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Pathogens (Basel, Switzerland) Oct 2022The objectives of the work were (a) to compare the efficacy of two routes for antibiotic administration in the treatment of mastitis in ewes and (b) to assess the...
The objectives of the work were (a) to compare the efficacy of two routes for antibiotic administration in the treatment of mastitis in ewes and (b) to assess the potential importance of the timing of the initiation of the therapeutic regime on the outcome of the treatment. The ewes were allocated at random into three equal groups; intramammary inoculation with a isolate was performed, and clinical mastitis developed. The ewes in groups T1 ( = 6) and T2 ( = 6) were treated by the intramammary administration of ampicillin and dicloxacillin (two administrations with a 12-h interval). The ewes in group T3 ( = 6) were treated by the intramuscular injection of ampicillin and dicloxacillin (0.75 mL per 10 kg bodyweight, three injections with a 24-h interval). In the ewes in groups T1 and T3, treatment started immediately when the clinical signs of mastitis were first detected during the periodic examination of the ewes; in the ewes in group T2, treatment started 24 h after the clinical signs of mastitis were first detected. The animals were monitored clinically; mammary secretion samples were collected for bacteriological and cytological examinations. The median duration of the clinical signs was 4.75, 7.13, and 4.75 d for T1, T2, and T3; significant differences in clinical severity between the groups were seen until the 7th day post-treatment. The median duration of bacterial recovery was 3.25, 8.00, and 8.00 d for T1, T2, and T3; significant differences in the frequency of bacterial recovery between the groups were seen until (64.1%, 94.9%, and 96.2% of the samples) and after (2.9%, 16.7%, and 11.8%) the 7th day post-treatment. The median period required for the complete cure (clinical, bacteriological, and cytological) was shorter in the T1 than in the T2 and T3 ewe groups: 20.0, 32.0, and 24.5 d, respectively. The findings cover a gap in the available literature regarding the treatment of clinical mastitis in ewes. Early treatment resulted in the improved cure of the infection. The comparison of the intramammary and injectable routes for antibiotic administration indicated some benefit for the former, primarily in the post-treatment somatic cell counts.
PubMed: 36297221
DOI: 10.3390/pathogens11101164 -
The Journal of Antimicrobial... Nov 2022Anti-staphylococcal penicillins (ASPs) are among the most commonly prescribed antibiotics in children and are associated with a risk of drug-induced liver injury (DILI).... (Review)
Review
INTRODUCTION
Anti-staphylococcal penicillins (ASPs) are among the most commonly prescribed antibiotics in children and are associated with a risk of drug-induced liver injury (DILI). Despite the frequent use of ASPs in children, there is no consensus on whether liver function tests (LFTs) should be routinely monitored during treatment.
OBJECTIVES
To review the literature on the frequency of ASP-related DILI in children to determine the incidence, risk factors and outcomes of hepatotoxicity.
METHODS
PubMed, MEDLINE and Embase were searched in January 2022 for original studies of children who received cloxacillin, dicloxacillin, flucloxacillin, methicillin, nafcillin or oxacillin that included ≥10 children aged up to 18 years, and presented data on the incidence of DILI in children exposed to ASPs.
RESULTS
Overall, two studies of oral flucloxacillin, two of intravenous (IV) methicillin, three of IV nafcillin and four of IV oxacillin were included. The mean onset of DILI ranged between 7.0 and 19.0 days following commencement of antibiotic treatment and all episodes resolved between 14.2 and 16.0 days after drug discontinuation, with no specific treatment required. This review found that the incidence of DILI in children was 1 in 50 000 for oral flucloxacillin and ranged from 1 in 3 to 13 for IV oxacillin, methicillin and nafcillin.
CONCLUSIONS
This review found that routine LFT monitoring is not required in children receiving low dose oral flucloxacillin in a primary care setting, although pharmacovigilance is critical. For IV preparations, the existing data support routine LFT monitoring in those receiving treatment for at least 7 days.
Topics: Child; Humans; Nafcillin; Methicillin; Penicillins; Floxacillin; Oxacillin; Cloxacillin; Anti-Bacterial Agents; Chemical and Drug Induced Liver Injury
PubMed: 36203386
DOI: 10.1093/jac/dkac325 -
Zoonoses and Public Health Dec 2022Animal bites have a high probability of becoming infected. In high-risk wounds, the use of antibiotics that kill the associated microorganisms is recommended. The aim of...
Animal bites have a high probability of becoming infected. In high-risk wounds, the use of antibiotics that kill the associated microorganisms is recommended. The aim of this study was to determine the use of inappropriate antibiotics in patients in different regions of Colombia who were attacked in 2020 by animals that can transmit rabies. This was a retrospective follow-up study of a cohort of patients with wounds caused by animals; the patients were affiliated with the Colombian Health System. Sociodemographic, clinical and pharmacological data were collected. A total of 280 patients were analysed. The median age was 28.0 years, and 52.1% were men. The attacks were attributed to dogs (85.0%) and cats (15.0%), and 9.6% were classified as severe exposure. Antibiotics were used in 71.1% of cases for prophylaxis and in 4.3% of the cases for the treatment of superinfection; cephalexin (37.5%), amoxicillin/clavulanic acid (15.7%) and dicloxacillin (10.4%) were the predominant antibiotics used. A total of 72.0% of patients who received antibiotics received inadequate prescriptions, and 49.2% had no indication to receive prophylaxis. Being treated in the Caribbean region (OR: 4.09; 95% CI: 1.79-9.30) and receiving analgesics (OR: 3.15; 95% CI: 1.25-7.94) were associated with a greater probability of being prescribed antibiotics inadequately; attacks resulting in severe exposure were associated with a lower probability (OR: 0.40; 95% CI: 0.16-0.98). A significant proportion of patients had no indication for prophylactic antibiotics or was prescribed antibiotics not recommended by clinical practice guidelines. There was a low prevalence of prescriptions for amoxicillin/clavulanic acid, the most recommended antibiotic.
Topics: Dogs; Animals; Anti-Bacterial Agents; Rabies; Retrospective Studies; Follow-Up Studies; Amoxicillin-Potassium Clavulanate Combination; Dog Diseases
PubMed: 36031732
DOI: 10.1111/zph.12995 -
Chemotherapy 2023Recent evidence has shown that oral antibiotic therapy is not inferior to IV antibiotic therapy in the treatment of complicated Staphylococcus aureus infections....
INTRODUCTION
Recent evidence has shown that oral antibiotic therapy is not inferior to IV antibiotic therapy in the treatment of complicated Staphylococcus aureus infections. Therefore, oral antibiotic therapy is now frequently prescribed in clinical practice due to cost benefit, ease of administration, decreased complication rate, and lack of need for IV access. In vitro susceptibility testing for β-lactam oral antibiotics is not routinely performed as the guidelines provided by the Clinical and Laboratory Standards Institute (CLSI) recommend using oxacillin and cefoxitin as surrogate markers. Hence, oral antibiotic susceptibilities for cephalexin and dicloxacillin are not reported and implied based on oxacillin and cefoxitin. The objective of the current study was to determine whether susceptibilities among S. aureus isolates are predictable when comparing commonly used IV and oral beta-lactams.
METHODS
Cefazolin, cephalexin, dicloxacillin, and oxacillin broth microdilution minimum inhibitory concentrations (MICs) were determined for 100 clinical isolates of methicillin-sensitive S. aureus by broth microdilution following CLSI guidelines.
RESULTS
Among these isolates, median MICs for cephalexin were eight-fold higher than cefazolin MICs and median MICs for dicloxacillin were four-fold less than oxacillin MICs. Ten percent of more strains studied had a major or very major error in its susceptibility reporting when cephalexin was compared to its surrogate marker oxacillin.
DISCUSSIONS/CONCLUSIONS
The variations in MICs observed compounded with the dosing and pharmacokinetic differences of oral versus IV β-lactam suggests that establishing breakpoints for oral β-lactam antibiotics is necessary to ensure adequate therapy is selected for the treatment of complex S. aureus infections.
Topics: Humans; Cefoxitin; beta-Lactams; Cefazolin; Staphylococcus aureus; Dicloxacillin; Anti-Bacterial Agents; Oxacillin; Staphylococcal Infections; Microbial Sensitivity Tests; Cephalexin; Monobactams; Methicillin-Resistant Staphylococcus aureus
PubMed: 36001946
DOI: 10.1159/000526630 -
Food Chemistry Oct 2022The transfer of 35 antibiotics from milk to curd and whey was evaluated. Cheeses were produced at laboratory scale, from antibiotic-free goat's milk spiked with...
The transfer of 35 antibiotics from milk to curd and whey was evaluated. Cheeses were produced at laboratory scale, from antibiotic-free goat's milk spiked with different antibiotic concentrations between 0.25 and 4 times the Maximum Residue Limits established in milk. Drug concentrations in milk, curd and whey were analysed by UHPLC-HRMS. Results indicated that most antibiotics were mainly transferred from milk to whey (up to 85.9%), with retention percentages in the curd lower than 50%, except for ceftiofur (59.7%) and dicloxacillin (52.8%). In most cases, drug distribution was unaffected by the antibiotic concentration in milk and correlated significantly to the drug lipophilicity (Log P) for β-lactams (R = 0.54) and sulfonamides (R = 0.62). When drug ionization was considered (Log D), improved correlation coefficients were obtained for macrolides (R = 0.98). However, other factors besides the drug solubility should be considered to explain and predict the partitioning of antibiotics during cheese-making.
Topics: Animals; Anti-Bacterial Agents; Cheese; Chymosin; Goats; Milk; Whey; Whey Proteins
PubMed: 35659161
DOI: 10.1016/j.foodchem.2022.133218 -
The British Journal of Dermatology Oct 2022Prolonged systemic antibiotic treatment is often a part of management of hidradenitis suppurativa (HS). Although biologic therapies are now available, the patient's...
BACKGROUND
Prolonged systemic antibiotic treatment is often a part of management of hidradenitis suppurativa (HS). Although biologic therapies are now available, the patient's treatment journey leading to biologic therapy is unclear.
OBJECTIVES
To examine treatment patterns and duration of systemic treatment use in patients with HS preceding biologic therapy.
METHODS
We identified all patients with HS receiving treatment with biologics in the Danish National Patient Registry from 2010 to 2018 and extracted their entire prescription history of specific systemic treatments from the Danish National Prescription Registry since its inception in 1995. The patients' treatment journeys are graphically displayed through Sankey diagrams and box plots generated to show temporal distributions. Descriptive patient characteristics were presented as frequencies with percentages for categorical variables and as means with SDs or medians with interquartile ranges (IQRs) for continuous variables.
RESULTS
A total of 225 patients with HS were included. Patients had most frequently been treated with penicillin (n = 214; 95·1%), dicloxacillin (n = 194; 86·2%), tetracycline (n = 145; 64·4%) and rifampicin/clindamycin (n = 111; 49·3%), as well as the retinoids isotretinoin and acitretin, and dapsone. Prior to biologic therapy, patients received a mean of 4·0 (SD 1·3) different systemic therapies, across a mean of 16·9 (SD 11·3) different treatment series. The mean time from first systemic therapy until biologic therapy was initiated was 15·3 (SD 5·1) years [8·2 (SD 5·9) years when excluding penicillin and dicloxacillin].
CONCLUSIONS
Patients with HS who receive biologic therapy have long preceding treatment histories with multiple drug classes and treatment series, many of which are supported by relatively weak evidence in HS. Delay in the initiation of biologic therapy may represent a missed opportunity to prevent disease progression. What is already known about this topic? The treatment journey leading to biologic therapy in patients with HS has not previously been investigated. What does this study add? Our data from 225 patients with HS illustrate that patients who receive biologic therapy have long preceding treatment histories with multiple drug classes and treatment series, many of which are supported by relatively weak evidence in HS.
Topics: Acitretin; Anti-Bacterial Agents; Biological Factors; Biological Products; Clindamycin; Dapsone; Dicloxacillin; Drug Utilization; Hidradenitis Suppurativa; Humans; Isotretinoin; Rifampin; Tetracyclines
PubMed: 35603888
DOI: 10.1111/bjd.21673 -
F1000Research 2021Worldwide, chicken meat is widely consumed due to its low cost, high nutritional value and non-interference with religious or cultural beliefs. However, during animal...
Worldwide, chicken meat is widely consumed due to its low cost, high nutritional value and non-interference with religious or cultural beliefs. However, during animal husbandry chickens are exposed to many chemical substances, including tetracyclines and β-lactams, which are used to prevent and cure several infections. Some residues of these compounds may bioaccumulate and be present in chicken meat after slaughtering, promoting oxidative reactions. In order to evaluate carbonylation induced by tetracyclines and β-lactams residues, a proteomic approach was used. For this, chicken muscle was individually contaminated with tetracyclines (tetracycline, chlortetracycline, oxytetracycline, and doxycycline) and β-lactams (ampicillin, benzathine penicillin, dicloxacillin and oxacillin) at 0.5, 1.0 and 1.5 times their maximum residue level (MRL). Then, sarcoplasmic, myofibrillar and insoluble proteins were extracted and their content were measured using the Bradford method. Protein carbonylation was measured using the 2,4-Dinitrophenylhydrazine alkaline method. Residues of tetracyclines and β-lactams induced carbonylation on sarcoplasmic, myofibrillar and insoluble proteins even at 0.5MRL concentrations ( ). When comparing the carbonylation induced by both antibiotics no differences were found ( ). Variables such as the partition coefficient (log P) and the concentration of these antibiotics showed a high correlation with the oxidative capacity of tetracyclines and β-lactams on chicken breast proteins. : This study shows that the presence of tetracyclines and β-lactams residues at MRLs concentrations promotes carbonylation on chicken breast proteins. Our results provide important insights about the impact of antibiotics on the integrity of meat proteins intended for human consumption.
Topics: Animals; Anti-Bacterial Agents; Chickens; Drug Residues; Food Contamination; Meat; Proteomics; Tetracyclines; beta-Lactams
PubMed: 35316938
DOI: 10.12688/f1000research.53863.1 -
Journal of Infection in Developing... Feb 2022Dynamic movement in the hospital environment promotes the transmission of nosocomial pathogens and multidrug resistance mechanisms through the dissemination of organisms...
INTRODUCTION
Dynamic movement in the hospital environment promotes the transmission of nosocomial pathogens and multidrug resistance mechanisms through the dissemination of organisms that carry genetic determinants. Healthcare workers play an important role in the spread of pathogens; however, the role of visitors in this environment is poorly understood.
OBJECTIVE
This study aimed to molecularly identify and examine the antibiotic resistance of the palmar microbiota of patients' companions in a hospital waiting room.
METHODOLOGY
Twenty-five palmar surface and interdigital space sample swabs were randomly collected and cultured on blood agar plates, and 19 colonies with different macro- and microscopic characteristics were isolated. The V4 and V6 hypervariable regions of the 16S rRNA gene from each isolate were amplified by PCR and sequenced. Maximum likelihood- and Bayesian inference-based phylogenetic analyses were performed to determine taxonomic relationships. Antibiotic resistance was evaluated by disk diffusion and broth microdilution.
RESULTS
Among the isolates, 52.6% were related to Bacillus, 36.8% to Staphylococcus, 5.3% to Enterococcus and 5.3% to Atlantibacter. All of the isolates exhibited ampicillin and penicillin resistance, while 94.7% also exhibited dicloxacillin resistance. Staphylococcus aureus was resistant to penicillins but sensitive to the remaining drugs. Bacteria identified as Bacillus subtilis (MLM14B99), Bacillus pumilus (MLM23B07 and MLM25B06), Staphylococcus epidermidis (MLM24S31 and MLM29S04), and Enterococcus (MLM22E08) showed resistance to at least 46.7% of the antibiotics.
CONCLUSIONS
To decrease the transmission of pathogenic bacteria with an antibiotic resistance profile, re-evaluation of hand cleaning measures and their application by people who visit hospital centres is needed.
Topics: Bayes Theorem; Drug Resistance, Microbial; Hospitals; Humans; Phylogeny; RNA, Ribosomal, 16S; Staphylococcus epidermidis
PubMed: 35298428
DOI: 10.3855/jidc.15252 -
Clinical Case Reports Jan 2022We present a case with a phototoxic reaction following topical use of NSAID. The phototoxic reaction was initially mistaken for cellulitis which led to treatment with...
We present a case with a phototoxic reaction following topical use of NSAID. The phototoxic reaction was initially mistaken for cellulitis which led to treatment with dicloxacillin, which led to an exanthematous drug eruption. The patient was treated with topical clobetasol propionate and oral non-sedating antihistamines. Follow-up revealed post-inflammatory hypopigmentation.
PubMed: 35079385
DOI: 10.1002/ccr3.5251 -
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