-
Clinical Infectious Diseases : An... Mar 2020
Topics: Acute Kidney Injury; Anti-Bacterial Agents; Critical Illness; Humans; Penicillanic Acid; Piperacillin; Piperacillin, Tazobactam Drug Combination; Retrospective Studies; Vancomycin
PubMed: 31297504
DOI: 10.1093/cid/ciz643 -
Antimicrobial Agents and Chemotherapy Jan 2021We examined the effects of piperacillin-tazobactam (TZP) concentration and bacterial inoculum on killing and the emergence of resistance in The MICs for 15 clinical...
We examined the effects of piperacillin-tazobactam (TZP) concentration and bacterial inoculum on killing and the emergence of resistance in The MICs for 15 clinical respiratory isolates were determined by broth microdilution for TZP and by Etest for ceftriaxone (CRO) and cefepime (FEP). The presence of resistance in TZP-susceptible isolates ( = 10) was determined by serial passes over increasing concentrations of TZP-containing and CRO-containing agar plates. Isolates with growth on TZP 16/4-μg/ml and CRO 8-μg/ml plates ( = 5) were tested in high-inoculum (HI; 7.0 log CFU/ml) and low-inoculum (LI; 5.0 log CFU/ml) time-kill studies. Antibiotic concentrations were selected to approximate TZP 3.375 g every 8 h (q8h) via a 4-h prolonged-infusion free peak concentration (40 μg/ml [TZP40]), peak epithelial lining fluid (ELF) concentrations, and average AUC values for TZP (20 μg/ml [TZP20] and 10 μg/ml [TZP10], respectively), the ELF FEP concentration (14 μg/ml), and the average AUC CRO concentration (6 μg/ml). For HI, FEP exposure significantly reduced 24-h inocula against all comparators ( ≤ 0.05) with a reduction of 4.93 ± 0.64 log CFU/ml. Exposure to TZP40, TZP20, and TZP10 reduced inocula by 0.81 ± 0.43, 0.21 ± 0.18, and 0.05 ± 0.16 log CFU/ml, respectively. CRO-exposed isolates demonstrated an increase of 0.42 ± 0.39 log CFU/ml compared to the starting inocula, with four of five CRO-exposed isolates demonstrating TZP-nonsusceptibility. At LI after 24 h of exposure to TZP20 and TZP10, the starting inoculum decreased by averages of 2.24 ± 1.98 and 2.91 ± 0.50 log CFU/ml, respectively. TZP demonstrated significant inoculum-dependent killing, warranting dose optimization studies.
Topics: Anti-Bacterial Agents; Ceftriaxone; Enterobacter aerogenes; Microbial Sensitivity Tests; Penicillanic Acid; Piperacillin; Piperacillin, Tazobactam Drug Combination; beta-Lactamases
PubMed: 33139285
DOI: 10.1128/AAC.01038-20 -
Acta Paediatrica (Oslo, Norway : 1992) May 2023We evaluated antibiotic prescriptions issued for Finnish children with acute sinusitis by a nationwide private outpatient clinic network from 2014-2020. Data were...
AIM
We evaluated antibiotic prescriptions issued for Finnish children with acute sinusitis by a nationwide private outpatient clinic network from 2014-2020. Data were compared before and after updated guidelines in 2018.
METHODS
The study comprised data on 45 296 children aged 2-17 years with acute sinusitis, namely diagnoses, ages, dates, the doctor's specialty and any antibiotics. We measured compliance with the updated 2018 Finnish guidelines, which recommended amoxicillin or amoxicillin-clavulanic acid for children under 12 years old, with doxycycline as an alternative for 12 years plus.
RESULTS
There were 6621-7585 visits per year for acute sinusitis in 2014-2019 and 2954 in 2020. Antibiotics were prescribed for 37.9%-41.6% of patients during the study years. Amoxicillin, including penicillin, accounted for 35.9% of prescriptions, followed by amoxicillin-clavulanic acid (26.9%). Macrolides accounted for 20.6% and, encouragingly, decreased by 38% from 2014-2019. Doxycycline accounted for 5.3%. Paediatricians, general practitioners (GPs) and ear, nose and throat specialists followed the guidelines in 75.1%, 73.8% and 66.7% of cases, respectively. GPs prescribed antibiotics more often than other physicians.
CONCLUSION
Antibiotics were prescribed for about 40% of acute sinusitis visits by Finnish children from 2014-2019. Specialities differed with regard to prescribing rates and whether they followed the guidelines.
Topics: Child; Humans; Anti-Bacterial Agents; Amoxicillin-Potassium Clavulanate Combination; Doxycycline; Finland; Drug Prescriptions; Sinusitis; Amoxicillin; Acute Disease; Practice Patterns, Physicians'; Respiratory Tract Infections
PubMed: 36562286
DOI: 10.1111/apa.16641 -
The Journal of Allergy and Clinical... Feb 2020
Topics: Amoxicillin-Potassium Clavulanate Combination; Anaphylaxis; Humans
PubMed: 32037114
DOI: 10.1016/j.jaip.2019.08.032 -
BioMed Research International 2022This study was designed to identify from clinical mastitis of cattle and determine their antimicrobial resistance and virulence determinants to evaluate their potential...
This study was designed to identify from clinical mastitis of cattle and determine their antimicrobial resistance and virulence determinants to evaluate their potential public health significance. A total of 105 composite milk samples (80 from cattle with clinical mastitis and 25 from apparently healthy cattle) were analyzed. were isolated by culturing on enterococcal selective media and identified by PCR and sequencing. Antimicrobial resistance phenotype was elucidated by the disc diffusion method, and MIC was determined by broth microdilution method according to CLSI guidelines. Detection of antimicrobial resistance and virulence genes was done by PCR. were isolated from 11.25% (9/80) of the clinical mastitis and 4% (1/25) of the apparently healthy cattle milk samples. The disc diffusion test revealed 40% isolates as resistant to tetracycline and azithromycin, respectively. Among them, 20% (2/10) of isolates showed resistance to both tetracycline and azithromycin. Tetracycline-resistant isolates showed MIC ranging from ≥64 to >128 g/ml and carried tetracycline-resistant genes , , and in 25%, 25%, and 50% of the resistant isolates, respectively. On the other hand, all the isolates were sensitive to amoxicillin, ampicillin, bacitracin, chloramphenicol, gentamicin, penicillin, and vancomycin. In addition, the isolates carried at least one of the nine virulence genes screened with having the highest frequency, followed by , , , , , and genes. Positive correlations were evident between , , , and genes that are associated with the attachment and biofilm formation in isolated in this study carried antibiotic resistance and virulence determinants which explain their competence to be potential human pathogens.
Topics: Amoxicillin; Ampicillin; Animals; Anti-Bacterial Agents; Azithromycin; Bacitracin; Bangladesh; Cattle; Chloramphenicol; Drug Resistance, Bacterial; Enterococcus faecalis; Female; Gentamicins; Humans; Mastitis; Microbial Sensitivity Tests; Penicillins; Public Health; Tetracyclines; Vancomycin; Virulence; Virulence Factors
PubMed: 36203487
DOI: 10.1155/2022/8101866 -
European Endodontic Journal May 2023This study aimed to evaluate the efficacy and duration of antibiotic therapy with different regi- mens of antibiotics for patients presenting with primary and secondary...
OBJECTIVE
This study aimed to evaluate the efficacy and duration of antibiotic therapy with different regi- mens of antibiotics for patients presenting with primary and secondary endodontic infections.
METHODS
In a case series outcome study, all patients needing antibiotics due to endodontic infection were included. In patients with no history of hypersensitivity to penicillin, amoxicillin was used as the first-line antibiotic, followed by adding metronidazole if the symptoms did not show signs of recovery during the first 24 hours after prescribing the medication. If a patient did not respond to the combination of amoxicillin and metronidazole, amoxicillin was substituted with a parental penicillin G procaine. Patients who had sensitivity to penicillin received clindamycin. In cases where drainage was possible, the effect of the procedure on the success rate of antibiotic therapy was evaluated. All patients were asked to continue taking the antibiotic for up to two days following the relief of symptoms. Data were analysed by Chi-square, Fisher exact test, Indepen- dent t-test, and One-way ANOVA.
RESULTS
Over a period of 6 years, 97 patients were eligible to be included in this study. In patients with no history of sensitivity to penicillin (95.9% of the patients), 52.7% of patients on amoxicillin and 43% of patients on amoxicillin plus metronidazole overcame the endodontic infections. In addition, drainage significantly increased the success rate of antibiotic therapy when amoxicillin was prescribed (p=0.046). There were no significant differences between the gender, age, type of tooth, need for primary or secondary endodontic treatment, previous history of infection, need for drainage or duration of antibiotic consumption (p>0.05), and the success of antibiotic prescription. However, patients who received a single antibiotic (either amoxi- cillin or clindamycin) had significantly shorter average times for the recovery of symptoms (p<0.05).
CONCLUSION
Amoxicillin helped patients recover from endodontic infection symptoms in more than half of the cases. However, it is necessary to monitor the patients to understand if they should be needed further treatment, such as another antibiotic or drainage. (EEJ-2022-11-138).
Topics: Humans; Anti-Bacterial Agents; Clindamycin; Metronidazole; Amoxicillin; Penicillins
PubMed: 37257032
DOI: 10.14744/eej.2023.39306 -
Contrast Media & Molecular Imaging 2022This study aimed to compare the identification efficiency of metagenome next generation sequencing (mNGS) and traditional methods in detecting pathogens in patients with...
OBJECTIVE
This study aimed to compare the identification efficiency of metagenome next generation sequencing (mNGS) and traditional methods in detecting pathogens in patients with severe bacterial pneumonia (BP) and further analyze the drug resistance of common pathogens.
METHODS
A total of 180 patients with severe BP who were admitted to our hospital from June 2017 to July 2020 were selected as the research objects. Alveolar lavage fluid from the patients were collected, and pathogens were detected by the mNGS technology and traditional etiological detection technology. Common pathogens detected by mNGS were tested for the drug sensitivity test. The difference between mNGS and traditional detection method in the identification of pathogenic bacteria in severe BP patients was compared, and the distribution characteristics and drug resistance of pathogenic bacteria were analyzed.
RESULTS
The positive rate of mNGS detection was 92.22%, which was significantly higher than that of the traditional culture method (58.33%, < 0.05). 347 strains of pathogenic bacteria were detected by mNGS, including 256 strains of Gram-negative bacteria (G), 89 strains of Gram-positive bacteria (G), and 2 strains of fungi. Among G bacteria, had higher resistance to piperacillin/tazobactam, ceftazidime, imipenem, levofloxacin, amikacin, ciprofloxacin, gentamicin, and the lowest resistance to tigecycline. The resistance of to piperacillin/tazobactam and ceftazidime was higher. had low resistance to all the drugs. Escherichia coli had high drug resistance to most drugs, and the drug resistant rates to cefoperazone/sulbactam, piperacillin/tazobactam, ceftazidime, imipenem, and gentamicin were all more than 50.00%. G bacteria had high resistance to penicillin, azithromycin, amoxicillin and levofloxacin, and amoxicillin and levofloxacin had high resistance, up to 100.00%.
CONCLUSION
mNGS has high sensitivity for the identification of pathogenic bacteria in patients with BP. G bacteria were the main pathogens of BP, but both G and G bacteria had high resistance to a variety of antibacterial drugs.
Topics: Humans; Cefoperazone; Microbial Sensitivity Tests; Drug Resistance, Bacterial; Sulbactam; Ceftazidime; Levofloxacin; Tigecycline; Amikacin; Azithromycin; Gram-Negative Bacteria; Anti-Bacterial Agents; Imipenem; Intensive Care Units; Piperacillin, Tazobactam Drug Combination; Pneumonia, Bacterial; Amoxicillin; Gentamicins; Ciprofloxacin
PubMed: 36262997
DOI: 10.1155/2022/6980091 -
Scientific Reports May 2021Thienamycin, the first representative of carbapenem antibiotics was discovered in the mid-1970s from soil microorganism, Streptomyces cattleya, during the race to...
Thienamycin, the first representative of carbapenem antibiotics was discovered in the mid-1970s from soil microorganism, Streptomyces cattleya, during the race to discover inhibitors of bacterial peptidoglycan synthesis. Chemically modified into imipenem (N-formimidoyl thienamycin), now one of the most clinically important antibiotics, thienamycin is encoded by a thienamycin gene cluster composed of 22 genes (thnA to thnV) from S. cattleya NRRL 8057 genome. Interestingly, the role of all thn-genes has been experimentally demonstrated in the thienamycin biosynthesis, except thnS, despite its annotation as putative β-lactamase. Here, we expressed thnS gene and investigated its activities against various substrates. Our analyses revealed that ThnS belonged to the superfamily of metallo-β-lactamase fold proteins. Compared to known β-lactamases such as OXA-48 and NDM-1, ThnS exhibited a lower affinity and less efficiency toward penicillin G and cefotaxime, while imipenem is more actively hydrolysed. Moreover, like most MBL fold enzymes, additional enzymatic activities of ThnS were detected such as hydrolysis of ascorbic acid, single strand DNA, and ribosomal RNA. ThnS appears as a MBL enzyme with multiple activities including a specialised β-lactamase activity toward imipenem. Thus, like toxin/antitoxin systems, the role of thnS gene within the thienamycin gene cluster appears as an antidote against the produced thienamycin.
Topics: Anti-Bacterial Agents; Cefotaxime; Cephamycins; Penicillin G; Streptomyces; Thienamycins; beta-Lactamases
PubMed: 33980996
DOI: 10.1038/s41598-021-89600-x -
Journal of Autoimmunity Feb 2024The term Hoigné's syndrome denotes a mimicker of anaphylaxis, which occurs immediately after the parenteral administration of a drug and is likely caused by... (Review)
Review
The term Hoigné's syndrome denotes a mimicker of anaphylaxis, which occurs immediately after the parenteral administration of a drug and is likely caused by non-thrombotic pulmonary and systemic drug micro-embolization. It has so far been documented uniquely in case reports and small case series. Because this condition has never been systematically evaluated, we performed a structured literature review (pre-registered as CRD42023392962). The search was carried out in Excerpta Medica, National Library of Medicine, and Google Scholar. Cases with features consistent with anaphylaxis, urticaria, angioedema, asthma, syncope, anxiety, or panic attack triggered by needle phobia, and local anesthetic systemic toxicity were excluded. For the final analysis, we retained reports published between 1951 and 2021, which presented 247 patients with Hoigné's syndrome: 37 children and 211 adults with a male: female ratio of 2.1 : 1.0. The patients presented within 1 min after parenteral administration of a drug (intramuscular penicillin in 90 % of the cases) with chest discomfort, shortness of breath, fear of death, psychomotor agitation, and auditory or visual hallucinations and impairment. Recovery occurred within 30 min. The diagnosis of Hoigné's syndrome was also established in five patients 66-91 years of age with pre-existing cardiovascular or pulmonary diseases, who suddenly died after the administration of penicillin despite not exhibiting the aforementioned symptoms. It was therefore speculated that pulmonary drug micro-embolization induced a lethal cardiovascular compromise in these individuals. Histologic investigations supporting this hypothesis were performed in only one case. The diagnosis of Hoigné's pulmonary drug micro-embolization was established also in five patients with pre-existing cardiovascular or pulmonary diseases, who suddenly died after the administration of penicillin despite not exhibiting the afore mentioned symptoms. Histologic investigations supporting this hypothesis were performed in only one case. In conclusion, Hoigné's syndrome is an uncommon non-immune-mediated reaction. This report seeks to promote broader awareness and knowledge regarding this alarming mimicker of anaphylaxis. Diagnosis relies solely on clinical evaluation.
Topics: United States; Adult; Child; Humans; Male; Female; Penicillin G Procaine; Anaphylaxis; Penicillins; Hallucinations; Syndrome; Lung Diseases
PubMed: 38194789
DOI: 10.1016/j.jaut.2023.103164 -
Oral Health & Preventive Dentistry Apr 2023Antibiotics play an important role in treating periodontal diseases. Due to the effectiveness of antibiotic therapies, their usage in dentistry has significantly...
PURPOSE
Antibiotics play an important role in treating periodontal diseases. Due to the effectiveness of antibiotic therapies, their usage in dentistry has significantly increased. The aim of this study focused on the in-vitro susceptibility of different gram-negative oral bacteria species - which are associated with periodontal diseases (Fusobacterium spp., Capnocytophaga spp. and Leptotrichia buccalis) and have different geographical origins (Asia and Europe) - against antimicrobials that are clinically relevant in dental therapy.
MATERIALS AND METHODS
A total of 45 strains were tested (29 Fusobacterium spp., 13 Capnocytophaga spp. and 3 L. buccalis) that were either isolated from Chinese patients or were obtained from different strain collections. Their antimicrobial susceptibility to the antimicrobial agents benzylpenicillin, amoxicillin, amoxicillin-clavulanic acid, ciprofloxacin, moxifloxacin, clindamycin, doxycycline, tetracycline and metronidazole was tested using the E-Test. Strains with particular resistance to penicillin, clindamycin and metronidazole were further analysed for resistance genes.
RESULTS
All tested bacterial isolates were sensitive to amoxicillin, amoxicillin-clavulanic acid, doxycycline and tetracycline, but showed variable sensitivity towards other antibiotics such as benzylpenicillin, ciprofloxacin, moxifloxacin, clindamycin and metronidazole.
CONCLUSION
The results of the present study suggest that certain periodontal disease-related bacterial strains can be resistant towards antimicrobial agents commonly used in adjuvant periodontal therapy.
Topics: Humans; Clindamycin; Metronidazole; Capnocytophaga; Doxycycline; Fusobacterium; Amoxicillin-Potassium Clavulanate Combination; Moxifloxacin; Leptothrix; Leptotrichia; Drug Resistance, Bacterial; Microbial Sensitivity Tests; Anti-Bacterial Agents; Amoxicillin; Anti-Infective Agents; Ciprofloxacin; Periodontal Diseases
PubMed: 37014213
DOI: 10.3290/j.ohpd.b4009553