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RoFo : Fortschritte Auf Dem Gebiete Der... Sep 2018
Topics: Adult; Disease Progression; Hemorrhage; Humans; Intensive Care Units; Lung Diseases; Male; Penicillin G; Weil Disease
PubMed: 29621809
DOI: 10.1055/a-0591-4137 -
Annals of Allergy, Asthma & Immunology... Nov 2018
Topics: Drug Hypersensitivity; Humans; Liability, Legal; Penicillin G; Penicillins; beta-Lactams
PubMed: 30389082
DOI: 10.1016/j.anai.2018.09.451 -
The Journal of Emergency Medicine Feb 2017
Topics: Adult; Anthrax; Anti-Bacterial Agents; Bacillus anthracis; Blister; Edema; Female; Humans; Penicillin G; Skin Diseases, Bacterial
PubMed: 27742398
DOI: 10.1016/j.jemermed.2016.08.043 -
Veterinary Surgery : VS Jan 2023To determine the effects of general anesthesia on the safety and efficacy of co-administered potassium penicillin G (PEN) and gentamicin (GENT) in horses.
OBJECTIVE
To determine the effects of general anesthesia on the safety and efficacy of co-administered potassium penicillin G (PEN) and gentamicin (GENT) in horses.
STUDY DESIGN
Nonrandomized crossover.
ANIMALS
Six adult, Thoroughbred horses.
METHODS
Horses were administered PEN (22 000 IU/kg IV) and GENT (6.6 mg/kg IV). Plasma samples were collected over a 6 h period and synovial fluid was collected at 30 min and 6 h respectively. Drug administration and sample collection protocols were repeated after at least a 48 hour washout period and induction of anesthesia using xylazine/ketamine and maintenance with isoflurane gas. Drug concentrations were determined using ultrapressure liquid chromatography with mass spectrometry. A 2-compartment model was used to determine pharmacokinetics and differences were determined between conscious and anesthetized horses using paired t-tests (significance P < .05).
RESULTS
Potassium penicillin g and GENT had higher minimum plasma concentrations (PEN 0.44 vs. 0.11 μg/mL, P = .002; GENT 3.0 vs. 1.9 μg/mL, P = .009), longer half lives (PEN 71 vs. 59 min, P = .018; GENT 149 vs. 109 min, P = .038), and slower clearances (PEN 3.41 vs. 5.1 mL/kg/min, P = .005; GENT 1.18 vs. 1.48 mL/kg/min, P = .028) in anesthetized horses vs. conscious horses. The PEN concentrations remained above the breakpoint minimum inhibitory concentration (MIC, 0.5 μg/mL) for 332 min in anesthetized vs. 199 min in conscious horses. The GENT concentrations reached 10 times higher than the breakpoint MIC (2 μg/mL) in all horses and were maintained for 58 vs. 59 min in anesthetized and conscious states, respectively. Synovial fluid concentrations were higher in conscious horses vs. anesthetized horses at 30 min for PEN (7.0 vs. 0.93 μg/mL, P < .001) and 30 (5.3 μg/mL vs. 0.79 μg/mL, P < .001) and 360 min (3.4 vs. 1.82 μg/mL, P < .003) for GENT.
CONCLUSION
General anesthesia resulted in lower intrasynovial concentrations and delayed clearance of PEN/GENT in horses.
CLINICAL SIGNIFICANCE
Redosing healthy anesthetized horses with PEN prior to 4-5 h is not necessary. When administered to anesthetized horses, intravenous PEN/GENT may not reach adequate intrasynovial concentrations to treat or prevent common pathogens. The doses or dosing intervals of antimicrobials administered to horses undergoing anesthesia may need to be adjusted to ensure maintenance of safe and effective plasma concentrations.
Topics: Horses; Animals; Penicillins; Gentamicins; Penicillin G; Xylazine; Isoflurane
PubMed: 36286077
DOI: 10.1111/vsu.13896 -
Amyotrophic Lateral Sclerosis &... Feb 2019
Review
Topics: Amyotrophic Lateral Sclerosis; Anti-Bacterial Agents; Anti-Inflammatory Agents; Drug Therapy, Combination; Humans; Hydrocortisone; Penicillin G
PubMed: 30430873
DOI: 10.1080/21678421.2018.1512704 -
Annales de Dermatologie Et de... Nov 2016
Topics: Anti-Bacterial Agents; Continuity of Patient Care; Humans; Penicillin G; Spinal Puncture; Syphilis
PubMed: 27773512
DOI: 10.1016/j.annder.2016.09.008 -
The British Journal of Oral &... Dec 2021The purpose of this overview was to assess different antibiotic regimens used in orthognathic surgery and to establish an evidence-based protocol so that beneficial and... (Review)
Review
The purpose of this overview was to assess different antibiotic regimens used in orthognathic surgery and to establish an evidence-based protocol so that beneficial and adverse effects can be determined. A comprehensive literature search for systematic reviews and/or meta-analyses was conducted in MEDLINE (PubMed), EMBASE, and the Cochrane Library until March 2020. Grey literature was investigated in Google Scholar, and a manual search was done of references lists. Two meta-analyses and four systematic reviews met the inclusion criteria. The AMSTAR-2-tool was used to ascertain the potential risk of bias in the included studies, which presented moderate to high methodological quality. Lower infection rates were associated with long-term therapies of penicillin, cefazolin-cephalexin, and amoxicillin-clavulanic-acid, with rates varying from 0% - 3.13%. Higher rates were reported in placebo groups (52.6%) and short-term penicillin therapy (60%). Side effects were reported with cefazolin, clindamycin, and penicillin therapies, including nausea, pain, swelling, headache, vomiting, and skin rash. Evidence suggests that long-term antibiotics can reduce the risk of a surgical site infection (SSI) in orthognathic surgery, but there is uncertainty regarding the effects of one dose of antibiotics preoperatively versus short-term antibiotics. In the same way, intravenous penicillin, cefazolin, clindamycin, and amoxicillin-clavulanic acid kept the infection rates associated with bimaxillary procedures under 3.5%.
Topics: Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Antibiotic Prophylaxis; Cefazolin; Clindamycin; Humans; Orthognathic Surgery; Penicillins; Systematic Reviews as Topic
PubMed: 34465488
DOI: 10.1016/j.bjoms.2021.05.010 -
The Journal of Allergy and Clinical... Sep 2021
Topics: Humans; Penicillin G; Tongue; Tongue Diseases
PubMed: 34507710
DOI: 10.1016/j.jaip.2021.04.036 -
The New England Journal of Medicine Jan 2022Rheumatic heart disease affects more than 40.5 million people worldwide and results in 306,000 deaths annually. Echocardiographic screening detects rheumatic heart... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Rheumatic heart disease affects more than 40.5 million people worldwide and results in 306,000 deaths annually. Echocardiographic screening detects rheumatic heart disease at an early, latent stage. Whether secondary antibiotic prophylaxis is effective in preventing progression of latent rheumatic heart disease is unknown.
METHODS
We conducted a randomized, controlled trial of secondary antibiotic prophylaxis in Ugandan children and adolescents 5 to 17 years of age with latent rheumatic heart disease. Participants were randomly assigned to receive either injections of penicillin G benzathine (also known as benzathine benzylpenicillin) every 4 weeks for 2 years or no prophylaxis. All the participants underwent echocardiography at baseline and at 2 years after randomization. Changes from baseline were adjudicated by a panel whose members were unaware of the trial-group assignments. The primary outcome was echocardiographic progression of latent rheumatic heart disease at 2 years.
RESULTS
Among 102,200 children and adolescents who had screening echocardiograms, 3327 were initially assessed as having latent rheumatic heart disease, and 926 of the 3327 subsequently received a definitive diagnosis on the basis of confirmatory echocardiography and were determined to be eligible for the trial. Consent or assent for participation was provided for 916 persons, and all underwent randomization; 818 participants were included in the modified intention-to-treat analysis, and 799 (97.7%) completed the trial. A total of 3 participants (0.8%) in the prophylaxis group had echocardiographic progression at 2 years, as compared with 33 (8.2%) in the control group (risk difference, -7.5 percentage points; 95% confidence interval, -10.2 to -4.7; P<0.001). Two participants in the prophylaxis group had serious adverse events that were attributable to receipt of prophylaxis, including one episode of a mild anaphylactic reaction (representing <0.1% of all administered doses of prophylaxis).
CONCLUSIONS
Among children and adolescents 5 to 17 years of age with latent rheumatic heart disease, secondary antibiotic prophylaxis reduced the risk of disease progression at 2 years. Further research is needed before the implementation of population-level screening can be recommended. (Funded by the Thrasher Research Fund and others; GOAL ClinicalTrials.gov number, NCT03346525.).
Topics: Adolescent; Anti-Bacterial Agents; Antibiotic Prophylaxis; Child; Child, Preschool; Disease Progression; Echocardiography; Female; Humans; Injections, Intramuscular; Intention to Treat Analysis; Latent Infection; Male; Mass Screening; Penicillin G Benzathine; Rheumatic Heart Disease; Uganda
PubMed: 34767321
DOI: 10.1056/NEJMoa2102074 -
BMJ Open Quality Jul 2022Patients with self-reported antibiotic allergies have a higher cost of care, more frequent infections with resistant bacteria and worse health outcomes than patients...
BACKGROUND
Patients with self-reported antibiotic allergies have a higher cost of care, more frequent infections with resistant bacteria and worse health outcomes than patients without antibiotic allergies. Ultimately, less than 5% of patients who report a penicillin allergy have a clinically significant immune-mediated hypersensitivity reaction when tested. As 10%-30% of the population of pregnant patients are colonised for group B (GBS) and guidelines recommend penicillin as the treatment of choice for GBS, current recommendations support penicillin allergy testing in pregnant patients who report an allergy.
METHODS AND INTERVENTION
In this quality improvement project, nursing staff used an algorithm outlining inclusion and exclusion criteria to determine which patients were eligible to have penicillin allergy testing completed. Penicillin allergy testing consisted of a skin test using benzylpenicilloyl polylysine (Pre-Pen), penicillin G potassium, amoxicillin and alkaline hydrolysis mix (penicilloate) as a prick skin test, followed by intradermal skin test and finally an oral challenge with either amoxicillin or penicillin. Patient outcomes were analysed to evaluate the impact of the intervention.
RESULTS
Of the 1266 patients receiving prenatal care during the intervention, 236 (19%) reported a history of penicillin allergy, and 212 if these were eligible for testing. 150 of the eligible patients were offered penicillin allergy testing. 101 patients (67%) completed testing and 49 (33%) declined testing. Seven patients (7%) had positive penicillin allergy testing, while 94 patients (93%) had negative penicillin allergy testing and were immediately de-labelled as penicillin allergic. Seventeen of the de-labelled patients subsequently tested positive for GBS colonisation, and all received intrapartum penicillin without adverse events.
CONCLUSIONS
Pursuing penicillin allergy testing for pregnant patients with reported penicillin allergy is a safe and feasible approach, allowing for allergy de-labelling and safe, guideline-driven antimicrobial therapy during subsequent labour and delivery hospitalisations. Cost-effectiveness of the allergy testing and impact on later episodes of care should be further investigated.
Topics: Amoxicillin; Anti-Bacterial Agents; Drug Hypersensitivity; Female; Humans; Penicillins; Pregnancy; Skin Tests
PubMed: 35906008
DOI: 10.1136/bmjoq-2022-001859