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Expert Review of Anti-infective Therapy

Matthew W McCarthy, Thomas J Walsh
The presence of Candida species in the blood is known as candidemia and may constitute a medical emergency for patients with cancer. Despite advances in diagnosis and treatment of this fungal infection, mortality remains unacceptably high. Areas covered: This paper reviews recent advances in molecular diagnostics to detect species of Candida as well as novel antifungal agents that have been developed to address candidiasis. We also review prophylaxis strategies to prevent candidiasis in high-risk cancer patients...
October 16, 2018: Expert Review of Anti-infective Therapy
Stephanie Noviello, David B Huang, G Ralph Corey
Iclaprim is a selective bacterial dihydrofolate reductase inhibitor. Although there are alternative options for the treatment of acute bacterial skin and skin structure infections (ABSSSI), iclaprim is differentiated from other available antibiotics. Areas covered: Iclaprim is under clinical development for ABSSSI. This review summarizes the mechanism of action, pharmacokinetics, microbiology, clinical development program, and the differentiation of iclaprim from other antibiotics. Expert commentary: Iclaprim has a different mechanism of action (dihydrofolate reductase inhibitor) compared to most other antibiotics, is active and rapidly bactericidal against Gram-positive pathogens including antibiotic-resistant pathogens, and suppresses bacterial exotoxins (alpha hemolysin, Panton Valentine leukocidin, and toxic shock syndrome toxin-1)...
October 13, 2018: Expert Review of Anti-infective Therapy
Kuan Shion Ong, Christina Injan Mawang, Delhousie Daniel-Jambun, Yau Yan Lim, Sui Mae Lee
Biofilm formation is a strategy for microorganisms to adapt and survive in hostile environments. Microorganisms that are able to produce biofilms are currently recognized as a threat to human health. Areas covered: Many strategies have been employed to eradicate biofilms, but several drawbacks from these methods had subsequently raised concerns on the need for alternative approaches to effectively prevent biofilm formation. One of the main mechanisms that drives a microorganism to transit from a planktonic to a biofilm-sessile state, is oxidative stress...
October 11, 2018: Expert Review of Anti-infective Therapy
Shyam Sundar, Om Prakash Singh, Jaya Chakravarty
Visceral leishmaniasis (VL) is a fatal parasitic disease caused by a parasite belonging to the Leishmania donovani complex and transmitted by infected female Phlebotomous argentipes sand flies. The VL elimination strategy in the Indian subcontinent, that has a current goal of reducing the incidence of VL to below 1/10,000 of population by the year 2020, consists of rapid detection and treatment of VL to reduce the number of human reservoirs, and vector control using indoor residual spraying (IRS). However, as the incidence of VL declines towards the elimination goal, greater targeting of control methods will be required to ensure appropriate early action to prevent the resurgence of VL...
October 5, 2018: Expert Review of Anti-infective Therapy
Sean Keane, Pierce Geoghegan, Pedro Povoa, Saad Nseir, Alejandro Rodriguez, Ignacio Martin-Loeches
Invasive candidiasis is the most common fungal infection affecting critically ill adults. International guidelines provide differing recommendations for first-line antifungal therapy, with echinocandins considered first-line in the majority. Amphotericin B has broad activity and low minimum inhibitory concentration resistance patterns across most Candida species and guidance away from its use should be supported by the available evidence. Areas Covered: A systematic literature review was conducted from August to September 2017 to determine whether treatment with echinocandins or other available drugs, namely voriconazole, confers a therapeutic or survival benefit over amphotericin B in critically ill adults with invasive candidiasis...
September 26, 2018: Expert Review of Anti-infective Therapy
Michele Bartoletti, Russell Edward Lewis, Maddalena Giannella, Sara Tedeschi, Pierluigi Viale
Bloodstream infections (BSIs) in patients with liver cirrhosis are associated with significant morbidity and mortality. Early appropriated antibiotic treatment is essential for the correct management of these patients. Areas covered: This review covers several aspects of how the pharmacokinetic/pharmacodynamic behavior of antimicrobials may change in patients with liver cirrhosis. Common features of cirrhosis, including hypoproteinemia, third space expansion and impairment of renal function may alter drug distribution in patients receiving hydrophilic drugs like β-lactams, which are often frontline agents...
September 15, 2018: Expert Review of Anti-infective Therapy
Amin Talebi Bezmin Abadi, Johannes G Kusters
No abstract text is available yet for this article.
September 13, 2018: Expert Review of Anti-infective Therapy
Matteo Bassetti, Elda Righi, Alessia Carnelutti, Elena Graziano, Alessandro Russo
Management of antimicrobial resistance in multi-drug-resistant-Klebsiella pneumoniae (MDR-KP) is a major challenge for clinicians. The optimal treatment option for MDR-KP infections is still not well established. Combination therapies including high-dose meropenem, colistin, fosfomycin, tigecycline, and aminoglycosides are widely used, with suboptimal results. New antimicrobials targeting MDR-KP have been developed during the last decades and are now at various stages of clinical research. Areas covered: The PubMed database was searched to review the most significant literature on the topic, with a special consideration for articles coming from endemic countries...
September 12, 2018: Expert Review of Anti-infective Therapy
Ivan Noreña, Mario Fernández-Ruiz, José María Aguado
The development of biologic therapies for treating patients with rheumatic, hematologic, or oncological diseases has increased in the last few years, spreading their use in clinical practice. Areas covered: Clinical experience has evidenced substantial risks for some viral infections and/or reactivations such as viral hepatitis, herpetic infections, and other viruses, as a consequence of specific immune pathway blockages. Biological therapies produce a variable risk of reactivation of viral infections, which is particularly uncertain in the case of the most recently introduced agents...
September 8, 2018: Expert Review of Anti-infective Therapy
Leila Barss, Dick Menzies
Latent tuberculosis infection (LTBI) management is recognized as a key component of the World Health Organization End Tuberculosis Strategy. The term 'cascade of care in LTBI' has recently been used to refer to the process of LTBI management from identification of persons who may have LTBI to completion of treatment. Large gaps throughout the LTBI cascade of care have been identified. Areas covered: We have reviewed quality improvement (QI) as a potential approach for systematically improving gaps within the LTBI cascade of care...
October 2018: Expert Review of Anti-infective Therapy
Paul Froom, Zvi Shimoni
The diagnostic criteria for a urinary tract infection (UTI) and proper treatment of elderly patients hospitalized with nonspecific symptoms is uncertain. Areas covered: A nonsystematic literature review of the variable approaches in diagnosing and treating hospitalized elderly patients with a suspected UTI. Expert commentary: Bacteriuria and/or pyuria cannot confirm the diagnosis of a UTI because of the high prevalence in the elderly regardless of presentation so urine cultures are not indicated in those hospitalized for diseases outside the urinary tract...
October 2018: Expert Review of Anti-infective Therapy
Suhail Ahmad, Eiman Mokaddas, Noura M Al-Mutairi
Prevalence of TB and MDR-TB varies considerably among various regions of World Health Organization (WHO) and also among individual countries within each region. Many Middle Eastern countries have war/civil war-like situations, refugees from war-torn countries or dynamic expatriate population from TB endemic countries which will likely affect the END-TB strategy launched by the WHO in 2015. Areas covered: The data for each of 17 countries comprising the Middle East were analyzed for estimated incidence of TB, number of notified TB cases, mortality rate, and rate of MDR-TB in new and previously treated TB cases as reported by WHO...
September 2018: Expert Review of Anti-infective Therapy
Lindsay A Hatzenbuehler, Jeffrey R Starke
Identifying and treating children with tuberculosis (TB) infection in both low and high-TB burden settings will decrease the incidence of TB disease worldwide. Areas covered: This review covers each of the available TB infection treatment options for children based on effectiveness, safety, tolerability and treatment completion rates. Six to 9 months of daily administered isoniazid is no longer the treatment of choice for many children with TB infection. Shorter, rifamycin based, TB infection treatment regimens are effective, safe and easier for children to complete...
September 2018: Expert Review of Anti-infective Therapy
Jose Garnacho-Montero, Irene Barrero-García, Maria de Gracia Gómez-Prieto, Ignacio Martín-Loeches
Despite advances in modern medicine, severe community-acquired pneumonia (CAP) continues to be a potentially deadly disease. Mortality rate reaches up to the 50% in patients requiring admission to the Intensive Care Unit (ICU) when developing septic shock. Areas covered: We aim to describe the optimal management of severe CAP, including antibiotic therapy, future antimicrobial options, and non-antibiotic (so-called adjunctive) therapies. A literature search was performed to identify all clinical trials, observational studies, meta-analysis, and reviews about this topic from PubMed...
September 2018: Expert Review of Anti-infective Therapy
George O Akpede, Danny A Asogun, Silvanus A Okogbenin, Peter O Okokhere
No abstract text is available yet for this article.
September 2018: Expert Review of Anti-infective Therapy
David Y Graham, Maria Pina Dore, Hong Lu
Recent Helicobacter pylori treatment guidelines recommend the 4-drug combinations bismuth quadruple therapy and concomitant therapy. Areas covered: We review antimicrobial therapy for H. pylori in the context of antimicrobial therapy in general and specifically in relation to good antimicrobial stewardship (defined as optimal selection, dose, and duration of an antimicrobial that results in the best clinical outcome for the treatment of infection, with minimal toxicity to the patient and minimal impact on subsequent resistance)...
September 2018: Expert Review of Anti-infective Therapy
Marta Bodro, Laura Linares, Diana Chiang, Asuncion Moreno, Carlos Cervera
Recurrent urinary tract infections (UTI) are a common clinical problem in kidney transplant recipients. Due to the complex urological anatomy derived from the implantation of the kidney graft, the spectrum of the disease and the broad underlying pathophysiological mechanisms. Recurrent UTI worsen the quality of life, decrease the graft survival and increase the costs of kidney transplantation. Areas covered: In this review, we describe the definitions, clinical characteristics, pathophysiological mechanisms and microbiology of recurrent urinary tract infections in kidney transplantations...
September 2018: Expert Review of Anti-infective Therapy
Anuli Nwaohiri, Sarah Schillie, Marc Bulterys, Athena P Kourtis
Hepatitis C virus (HCV) infection is an important contributor to the worldwide burden of liver-related morbidity and mortality. Mother-to-child transmission of HCV ranges from 6 to 11% in different populations globally, but accurate estimates on the burden of pediatric HCV infection are limited because screening approaches are not consistent. Areas covered: The advent of new direct-acting antiviral agents that achieve very high rates of sustained virologic response (representing virologic cure) with short (i...
September 2018: Expert Review of Anti-infective Therapy
Suresh Misra, Douglas T Dieterich, Behnam Saberi, Tatyana Kushner
Hepatitis C contributes to significant morbidity and mortality worldwide. AHCV is defined as documented infection within 6 months of exposure. Treating acute hepatitis C virus (AHCV) with direct-acting antiviral agents in persons who inject drugs, HIV-positive men who have sex with men, and patients who acquire HCV nosocomially can contribute to the elimination of disease globally, preclude the morbidity and mortality of chronic disease, and prevent further transmission. Areas covered: In this review, we describe the epidemiology of AHCV, its natural history, the considerations involved in the decision of whether to treat AHCV, and the most current DAA therapy guidelines...
August 2018: Expert Review of Anti-infective Therapy
Simone Lanini, Raffaella Pisapia, Maria Rosaria Capobianchi, Giuseppe Ippolito
The World Health Organization recognizes that viral hepatitis is not only a massive public health issue but also a huge opportunity to improve quality of life and equity at a global level. Viral hepatitis causes about 1.5 million deaths each year and significantly affects the quality of life of hundreds of millions of people. To date, frail individuals in high-income countries and people living in low-income settings are paying the heaviest tool. Areas covered. Here we present a broad discussion on current knowledge and topical issues about the hepatitis pandemic...
August 2018: Expert Review of Anti-infective Therapy
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