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Antibiotics short course

Liam P Shaw, Hassan Bassam, Chris P Barnes, A Sarah Walker, Nigel Klein, Francois Balloux
Treatment with antibiotics is one of the most extreme perturbations to the human microbiome. Even standard courses of antibiotics dramatically reduce the microbiome's diversity and can cause transitions to dysbiotic states. Conceptually, this is often described as a 'stability landscape': the microbiome sits in a landscape with multiple stable equilibria, and sufficiently strong perturbations can shift the microbiome from its normal equilibrium to another state. However, this picture is only qualitative and has not been incorporated in previous mathematical models of the effects of antibiotics...
March 15, 2019: ISME Journal
Mark J Taylor, Thomas W von Geldern, Louise Ford, Marc P Hübner, Kennan Marsh, Kelly L Johnston, Hanna T Sjoberg, Sabine Specht, Nicolas Pionnier, Hayley E Tyrer, Rachel H Clare, Darren A N Cook, Emma Murphy, Andrew Steven, John Archer, Dominique Bloemker, Franziska Lenz, Marianne Koschel, Alexandra Ehrens, Haelly M Metuge, Valerinne C Chunda, Patrick W Ndongmo Chounna, Abdel J Njouendou, Fanny F Fombad, Robert Carr, Howard E Morton, Ghaith Aljayyoussi, Achim Hoerauf, Samuel Wanji, Dale J Kempf, Joseph D Turner, Stephen A Ward
There is an urgent global need for a safe macrofilaricide drug to accelerate elimination of the neglected tropical diseases onchocerciasis and lymphatic filariasis. From an anti-infective compound library, the macrolide veterinary antibiotic, tylosin A, was identified as a hit against Wolbachia This bacterial endosymbiont is required for filarial worm viability and fertility and is a validated target for macrofilaricidal drugs. Medicinal chemistry was undertaken to develop tylosin A analogs with improved oral bioavailability...
March 13, 2019: Science Translational Medicine
Zeyou Chen, Wei Zhang, Luxi Yang, Robert D Stedtfeld, Anping Peng, Cheng Gu, Stephen A Boyd, Hui Li
Land application of animal manure could change the profiles of antibiotic resistant bacteria (ARB), antibiotic resistance genes (ARGs) and bacterial communities in receiving soils. Using high-throughput real-time quantitative PCR and 16S rRNA amplicon sequencing techniques, this study investigated the ARGs and bacterial communities in field soils under various crop (corn and pasture) and manure (swine and dairy) managements, which were compared with those of two non-manured reference soils from adjacent golf course and grassland...
March 1, 2019: Environmental Pollution
Yin Mo, Ivan Seah, Pei Shi Priscillia Lye, Xiang Lee Jamie Kee, Kien Yee Michael Wong, Kwan Ki Karrie Ko, Rick Twee-Hee Ong, Paul A Tambyah, Alex R Cook
OBJECTIVES: To study the correlation between knowledge, attitude and practices (KAP) of antibiotic consumption with epidemiology and molecular characteristics of extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE) carriage, in order to identify modifiable factors and public health interventions to reduce prevalence of multidrug-resistant organism colonisation in the community. DESIGN: Cross-sectional questionnaire of KAP towards antibiotic use and collection of stool samples or rectal swabs...
March 5, 2019: BMJ Open
Alexandra C Charron, Mike A Carl, Barbara B Warner, Jason G Newland, Christopher C McPherson
INTRODUCTION: Very low birth weight (VLBW) neonates (< 1500 g) are commonly exposed to prolonged antibiotic courses related to concerns for presumed early onset sepsis often with unclear indications. While antibiotics can be life-saving medications, prolonged antibiotic exposure (> 5 days) increases an infant's risk for necrotizing enterocolitis, late onset sepsis, colonization or infection with resistant organisms, and death. The aim of this study is to describe clinical and laboratory factors that influence the length of initial antibiotic courses in VLBW neonates...
March 1, 2019: Infectious Diseases and Therapy
Giannoula S Tansarli, Nikolaos Andreatos, Elina E Pliakos, Eleftherios Mylonakis
Background: The duration of antibiotic therapy for bacteremia due to Enterobacteriaceae is not well-defined. We sought to evaluate the clinical outcomes with shorter versus longer-course treatment. Methods: We performed a systematic search of the PubMed and EMBASE databases through May 2018. Studies presenting comparative outcomes between patients receiving antibiotic treatment for ≤10 days ("short-course") and those treated for >10 days ("long-course") were considered eligible. Results: Four retrospective cohort studies and one randomized controlled trial comprising 2,865 patients met the inclusion criteria...
February 25, 2019: Antimicrobial Agents and Chemotherapy
Andrea Hahn, Hani Fanous, Caroline Jensen, Hollis Chaney, Iman Sami, Geovanny F Perez, Anastassios C Koumbourlis, Stan Louie, James E Bost, John N van den Anker, Robert J Freishtat, Edith T Zemanick, Keith A Crandall
In persons with cystic fibrosis (CF), decreased airway microbial diversity is associated with lower lung function. Conflicting data exist on the impact of short-term antibiotics for treatment of acute pulmonary exacerbations. However, whether differences in antibiotic exposure impacts airway microbiome changes has not been studied. We hypothesized that subtherapeutic beta-lactam antibiotic exposure, determined by the pharmacokinetics and pharmacodynamics (PK/PD) after intravenous (IV) antibiotic administration, would be associated with different patterns of changes in CF airway microbial diversity...
February 22, 2019: Scientific Reports
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No abstract text is available yet for this article.
March 2019: American Journal of Surgery
Deepak A Kaji, John R Zech, Jun S Kim, Samuel K Cho, Neha S Dangayach, Anthony B Costa, Eric K Oermann
This study trained long short-term memory (LSTM) recurrent neural networks (RNNs) incorporating an attention mechanism to predict daily sepsis, myocardial infarction (MI), and vancomycin antibiotic administration over two week patient ICU courses in the MIMIC-III dataset. These models achieved next-day predictive AUC of 0.876 for sepsis, 0.823 for MI, and 0.833 for vancomycin administration. Attention maps built from these models highlighted those times when input variables most influenced predictions and could provide a degree of interpretability to clinicians...
2019: PloS One
Julio Plaza-Diaz, Francisco Javier Ruiz-Ojeda, Mercedes Gil-Campos, Angel Gil
Probiotics are living microorganisms that confer health benefits to the host when administered in adequate amounts; however, dead bacteria and their components can also exhibit probiotic properties. Bifidobacterium and strains of lactic acid bacteria are the most widely used bacteria that exhibit probiotic properties and are included in many functional foods and dietary supplements. Probiotics have been shown to prevent and ameliorate the course of digestive disorders such as acute, nosocomial, and antibiotic-associated diarrhea; allergic disorders such as atopic dermatitis (eczema) and allergic rhinitis in infants; and Clostridium difficile-associated diarrhea and some inflammatory bowel disorders in adults...
January 1, 2019: Advances in Nutrition
Justin E Bala-Hampton, Angela F Bazzell, Joyce E Dains
CASE STUDY A 48-year-old gentleman with metastatic melanoma currently receiving the cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4) inhibitor, ipilimumab (Yervoy), and the programmed cell death protein 1 (PD-1) inhibitor, nivolumab (Opdivo), returned for evaluation prior to receiving cycle 2. The patient presented with new onset dyspnea and a non-productive cough over the past week, with a temperature of 100.6°F at home on one occasion. He was placed on observation for fever, cough, and shortness of breath...
May 2018: Journal of the Advanced Practitioner in Oncology
Jessica Breton, Arthur Kastl, Natalie Hoffmann, Rachel Rogers, Andrew B Grossman, Petar Mamula, Judith R Kelsen, Robert N Baldassano, Lindsey Albenberg
Background: Recent studies have shown that oral combination antibiotics may improve disease course in refractory inflammatory bowel disease (IBD). Here, we describe the use of combination oral antibiotics as salvage therapy in refractory ulcerative colitis (UC), Crohn's colitis, and IBD-unclassified (IBD-U) at a large pediatric IBD center. Methods: Clinical response, disease activity indices, adverse events, and clinical outcomes were measured up to 1 year after antibiotic treatment in this retrospective cohort study of children with medically refractory IBD colitis...
February 4, 2019: Inflammatory Bowel Diseases
Dmitrij Marchukov, Benjamin Misselwitz
Insights into the Pathogenesis of Inflammatory Bowel Diseases: Genetics and Microbiota Abstract. An inadequate immune response against bacteria of the gastrointestinal tract is the basic mechanism mediating the pathophysiology of inflammatory bowel diseases (IBD). The risk of IBD is partially heritable and approximately 12 % of patients have a family history of IBD. Large genome-wide association studies (GWAS) were able to identify 240 genetic regions associated with IBD. Many of the implicated genes have a function in the immune system, are associated with primary immunodeficiencies or the defense against mycobacteria...
January 2019: Therapeutische Umschau. Revue Thérapeutique
Suzana Stanisavljević, Aleksa Čepić, Svetlana Bojić, Katarina Veljović, Sanja Mihajlović, Neda Đedović, Bojan Jevtić, Miljana Momčilović, Milica Lazarević, Marija Mostarica Stojković, Đorđe Miljković, Nataša Golić
Gut microbiota dysbiosis has been considered the essential element in the pathogenesis of multiple sclerosis and its animal model, experimental autoimmune encephalomyelitis (EAE). Antibiotics were administered orally to Dark Agouti (DA) rats early in their life with the aim of perturbing gut microbiota and investigating the effects of such intervention on the course of EAE. As a result, the diversity of the gut microbiota was reduced under the influence of antibiotics. Mainly, Firmicutes and Actinobacteria were replaced by Proteobacteria and Bacteroidetes, while decreased proportions of Clostridia and Bacilli classes were accompanied by an increase in Gamma-Proteobacteria in antibiotic-treated animals...
January 29, 2019: Scientific Reports
Kamilla Møller Gundersen, Jette Nygaard Jensen, Lars Bjerrum, Malene Plejdrup Hansen
BACKGROUND: It is well known that antibiotic use is the main driver for the increasing problems with resistant bacteria. Consequently, some countries have recommended shortening the duration of antibiotic treatment of community-acquired pneumonia (CAP). The aim of this study was to investigate if the effectiveness of a short-course antibiotic is comparable to a longer course of antibiotics in adults with CAP and to assess if the duration of an antibiotic course influences the development of resistant bacteria...
January 29, 2019: Basic & Clinical Pharmacology & Toxicology
Won Gun Kwack, Yun Jeong Lim, Ki Hwan Kwon, Jae Woo Chung, Jin Young Oh
Background/Aims: Diagnostic stool multiplex polymerase chain reaction (PCR) testing has attracted considerable interest, because of its high sensitivity, short turnaround time, and ability to detect multiple organisms simultaneously. This study investigates the clinical usefulness of a stool multiplex bacterial PCR in patients with acute diarrhea. Methods: We retrospectively evaluated the stool multiplex bacterial PCR results, clinical parameters, and clinical courses of patients hospitalized because of acute diarrhea between August 2014 and November 2016...
January 29, 2019: Korean Journal of Internal Medicine
Slobodan Galic, Dorottya Csuka, Zoltán Prohászka, Daniel Turudic, Petra Dzepina, Danko Milosevic
RATIONALE: This article describes a child with a life-threatening multiorgan failure with disseminated intravascular coagulation (DIC) and massive complement consumption. To our knowledge this therapeutic approach was for the first time effectively applied in a pediatric patient. PATIENT CONCERNS: A 14-month-old boy was presented with a severe, rapidly progressing, life-threatening disease because of sudden onset of fever, hemathemesis, hematuria, and bloody diarrhoea alongside fast spreading hematomas and general corporeal edema...
January 2019: Medicine (Baltimore)
Adrian Sousa, María Teresa Pérez-Rodríguez, Milagros Suárez, Nuria Val, Lucía Martínez-Lamas, Andrés Nodar, Rebeca Longueira, Manuel Crespo
Bacteremia due to gram-negative bacilli (GNB) is one of the most frequent causes of admission and prolongation of hospital stay. Nevertheless, optimal duration of antibiotic treatment is not clearly established. We designed an observational, prospective study of a cohort of adult patients with uncomplicated GNB bacteremia. They were classified according to the duration of treatment in short (7-10 days) or long (> 10 days) course. Mortality and bacteremia recurrence rate were evaluated, and propensity score for receiving short-course treatment was calculated...
January 24, 2019: European Journal of Clinical Microbiology & Infectious Diseases
Sarah E Posillico, Brian T Young, Husayn A Ladhani, Brenda M Zosa, Jeffrey A Claridge
BACKGROUND: After publication of the Study to Optimize Peritoneal Infection Therapy (STOP IT) trial, we sought to determine if we were implementing study findings into practice appropriately. We had three objectives: evaluate antibiotic usage; evaluate patient outcomes; and delineate differences in antibiotic usage between general surgeons (GS) and trauma/acute care surgery trained surgeons (TACS). PATIENTS AND METHODS: This was an analysis of patients with complicated intra-abdominal infection admitted via the emergency department from February 2014 through May 2017...
January 24, 2019: Surgical Infections
Guillaume Mahay, Mathilde Le Brun, Camille Taillé
Exacerbations of asthma are still responsible for 900 deaths per year in France, most of which are considered preventable. They have a major impact on the quality of life of patients and are responsible for a large part of the socio-economic cost of asthma in France. Exacerbations of asthma can be partly prevented by inhaled corticosteroid treatment as controller therapy, at a dose adapted to the level of control of symptoms and the management of aggravating factors. Every patient should benefit from a written action plan that allows them to start oral corticosteroid therapy as soon as possible during an exacerbation...
January 18, 2019: La Presse Médicale
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