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Expert Review of Anti-infective Therapy

Maddalena Giannella, Renato Pascale, Belén Gutiérrez-Gutiérrez, Angela Cano, Pierluigi Viale
Carbapenem-resistant Klebsiella pneumoniae (CR-KP) infections are associated with high morbidity and mortality rates. A therapeutic approach based on the patient risk stratification could improve outcome and avoid antibiotic misuse. Area covered: English literature search, from 2008 to 2018, was done using PubMed database. Risk factors for developing CR-KP infection in several settings were reviewed. Since, rectal carriage was a main risk factor for developing infection, we revised in deep clinical score to predict infection among colonized patients...
March 15, 2019: Expert Review of Anti-infective Therapy
Lai Wei, Yi-Hsiang Huang
Within the past decade, antiviral treatment for chronic hepatitis C virus (HCV) infection has evolved from interferon (IFN)-based regimens to IFN-free oral direct-acting antiviral agents (DAAs). However, data on long-term outcomes in HCV patients treated by DAAs are limited and complex. This review summarizes the literature on long-term outcomes in patients with chronic HCV infection who received IFN-based and DAA treatment. Areas covered: Original studies and meta-analyses reporting data on the impacts of IFN- and DAA-based treatments on late relapse, liver fibrosis/cirrhosis, decompensation progression, hepatocellular carcinoma (HCC) occurrence and recurrence, need for liver transplantation, mortality, and other topics of interest for long-term observation of HCV patients treated with DAAs...
March 11, 2019: Expert Review of Anti-infective Therapy
Lianlian Bian, Fan Gao, Qunying Mao, Shiyang Sun, Xing Wu, Siyuan Liu, Xiaoming Yang, Zhenglun Liang
Hand, foot, and mouth disease (HFMD) is a common viral childhood illness, that has been a severe public health concern worldwide, particularly in the Asia-Pacific region. According to epidemiological data of HFMD during the past decade, the most prevalent causal viruses were enterovirus (EV)-A71, coxsackievirus (CV)-A16, CV-A6 and CV-A10. The public health burden of CV-A10-related diseases has been underestimated as their incidence was lower than that of EV-A71 and CV-A16 in most HFMD outbreaks. However, cases of CV-A10 infection are more severe, and its genome is more variable, which has alerted the research community worldwide...
February 22, 2019: Expert Review of Anti-infective Therapy
Niccolò Parri, Giulia Trippella, Catiuscia Lisi, Maurizio de Martino, Luisa Galli, Elena Chiappini
Neonatal sepsis represents a major cause of morbidity and mortality in neonates. No diagnostic test has been demonstrated to be sufficiently accurate to confirm or exclude neonatal sepsis. This study aimed to evaluate the diagnostic accuracy of presepsin (P-SEP) for neonatal sepsis. Areas covered: A systematic review of literature was performed on Medline and EMBASE. A meta-analysis was performed to calculate pooled sensitivity, specificity, diagnostic odds ratio (DOR), and summary receiver operating characteristic of P-SEP for neonatal sepsis...
February 18, 2019: Expert Review of Anti-infective Therapy
Mainul Haque, Nor Azlina A Rahman, Judy McKimm, Shahidah Leong Binti Abdullah, Md Zakirul Islam, Zainal Zulkifli, Nurfarhana Binti Saidin, Nadia Iman Khairul Azhar, Siti Nur Najihah Binti Lutfi, Nur Syamirah Aishah Binti Othman
BACKGROUND: The introduction of antibiotics into modern medicine has changed clinical care by saving millions of lives. However, misuse of antibiotics has led to their benefits being overshadowed by the development of antimicrobial resistance. AIMS OF STUDY: This study aimed to assess university students' knowledge and beliefs about and their use of antibiotics. METHODS: This cross-sectional study was conducted among 674 medical and non-medical students of the National Defence University of Malaysia, using universal and convenience sampling methods...
February 14, 2019: Expert Review of Anti-infective Therapy
Zikria Saleem, Mohamed Azmi Hassali, Ann Versporten, Brian Godman, Furqan Khurshid Hashmi, Herman Goossens, Fahad Saleem
OBJECTIVES: In line with the recent global action plan for antimicrobial resistance, this is the first time such a comprehensive survey has been undertaken in Pakistan, sixth most populous country. METHODS: This point prevalence survey (PPS) was conducted in 13 hospitals among 7 different cities of Pakistan. The survey included all inpatients receiving an antibiotic on the day of PPS. A web-based application was used for data entry, validation, and reporting as designed by the University of Antwerp...
February 12, 2019: Expert Review of Anti-infective Therapy
Jean-Louis Vincent, Wasineenart Mongkolpun
Sepsis, defined as infection plus some degree of organ dysfunction, is still associated with high mortality and morbidity rates. Management focuses on three key areas: infection control, hemodynamic stabilization and organ support, and modulation of the sepsis response. Areas covered: This review will not cover infection control. Hemodynamic stabilization essentially involves use of adequate fluid resuscitation and vasopressors. Fluid and vasopressor choices and targets are discussed, and the need to adapt these to the individual patient is stressed...
February 12, 2019: Expert Review of Anti-infective Therapy
Bosco Paes, Xavier Carbonell-Estrany
The use of palivizumab for the prevention of respiratory syncytial virus-related hospitalization is well-established and has been adopted universally in pediatric position statements. Areas covered: The definition of chronic lung disease (CLD, bronchopulmonary dysplasia) has evolved over time and has significantly impacted the reported incidence of the condition, and the description of mild, moderate and severe disease in published studies. We reviewed lung function in infancy, childhood and adulthood of healthy preterm infants and those with CLD and how alterations in airway function, especially following respiratory syncytial virus infection may set the stage for chronic obstructive pulmonary disease in adults...
February 9, 2019: Expert Review of Anti-infective Therapy
Breanna R Campbell, Karen S Ingersoll, Tabor E Flickinger, Rebecca Dillingham
No abstract text is available yet for this article.
February 5, 2019: Expert Review of Anti-infective Therapy
Julio Alonso-Padilla, Nuria Cortés-Serra, María Jesús Pinazo, María Elena Bottazzi, Marcelo Abril, Fabiana Barreira, Sergio Sosa-Estani, Peter Jay Hotez, Joaquim Gascón
Chagas disease, caused by infection with the parasite Trypanosoma cruzi, represents a huge public health problem in the Americas, where millions of people are affected. Despite the availability of two drugs against the infection (benznidazole and nifurtimox), multiple factors impede their effective usage: 1) gaps in patient and healthcare provider awareness; 2) lack of access to diagnosis; 3) drug toxicity and absence of treatment algorithms to address adverse effects; 4) failures in drug supply and distribution; and 5) inconsistent drug efficacy against the symptomatic chronic stage...
February 4, 2019: Expert Review of Anti-infective Therapy
Meraf Wolle, Sheila West
Ocular Chlamydia trachomatis infection, the causative agent for trachoma, is responsible for 1.9 million cases of visual loss world-wide. Mass Drug Administration (MDA) with azithromycin to entire trachoma-endemic districts is part of the World Health Organization's public health strategy for trachoma elimination. Areas covered: Background on C. trachomatis and the epidemiology of trachoma are presented, followed by a review of the antibiotics for treatment and the need for a public health approach to trachoma elimination...
January 30, 2019: Expert Review of Anti-infective Therapy
Jordi Vila, Adelaide A Hebert, Antonio Torrelo, Yuly López, Marta Tato, María García-Castillo, Rafael Cantón
Impetigo is the most common bacterial skin infection in children. Treatment is becoming complicated due to the development of antimicrobial resistance, especially in the main pathogen, Staphylococcus aureus. Ozenoxacin, a novel non-fluorinated topical quinolone antimicrobial, has demonstrated efficacy in impetigo. Areas covered: This article reviews the microbiology, pharmacodynamic and pharmacokinetic properties of ozenoxacin, and its clinical and microbiological efficacy in impetigo. Expert opinion: In an environment of increasing antimicrobial resistance and concurrent slowdown in antimicrobial development, the introduction of a new agent is a major event...
January 28, 2019: Expert Review of Anti-infective Therapy
Martin Schmidt-Hieber, Daniel Teschner, Georg Maschmeyer, Enrico Schalk
Infections are among the most frequent complications in patients with hematological and oncological diseases. They might be classified as fever of unknown origin, and microbiologically or clinically documented infections. Optimal duration of antimicrobial treatment is still unclear in these patients. Areas covered: We provide an overview on the management of febrile neutropenia in the perspective of antimicrobial de-escalation and discontinuation. Expert opinion: Patients with febrile high-risk neutropenia should be treated empirically with an anti-pseudomonal agent such as piperacillin/tazobactam...
January 28, 2019: Expert Review of Anti-infective Therapy
George Dimopoulos, Despoina Koulenti, Suzanne L Parker, Jason A Roberts, Kostoula Arvaniti, Garyphalia Poulakou
The intravenous (IV) formulation of fosfomycin has been re-introduced in clinical practice mainly to overcome treatment failures against multidrug-resistant (MDR) bacteria. Appropriate dosing schedules of the IV formulation have not yet been established. Areas covered: The mechanism of action and resistance development, commercial IV formulations, pharmacokinetic/pharmacodynamic (PK/PD) properties, IV dosing regimens for the treatment of MDR infections along with efficacy and safety issues were reviewed. Data regarding specific MDR pathogens, daily doses and patients' outcomes, gaps in the current literature, and in progress research agenda are presented...
January 22, 2019: Expert Review of Anti-infective Therapy
Ying Dong, Kirsten Glaser, Christian P Speer
Very low birth weight (VLBW) infants are highly susceptible to late-onset sepsis (LOS). Compared to Gram-positive bacteria, Gram-negative bacteria are less common to cause LOS, but are associated with a more severe clinical manifestation, higher mortality, and increased risk of neonatal morbidity. So far, the clinical picture of late-onset Gram-negative sepsis (LOGNS) in VLBW infants has not been elucidated. An up-to-date and thorough understanding of the clinical picture of LOGNS in VLBW infants is important to optimize current anti-sepsis protocols...
January 14, 2019: Expert Review of Anti-infective Therapy
Thomas R Laws, Adam W Taylor, Paul Russell, Diane Williamson
Melioidosis is a significant health problem within endemic areas such as Southeast Asia and Northern Australia. The varied presentation of melioidosis and the intrinsic antibiotic resistance of Burkholderia pseudomallei, the causative organism, make melioidosis a difficult infection to manage. Often prolonged courses of antibiotic treatments are required with no guarantee of clinical success. Areas covered: B. pseudomallei is able to enter phagocytic cells, affect immune function, and replicate, via manipulation of the caspase system...
January 10, 2019: Expert Review of Anti-infective Therapy
Kotoji Iwamoto, Hanne Bak Pedersen, Juan E Tello, Danilo Lo Fo Wong, Jane Robertson
This meeting was held from the 30 October to the 1 November 2018 in Almaty, Kazakhstan. The meeting brought together participants from 16 countries of central Asia, Caucasus, eastern Europe and expert speakers from western Europe and India. Participants discussed the analysis and use of data on antimicrobial medicines consumption, country experiences in enforcing legislation for prescription-only access to antibiotics, the role of primary health care (PHC) in tackling antimicrobial resistance (AMR), strategies to improving competencies of practitioners using evidence-based clinical protocols and public engagement in the responsible use of medicines...
January 10, 2019: Expert Review of Anti-infective Therapy
Mary G Reynolds, Jeffry B Doty, Andrea M McCollum, Victoria A Olson, Yoshinori Nakazawa
Monkeypox is a re-emerging viral zoonosis that occurs naturally in heavily-forested regions of West and Central Africa. Inter-human transmission of monkeypox virus, although limited, drives outbreaks, particularly in household and healthcare settings. But the available evidence suggests that without repeated zoonotic introductions, human infections would eventually cease to occur. Therefore, interrupting virus transmission from animals to humans is key to combatting this disease. Such efforts, however, are hindered by an incomplete understanding of the maintenance and transmission dynamics of the virus in its natural reservoir host(s)...
January 9, 2019: Expert Review of Anti-infective Therapy
Mauro Viganò, Massimo Andreoni, Carlo Federico Perno, Antonio Craxì, Alessio Aghemo, Alfredo Alberti, Pietro Andreone, Sergio Babudieri, Stefano Bonora, Maurizia Rossana Brunetto, Raffaele Bruno, Savino Bruno, Vincenza Calvaruso, Nicola Caporaso, Fabio Cartabellotta, Francesca Ceccherini-Silberstein, Valeria Cento, Alessia Ciancio, Piero Colombatto, Nicola Coppola, Vito Di Marco, Giovanni Di Perri, Stefano Fagiuoli, Giovanni Battista Gaeta, Antonio Gasbarrini, Pietro Lampertico, Adriano Pellicelli, Tullio Prestileo, M Puoti, G Raimondo, Giuliano Rizzardini, Gloria Taliani, Anna Linda Zignego
Hepatitis C virus (HCV) infection is a major cause of chronic liver disease, with approximately 71 million chronically infected individuals worldwide. Treatment of chronic hepatitis C has considerably improved in the last few years thanks to the introduction of direct acting antivirals able to achieve sustained virological response in more than 95% of patients. Successful anti-HCV treatment can halt liver disease progression and solve the HCV-related extra-hepatic manifestations, eventually reducing liver-related and overall mortality...
December 24, 2018: Expert Review of Anti-infective Therapy
Jan J De Waele, Sofie Dhaese
Severe infections in critically ill patients carry a high morbidity and mortality rate. Given the impact of early and broad-spectrum empirical therapy in several studies and the emphasis on this in international guidelines, there is a low threshold for initiating antibiotics in many patients with suspected infection. This has led to the widespread use of antibiotics in critically ill patients, which is often unnecessary or inappropriate. Areas covered: Antimicrobial stewardship (AMS) attempts to reduce antibiotic exposure while improving outcomes and may intuitively contrast with current antibiotic prescription practices...
February 2019: Expert Review of Anti-infective Therapy
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