-
BMC Infectious Diseases Oct 2021Delafloxacin is a novel fluoroquinolone with broad antibacterial activity against pathogens causing acute bacterial skin and skin structure infections (ABSSSI). This...
BACKGROUND
Delafloxacin is a novel fluoroquinolone with broad antibacterial activity against pathogens causing acute bacterial skin and skin structure infections (ABSSSI). This network meta-analysis (NMA) was conducted to evaluate the relative efficacy of delafloxacin versus other comparators used for managing patients with ABSSSI.
METHODS
A systematic literature review was conducted to identify randomised controlled trials (RCTs) evaluating adults (≥ 18 years) with ABSSSI, complicated SSSI (cSSSI), complicated skin and soft tissue infections (cSSTI) or severe cellulitis with pathogen of gram-positive, gram-negative, or mixed aetiology. OVID MEDLINE, Embase, Epub Ahead of Print, Cochrane Central Register of Controlled Trials and Cochrane Database of Systematic Reviews were searched from inception through 12 April 2019. A feasibility assessment was conducted, followed by an NMA, which was run in a Bayesian framework. The interventions included in the NMA encompassed monotherapy or combination therapies of amoxicillin/clavulanate, ampicillin/sulbactam, ceftaroline, ceftobiprole, dalbavancin, daptomycin, delafloxacin, fusidic acid, iclaprim, linezolid, omadacycline, oxacillin + dicloxacillin, standard therapy, tedizolid, telavancin, tigecycline, vancomycin, vancomycin + aztreonam and vancomycin + linezolid.
RESULTS
A feasibility assessment was performed and evidence networks were established for composite clinical response (n = 34 studies), early clinical response (n = 16 studies) and microbiological response (n = 14 studies) in the overall study population, composite clinical response (n = 4 studies) in obese subpopulation and for composite clinical response (n = 18 studies) and microbiological response (n = 14 studies) in patients with methicillin-resistant Staphylococcus aureus (MRSA) infection. Delafloxacin performed significantly better than fusidic acid, iclaprim, vancomycin, and ceftobiprole for composite clinical response. Delafloxacin was comparable to dalbavancin, daptomycin, fusidic acid, iclaprim, linezolid, omadacycline, tedizolid, vancomycin, vancomycin + aztreonam and vancomycin + linezolid in the analysis of early clinical response, whereas for microbiological response, delafloxacin was comparable to all interventions. In the obese subpopulation, the results favoured delafloxacin in comparison to vancomycin, whilst the results were comparable with other interventions among the MRSA subpopulation.
CONCLUSIONS
Delafloxacin is a promising new antibiotic for ABSSSI demonstrating greater improvement (composite clinical response) compared to ceftobiprole, fusidic acid, iclaprim, telavancin and vancomycin and comparable effectiveness versus standard of care for all outcomes considered in the study.
Topics: Adult; Fluoroquinolones; Humans; Network Meta-Analysis; Skin Diseases, Infectious; Systematic Reviews as Topic
PubMed: 34610820
DOI: 10.1186/s12879-021-06736-x -
Clinical and Experimental Emergency... Mar 2021Centipede stings are a common problem in tropical countries. Current treatment guidelines do not include recommendations for antibiotic prophylaxis to prevent the...
OBJECTIVE
Centipede stings are a common problem in tropical countries. Current treatment guidelines do not include recommendations for antibiotic prophylaxis to prevent the associated bacterial infection since no previous study has assessed the effectiveness of antibiotic treatment in patients bitten by centipedes. Thus, this study aimed to compare the effectiveness of antibiotic prophylaxis over placebo for the skin infections that occur after a centipede sting.
METHODS
In this randomized, double-blind, multi-center clinical trial conducted in the emergency departments in four hospitals, patients with any history of a centipede sting were prospectively enrolled and divided randomly into two groups. One group received dicloxacillin and the other a placebo. The primary outcome was the incidence of wound infection 3 to 5 days after the centipede sting.
RESULTS
From December 2014 to October 2015, a total of 83 patients were enrolled in the study and were randomized into antibiotic (n=43) and placebo (n=40) groups. Two patients in the antibiotic group developed wound infections, while none showed wound infection in the placebo group (5% vs. 0%). The wound infection rate did not differ significantly between the two groups (P=0.496).
CONCLUSION
Antibiotic prophylaxis may be unnecessary in cases of centipede stings. Proper wound care is an adequate and appropriate treatment for patients with centipede stings. However, the patient should be re-evaluated for detection of secondary bacterial infection.
PubMed: 33845522
DOI: 10.15441/ceem.20.110 -
Journal of Chromatography. A Nov 2021The presence of antibiotics in the aquatic environment is becoming one of the main research focus of scientists and policy makers. Proof of that is the inclusion of four...
The presence of antibiotics in the aquatic environment is becoming one of the main research focus of scientists and policy makers. Proof of that is the inclusion of four antibiotics, amongst which is amoxicillin, in the EU Watch List (WL) (Decision 2020/1161/EU)) of substances for water monitoring. The accurate quantification of amoxicillin in water at the sub-ppb levels required by the WL is troublesome due to its physicochemical properties. In this work, the analytical challenges related to the determination of amoxicillin, and six related penicillins (ampicillin, cloxacillin, dicloxacillin, penicillin G, penicillin V and oxacillin), have been carefully addressed, including sample treatment, sample stability, chromatographic analysis and mass spectrometric detection by triple quadrupole. Given the low recoveries obtained using different solid-phase extraction cartridges, we applied the direct injection of water samples using a reversed-phase chromatographic column that allowed working with 100% aqueous mobile phase. Matrix effects were evaluated and corrected using the isotopically labelled internal standard or correction factors based on signal suppression observed in the analysis of spiked samples. The methodology developed was satisfactorily validated at 50 and 500 ng L for the seven penicillins studied, and it was applied to different types of water matrices, revealing the presence of ampicillin in one surface water sample and cloxacillin in three effluent wastewater samples.
Topics: Amoxicillin; Ampicillin; Chromatography, High Pressure Liquid; European Union; Penicillins; Solid Phase Extraction; Water
PubMed: 34662823
DOI: 10.1016/j.chroma.2021.462605 -
Pathogens (Basel, Switzerland) Apr 2023A case of severe mortality in farmed was investigated to characterize the causative agent. We identified the bacterial strain as isolated from the gut of infected by...
A case of severe mortality in farmed was investigated to characterize the causative agent. We identified the bacterial strain as isolated from the gut of infected by biochemical assay, scanning electron microscopy and 16S rRNA gene sequence analysis. The in vivo challenge experiment showed that the LD of was 2.2 × 10 CFU/fish. Virulence gene investigation revealed that the isolated possesses Aerolysin, Cytotoxic enterotoxin, Serine protease, Dnase and Type III secretion system genes. The isolated strain was resistant to two antibiotics (ampicillin and dicloxacillin) while susceptible to 22 other antibiotics. The study further revealed that induced both stresses along with non-specific and specific immune responses marked by elevated cortisol HSP70, HSP90 and IgM levels in the treated fingerlings. Although the bacterial pathogen enhances the immune response, the negative effect on fish, including stress, and high mortality, create concern and a need for management in farms. The knowledge gained from this study would facilitate future research aimed at assessing the pathogenicity of , with an emphasis on microbial disease management in other farmed fish species.
PubMed: 37111485
DOI: 10.3390/pathogens12040598 -
Medicina (Kaunas, Lithuania) Nov 2021: Drug-induced esophageal ulcer is caused by focal drug stimulation. It may occur in adults and children. Limited research is available in pediatric patients with...
: Drug-induced esophageal ulcer is caused by focal drug stimulation. It may occur in adults and children. Limited research is available in pediatric patients with drug-induced esophageal ulcer; therefore, we designed this study to determine the characteristics of this disease in this population. : Thirty-two pediatric patients diagnosed with drug-induced esophageal ulcers from a hospital database of upper gastrointestinal tract endoscopies were included. After treatment, patients were followed for 2 months after upper gastrointestinal endoscopy. : Female patients were predominant (56.2%/43.8%). The mean age of patients was 15.6 years (median, 16 years; interquartile range, 2 years). Doxycycline was administered in most cases (56.3%); other drugs were dicloxacillin, amoxicillin, clindamycin, L-arginine, and nonsteroidal anti-inflammatory drugs. Doxycycline was associated with kissing ulcers. Esophageal ulcers induced by nonsteroidal anti-inflammatory drugs were more often associated with gastric or duodenal ulcers. The most common location was the middle-third of the esophagus (78.1%). Patients were treated with proton pump inhibitors, sucralfate, or H2-blockers. The mean duration for which symptoms lasted was 9.2 days. No esophageal stricture was found in 24 patients who were followed for 2 months after upper gastrointestinal endoscopy. : The authors suggest informing patients to take medicine with enough water (approximately 100 mL) and enough time (15-30 min) before recumbency, especially high-risk drugs, such as doxycycline or nonsteroidal anti-inflammatory drugs.
Topics: Adolescent; Anti-Inflammatory Agents, Non-Steroidal; Child; Doxycycline; Female; Hospitals; Humans; Male; Peptic Ulcer; Taiwan
PubMed: 34946231
DOI: 10.3390/medicina57121286 -
Rural and Remote Health Oct 2021The Gram-negative organism Aeromonas is found in freshwater and marine environments and can cause a range of disease in humans, most commonly gastrointestinal illness...
CONTEXT
The Gram-negative organism Aeromonas is found in freshwater and marine environments and can cause a range of disease in humans, most commonly gastrointestinal illness and soft tissue infections. The severity of soft tissue infections can vary, ranging from cellulitis to rapidly spreading soft tissue infection. Prompt recognition of this pathogen is needed as empirical antibiotics for cellulitis generally do not provide sufficient cover for Aeromonas. Additionally, while cellulitis is generally managed medically, early surgical intervention may be required when Aeromonas is the causative pathogen.
ISSUES
A Caucasian male aged 39 years injured his right foot falling in a creek bed in the Darling Downs region of rural Queensland, sustaining a laceration in the webbing between his first and second toes. He was seen in two rural hospitals following this event, with oral antibiotics prescribed following his second presentation to cover for a localised soft tissue infection. Circumstances meant he did not take these, and he finally presented to a third hospital after noting erythema tracking up his leg and discharge emanating from the wound on his foot. He was admitted and commenced on empirical antibiotics, however severity of the infection necessitated surgical team involvement and multiple debridements. Due to the extent of tissue removal, a skin graft was required. Intraoperative specimens revealed polymicrobial Aeromonas as the causative pathogen.
LESSONS LEARNED
This case report documents a polymicrobial soft tissue infection in a systemically well young male requiring prompt surgical intervention, even without systemic symptoms of illness. Lack of early recognition of risk factors for infection may have delayed appropriate antibiotic therapy. It highlights the importance of early recognition and appropriate antibiotic cover to prevent spreading infection in individuals in whom Aeromonas may be the suspected pathogen. Empirical antibiotics for cellulitis generally do not include the agents to which Aeromonas is susceptible, hence guidelines recommend a regime of trimethoprim-sulfamethoxazole or ciprofloxacin in addition to either dicloxacillin or flucloxacillin. Initiation of appropriate antibiotics earlier in this case may have prevented the need for surgical intervention. This case also demonstrates that early surgical referral and intervention may be warranted in suspected Aeromonas infections.
Topics: Aeromonas; Aeromonas hydrophila; Anti-Bacterial Agents; Cellulitis; Gram-Negative Bacterial Infections; Humans; Male; Queensland
PubMed: 34655515
DOI: 10.22605/RRH6710 -
Tidsskrift For Den Norske Laegeforening... Oct 2023While standard blood tests are often sufficient for an anaemia workup, sometimes more invasive diagnostic testing is required to exclude rare conditions.
BACKGROUND
While standard blood tests are often sufficient for an anaemia workup, sometimes more invasive diagnostic testing is required to exclude rare conditions.
CASE PRESENTATION
A man in his forties contacted his general practitioner because of increasing functional dyspnoea. He had completed a course of dicloxacillin a few months previously for a skin abscess on his abdomen. Bloodwork revealed severe anaemia (haemoglobin 5.4 g/dL), which required transfusion. Subsequent testing excluded iron and vitamin deficiency anaemia, haemolysis and malignancy. Initial bone marrow biopsy was of suboptimal quality. However, repeat tissue sample supported a diagnosis of pure red cell aplasia. The patient improved with ciclosporin treatment, which was gradually tapered.
INTERPRETATION
Pure red cell aplasia should be considered in patients with new onset isolated anaemia with severe reticulocytopenia. Diagnosis depends on obtaining representative tissue from bone marrow biopsy. It is difficult to conclude for this patient whether the aetiology of his pure red cell aplasia was idiopathic or secondary to recent dicloxacillin use.
Topics: Humans; Male; Anemia; Bone Marrow; Dicloxacillin; Neoplasms; Red-Cell Aplasia, Pure; Adult
PubMed: 37874056
DOI: 10.4045/tidsskr.23.0022 -
RSC Advances Mar 2024In this study, we designed and synthesized a number of novel 1,2,3-triazole-piperazin-benzo[][1,4]thiazine 1,1-dioxide derivatives and investigated their antibacterial...
In this study, we designed and synthesized a number of novel 1,2,3-triazole-piperazin-benzo[][1,4]thiazine 1,1-dioxide derivatives and investigated their antibacterial and hemolytic activity. When compared to the lead chemical, dicloxacillin, the majority of the compounds demonstrated acceptable activity. Among them, the most promising compounds 6e, 6g, 6i, 8d, and 8e exhibited excellent antibacterial activity against the methicillin-susceptible (MSSA), methicillin-resistant (MRSA), and vancomycin-resistant (VRSA) with MIC values of 1.56 ± 0.22 to 12.5 ± 1.75 μg mL, respectively, The percentage of hemolysis ranged from 21.3 μg mL to 33.8 μg mL. Out of the six compounds (6i, 6e, 6f, 6g, 8e, 8d) tested compound 8e and 8d displayed minimal or negligible hemolytic activity across all the tested concentrations 29.6% and 30.2% recorded at 100 μg mL concentration respectively. docking studies were performed to evaluate the molecular interactions of 6e, 6f, 6g, 6i, 8d, and 8e compounds with Human, Mouse and Bovine TLR4 proteins (PDB: 3FXI, 3VQ1, 3RG1) and observed that three of the compounds (6i, 8d, and 8i) had appreciable binding energies ranging from -8.5 to -9.0 Kcal mol. Finally, the pharmacokinetic profile was predicted for potent compounds 8d, 8e and 6i using SWISS/ADME, All compounds investigated in this study adhered to Lipinski's rule of five with slight deviation in molecular weight (8d and 8e).
PubMed: 38500620
DOI: 10.1039/d3ra07509e -
Clinical Case Reports Mar 2020Photoinduced acute exanthematous pustulosis is a rare condition; only few cases of photo-AEP have been described previously with drugs such as norfloxacin,...
Photoinduced acute exanthematous pustulosis is a rare condition; only few cases of photo-AEP have been described previously with drugs such as norfloxacin, ciprofloxacin, and enoxacin. In this case, the reaction is seen after intake of dicloxacillin.
PubMed: 32185054
DOI: 10.1002/ccr3.2681 -
BMC Pulmonary Medicine Jan 2020Simultaneous infection in tuberculosis (TB) is rare. The mixed infection between Streptococcus anginosus group (SAG) and M. tuberculosis (MTB) has not been reported in...
BACKGROUND
Simultaneous infection in tuberculosis (TB) is rare. The mixed infection between Streptococcus anginosus group (SAG) and M. tuberculosis (MTB) has not been reported in children. The aim of this report was to describe a pediatric case with a pulmonary abscess caused by the duality SAG-MTB co-infection.
CASE PRESENTATION
An 11-year-old boy with an acute onset of throbbing pain of two-day evolution located in the anterior chest wall. The patient reported a history of fever, cough and rhinorrhea during the last seven days. An anterior chest radiography revealed a heterogenic opacity at the lower right lobe while the lateral projection showed an obliteration at the anterior diaphragmatic insertion. Parenteral Ceftriaxone (100 mg/kg/day) and Dicloxacillin (200 mg/kg/day) was started. The abscess was subsequently drained and analyzed. After a year of follow-up, the patient remained asymptomatic.
CONCLUSION
This case represents the first reported case of pulmonary co-infection involving MTB and SAG in an immunocompetent pediatric patient.
Topics: Anti-Bacterial Agents; Child; Coinfection; Drainage; Humans; Immunocompetence; Lung Abscess; Male; Mycobacterium tuberculosis; Pleural Effusion; Radiography, Thoracic; Streptococcal Infections; Streptococcus anginosus; Treatment Outcome; Tuberculosis
PubMed: 31914982
DOI: 10.1186/s12890-019-1044-y