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https://www.readbyqxmd.com/read/27921442/nebulized-antibiotics-in-mechanically-ventilated-patients-roadmap-and-challenges
#1
G Poulakou, G Siakallis, S Tsiodras, A Arfaras Melainis, G Dimopoulos
Nebulized antibiotics use has become common practice in the therapeutics of pneumonia in cystic fibrosis patients. There is an increasing interest in their use for respiratory infections in mechanically ventilated (MV) patients in order to a) overcome pharmacokinetic issues in the lung compartment with traditional systemic antibiotic use and b) prevent the emergence of multi-drug-resistant (MDR) pathogens. Areas covered: The beneficial effects of antibiotic nebulization in MV patients e.g. increasing efficacy, reduced toxicity and prevention of resistance are described...
December 6, 2016: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/27918379/nontuberculous-mycobacteria-in-children-a-focus-on-bloodstream-infections
#2
Laila S Al Yazidi, Ben J Marais, Briony Hazelton, Alexander Outhred, Alison Kesson
BACKGROUND: Nontuberculous mycobacteria (NTM) are ubiquitous organisms with variable disease-causing potential. Bloodstream infections caused by NTM in children are poorly described. METHODS: We describe a retrospective case series of children with culture-confirmed mycobacterial disease managed at The Children's Hospital at Westmead from July 2005 - June 2015. RESULTS: Sixty-five patients had 149 positive NTM cultures; 55 (83.0%) episodes in 54 patients were considered clinically significant...
December 1, 2016: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/27912842/the-rapid-spread-of-carbapenem-resistant-enterobacteriaceae
#3
REVIEW
Robert F Potter, Alaric W D'Souza, Gautam Dantas
Carbapenems, our one-time silver bullet for multidrug resistant bacterial infections, are now threatened by widespread dissemination of carbapenem-resistant Enterobacteriaceae (CRE). Successful expansion of Enterobacteriaceae clonal groups and frequent horizontal gene transfer of carbapenemase expressing plasmids are causing increasing carbapenem resistance. Recent advances in genetic and phenotypic detection facilitate global surveillance of CRE diversity and prevalence. In particular, whole genome sequencing enabled efficient tracking, annotation, and study of genetic elements colocalized with carbapenemase genes on chromosomes and on plasmids...
November 2016: Drug Resistance Updates: Reviews and Commentaries in Antimicrobial and Anticancer Chemotherapy
https://www.readbyqxmd.com/read/27906606/influence-of-a-shorter-duration-of-post-operative-antibiotic-prophylaxis-on-infectious-complications-in-patients-undergoing-elective-liver-resection
#4
Masahiko Sakoda, Satoshi Iino, Yuko Mataki, Yota Kawasaki, Hiroshi Kurahara, Kosei Maemura, Shinichi Ueno, Shoji Natsugoe
BACKGROUND: Antibiotic prophylaxis has been recommended to reduce post-operative infectious complications. Discontinuation of post-operative antibiotic administration within 24 hours of operation is currently recommended. Many surgeons, however, conventionally tend to extend the duration of prophylactic antibiotic use. In this study, we performed a retrospective analysis to assess the efficacy of extended post-operative antibiotic use in patients who underwent elective liver resection...
December 1, 2016: Surgical Infections
https://www.readbyqxmd.com/read/27905884/the-efficacy-of-pivmecillinam-3%C3%A2-days-or-5%C3%A2-days%C3%A2-t-i-d-against-community-acquired-uncomplicated-lower-urinary-tract-infections-a-randomized-double-blinded-placebo-controlled-clinical-trial-study-protocol
#5
Filip Jansåker, Niels Frimodt-Møller, Lars Bjerrum, Jenny Dahl Knudsen
BACKGROUND: Uncomplicated lower urinary tract infections (LUTI) are very common, and presumably around 200,000 female patients are treated for this annually in Denmark. The current Danish national clinical practice guidelines recommend pivmecillinam as a first-line drug (i.e., 400 mg t.i.d. for 3 days). Pivmecillinam is also one of the first-line drugs recommended in the international guidelines for LUTIs (i.e., 400 mg b.i.d. for 5 days). The international recommended duration is based on evidence saying that a 7-day regimen is better than a 3-day regimen...
December 1, 2016: BMC Infectious Diseases
https://www.readbyqxmd.com/read/27899322/a-randomized-controlled-trial-of-prophylactic-antibiotics-in-the-prevention-of-electrocoagulation-syndrome-after-colorectal-endoscopic-submucosal-dissection
#6
Sang Pyo Lee, In-Kyung Sung, Jeong Hwan Kim, Sun-Young Lee, Hyung Seok Park, Chan Sup Shim, Hyun Kyun Ki
BACKGROUND AND AIMS: Endoscopic submucosal dissection (ESD) is currently commonly performed, but colorectal ESD has a substantial risk of adverse events, including post-ESD electrocoagulation syndrome (PEECS). We investigated whether the use of prophylactic antibiotics can reduce the occurrence of PEECS. METHODS: Patients who underwent colorectal ESD were randomly assigned to 1 of 2 treatment regimens. Ampicillin/sulbactam mixed with normal saline solution was administered 1 hour before ESD in group I, and then additionally injected every 8 hours twice more...
November 26, 2016: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27899019/antibiotic-resistance-in-severe-orofacial-infections
#7
Min Kyoung Kim, Sung-Kiang Chuang, Meredith August
PURPOSE: This study assessed the antibiotic resistance profile in patients with severe orofacial infections treated at a single institution from 2009 through 2014. Factors contributing to resistance were studied. The resistance profile was compared with that of a cohort of similar patients treated a decade previously to identify changes in antibiotic resistance. In addition, the effect of antibiotic resistance on in-hospital course was studied. MATERIALS AND METHODS: This was a 5-year retrospective cohort study...
November 9, 2016: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/27898456/the-role-of-nonantibiotic-treatment-of-community-acquired-urinary-tract-infections
#8
Elisabetta Costantini, Konstantinos Giannitsas, Ester Illiano
PURPOSE OF REVIEW: To summarize evidence on the efficacy of nonantibiotic treatments in the prevention of recurrent urinary tract infections (UTIs). The need for antibiotic-free regimens seems to be imperative given the worldwide rates of resistance of uropathogens to available antibiotics. RECENT FINDINGS: In the recently published literature, cranberry products and probiotics are the focus of research. They both seem to be effective in preventing recurrent UTIs compared with placebo, but their benefit becomes less clear when they are compared with antibiotics...
November 24, 2016: Current Opinion in Urology
https://www.readbyqxmd.com/read/27898266/methicillin-resistant-staphylococcus-aureus-in-foot-osteomyelitis
#9
Chester N Ashong, Shazia A Raheem, Andrew S Hunter, Cezarina Mindru, Neal R Barshes
BACKGROUND: Conflicting studies exist regarding the impact of methicillin-resistant Staphylococcus aureus (MRSA) on increased time to wound healing, future need for surgical procedures, and likelihood of treatment failure in patients with diabetic foot osteomyelitis. The purpose of this study is to determine the overall significance of MRSA in predicting treatment failure in bone infections of the foot and to determine an appropriate pre-operative and empiric post-operative antibiotic regimen...
November 29, 2016: Surgical Infections
https://www.readbyqxmd.com/read/27898166/neither-10-nor-14-day-sequential-treatment-is-better-than-standard-triple-therapy-for-helicobacter-pylori-eradication
#10
Emanuel Warrington, Orlando López-Román, Rafael Tirado Montijo, Rafael Urbina, Marcia Cruz-Correa, Doris H Toro
OBJECTIVE: Helicobacter pylori is a bacterial pathogen associated with chronic gastritis, peptic ulcer disease, gastric adenocarcinoma, and gastric mucosa associated lymphoid tissue lymphoma. Current treatment guidelines support a 7- to 14-day, triple-drug protocol consisting of a proton-pump inhibitor (PPI), clarithromycin, and either amoxicillin or an imidazole. The initial eradication rates for this regimen were 80 to 90%. Nevertheless its effectiveness has declined as the antibiotic resistance to clarithromycin and metronidazole has emerged...
December 2016: Puerto Rico Health Sciences Journal
https://www.readbyqxmd.com/read/27897120/dropless-cataract-surgery-an-overview
#11
Richard L Lindstrom, M Stewart Galloway, Andrzej Grzybowski, Jeffrey T Liegner
Risk reduction and the attainment of good outcomes in contemporary cataract surgery depend in part on patient compliance with a postoperative regimen of topical eye drops. Topical drops are expensive and challenging to instill properly for patients. The consequences of noncompliance or poor compliance can be significant for the patient (in the case of a complication) and for society (in the case of development of antibiotic resistance). For all of these reasons, new approaches that reduce the need for topical therapy are beginning to emerge, including intracameral injection, sustained or slow-release drug delivery mechanisms, and the recently introduced "Dropless cataract surgery," which involves intravitreal injection of single-use, compounded combination of antibiotics and corticosteroids...
November 29, 2016: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/27895846/antibiotics-as-part-of-the-management-of-severe-acute-malnutrition
#12
Indi Trehan, Hayley S Goldbach, Lacey N LaGrone, Guthrie J Meuli, Richard J Wang, Kenneth M Maleta, Mark J Manary
BACKGROUND: Severe acute malnutrition contributes to 1 million deaths among children annually. Adding routine antibiotic agents to nutritional therapy may increase recovery rates and decrease mortality among children with severe acute malnutrition treated in the community. METHODS: In this randomized, double-blind, placebo-controlled trial, we randomly assigned Malawian children, 6 to 59 months of age, with severe acute malnutrition to receive amoxicillin, cefdinir, or placebo for 7 days in addition to ready-to-use therapeutic food for the outpatient treatment of uncomplicated severe acute malnutrition...
September 2016: Malawi Medical Journal: the Journal of Medical Association of Malawi
https://www.readbyqxmd.com/read/27895415/factoring-the-intestinal-microbiome-into-the-pathogenesis-of-autoimmune-hepatitis
#13
EDITORIAL
Albert J Czaja
The intestinal microbiome is a reservoir of microbial antigens and activated immune cells. The aims of this review were to describe the role of the intestinal microbiome in generating innate and adaptive immune responses, indicate how these responses contribute to the development of systemic immune-mediated diseases, and encourage investigations that improve the understanding and management of autoimmune hepatitis. Alterations in the composition of the intestinal microflora (dysbiosis) can disrupt intestinal and systemic immune tolerances for commensal bacteria...
November 14, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27892627/withdrawn-pulp-management-for-caries-in-adults-maintaining-pulp-vitality
#14
REVIEW
Hiroshi Miyashita, Helen V Worthington, Alison Qualtrough, Alphons Plasschaert
BACKGROUND: There is a range of treatment options for the management of the pulp in extensively decayed teeth. These include direct and indirect pulp capping, pulpotomy or pulpectomy. If the tooth is symptomatic or if there are periapical bone changes, then endodontic treatment is required. However, if the tooth is asymptomatic but the caries is extensive, there is no consensus as to the best method of management. In addition, there has been a recent move towards using alternative materials and methods such as the direct or indirect placement of bonding agents and mineral trioxide aggregate...
November 28, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27892497/optimising-antibiotic-usage-to-treat-bacterial-infections
#15
Iona K Paterson, Andy Hoyle, Gabriela Ochoa, Craig Baker-Austin, Nick G H Taylor
The increase in antibiotic resistant bacteria poses a threat to the continued use of antibiotics to treat bacterial infections. The overuse and misuse of antibiotics has been identified as a significant driver in the emergence of resistance. Finding optimal treatment regimens is therefore critical in ensuring the prolonged effectiveness of these antibiotics. This study uses mathematical modelling to analyse the effect traditional treatment regimens have on the dynamics of a bacterial infection. Using a novel approach, a genetic algorithm, the study then identifies improved treatment regimens...
November 28, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27888863/helicobacter-pylori-related-diseases
#16
Javier P Gisbert
This article describes the main conclusions drawn from the presentations on Helicobacter pylori infection in Digestive Diseases Week, 2016. Despite the undeniable widespread reduction in the prevalence of this infection, infection rates continue to be high in developing countries. The prevalence of clarithromycin, metronidazole and quinolone resistance is markedly high in most countries and continues to rise. The management of H. pylori infection in patients with peptic ulcers still leaves much to be desired...
September 2016: Gastroenterología y Hepatología
https://www.readbyqxmd.com/read/27887963/animal-models-in-the-pharmacokinetic-pharmacodynamic-evaluation-of-antimicrobial-agents
#17
Miao Zhao, Alexander J Lepak, David R Andes
Animal infection models in the pharmacokinetic/pharmacodynamic (PK/PD) evaluation of antimicrobial therapy serve an important role in preclinical assessments of new antibiotics, dosing optimization for those that are clinically approved, and setting or confirming susceptibility breakpoints. The goal of animal model studies is to mimic the infectious diseases seen in humans to allow for robust PK/PD studies to find the optimal drug exposures that lead to therapeutic success. The PK/PD index and target drug exposures obtained in validated animal infection models are critical components in optimizing dosing regimen design in order to maximize efficacy while minimize the cost and duration of clinical trials...
November 9, 2016: Bioorganic & Medicinal Chemistry
https://www.readbyqxmd.com/read/27885778/single-dose-versus-multiple-dose-of-antibiotic-prophylaxis-in-caesarean-section-a-systematic-review-and-meta-analysis
#18
REVIEW
R Pinto-Lopes, B Sousa-Pinto, L F Azevedo
BACKGROUND: Prophylactic antibiotics are traditionally given as a single dose for caesarean section. However, inconsistent application of recommendations and recent evidence prompted a literature review. OBJECTIVES: To assess the optimal regimen for antibiotic prophylaxis in caesarean section by comparing single versus multiple doses of the same intervention. SEARCH STRATEGY: MEDLINE, Web of Knowledge, SCOPUS, CENTRAL and ongoing trials databases were searched...
November 24, 2016: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/27883161/-is-it-necessary-to-prescribe-antibiotics-in-impacted-third-molar-surgical-removal-comparative-study-between-prescribing-patterns
#19
I Izuzquiza, K A Jamtøy, N P Fossland, I Martínez-Padilla, F Falahat, L Alou, J Prieto, M L Gómez-Lus
OBJECTIVE: To assess whether there is a significant difference in infection rate after surgery tooth extraction in two different hospitals from Norway and Spain where different surgical antimicrobial prophylaxis protocols are applied. METHODS: An analytical observational study was conducted, retrospective cohorts type, analyzing healthy patients with no risk factors, who were third molar tooth operated in maxillofacial services of two different hospitals: St. Olav in Trondheim (Norway) and Clínico San Carlos in Madrid (Spain)...
November 22, 2016: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
https://www.readbyqxmd.com/read/27882804/a-comparison-of-high-frequency-chest-wall-oscillation-and-intrapulmonary-percussive-ventilation-for-airway-clearance-in-pediatric-patients-with-tracheostomy
#20
Aneela Bidiwala, Linda Volpe, Claudia Halaby, Melissa Fazzari, Christina Valsamis, Melodi Pirzada
OBJECTIVES: The aim of this study was to compare two modes of airway clearance, the intrapulmonary percussive ventilation system (IPV) to high frequency chest wall oscillation system (HFCWO) in medically complex pediatric patients with tracheostomy requiring long term care. METHODS: This was a single center, retrospective study comparing the number of respiratory illnesses, lower respiratory tract infections (LRTI), utilization of bronchodilator and systemic steroids, and respiratory illnesses requiring acute care hospitalizations...
November 24, 2016: Postgraduate Medicine
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