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Journal of the American Academy of... Aug 2019Radiation dermatitis is a common sequela of radiation therapy; up to 95% of patients will develop moderate-to-severe skin reactions. No criterion standard currently... (Review)
Review
Radiation dermatitis is a common sequela of radiation therapy; up to 95% of patients will develop moderate-to-severe skin reactions. No criterion standard currently exists for the treatment of acute radiation-induced skin toxicity. It is therefore imperative to develop a greater understanding of management options available to allow clinicians to make informed decisions when managing radiation oncology patients. This literature review discusses the topical agents that have been studied for the treatment of acute radiation dermatitis, reviews their mechanisms of action, and presents a treatment algorithm for clinicians managing patients experiencing radiation dermatitis.
Topics: Acute Disease; Adrenal Cortex Hormones; Algorithms; Anti-Infective Agents, Local; Bandages; Biological Products; Dermatologic Agents; Ethanolamines; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Plant Preparations; Radiodermatitis; Radiotherapy; Silver Sulfadiazine; Sucralfate; Vitamins
PubMed: 30802561
DOI: 10.1016/j.jaad.2019.02.047 -
Wounds : a Compendium of Clinical... Feb 2020Radiation therapy (RT) following breast-conserving surgical excision of cancer reduces cancer-related mortality and recurrence.1 However, most patients experience acute...
Radiation therapy (RT) following breast-conserving surgical excision of cancer reduces cancer-related mortality and recurrence.1 However, most patients experience acute radiation dermatitis (ARD) within weeks after beginning RT2; symptoms of ARD, including severe skin erythema, dryness, moist or dry desquamation, and/or ulceration, may interrupt radiotherapy. This can negatively affect patient quality of life (QoL) and cancer outcomes. Acute radiation dermatitis is not to be confused with chronic radiation dermatitis, which can lead to fibrosis, skin atrophy, pigmentation, and telangiectasia months to years after RT.3 Evidence-based guidelines4 to both prevent and treat ARD recommend the application of 1 of 2 topical interventions during and/or after RT: (1) corticosteroids to improve ARD-related discomfort and itching5 or (2) 1% silver sulfadiazine (SSD) cream to reduce ARD-related dermatitis scores.6 This Evidence Corner reviews evidence supporting the 2 aforementioned topical interventions for patients undergoing RT for breast cancer.
Topics: Adrenal Cortex Hormones; Dermatologic Agents; Humans; Radiodermatitis; Silver Sulfadiazine
PubMed: 32155122
DOI: No ID Found -
The disposition of trimethoprim and sulfadiazine in neonatal foals after intravenous administration.Veterinary Medicine and Science May 2022Septicaemia in the neonatal foal is caused by both Gram positive and Gram negative bacteria. The life-threatening nature of this condition requires treatment to be...
BACKGROUND
Septicaemia in the neonatal foal is caused by both Gram positive and Gram negative bacteria. The life-threatening nature of this condition requires treatment to be initiated with broad spectrum antimicrobial drugs pending antimicrobial susceptibility testing. Potentiated sulphonamides, for example, trimethoprim combined with sulfadiazine, could be clinically relevant options but their pharmacokinetics in the neonatal foal are unknown.
OBJECTIVES
To describe the plasma disposition of trimethoprim and sulfadiazine in neonatal foals and to relate the results to patterns in the minimum inhibitory concentration (MIC) for Escherichia coli, a recognized pathogen in neonatal foal sepsis.
METHOD
A total of five doses of trimethoprim (2.5 mg/kg) and sulfadiazine (12.5 mg/kg) were administered intravenously every 12 h to eight neonatal foals that were 3 days old at inclusion. A non-linear mixed effects model was fitted to the trimethoprim and sulfadiazine experimental data. The 24 h area under the free plasma trimethoprim and sulfadiazine concentration-time curves (fAUC) and the pharmacokinetic/pharmacodynamik (PK/PD)-index fAUC/MIC was calculated to evaluate the potential clinical benefits of the administered dose.
RESULTS
For trimethoprim, the typical values were 1.99 L/kg, 0.33 L/h·kg and 4.2 h for the apparent volume of distribution, clearance and terminal half-life, respectively. The 24 h fAUC for trimethoprim was 11.3 μg·h/ml (7.2-15.2) and the fAUC/MIC ratio for E. coli was 23 (16.4-29.2) (population mean (range)). For sulfadiazine, the typical values were 0.61 L/kg, 0.09 L/h·kg and 5.3 h for the apparent volume of distribution, clearance and terminal half-life, respectively. The 24 h fAUC for sulfadiazine was 246.8 μg·h/ml (175.6-335.4).
CONCLUSION
For trimethoprim, the plasma exposure is insufficient in some foals to successfully treat bacterial infections with an MIC-value of 0.5 μg/ml using the studied dosing regimen.
Topics: Administration, Intravenous; Animals; Anti-Bacterial Agents; Anti-Infective Agents; Escherichia coli; Gram-Negative Bacteria; Gram-Positive Bacteria; Horses; Sulfadiazine; Trimethoprim
PubMed: 35152563
DOI: 10.1002/vms3.763 -
Supportive Care in Cancer : Official... Jun 2022Radiation dermatitis (RD) is a common side effect of radiation therapy (RT). While many different treatment strategies are currently used to address RD, there is a lack... (Review)
Review
PURPOSE
Radiation dermatitis (RD) is a common side effect of radiation therapy (RT). While many different treatment strategies are currently used to address RD, there is a lack of consensus and RD prophylaxis and management guidelines have remained largely unchanged over the last 10 years. This review aims to formulate unambiguous supportive care interventions by comparing RD clinical practice guidelines published between 2010 and 2021 by several organizations: Multinational Association for Supportive Care in Cancer (MASCC), British Columbia Cancer Agency (BCCA), Cancer Care Manitoba (CCMB), Oncology Nursing Society (ONS), Society and College of Radiographers (SCoR), and International Society of Nurses in Cancer Care (ISNCC).
METHODS
Areas of agreement and discordance were assessed among the MASCC, BCCA, CCMB, ONS, SCoR, and ISNCC guidelines.
RESULTS
Treatment recommendations across guidelines for acute RD and chronic RT-induced skin toxicities have been summarized. The strongest agreement among the guidelines exists for the use of topical corticosteroids, silver sulfadiazine, washing, and deodorant. All guidelines recommend the use of topical corticosteroids, and washing with water and soap is consistently supported. There is minimal consensus on an optimal dressing or barrier film for RD prophylaxis or management. MASCC weakly recommends prophylactic use of silver sulfadiazine to reduce RD, while BCCA, CCMB, and SCoR recommend its use upon signs of infection. MASCC and CCMB recommend the use of a long-pulsed dye laser to manage telangiectasia, a late effect of RT.
CONCLUSIONS
Given the extent of discordance among guideline recommendations, further research is recommended to establish optimal treatments for RD prophylaxis and management.
Topics: Adrenal Cortex Hormones; Dermatologic Agents; Humans; Neoplasms; Practice Guidelines as Topic; Radiodermatitis; Silver Sulfadiazine
PubMed: 35067732
DOI: 10.1007/s00520-022-06829-6 -
Environmental Research Nov 2022In view of the environmental issues caused by antibiotics, this research studies competitive adsorption/desorption for tetracycline (TC) and sulfadiazine (SDZ) in...
In view of the environmental issues caused by antibiotics, this research studies competitive adsorption/desorption for tetracycline (TC) and sulfadiazine (SDZ) in agricultural soils. Competitive adsorption was studied in binary systems (adding equal concentrations of both antibiotics). In addition, it was compared with results from simple systems. In all cases, batch-type adsorption/desorption experiments were carried out. In the binary systems, for the highest antibiotic concentration added, adsorption percentages were always higher for TC (close to 100%) than for SDZ (10-90%). In these systems, TC desorption was lower than 5% for all soils, and generally <10% for SDZ. Comparing TC and SDZ adsorption for the different systems, SDZ was clearly affected by the presence of TC, with SDZ adsorption percentages being was much higher (with differences generally above 65%) in the binary than in the simple systems. On the contrary, comparing the results of TC adsorption in simple and binary systems, TC was not affected by the presence of SDZ, obtaining similar adsorption percentages in both systems. K and K values (in the Linear and Freundlich models), were higher in the simple systems in the case of TC, which could be due to competition with SDZ, while for SDZ K and K were higher in the binary systems, with a synergistic effect of TC favoring SDZ adsorption. Regarding desorption, it reached 100% for SDZ in some soils in simple systems, dropping to 10% in the presence of TC. TC desorption was <4%, not affected by SDZ. The results indicate that environmental risks would be higher for SDZ, showing differences when both antibiotics are present. This can be considered relevant as regards public health and environmental preservation, in view of direct toxicities and the promotion of resistance to antibiotics associated with the presence of these contaminants in the environment.
Topics: Adsorption; Anti-Bacterial Agents; Soil; Soil Pollutants; Sulfadiazine; Tetracycline
PubMed: 35750125
DOI: 10.1016/j.envres.2022.113726 -
Journal of Burn Care & Research :... Sep 2021Pavement burns are common in a dry high heat climate. This study reviews the etiology, management, and outcome pavement burns in children. All patients age <18 who...
Pavement burns are common in a dry high heat climate. This study reviews the etiology, management, and outcome pavement burns in children. All patients age <18 who sustained contact burns from hot pavement from January 1, 2014 to December 31, 2019 were reviewed for mechanism, medical history, treatment course, and outcome. The high ambient temperature on each date and zip code of each injury were extracted from Weather Underground (www.wunderground.com). In this study, 45 patients met criteria and were reviewed 27 patients (60%) were male. Average age was 3.29 years (SD 0.69), made up two discrete age groups: age 3 years and under (n = 40, 89%) and older patients 14 years of age and up (n = 5, 11%). Thirty-eight patients (84%) had no known medical history. All had second-degree burns and one patient (2%) also had third-degree burns. Mean TBSA was 2.5% (SD 1.4%, range 0.75%-5.5%). Burn etiology included 31 patients (69%) who were walking barefoot on pavement, six (13%) who fell onto pavement, one (2%) seizure, and other/unknown etiology for the remaining seven patients (16%). Thirty patients (67%) had injuries on the plantar aspect of the bilateral feet, two (4%) to bilateral palms of hands, four (9%) to other parts of upper extremities, and 10 (22%) to other parts of lower extremities. Thirty-four patients (76%) were managed without any hospitalization. Those that were hospitalized had an average length of stay of 2.72 days (range 1-9 days). All burns were managed nonoperatively with topical therapy alone. Thirty-four patients (76%) were managed initially with silver sulfadiazene alone and six (13%) with bacitracin alone. Aquacel dressing was utilized in 10 patients at a follow-up visit (22%). Three patients (6.7%) were treated with collagenase enzyme therapy at some point in their care. One patient developed a superficial infection requiring oral antibiotic therapy. There were no mortalities in this group. High ambient temperature on date and location of each injury was 102.1°F (SD 5.4°F, range 89-111°F). Of the 30 patients that continued to follow up in clinic the average time to the burn being 95% healed was 10.50 days (SD 8.97 days, range 2-40 days). Pavement burns in children are partial thickness and are safely managed with topical therapy alone with good outcomes. Patients age 3 and under are at high risk.
Topics: Ambulatory Care; Anti-Infective Agents, Local; Bandages; Burns; Child; Child, Preschool; Female; Hot Temperature; Humans; Infant; Length of Stay; Male; Retrospective Studies; Silver Sulfadiazine; Wound Healing
PubMed: 34015098
DOI: 10.1093/jbcr/irab084 -
Revista Da Associacao Medica Brasileira... Nov 2019to identify, through an integrative review, national studies published over the last ten years highlighting products and therapies used in burns. (Review)
Review
OBJECTIVE
to identify, through an integrative review, national studies published over the last ten years highlighting products and therapies used in burns.
METHODS
integrative research with studies published in the last ten years. Including clinical studies describing the use of the already established or innovative therapies in burns and the results obtained, published in national journals in the last ten years. Excluding articles published before 2007 and those that did not present results regarding the use of products in burns.
RESULTS
ten articles that met the inclusion criteria were selected. Collagenase, 1% silver sulfadiazine, and porous cellulose membrane were some of the therapies cited.
CONCLUSION
the casuistry was low; however, the good results obtained with porous cellulose membrane and silver nanocrystalline dressing are highlighted, since they were used in a larger number of patients in the studies evaluated.
Topics: Bandages; Burns; Collagenases; Debridement; Humans; Membranes, Artificial; Silver Sulfadiazine
PubMed: 31800905
DOI: 10.1590/1806-9282.65.11.1405 -
Acta Cirurgica Brasileira 2022To evaluate the morphometric, macroscopic and microscopic aspects of experimentally induced partial-thickness burns in rats treated with different silver-based dressings.
PURPOSE
To evaluate the morphometric, macroscopic and microscopic aspects of experimentally induced partial-thickness burns in rats treated with different silver-based dressings.
METHODS
Wistar rats were used, divided into six treatments: saline (NaCl 0.9%); silver sulfadiazine 1%; Silvercel; Mepilex Ag; Aquacel Ag and Acticoat. The animals were monitored daily and euthanized at 7, 14 and 30 days after injury induction (DAI).
RESULTS
At 7 DAI, necrosis/crust was greater in control, silver sulfadiazine and Mepilex Ag treatments, granulation tissue was induced by Aquacel Ag, polymorphonuclear infiltrate (PMN) infiltration was intensified by Mepilex Ag; mononuclear infiltrate (MN) infiltration and angiogenesis were increased by Silvercel. At 14 DAI, hemorrhage was decreased by Silvercel and Mepilex Ag, PMN infiltration increased by Acticoat. At 30 DAI, angiogenesis was greater in the Acticoat treatment and fibroblasts were increased by Acticoat and Mepilex Ag. Collagen was induced at 14 DAI by silver sulfadiazine and Aquacel Ag and, at 30 DAI, by silver sulfadiazine and Silvercel treatments.
CONCLUSIONS
Silvercel and Acticoat presented better results than the other products. However, all the dressings were better than the control at some point during the process, and may contribute to the healing of partial thickness burns. Silvercel and Aquacel Ag treatments induced better cosmetic outcomes regarding wound closure and scarring.
Topics: Rats; Animals; Silver Sulfadiazine; Silver; Carboxymethylcellulose Sodium; Rats, Wistar; Bandages; Burns
PubMed: 36449949
DOI: 10.1590/acb370801 -
Journal of Biomaterials Applications Apr 2021(Bio)nanocomposites have been studied for biomedical applications, including the treatment of wounds. However, wound infection is one of the main problems of wound care...
(Bio)nanocomposites have been studied for biomedical applications, including the treatment of wounds. However, wound infection is one of the main problems of wound care management, and the use of wound dressings with antibacterial agents is essential. This work focused on developing and characterizing silver sulfadiazine-loaded halloysite/cassava starch-based (bio)nanocomposites potentially suitable as antimicrobial dressing. Silver sulfadiazine was complexed inside the halloysite nanotubes lumen, and the drug-loaded nanotubes were incorporated in thermoplastic starch dispersion, forming the (bio)nanocomposites. The silver sulfadiazine-loaded halloysite and the (bio)nanocomposite were characterized by zeta potential, scanning electron microscopy, X-ray diffraction, and infrared spectroscopy. The dressing properties of (bio)nanocomposites (water vapor permeability and mechanical stability) and their antimicrobial efficacy by , and were also evaluated. Physicochemical studies suggested the silver sulfadiazine-loaded halloysite complexation (zeta potential of -38.9 mV) and its interactions with the starch forming the nanocomposites. The silver sulfadiazine-loaded halloysite/starch-based (bio)nanocomposites possessed a homogeneous and organized structure. Also, they had mechanical properties to be used as a dressing (13.73 ± 3.09 MPa and 3.17 ± 1.28% of elongation at break), and its permeability (6.18 ± 0.43 (10) g.Pa.s.m) could be able to maintain the environmental moisture at the wound surface. Besides that, the (bio)nanocomposites acted against the studied bacteria, being a potential contact antimicrobial and biodegradable wound dressing. Finally, the developed (bio)nanocomposites are semi-occlusive and good candidates for dry wounds to be widely and tested as controlled silver sulfadiazine delivery dressing.
Topics: Anti-Bacterial Agents; Bandages; Biocompatible Materials; Clay; Escherichia coli; Manihot; Nanocomposites; Permeability; Pseudomonas aeruginosa; Silver Sulfadiazine; Spectroscopy, Fourier Transform Infrared; Staphylococcus aureus; Starch; Steam; X-Ray Diffraction
PubMed: 33611961
DOI: 10.1177/0885328221995920 -
The Science of the Total Environment May 2022Rapid population growth and increasing demand for animal protein food have led to a continuous increase in global utilization of antibiotic. Sulfonamides (SAs) are... (Review)
Review
Rapid population growth and increasing demand for animal protein food have led to a continuous increase in global utilization of antibiotic. Sulfonamides (SAs) are ubiquitous in aquatic environments and pose an ecological risk owing to their large consumption and strong environmental persistence. Hence, this review focuses on the recent publications on 12 different SAs and provides a detailed summary of selected antibiotic concentrations in various water systems. We evaluated the ecotoxicity of SAs on organisms at different trophic level organisms and the environmental risks regarding aquatic systems. The results indicated that SA antibiotics were ubiquitous in aquatic environments at concentrations ranging from ng/L to μg/L. According to the data using standard ecotoxicity bioassays, algae were the most susceptible aquatic organisms for selected antibiotics, followed by crustaceans and fish. The risk data suggested that some antibiotics, such as sulfadiazine (SDZ), sulfamethoxazole (SMX), and sulfamethazine (SMZ) pose a great risk to the aquatic system. Based on the present review, it is necessary to strengthen the research into their ecotoxicity to marine systems and the chronic toxicity of antibiotic mixtures.
Topics: Animals; Anti-Bacterial Agents; Aquatic Organisms; Environmental Monitoring; Sulfadiazine; Sulfamethoxazole; Sulfonamides; Water Pollutants, Chemical
PubMed: 35051455
DOI: 10.1016/j.scitotenv.2022.153178