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Optimal duration of antibiotic

Daniel B Chastain, Anthony Davis
Osteomyelitis remains difficult to treat, typically requiring a prolonged course of intravenous (IV) antibiotics. The optimal route and duration of antibiotics remains ill-defined due to limited prospective clinical trials. Oritavancin is a long acting, semisynthetic, lipoglycopeptide antibiotic with rapid, concentration-dependent bactericidal activity against many Gram-positive organisms. Favorable pharmacokinetics makes oritavancin an appealing alternative for currently available antibiotics requiring daily infusions to decrease the risk of vascular access complications associated with outpatient antimicrobial therapy...
December 8, 2018: International Journal of Antimicrobial Agents
Ravina Kullar, Julia Frisenda, Paul S Nassif
Background: With antimicrobial resistance a global threat, optimizing antibiotic usage across the surgical continuum is vital. The American Academy of Otolaryngology-Head and Neck Surgery Foundation recently published the first guidelines addressing management in rhinoplasty. The authors reviewed pertinent literature on the role of systemic antibiotics in rhinoplasty and septorhinoplasty. Methods: The authors performed a MEDLINE search through PubMed using the key terms rhinoplasty, septorhinoplasty, infection, antimicrobials, and antibiotics...
October 2018: Plastic and Reconstructive Surgery. Global Open
Joāo Luís Rheingantz Scaini, Alex Dias Camargo, Vinicius Rosa Seus, Andrea von Groll, Adriano Velasque Werhli, Pedro Eduardo Almeida da Silva, Karina Dos Santos Machado
Tuberculosis is a major cause of mortality and morbidity in developing countries, and the emergency of multidrug and extensive drug resistance cases is an utmost issue on the control of the disease. Despite the efforts on the development of new antibiotics, eventually there will be strains resistant to them as well. Efflux plays an important role in the evolution of resistance in Mycobacterium tuberculosis. Tap is an important efflux pump associated with tuberculosis resistant to isoniazid, rifampicine and ofloxacin and with multidrug resistance...
December 3, 2018: Journal of Molecular Graphics & Modelling
Aurora Pop-Vicas, Stephen Johnson, Nasia Safdar
OBJECTIVE: Current practice guidelines recommend cefazolin, cefoxitin, cefotetan, or ampicillin-sulbactam as first-line antibiotic prophylaxis in hysterectomy. We undertook this systematic review and meta-analysis of randomized controlled trials (RCTs) to determine whether cefazolin, with limited antianaerobic spectrum, is as effective in preventing surgical site-infection (SSI) as the other first-choice antimicrobials that have more extensive antianaerobic activity. METHODS: We searched PubMed, Scopus, Web of Science, Cochrane Central, and EMBASE for relevant randomized controlled trials (RCT) in any language up to January 23, 2018...
December 5, 2018: Infection Control and Hospital Epidemiology
Roos Wijnakker, Loes E Visser, Emile F Schippers, Leo G Visser, Nathalie D van Burgel, Cees van Nieuwkoop
Background There is increasing interest in outpatient parenteral antimicrobial treatment. Objective To evaluate the added value of consultation of an infectious diseases expert team (consisting of two internist-infectious diseases specialists and a microbiologist) for advice regarding type, administration route and duration of antibiotic treatment. Setting A retrospective case series was performed at the Haga Teaching Hospital, a 700-bed regional teaching hospital in The Hague, The Netherlands. Methods Complication rate and mortality was evaluated during 60 days of follow-up...
November 26, 2018: International Journal of Clinical Pharmacy
John J Lewin, Aaron M Cook, Cynthia Gonzales, David Merola, Ron Neyens, William J Peppard, Gretchen M Brophy, Lisa Kurczewski, Melissa Giarratano, Jason Makii, A Shaun Rowe, Eljim P Tesoro, Amber Zaniewski, Sarah Clark, Wendy C Ziai
BACKGROUND: Central nervous system (CNS) infections are particularly prevalent in the adult neurocritical care patient population and are associated with significant morbidity and mortality. Factors relevant to the nature of CNS infections pose significant challenges to clinicians treating afflicted patients. Intraventricular (IVT) administration of antibiotics may offer several benefits over systemic therapy; however, the outcomes and current practices of such treatments are poorly described in the literature...
November 16, 2018: Neurocritical Care
Anna N Berlina, Anastasia V Bartosh, Anatoly V Zherdev, Chuanlai Xu, Boris B Dzantiev
Determining antibiotic concentration in human blood provides useful pharmacokinetic information. Commonly used methods such as ELISA require a long time to obtain results and thus cannot be applied when information is needed immediately. In this study, a novel antibody-based lateral flow technique was developed for tetracycline detection in human serum. Contrary to tests developed to analyze food samples, the features of work with serum as analyzed probe were studied for the first time here. The application of labeled and unlabeled specific antibodies was compared...
November 13, 2018: Antibiotics
Charles Walker, Katelyn Young, Ali Moosavi, Nicholas Molacek, James Dove, Marie Hunsinger, Joseph Blansfield, Kenneth Widom, Denise Torres, James Gregory, Jeffrey Wild
BACKGROUND: Current guidelines do not specifically address optimal antibiotic duration following cholecystostomy. This study compares outcomes for short-course (<7 days) and long-course (≥7 days) antibiotics post-cholecystostomy. METHODS: This was a retrospective review of cholecystostomy patients (≥18 years) admitted (1/1/2007-12/31/2017) to one healthcare system. RESULTS: Overall, 214 patients were studied. Demographics were similar, except short-course patients had higher Charlson Comorbidity Index (p < 0...
October 29, 2018: American Journal of Surgery
Jan J De Waele, Ignacio Martin-Loeches
PURPOSE OF REVIEW: Whilst many guidelines recommend limiting the use of antibiotics because of the increase in antimicrobial resistance (AMR), this strategy becomes challenging when dealing with severe infections in critically ill patients. Moreover, some Gram-negative bacilli (GNB) can exhibit mechanisms of resistance that make the patient more vulnerable to recurrence of infections. We reviewed recent data on the optimal duration of antibiotic therapy in these patients. RECENT FINDINGS: Apart from having no additional clinical benefit at a certain point after initiation, antibiotics might have negative effects...
December 2018: Current Opinion in Infectious Diseases
Mehran Izadi, Banafsheh Dadsetan, Zeinab Najafi, Sirous Jafari, Elham Mazaheri, Omid Dadras, Hajar Heidari, SeyedAhmad SeyedAlinaghi, Fabricio Voltarelli
BACKGROUND: In Asia, an estimated of one million deaths caused by community-acquired pneumonia (CAP) each year. Despite the high mortality in elderly people, a large number of CAP patients have been treated and survived with optimal life expectancy. A few studies have been done on adult CAP therapeutic approaches in Asia. Moreover, differences have been noted between these studies and European data. We aimed to investigate the efficacy of oral Levofloxacin (TAVANEX), 750 mg, once daily for five days versus parenteral Ceftriaxone 1gr BD, plus oral Azithromycin (250 mg, once daily) for seven to ten days (standard regimen) in CAP treatment...
October 24, 2018: Recent Patents on Anti-infective Drug Discovery
Maria Gabriella Matera, Paola Rogliani, Josuel Ora, Mario Cazzola
Antibiotics are frequently prescribed to children in the community and in nosocomial settings, mainly because of lower respiratory tract infections(LRTIs), which include influenza, bronchitis, bronchiolitis, pneumonia, and tuberculosis, in addition to bronchiectasis and cystic fibrosis lung disease. It is important to note, however, that more than 50% of these prescriptions are unnecessary or inappropriate. Areas covered: The current choice of antimicrobial therapy for etiological agents of LRTIs is examined and discussed considering each type of LRTI...
October 25, 2018: Expert Opinion on Pharmacotherapy
Vivek Ajit Singh, Lim Han Sim, Amber Haseeb, Cindy Teh Shuan Ju
PURPOSE: Allograft infection remains the greatest challenge in orthopaedic reconstructive surgery especially methicillin-resistant Staphylococcus aureus (MRSA). This risk can be minimized with the use of antibiotic laden allograft (ALA) via iontophoresis. Ceftaroline fosamil (CF) is an advanced-generation cephalosporin, an alternative treatment for MRSA infections. Its antibacterial activity and safety profile are better than vancomycin. CF iontophoresed bone has not been used before...
May 2018: Journal of Orthopaedic Surgery
Maki Jitsumura, Andrew Laurence Cunningham, Matthew David Hitchings, Saiful Islam, Angharad P Davies, Paula E Row, Andrew D Riddell, James Kinross, Tom S Wilkinson, G J Jenkins, John G Williams, Dean Anthony Harris
BACKGROUND: The interaction of the gut microbiota with the human host is implicated in the pathogenesis of inflammatory and immunological diseases including ulcerative colitis (UC). Faecal microbiota transplantation (FMT) as a method of restoring gut microbial diversity is of increasing interest as a therapeutic approach in the management of UC. The current literature lacks consensus about the dose of FMT, route of administration and duration of response. METHODS AND ANALYSIS: This single-blinded randomised trial will explore the feasibility of FMT in 30 treatment-naïve patients with histologically confirmed distal UC limited to the recto-sigmoid region (up to 40 cm from the anal verge)...
October 18, 2018: BMJ Open
En-Pei Lee, Meng-Kung Yu, Shu-Chun Lee, Feng-Xia Gao, Han-Ping Wu
The aim of this study was to identify the clinical parameters indicative of serious etiology of neonatal hyperthermia and to determine the appropriate cutoff value of body temperature (BT) for predicting the need to transfer the newborn to the special care (SC) nursery.The nursery records of newborns diagnosed with hyperthermia between 2007 and 2013 were retrospectively reviewed. The clinical characteristics of newborns with hyperthermia remained in the nursery were compared with those transferred to the SC nursery...
October 2018: Medicine (Baltimore)
Muhammad Yasin, Shaista Zafar, Hazir Rahman, Taj Ali Khan, Shabnum Nazir, Salman Shah, Muhammad Dawood, Shahbaz Ahmad, Abdul Basit, Shahid Niaz Khan, Shamim Saleha
OBJECTIVE: Studies on diabetic foot ulcers (DFU) involving a representative sample of patients in Pakistan are scarce. This study aimed to determine baseline characteristics of infected DFUs in patients hospitalised at the Pakistan Institute of Medical Sciences Islamabad. METHOD: In this cross-sectional study, carried out during May 2015 and June 2016, foot ulcer characteristics of patients with DFUs were investigated and documented. From infected DFUs, aerobic bacterial pathogens were isolated, identified and evaluated for antimicrobial susceptibility...
October 1, 2018: Journal of Wound Care
Ernesto Crisafulli, Enric Barbeta, Antonella Ielpo, Antoni Torres
Background: Patients with chronic obstructive pulmonary disease (COPD) may experience an acute worsening of respiratory symptoms that results in additional therapy; this event is defined as a COPD exacerbation (AECOPD). Hospitalization for AECOPD is accompanied by a rapid decline in health status with a high risk of mortality or other negative outcomes such as need for endotracheal intubation or intensive care unit (ICU) admission. Treatments for AECOPD aim to minimize the negative impact of the current exacerbation and to prevent subsequent events, such as relapse or readmission to hospital...
2018: Multidisciplinary Respiratory Medicine
Erica L Ditkoff, Marissa Theofanides, Carrie Mlynarczyk Aisen, Casey G Kowalik, Joshua A Cohn, Wilson Sui, Matthew Rutman, Rony A Adam, Roger R Dmochowski, Kimberly L Cooper
INTRODUCTION: Evidence-based screening and treatment for bacteriuria is crucial to prevent increasing antibiotic resistance. The Infectious Disease Society of America (IDSA) previously released guidelines on the management of asymptomatic bacteriuria (ASB) and uncomplicated urinary tract infections (UTIs) in women. The study's objective was to assess physicians' practices in managing women with bacteriuria relative to these guideline recommendations. MATERIALS AND METHODS: Cross-sectional data from physicians were collected using an anonymous questionnaire...
October 2018: Canadian Journal of Urology
Vanina Meyssonnier, Valérie Zeller, Stéphanie Malbos, Beate Heym, Luc Lhotellier, Nicole Desplaces, Simon Marmor, Jean-Marc Ziza
OBJECTIVE: Tuberculous prosthetic joint infection (PJI) is uncommon and often diagnosed late. The objective here is to describe the management of tuberculous PJI at an osteoarticular infection referral center. METHODS: A single-center retrospective study of patients managed between 1987 and 2016 was performed. RESULTS: We identified 9 patients with a median age of 80 years. The hip was involved in all 9 patients. A known history of tuberculosis was noted in 2 patients and tuberculosis was present at other sites in 4 patients (lung, n = 3; urinary tract and scrotum, n = 1; and spine, n = 1)...
September 26, 2018: Joint, Bone, Spine: Revue du Rhumatisme
Yutaka Ito, Satoru Iwashima, Satoshi Hayano, Tomohiro Nishio, Ryosuke Shiozawa, Soichiro Yata, Toshiko Kubota, Akira Kubota, Keiichi Uemura
BACKGROUND AND OBJECTIVES: Macrolide-resistant Mycoplasma pneumoniae (MR-MP) have been reported worldwide. Strategies for the treatment of MR-MP are a key focus of research. The GENECUBE® is a novel, fully automated rapid genetic analyzer. The goals of this study were to assess the macrolide sensitivity of M. pneumoniae (MP) isolates by analyzing 23S ribosomal RNA (rRNA) gene sequences using a GENECUBE® -based system and to determine the validity of this system in determining clinical treatment options for MP pneumonia...
December 2018: Molecular Diagnosis & Therapy
Arnold Louie, Brandon Duncanson, Jenny Myrick, Michael Maynard, Jocelyn Nole, David Brown, Stephan Schmidt, Michael Neely, C A Scanga, Charles Peloquin, G L Drusano
A major goal for improving tuberculosis therapy is to identify drug regimens with improved efficacy and shorter treatment durations. Shorter therapies improve patient adherence to the antibiotic regimens that, in turn, decreases resistance emergence. M. tuberculosis exists in multiple metabolic states. At the initiation of therapy, the bulk of the population is in Log-Phase growth. Consequently, it is logical to focus initial therapy on these organisms. Moxifloxacin has good early bactericidal activity against Log-Phase growth bacteria and is a logical component of initial therapy...
September 24, 2018: Antimicrobial Agents and Chemotherapy
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