the emergency room with detectable anti microbial concentrations in urine were nearly twice as likely to have a masked or missed diagnosis of an infectious disease. 97 Two case reports described severe adverse events in relation to non-prescription antimicrobials (table 2).…”

Absceso del iliopsoas: Claves para el diagnóstico imagenológico

“…El cuadro clínico es inespecífico, por lo que la sospecha inicial es a menudo escasa. La triada clásica de presentación (fiebre, dolor lumbar y cojera) se observa tan solo en un 30% de los casos, dificultándose aún más en la actualidad su diagnóstico, por el enmascaramiento de la sintomatología generado por el indiscriminado uso de antibióticos 3,4,5,6 . Ante tal escenario, los estudios de imagen se han convertido en un pilar diagnóstico fundamental, tanto por la precocidad de su detección como por la especificidad alcanzada por algunas técnicas.…”

Antibiotic utilisation amongst Australian Chinese migrants: a web-based bilingual health survey

“…Nonprescribed antibiotic use is often related to unnecessary use for non-bacterial infections and incorrect dosing, which may contribute to antimicrobial resistant bacteria in the community (67). The self-medication of antibiotics before admission to hospital may postpone the initial clinical diagnosis (137).…”