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The article presents a case of pediatric Mycobacterium abscessus mastoiditis resistant to standard treatments, emphasizing the importance of considering M. abscessus in treatment-resistant chronic otitis media and mastoiditis, especially in children with tympanostomy tubes. Topics include challenges in diagnosing M. abscessus infections, treatment strategies, and the effectiveness of tigecycline in multidrug regimens.

Background: Acute uncomplicated cystitis is one of the most common diagnoses for which antibiotic treatment is prescribed in the outpatient setting. Despite the availability of national guidelines, there remains a wide pattern in prescriber choices for therapy. Recent data portray a picture of consistently longer durations than recommended prescribed in outpatient settings.Objective: The objective was to evaluate the effect of a system-based intervention on adherence to guideline-recommended durations of therapy for uncomplicated cystitis in the outpatient setting.Methods: This quasi-experimental study included women aged 18-64 years who were seen at five family medicine clinics at an academic medical centre and were prescribed targeted antibiotics for uncomplicated cystitis (nitrofurantoin monohydrate/macrocrystals 100 mg, trimethoprim-sulfamethoxazole 160/800 mg or ciprofloxacin 250 mg). The intervention involved revising or adding pre-filled, but modifiable, default prescribing instructions in the electronic health record (EHR) for the targeted antibiotics. We evaluated adherence to guideline-recommended duration of therapy as well as days of therapy (DOT) before and after the intervention.Results: A total of 787 pre-intervention and 862 post-intervention cases were included. Adherence to recommended duration of therapy increased from 29.4% to 76.3% (P < 0.01). The average DOT decreased by 23% from 6.6 to 5.1 (P < 0.01).Conclusion: A stewardship intervention consisting of revising/adding default prescribing instructions to targeted antimicrobials in an EHR was associated with increased adherence to recommended durations of therapy for uncomplicated cystitis and reduction of unnecessary antibiotic exposure. More studies are needed to confirm effectiveness across multiple medical record platforms. [ABSTRACT FROM AUTHOR]

Group B streptococcus (GBS) is a known cause of invasive infection in neonates and adults with significant underlying medical conditions, particularly diabetes mellitus. There is no evidence in the literature of a pediatric diabetic patient with a GBS infection. The first case is presented of a 12-year-old female with an invasive GBS infection as the initial presenting complaint of new onset type I diabetes mellitus. [ABSTRACT FROM AUTHOR]