T MacDonald

Publications (4)32.52 Total impact

• Article: Community antibiotic therapy, hospitalization and subsequent respiratory tract isolation of Haemophilus influenzae resistant to amoxycillin: a nested case-control study.

  R A Seaton, D T Steinke, G Phillips, T MacDonald, P G Davey
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  ABSTRACT: The study objective was to determine whether recent community antibiotic prescribing and hospitalization are associated with beta-lactam resistance in respiratory isolates of Haemophilus influenzae. Data obtained for hospitalization and community prescribing (in the previous 3 months) from 412 adults (>15 years) in whom an episode of respiratory tract infection had been described, during which H. influenzae was isolated, were analysed. Seventy-three (17.7%) isolates of H. influenzae were resistant to amoxycillin. Resistance was associated with recent hospitalization [odds ratio (OR) 3.2, 1.8-5.6] and antibiotic exposure in the community (2.1, 1.2-3.6). These variables were independently associated with amoxycillin resistance [hospitalization (OR 4.5, 1. 7-12.5) and community beta-lactam antibiotic exposure (3.9, 1.6-9. 8)]. Hospitalized patients probably received antibiotics during their admission although aquisition of the organism or the beta-lactamase via plasmids from other Gram-negative organisms in the hospital could also be a factor. Control measures to reduce the inappropriate use of antimicrobials in the community and in hospital need to be reinforced.
  Journal of Antimicrobial Chemotherapy 08/2000; 46(2):307-9. · 5.07 Impact Factor
• Article: Health resource use and costs associated with viral hepatitis

  D T Steinke, A Morris, T MacDonald, J F Dillon
  Hepatology 01/2000; 32(4). · 11.66 Impact Factor
• Article: Incidence and prevalence of primary biliary cirrhosis in Tayside, Scotland

  D T Steinke, A Morris, T MacDonald, J F Dillon
  Hepatology 01/2000; 32(4). · 11.66 Impact Factor
• Article: Acute Herpes zoster in Tayside: demographic and treatment details in immunocompetent patients 1989-1992.

  J Torrens, D Nathwani, T MacDonald, P G Davey
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  ABSTRACT: Medical records of 105 patients admitted to Tayside hospitals with acute Herpes zoster without underlying immunosuppression were examined retrospectively for the period 1984-1992. In this elderly population (median age: 79 years) there was a female preponderance (70.5%), most admissions were for trigeminal zoster (49.5%) and length of stay ranged from 1-70 days (median: 11 days), indicating significant morbidity. There was a wide variation in both pre-admission and inpatient treatment; 53.3% of patients did not receive any anti-viral therapy prior to admission, and prescribing patterns for in-patients revealed marked differences, according to the dermatome affected. Idoxuridine 5% solution was prescribed by 15.24% of General Practitioners. Given the significant morbidity and associated costs of Herpes zoster, and that existing anti-viral agents exert maximal benefit when administered early in the course of the disease, recommendations are made with respect to appropriate therapy, and auditing current management of this serious illness, which is expected to increase in prevalence as the population ages.
  Journal of Infection 04/1998; 36(2):209-14. · 4.13 Impact Factor