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antibiotic regimens

Jan Puetzler, Willem-Jan Metsemakers, Daniel Arens, Stephan Zeiter, Richard Kuehl, Michael J Raschke, Robert Geoff Richards, Thomas Fintan Moriarty
OBJECTIVES: The optimal duration of perioperative antibiotic prophylaxis (PAP) for open fractures remains controversial because of heterogeneous or unclear guidelines and highly variable prophylactic regimens in clinical practice. We aimed at testing different PAP durations under controlled conditions in a contaminated rabbit fracture model. METHODS: A complete humeral osteotomy in 18 rabbits was fixed with a 7-hole locking compression plate and inoculated with Staphylococcus aureus...
April 2018: Journal of Orthopaedic Trauma
G F Dall, S-T J Tsang, P J Gwynne, S P MacKenzie, A H R W Simpson, S J Breusch, M P Gallagher
Objectives: To evaluate putative anti-staphylococcal biofilm antibiotic combinations used in the management of periprosthetic joint infections (PJIs). Methods: Using the dissolvable bead biofilm assay, the minimum biofilm eradication concentration (MBEC) was determined for the most commonly used antimicrobial agents and combination regimens against staphylococcal PJIs. The established fractional inhibitory concentration (FIC) index was modified to create the fractional biofilm eradication concentration (FBEC) index to evaluate synergism or antagonism between antibiotics...
March 14, 2018: Journal of Antimicrobial Chemotherapy
Said Alyacoubi, Yousef Abuowda, Loai Albarqouni, Bettina Böttcher, Khamis Elessi
BACKGROUND: Disease severity scores such as CURB-65 are often used to guide the management of patients with community-acquired pneumonia. Early and adequate empirical antibiotic treatment reduces mortality. The aim of this study was to examine the severity assessment and management of patients presenting with community-acquired pneumonia at the European Gaza Hospital in the Gaza Strip and to compare this to the best available evidence. METHODS: Medical records of all patients admitted to the European Gaza Hospital with a diagnosis of community-acquired pneumonia between Dec 1, 2015, and March 31, 2016, were reviewed retrospectively...
February 21, 2018: Lancet
Rami Musallam, Nabeel Salem, Ramez Al Halol, Hammam Al Deeb, Bettina Bottcher, Hanaa AlHamaida
BACKGROUND: Early pregnancy loss occurs in 10% of all clinically recognised pregnancies. 80% of pregnancy losses occur in the first trimester. Offering choice and participation in the management decisions is essential to patient-centred care. The aim of this study was to assess the management of first trimester pregnancy loss at the Emirati Hospital in Rafah, Gaza Strip. METHODS: In this retrospective audit, we compared the management of first trimester pregnancy loss at Emirati Hospital using the American College of Obstetricians and Gynecologists guidelines (ACOG, No...
February 21, 2018: Lancet
Qusay Abdoh, Lubna Kharraz, Khubaib Ayoub, Jana Khraim, Wafaa Awad, Aysha Sbeah, Safaa Turman
BACKGROUND: Bacterial resistance to antibiotics is considered the most important determinant of treatment failure. Monitoring the evolution of antimicrobial resistance to common antibiotics is therefore of special importance for clinicians. The frequency of resistance to antibiotics in Helicobacter pylori isolates is increasing. The aim of this study was to determine the pattern of H pylori antibiotic resistance at the An-Najah National University Hospital. METHODS: In this cross-sectional study, we recruited patients older than 18 year who were admitted to the An-Najah National University Hospital...
February 21, 2018: Lancet
Amir S Steinberg, Anish B Parikh, Sara Kim, Damaris Peralta-Hernandez, Talaat Aggour, Luis Isola
OBJECTIVES: Antibiotic stewardship is an integral aspect of hospital care, limiting the potential for resistance while working to minimize waste. A similar system is needed in oncology, given the rapid proliferation of new therapies and the challenges of navigating a complicated reimbursement environment. A "cancer therapy stewardship program" has never been described in the literature. Here, we detail our efforts to design and implement such a program and share lessons learned to inform future projects...
March 2018: American Journal of Managed Care
Fabio Rodríguez Sánchez, Carlos Rodríguez Andrés, Iciar Arteagoitia
OBJECTIVE: To assess which antibiotic regimen prevents dental implant failures or postoperative infections following dental implant placement. MATERIALS AND METHODS: Systematic review and meta-analysis. DATA SOURCES: Pubmed, Cochrane, Science Direct, and EMBASE via OVID were searched up to August 2017. Only randomized controlled clinical trials (RCT) using antibiotics were included. Outcome measures were set on dental implant failures or postoperative infection incidence after dental implant surgery...
February 26, 2018: Journal of Cranio-maxillo-facial Surgery
André Campaniço, Rui Moreira, Francisca Lopes
Tuberculosis (TB) remains a major health problem worldwide. The infectious agent, Mycobacterium tuberculosis, has a unique ability to survive within the host, alternating between active and latent disease states, and escaping the immune system defences. The extended duration of anti-TB regimens and the increasing prevalence of multidrug- (MDR) and extensively drug-resistant (XDR) M. tuberculosis strains have created an urgent need for new antibiotics active against drug-resistant organisms and that can shorten standard therapy...
March 9, 2018: European Journal of Medicinal Chemistry
Hiroki Tashiro, Koichiro Takahashi, Koji Kusaba, Masahide Tanaka, Kazutoshi Komiya, Tomomi Nakamura, Yosuke Aoki, Shinya Kimura, Naoko Sueoka-Aragane
BACKGROUND: Despite treatment, pulmonary nocardiosis, which is a rare opportunistic disease caused by Nocardia species, has poor clinical outcomes including recurrence and death. Currently, the treatment regimen and duration for pulmonary nocardiosis are not fully understood. The present study aimed to clarify the factors related to the clinical outcome of pulmonary nocardiosis. METHODS: The medical records of 24 patients with pulmonary nocardiosis were retrospectively reviewed...
March 2018: Respiratory Investigation
Farnaz Foolad, Brandie D Taylor, Samuel A Shelburne, Cesar A Arias, Samuel L Aitken
VRE are associated with ∼1300 deaths per year in the USA. Recent literature suggests that daptomycin, a cyclic lipopeptide antibiotic with concentration-dependent bactericidal activity, is the preferred treatment option for VRE bacteraemia, yet the optimal dosing strategy for this indication has not been established. In vitro evidence suggests that higher-than-labelled doses of daptomycin are required to optimally treat VRE bacteraemia and to inhibit the development of resistance. However, concern of dose-dependent toxicities, notably increases in creatine phosphokinase and the development of rhabdomyolysis, are a barrier to initiating high-dose schemes in clinical practice...
March 13, 2018: Journal of Antimicrobial Chemotherapy
Amanda N Seddon, Joshua Chaim, Oguz Akin, Esther Drill, Angela G Michael, Nelly Adel, Martin S Tallman
BACKGROUND: The current standard of care for the treatment of patients with newly diagnosed acute myeloid leukemia (AML) is an anthracycline plus cytarabine. Both anthracyclines and cytarabine have been associated with the development of typhlitis, a serious adverse event characterized by inflammation of the bowel wall in patients with profound neutropenia, diagnosed by abdominal CT imaging and clinical symptoms. Given the paucity of available data, the aim of our study was to determine the incidence of typhlitis among AML patients receiving induction chemotherapy with idarubicin 12 mg/m2 (IDA), daunorubicin 60 mg/m2 (DNA60), or daunorubicin 90 mg/m2 (DNA90)...
March 8, 2018: Leukemia Research
Ka Pang Chan, Deirdre B Fitzgerald, Y C Gary Lee
PURPOSE OF REVIEW: Pleural infection remains an important pulmonary disease, causing significant morbidity and mortality. There is a resurgence of disease burden despite introduction of antibiotics and pneumococcal vaccines. A revisit of the pathogenesis and update on intervention may improve the care of pleural infection. RECENT FINDINGS: Recent studies have uncovered the prognostic implication of the presence of a pleural effusion in patients with pneumonia. Identifying where the bacteria lives may have diagnostic and therapeutic implications...
March 13, 2018: Current Opinion in Pulmonary Medicine
James Q Del Rosso, Linda Stein Gold, Sandra Marchese Johnson, Maria Jose Rueda, Hilary Baldwin, Edward L Lain, Megan Landis, Marta Rendon, Emil Tanghetti, Jonathan Weiss
INTRODUCTION: Acne treatment guidelines suggest a combination approach with topical therapy including a topical retinoid, benzoyl peroxide and an oral antibiotic, or oral isotretinoin (OI), as first-line treatment options for severe acne vulgaris (AV). This study evaluated the efficacy and safety of a daily regimen of 0.3% adapalene and 2.5% benzoyl peroxide (0.3% A/BPO) gel and oral doxycycline 100 mg twice daily in severe (nonnodulocystic, non-conglobate) inflammatory AV. METHODS: This was a phase 4, 12-week, single-arm, openlabel, multi-center investigational study...
March 1, 2018: Journal of Drugs in Dermatology: JDD
L Gatta, C Scarpignato, G Fiorini, J Belsey, I M Saracino, C Ricci, D Vaira
BACKGROUND: The increasing prevalence of strains resistant to antimicrobial agents is a critical issue in the management of Helicobacter pylori (H. pylori) infection. AIMS: (1) To evaluate the prevalence of primary resistance to clarithromycin, metronidazole and levofloxacin (2) to assess the effectiveness of sequential therapy on resistant strains (3) to identify the minimum number of subjects to enrol for evaluating the effectiveness of an eradication regimen in patients harbouring resistant strains...
March 14, 2018: Alimentary Pharmacology & Therapeutics
Jordan R Smith, Juwon Yim, Seth Rice, Kyle Stamper, Razie Kebriaei, Michael J Rybak
Background: Methicillin-resistant Staphylococcus aureus (MRSA) is a major pathogen responsible for healthcare-associated infections, and treatment options are limited. Tedizolid (TZD), is a novel, oxazolidinone antibiotic with activity against MRSA. Previously, daptomycin (DAP), has demonstrated synergy with other antibiotics against MRSA. We sought to determine the efficacy of the combination of TZD + DAP against MRSA in an in vitro model of simulated endocardial vegetations (SEVs). Methods: TZD simulations of 200 mg once daily and DAP simulations of 6-mg/kg and 10-mg/kg once daily were tested alone and in the combinations of TZD + DAP 6-mg/kg or DAP 10-mg/kg against two clinical strains of MRSA, 494 and 67...
March 12, 2018: Antimicrobial Agents and Chemotherapy
Ahmed Siddiqi, Nicole E George, Peter B White, Bartlomiej W Szczech, John V Thompson, Jennifer I Etcheson, Chukwuweike U Gwam, Alexander T Caughran, Ronald E Delanois, James Nace
INTRODUCTION: Periprosthetic joint infection (PJI) following primary total knee arthroplasty (TKA) is a challenging complication for surgeons and patients alike. Although two-stage revision arthroplasty remains the gold standard PJI management in the United States, one-stage revision has had success in many parts of Europe. The aim of this study was to retrospectively review: 1) ultimate treatment success; 2) necessary antibiotic duration; 3) change in knee range of motion (ROM); and 4) final Knee Society Scores (KSS) in a case series of patients managed with retention of articulating antibiotic spacers following PJI...
March 12, 2018: Surgical Technology International
Patricia A Lohr, Jennifer E Starling, James G Scott, Abigail R A Aiken
OBJECTIVE: To evaluate outcomes with simultaneous administration of mifepristone and misoprostol for medical abortion at 63 days of gestation or less in the year after its implementation in a British clinic system. METHODS: We conducted a retrospective cohort study using deidentified data from the electronic booking and complications databases and medical records of women who underwent medical abortion at British Pregnancy Advisory Service. Our primary outcome was treatment success with simultaneous dosing compared with a regimen with a 24- to 48-hour interval between medications...
March 8, 2018: Obstetrics and Gynecology
Haisam Abid, Junaid Khan, Nazir Lone
We report a case of Hodgkin's lymphoma presenting as an endobronchial mass in a 40-year-old man with history of 8 months of non-specific symptoms like cough, fatigue and weight loss. Initially he was treated with broad-spectrum antibiotics for suspicion of pneumonia without recovery. Radiographic work-up showed cavitary consolidation of the upper lobe of the left lung, followed by bronchoscopy which showed obstructing mass of the upper lobe of the left lung mimicking primary lung carcinoma. Immunohistochemical staining of the specimen was suggestive of Hodgkin's lymphoma...
March 9, 2018: BMJ Case Reports
Kathryn Samai, Antonia Vilella
Acute management of open fractures is associated with high morbidity and mortality. Recommended antibiotic regimens for all Gustilo-Anderson fracture grades include first-, second-, and third-generation cephalosporins. Expanded gram-negative coverage is recommended for Grade II and III fractures if a first- or second-generation cephalosporin is selected, and additional anaerobic coverage is required if the open fracture is contaminated with organic or farm-related material. Open fractures endure a high rate of bacterial contamination, and antibiotics have demonstrated effectiveness at reducing infection rates when initiated early...
March 2018: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
S S Almarzoky Abuhussain, K J Goodlet, M D Nailor, D P Nicolau
Skin and skin structure infections (SSSIs) refer to a collection of clinical infectious syndromes involving layers of skin and associated soft tissues. Although associated with less morbidity and mortality than other common skin infections, SSSIs represent a significant increasing source of healthcare expense, with a prevalence of 500 episodes per 10,000 patient-years in the United States resulting in burdening health care systems, of approximately $6 billion annually. Areas covered: Opportunities to reduce costs of care associated with SSSI are highlighted, including transitions of care and avoiding unnecessary hospital admissions...
March 9, 2018: Expert Review of Pharmacoeconomics & Outcomes Research
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