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cystic fibrosis antibiotics

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https://www.readbyqxmd.com/read/29684249/standard-head-down-tilt-versus-modified-without-head-down-tilt-postural-drainage-in-infants-and-young-children-with-cystic-fibrosis
#1
REVIEW
Diana A Freitas, Gabriela Ss Chaves, Thayla A Santino, Cibele Td Ribeiro, Fernando Al Dias, Ricardo O Guerra, Karla Mpp Mendonça
BACKGROUND: Postural drainage is used primarily in infants with cystic fibrosis from diagnosis up to the moment when they are mature enough to actively participate in self-administered treatments. However, there is a risk of gastroesophageal reflux associated with this technique.This is an update of a review published in 2015. OBJECTIVES: To compare the effects of standard postural drainage (15º to 45º head-down tilt) with modified postural drainage (15º to 30º head-up tilt) with regard to gastroesophageal reflux in infants and young children up to six years old with cystic fibrosis in terms of safety and efficacy...
March 9, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29681898/the-versatile-mutational-resistome-of-pseudomonas-aeruginosa
#2
REVIEW
Carla López-Causapé, Gabriel Cabot, Ester Del Barrio-Tofiño, Antonio Oliver
One of the most striking features of Pseudomonas aeruginosa is its outstanding capacity for developing antimicrobial resistance to nearly all available antipseudomonal agents through the selection of chromosomal mutations, leading to the failure of the treatment of severe hospital-acquired or chronic infections. Recent whole-genome sequencing (WGS) data obtained from in vitro assays on the evolution of antibiotic resistance, in vivo monitoring of antimicrobial resistance development, analysis of sequential cystic fibrosis isolates, and characterization of widespread epidemic high-risk clones have provided new insights into the evolutionary dynamics and mechanisms of P...
2018: Frontiers in Microbiology
https://www.readbyqxmd.com/read/29680812/a-smartphone-application-for-reporting-symptoms-in-adults-with-cystic-fibrosis-protocol-of-a-randomised-controlled-trial
#3
Jamie Wood, Sue Jenkins, David Putrino, Siobhain Mulrennan, Sue Morey, Nola Cecins, Kylie Hill
INTRODUCTION: In people with cystic fibrosis (CF), exacerbations have been shown to have profound and prolonged negative effects such as reducing physical activity and health-related quality of life, increasing the rate of decline of lung function and healthcare costs, and ultimately increasing the risk of mortality. Delayed initiation of treatment following the signs of an exacerbation has been shown to be associated with failure to recover to baseline. Therefore, the late identification and treatment of an exacerbation due to delayed presentation will potentially worsen short-term and long-term outcomes...
April 21, 2018: BMJ Open
https://www.readbyqxmd.com/read/29678900/prevention-of-exacerbations-in-patients-with-stable-non-cystic-fibrosis-bronchiectasis-a-systematic-review-and-meta-analysis-of-pharmacological-and-non-pharmacological-therapies
#4
Abd Moain Abu Dabrh, Adam T Hill, Claudia C Dobler, Noor Asi, Wigdan H Farah, Qusay Haydour, Zhen Wang, Khalid Benkhadra, Larry J Prokop, Mohammad Hassan Murad
BACKGROUND: Several pharmacological and non-pharmacological therapies are used to treat stable bronchiectasis of non-cystic fibrosis (CF) aetiology. OBJECTIVE: We conducted a systematic review and meta-analysis to assess the evidence of the effectiveness of pharmacological and non-pharmacological treatment options in patients with stable non-CF bronchiectasis with a focus on reducing exacerbations. STUDY SELECTION: Multiple databases were searched through September 2017...
April 20, 2018: BMJ evidence-based medicine
https://www.readbyqxmd.com/read/29676014/autoinflammatory-disease-in-the-lung
#5
REVIEW
Thomas Scambler, Jonathan Holbrook, Sinisa Savic, Michael F McDermott, Daniel Peckham
Ascertaining the dominant cell type driving an immunological disease is essential to understanding the causal pathology and, therefore, selecting or developing an effective treatment. Classifying immunological diseases in this way has led to successful treatment regimens for many monogenic diseases; however, when the dominant cell type is unclear and there is no obvious causal genetic mutation, then identifying the correct disease classification and appropriate therapy can be challenging. In this review we focus on pulmonary immunological diseases where an innate immune signature has been identified as a predominant aspect of the immunopathology...
April 19, 2018: Immunology
https://www.readbyqxmd.com/read/29671915/estimating-long-term-treatment-effects-in-observational-data-a-comparison-of-the-performance-of-different-methods-under-real-world-uncertainty
#6
Simon J Newsome, Ruth H Keogh, Rhian M Daniel
In the presence of time-dependent confounding, there are several methods available to estimate treatment effects. With correctly specified models and appropriate structural assumptions, any of these methods could provide consistent effect estimates, but with real-world data, all models will be misspecified and it is difficult to know if assumptions are violated. In this paper, we investigate five methods: inverse probability weighting of marginal structural models, history-adjusted marginal structural models, sequential conditional mean models, g-computation formula, and g-estimation of structural nested models...
April 19, 2018: Statistics in Medicine
https://www.readbyqxmd.com/read/29669887/pseudomonas-aeruginosa-gsha-mutant-is-defective-in-biofilm-formation-swarming-and-pyocyanin-production
#7
Tricia A Van Laar, Saika Esani, Tyler J Birges, Bethany Hazen, Jason M Thomas, Mamta Rawat
Pseudomonas aeruginosa is a ubiquitous Gram-negative bacterium that can cause severe opportunistic infections. The principal redox buffer employed by this organism is glutathione (GSH). To assess the role of GSH in the virulence of P. aeruginosa , a number of analyses were performed using a mutant strain deficient in gshA , which does not produce GSH. The mutant strain exhibited a growth delay in minimal medium compared to the wild-type strain. Furthermore, the gshA mutant was defective in biofilm and persister cell formation and in swimming and swarming motility and produced reduced levels of pyocyanin, a key virulence factor...
April 25, 2018: MSphere
https://www.readbyqxmd.com/read/29669883/impact-of-long-term-erythromycin-therapy-on-the-oropharyngeal-microbiome-and-resistance-gene-reservoir-in-non-cystic-fibrosis-bronchiectasis
#8
Jocelyn M Choo, Guy C J Abell, Rachel Thomson, Lucy Morgan, Grant Waterer, David L Gordon, Steven L Taylor, Lex E X Leong, Steve L Wesselingh, Lucy D Burr, Geraint B Rogers
Long-term macrolide therapy reduces rates of pulmonary exacerbation in bronchiectasis. However, little is known about the potential for macrolide therapy to alter the composition and function of the oropharyngeal commensal microbiota or to increase the carriage of transmissible antimicrobial resistance. We assessed the effect of long-term erythromycin on oropharyngeal microbiota composition and the carriage of transmissible macrolide resistance genes in 84 adults with bronchiectasis, enrolled in the Bronchiectasis and Low-dose Erythromycin Study (BLESS) 48-week placebo-controlled trial of twice-daily erythromycin ethylsuccinate (400 mg)...
April 25, 2018: MSphere
https://www.readbyqxmd.com/read/29661867/triclosan-is-an-aminoglycoside-adjuvant-for-the-eradication-of-pseudomonas-aeruginosa-biofilms
#9
Michael M Maiden, Alessandra M Agostinho Hunt, Mitchell P Zachos, Jacob A Gibson, Martin E Hurwitz, Martha H Mulks, Christopher M Waters
One of the most important clinical obstacles in cystic fibrosis (CF) is antibiotic treatment failure due to biofilms produced by Pseudomonas aeruginosa The ability of this pathogen to survive eradication by tobramycin and pathoadapt into a hyper-biofilm state leading to chronic infections is key to its success. Retrospective studies have demonstrated that preventing this pathoadaptation by improving eradication is essential to extend the lives of CF patients. To identify adjuvants that enhance tobramycin eradication of P...
April 16, 2018: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/29660401/intravenous-fosfomycin-for-pulmonary-exacerbation-of-cystic-fibrosis-real-life-experience-of-a-large-adult-cf-centre
#10
G Spoletini, M Kennedy, L Flint, T Graham, C Etherington, N Shaw, P Whitaker, M Denton, I Clifton, D Peckham
BACKGROUND: The increased prevalence of multi-drug resistant strains of P.aeruginosa and allergic reactions among adult patients with cystic fibrosis (CF) limits the number of antibiotics available to treat pulmonary exacerbations. Fosfomycin, a unique broad spectrum bactericidal antibiotic, might offer an alternative therapeutic option in such cases. AIM: To describe the clinical efficacy, safety and tolerability of intravenous fosfomycin in combination with a second anti-pseudomonal antibiotic to treat pulmonary exacerbations in adult patients with CF...
April 13, 2018: Pulmonary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/29655935/establishing-the-diagnosis-of-chronic-colonization-with-pseudomonas-aeruginosa-of-cystic-fibrosis-patients-comparison-of-the-european-consensus-criteria-with-genotyping-of-p-aeruginosa-isolates
#11
Leander Jonckheere, Petra Schelstraete, Leen Van Simaey, Eva Van Braeckel, Julie Willekens, Sabine Van Daele, Frans De Baets, Mario Vaneechoutte
After antibiotic eradication treatment for a first ever Pseudomonas aeruginosa isolation, the European consensus criteria (ECC) are widely used to assess colonization status with P. aeruginosa in CF-patients. We evaluated to what extent genotyping (GT) of subsequent P. aeruginosa isolates could predict/assess chronic colonization (CC), in comparison with the ECC. METHODS: Over a 14-year period, sputa were cultured from 80 CF-patients (age range: 2-51 years), from a first ever isolation of P...
April 11, 2018: Journal of Cystic Fibrosis: Official Journal of the European Cystic Fibrosis Society
https://www.readbyqxmd.com/read/29653129/delivering-drugs-to-the-lungs-the-history-of-repurposing-in-the-treatment-of-respiratory-diseases
#12
Stephen P Newman
The repurposing of drug delivery by the pulmonary route has been applied to treatment and prophylaxis of an increasingly wide range of respiratory diseases. Repurposing has been most successful for the delivery of inhaled bronchodilators and corticosteroids in patients with asthma and chronic obstructive pulmonary disease (COPD). Repurposing utilizes the advantages that the pulmonary route offers in terms of more targeted delivery to the site of action, the use of smaller doses, and a lower incidence of side-effects...
April 10, 2018: Advanced Drug Delivery Reviews
https://www.readbyqxmd.com/read/29648588/influence-of-three-dimensional-lung-epithelial-cells-and-interspecies-interactions-on-antibiotic-efficacy-against-mycobacterium-abscessus-and-pseudomonas-aeruginosa
#13
Graciela Rodríguez-Sevilla, Charlotte Rigauts, Eva Vandeplassche, Lisa Ostyn, Ignacio Mahíllo-Fernández, Jaime Esteban, Concepción Pérez-Jorge Peremarch, Tom Coenye, Aurélie Crabbé
Mycobacterium abscessus lung infection is a major health problem for cystic fibrosis (CF) patients. Understanding the in vivo factors that influence the outcome of therapy may help addressing the poor correlation between in vitro and in vivo antibiotic efficacy. We evaluated the influence of interspecies interactions and lung epithelial cells on antibiotic efficacy. Therefore, single and dual species biofilms of M. abscessus and a major CF pathogen (Pseudomonas aeruginosa) were cultured on a plastic surface or on in vivo-like three-dimensional (3-D) lung epithelial cells, and the activity of antibiotics (colistin, amikacin, clarithromycin, ceftazidime) in inhibiting biofilm formation was evaluated...
April 10, 2018: Pathogens and Disease
https://www.readbyqxmd.com/read/29624919/increased-cytokines-in-cystic-fibrosis-patients-upper-airways-during-a-new-p-aeruginosa-colonization
#14
Anke Jaudszus, Christin Arnold, Julia Hentschel, Kerstin Hünniger, Michael Baier, Jochen G Mainz
OBJECTIVES: Previously, we found linkages of inflammatory mediator levels in CF upper airways (UAW) sampled by nasal lavage (NL) to disease severity and to chronic pathogen colonization such as Pseudomonas aeruginosa (PsA). Here, we assess UAW cytokine dynamics in CF patients with a new PsA colonization. METHODS: We measured cytokines in 149 longitudinally obtained NL samples from 34 CF patients. Cytokine concentrations determined prior to, at the time of de novo PsA detection in either UAW or lower airways (LAW), and in a subsequent PsA free period in newly colonized patients (PsA-new/n = 7) were compared to levels of not- (PsA-free/n = 13) and chronically colonized patients (PsA-chron/n = 14)...
April 6, 2018: Pediatric Pulmonology
https://www.readbyqxmd.com/read/29621625/ciprofloxacin-dry-powder-for-inhalation-ciprofloxacin-dpi-technical-design-and-features-of-an-efficient-drug-device-combination
#15
REVIEW
Pamela J McShane, Jeffry G Weers, Thomas E Tarara, Alfred Haynes, Preeti Durbha, Danforth P Miller, Tobias Mundry, Elisabeth Operschall, J Stuart Elborn
Bronchiectasis is a chronic respiratory disease with heterogeneous etiology, characterized by a cycle of bacterial infection and inflammation, resulting in increasing airway damage. Exacerbations are an important cause of morbidity and are strongly associated with disease progression. Many patients with bronchiectasis suffer from two or more exacerbations per year. However, there are no approved therapies to reduce or delay exacerbations in this patient population. Ciprofloxacin DPI is in development as a long-term, intermittent therapy to reduce exacerbations in patients with non-cystic fibrosis (CF) bronchiectasis and evidence of respiratory pathogens...
April 2, 2018: Pulmonary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/29617698/pseudomonas-aeruginosa-and-klebsiella-pneumoniae-adaptation-to-innate-immune-clearance-mechanisms-in-the-lung
#16
Sebastian A Riquelme, Danielle Ahn, Alice Prince
Many different species of gram-negative bacteria are associated with infection in the lung, causing exacerbations of chronic obstructive pulmonary disease, cystic fibrosis (CF), and ventilator-associated pneumonias. These airway pathogens must adapt to common host clearance mechanisms that include killing by antimicrobial peptides, antibiotics, oxidative stress, and phagocytosis by leukocytes. Bacterial adaptation to the host is often evident phenotypically, with increased extracellular polysaccharide production characteristic of some biofilm-associated organisms...
April 4, 2018: Journal of Innate Immunity
https://www.readbyqxmd.com/read/29608955/pseudomonas-aeruginosa-pyocyanin-production-reduced-by-quorum-sensing-inhibiting-nanocarriers
#17
Hoang D Lu, Elizabeth Pearson, Kurt D Ristroph, Gregg A Duncan, Laura M Ensign, Jung Soo Suk, Justin Hanes, Robert K Prud'homme
Pseudomonas aeruginosa is an opportunistic gram-negative pathogen that causes a wide range of infections; it is becoming increasingly difficult to treat due to antibiotic resistance. Quorum-sensing (QS) based therapeutics, which function by disabling pathogen virulence without killing pathogens, are a promising class of drugs that may be used to treat bacterial infections without eliciting resistance development. The use of QS drugs to treat pulmonary P. aeruginosa infections, however, has been greatly limited due to the inability to deliver QS drugs at sufficiently high concentrations past physiological barriers such as pulmonary mucus...
March 30, 2018: International Journal of Pharmaceutics
https://www.readbyqxmd.com/read/29607494/inhaled-anti-pseudomonal-antibiotics-for-long-term-therapy-in-cystic-fibrosis
#18
REVIEW
Sherie Smith, Nicola J Rowbotham, Kate H Regan
BACKGROUND: Inhaled antibiotics are commonly used to treat persistent airway infection with Pseudomonas aeruginosa that contributes to lung damage in people with cystic fibrosis. Current guidelines recommend inhaled tobramycin for individuals with cystic fibrosis and persistent Pseudomonas aeruginosa infection who are aged six years or older. The aim is to reduce bacterial load in the lungs so as to reduce inflammation and deterioration of lung function. This is an update of a previously published review...
March 30, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29594066/a-simple-and-rapid-gene-disruption-strategy-in-mycobacterium-abscessus-on-the-design-and-application-of-glycopeptidolipid-mutants
#19
Albertus Viljoen, Ana Victoria Gutiérrez, Christian Dupont, Eric Ghigo, Laurent Kremer
Little is known about the disease-causing genetic determinants that are used by Mycobacterium abscessus , increasingly acknowledged as an important emerging pathogen, notably in cystic fibrosis. The presence or absence of surface exposed glycopeptidolipids (GPL) conditions the smooth (S) or rough (R) M. abscessus subsp. abscessus ( M. abscessus ) variants, respectively, which are characterized by distinct infective programs. However, only a handful of successful gene knock-out and conditional mutants have been reported in M...
2018: Frontiers in Cellular and Infection Microbiology
https://www.readbyqxmd.com/read/29588399/mixed-communities-of-mucoid-and-nonmucoid-pseudomonas-aeruginosa-exhibit-enhanced-resistance-to-host-antimicrobials
#20
Sankalp Malhotra, Dominique H Limoli, Anthony E English, Matthew R Parsek, Daniel J Wozniak
Pseudomonas aeruginosa causes chronic pulmonary infections in patients with cystic fibrosis (CF). P. aeruginosa mucoid conversion, defined by overproduction of the exopolysaccharide alginate, correlates with accelerated decline in CF patient lung function. Recalcitrance of the mucoid phenotype to clearance by antibiotics and the immune response is well documented. However, despite advantages conferred by mucoidy, mucoid variants often revert to a nonmucoid phenotype both in vitro and in vivo Mixed populations of mucoid isolates and nonmucoid revertants are recovered from CF lungs, suggesting a selective benefit for coexistence of these variants...
March 27, 2018: MBio
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