Jerneja Ahčan

Klinički Bolnički Centar Rijeka

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Dušica Pleterski-Rigler

Ljubljana University Medical Centre

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Milan Čižman

Ljubljana University Medical Centre

Tom Bajec

Rasta Rakar

Klinički Bolnički Centar Rijeka

Maja Arnež

Ljubljana University Medical Centre

Maja Sočan

National Institute of Public Health

Eva Ružić‐Sabljić

University of Ljubljana

Franc Strle

Ljubljana University Medical Centre

Aleš Korošec

National Institute of Public Health

Tina Plankar Srovin

Ljubljana University Medical Centre

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Ljubljana University Medical Centre

University Medical Center

University of Ljubljana

Klinički Bolnički Centar Rijeka

National Institute of Public Health

Angela Boškin Faculty of Health Care

Health Insurance Institute of Slovenia

Czech Academy of Sciences, Institute of Microbiology

Institute of Oncology Ljubljana

Massachusetts General Hospital

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Isolation of Borrelia burgdorferi sensu lato from blood of children with solitary erythema migrans

The Pediatric Infectious Disease Journal (2001)

Maja Arnež Eva Ružić‐Sabljić Jerneja Ahčan ALENKA RADŠEL-MEDVEŠČEK Dušica Pleterski-Rigler

Objectives. To establish the frequency of isolation of Borrelia burgdorferi sensu lato from blood of children with solitary erythema migrans (EM) in Europe, to determine the strains of the isolated borreliae and to compare the clinical course and the outcome of the disease according to positive and negative blood culture result. Methods. In the prospective study we included 134 consecutive patients younger than 15 years with solitary EM, referred to our institution in 1996 and 1997. One milliliter of blood was withdrawn before treatment and cultured in modified Kelly-Pettenkofer medium. Isolated borreliae were typed according to LRFP analysis. Patients were treated with either penicillin V or cefuroxime axetil for 14 days. The posttreatment course was surveyed by follow-up visits during 1 year. Results. B. burgdorferi sensu lato was isolated in 12 of 134 (9%) patients. Eleven blood isolates were typed: 10 were found to be B. afzelii and 1 was Borrelia garinii. Comparison of blood culture-positive and -negative patients revealed no differences in pretreatment characteristics or in posttreatment clinical course. However, worsening of local and/or systemic signs and symptoms at the beginning of antibiotic therapy (Jarish-Herxheimer's reaction) was identified more often in the blood culture-positive than in the blood culture-negative group (5 of 12 vs. 17 of 122, respectively;P = 0.0274). Conclusions. The isolation rate of B. burgdorferi sensu lato from the blood of children with solitary EM was 9%. The majority of the isolates were B. afzelii. Blood culture-positive patients treated with oral antibiotics were not at greater risk for unfavorable course of the disease than patients with negative blood culture result.

Erythema migrans

Borrelia garinii

Borrelia afzelii

Sensu

Blood Culture

Cefuroxime

Isolation

10.1097/00006454-200103000-00007

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Ambulantna poraba antibiotikov pri otrocih v Sloveniji

Slovenian Medical Journal (2017)

Milan Čižman Tina Plankar Srovin Maja Sočan Aleš Korošec Jerneja Ahčan

Background: Antibiotics are among the most common drugs prescribed in outpatient settings. It is estimated that up to 50 % are prescribed unnecessarily or inappropriately. To plan the actions for optimizing the use of antibiotics, we conducted a national antibiotic consumption study in children aged 0–18 years in the period between 2003 and 2015.Methods: In this national retrospective research we analyzed outpatient antibiotic consumption using ATC/DDD classification. The use of antibiotics was recorded in relation to the pattern of prescription, age, gender and health region.Results: The total consumption of antibiotics decreased by 35 % from 979 to 636 prescriptions per 1000 children/year (PTY) during the whole study period. Te use of all antibiotic classes decreased (except for quinolones and nitrofuran derivatives) by 12.5 %–81 %. In all those years we recorded the highest consumption in children aged 1 to 4 years (2184–1160 PTY). Amoxicillin was the most commonly prescribed antibiotic in children aged 0 to 4 years, penicillin V among 5 to 14 years and co-amoxiclav among adolescents aged 15 to 19 years. In health regions in the northeastern part of Slovenia much more antibiotics were prescribed than in other regions. In 2015, 65 % of prescriptions were prescribed by pediatricians and school medicine specialists, 16 % by physicians without specialization, 14 % by GPs/family doctors and 5 % by other specialists.Conclusions: Despite the decrease in outpatient antibiotic use in children and adolescents in Slovenia, the overall and especially broad-spectrum antibiotic consumption (amoxicillin with clavulanic acid, azithromycin and second/third generation cephalosporins) is still too high. It is necessary to strengthen activities to reduce prescribing, particularly for acute (upper) respiratory tract infections.

Defined daily dose

10.6016/zdravvestn.2474

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VALUE OF UNIVERSAL CHILDHOOD VARICELLA VACCINATION IN SLOVENIA

DOAJ (DOAJ: Directory of Open Access Journals) (2002)

Jerneja Ahčan Milan Čižman Dušica Pleterski-Rigler Rasta Rakar

Background. In 1974 effective and safe vaccine against varicella was developed. Vaccination is recomended for universal childhood immunisation in some of west European countries and in the United States. The aim of the study was to perform economic analysis of universal childhood vaccination against varicella in Slovenia. Methods. We examined hypothetical birth cohort of 5800 persons followed from birth to their 30th birthday and calculated the cost-benefit ratio for varicella vaccination program. We assumed that one dose of vaccine would be given to 15-monthold children along with measles, mumps and rubella vaccination. It was also assumed that 95% of children would be vaccinated, that vaccine efficacy would be 90%, that vaccine induced immunity would be lifelong and that the program would have no effect on either the incidence rate or severity of herpes zoster. For both disease and vaccine we measured the direct medical cost and indirect cost. Results. Indirect cost represented major part compared to medical cost. The benefit to cost ratio was 0.89. Conclusions. Considering major assumptions in this analysis, there is no financial benefits from vaccinating all children against varicella in our country.

Value (mathematics)

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Outpatient use of antibiotics in children in Slovenia

DOAJ (DOAJ: Directory of Open Access Journals) (2017)

Milan Čižman Tina Plankar Srovin Maja Sočan Aleš Korošec Jerneja Ahčan

Background: Antibiotics are among the most common drugs prescribed in outpatient settings. It is estimated that up to 50 % are prescribed unnecessarily or inappropriately. To plan the actions for optimizing the use of antibiotics, we conducted a national antibiotic consumption study in children aged 0–18 years in the period between 2003 and 2015. Methods: In this national retrospective research we analyzed outpatient antibiotic consumption using ATC/DDD classification. The use of antibiotics was recorded in relation to the pattern of prescription, age, gender and health region. Results: The total consumption of antibiotics decreased by 35 % from 979 to 636 prescriptions per 1000 children/year (PTY) during the whole study period. Te use of all antibiotic classes decreased (except for quinolones and nitrofuran derivatives) by 12.5 %–81 %. In all those years we recorded the highest consumption in children aged 1 to 4 years (2184–1160 PTY). Amoxicillin was the most commonly prescribed antibiotic in children aged 0 to 4 years, penicillin V among 5 to 14 years and co-amoxiclav among adolescents aged 15 to 19 years. In health regions in the northeastern part of Slovenia much more antibiotics were prescribed than in other regions. In 2015, 65 % of prescriptions were prescribed by pediatricians and school medicine specialists, 16 % by physicians without specialization, 14 % by GPs/family doctors and 5 % by other specialists. Conclusions: Despite the decrease in outpatient antibiotic use in children and adolescents in Slovenia, the overall and especially broad-spectrum antibiotic consumption (amoxicillin with clavulanic acid, azithromycin and second/third generation cephalosporins) is still too high. It is necessary to strengthen activities to reduce prescribing, particularly for acute (upper) respiratory tract infections.

Outpatient clinic

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Citations (1)

VARICELLA HOSPITALISATION

DOAJ (DOAJ: Directory of Open Access Journals) (2002)

Jerneja Ahčan Milan Čižman Dušica Pleterski-Rigler Rasta Rakar

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Demographic features, clinical characteristics and laboratory findings in children with multiple erythema migrans in Slovenia.

PubMed (2001)