Role of biomarkers in the management of antibiotic therapy: an expert panel review II: clinical use of biomarkers for initiation or discontinuation of antibiotic therapy

AbstractImmunosuppression permits graft survival after transplantation and consequently a longer and better life. On the other hand, it increases the risk of infection, for instance with cytomegalovirus (CMV). However, the various available immunosuppressive therapies differ in this regard. One of the first clinical trials using de novo everolimus after kidney transplantation [1] already revealed a considerably lower incidence of CMV infection in the everolimus arms than in the mycophenolate mofetil (MMF) arm. This result was repeatedly confirmed in later studies [2–4]. Everolimus is now considered a substance with antiviral properties. This article is based on the expert meeting “Posttransplant CMV infection and the role of immunosuppression”. The expert panel called for a paradigm shift: In a CMV prevention strategy the targeted selection of the immunosuppressive therapy is also a key element. For patients with elevated risk of CMV, mTOR inhibitor-based immunosuppression is advantageous as it is associated with a significantly lower incidence of CMV events.

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The Renal Outer Medullary Potassium Channel (ROMK): An Intriguing Pharmacological Target for an Innovative Class of Diuretic Drugs

Current Medicinal Chemistry ◽

10.2174/0929867324666171012120937 ◽

2018 ◽

Vol 25 (23) ◽

pp. 2627-2636 ◽

Cited By ~ 2

Author(s):

Vincenzo Calderone ◽

Alma Martelli ◽

Eugenia Piragine ◽

Valentina Citi ◽

Lara Testai ◽

...

Keyword(s):

Physiological Role ◽

Clinical Use ◽

Diuretic Activity ◽

First Line ◽

Potassium Homeostasis ◽

Diuretic Drugs ◽

Pharmacological Target ◽

Diuretic Agents ◽

Effective Drugs

In the last four decades, the several classes of diuretics, currently available for clinical use, have been the first line option for the therapy of widespread cardiovascular and non-cardiovascular diseases. Diuretic drugs generally exhibit an overall favourable risk/benefit balance. However, they are not devoid of side effects. In particular, all the classes of diuretics cause alteration of potassium homeostasis. <p> In recent years, understanding of the physiological role of the renal outer medullary potassium (ROMK) channels, has shown an intriguing pharmacological target for developing an innovative class of diuretic agents: the ROMK inhibitors. This novel class is expected to promote diuretic activity comparable to (or even higher than) that provided by the most effective drugs used in clinics (such as furosemide), with limited effects on potassium homeostasis. <p> In this review, the physio-pharmacological roles of ROMK channels in the renal function are reported, along with the most representative molecules which have been currently developed as ROMK inhibitors.

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Consistent evidence on the detrimental role of severe chronic endometritis on in vitro fertilization outcome and the reproductive improvement after antibiotic therapy: on the other hand, mild chronic endometritis appears a more intricate matter

Fertility and Sterility ◽

10.1016/j.fertnstert.2021.06.022 ◽

2021 ◽

Author(s):

Ettore Cicinelli ◽

Rossana Cicinelli ◽

Amerigo Vitagliano

Keyword(s):

In Vitro Fertilization ◽

Antibiotic Therapy ◽

The Other ◽

Chronic Endometritis ◽

Vitro Fertilization ◽

Other Hand

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Additional Diagnostic Yield of Adding Serology to PCR in Diagnosing Viral Acute Respiratory Infections in Kenyan Patients 5 Years of Age and Older

Clinical and Vaccine Immunology ◽

10.1128/cvi.00325-12 ◽

2012 ◽

Vol 20 (1) ◽

pp. 113-114 ◽

Cited By ~ 17

Author(s):

Daniel R. Feikin ◽

M. Kariuki Njenga ◽

Godfrey Bigogo ◽

Barrack Aura ◽

Stella Gikunju ◽

...

Keyword(s):

Respiratory Infections ◽

Diagnostic Yield ◽

Epidemiologic Studies ◽

Acute Respiratory Infections ◽

Clinical Use ◽

Paired Sample ◽

Parainfluenza Viruses ◽

Syncytial Virus ◽

Etiologic Diagnosis

ABSTRACTThe role of serology in the setting of PCR-based diagnosis of acute respiratory infections (ARIs) is unclear. We found that acute- and convalescent-phase paired-sample serologic testing increased the diagnostic yield of naso/oropharyngeal swabs for influenza virus, respiratory syncytial virus (RSV), human metapneumovirus, adenovirus, and parainfluenza viruses beyond PCR by 0.4% to 10.7%. Although still limited for clinical use, serology, along with PCR, can maximize etiologic diagnosis in epidemiologic studies.

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Role of Antibiotic Therapy in Mild Acute Calculus Cholecystitis: A Prospective Randomized Controlled Trial

World Journal of Surgery ◽

10.1007/s00268-012-1572-6 ◽

2012 ◽

Vol 36 (8) ◽

pp. 1750-1759 ◽

Cited By ~ 39

Author(s):

Haggi Mazeh ◽

Ido Mizrahi ◽

Uri Dior ◽

Natalia Simanovsky ◽

Mervyn Shapiro ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Antibiotic Therapy ◽

Controlled Trial ◽

Randomized Controlled ◽

Prospective Randomized Controlled Trial

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A randomised placebo-controlled double-blind multicentre trial comparing antibiotic therapy with placebo in the treatment of uncomplicated acute appendicitis: APPAC III trial study protocol

BMJ Open ◽

10.1136/bmjopen-2018-023623 ◽

2018 ◽

Vol 8 (11) ◽

pp. e023623 ◽

Cited By ~ 12

Author(s):

Suvi Sippola ◽

Juha Grönroos ◽

Ville Sallinen ◽

Tero Rautio ◽

Pia Nordström ◽

...

Keyword(s):

Acute Appendicitis ◽

Antibiotic Therapy ◽

Ct Scan ◽

Symptomatic Treatment ◽

Spontaneous Resolution ◽

University Hospital ◽

Controlled Study ◽

Double Blind ◽

Uncomplicated Acute Appendicitis

IntroductionRecent studies show that antibiotic therapy is safe and feasible for CT-confirmed uncomplicated acute appendicitis. Spontaneous resolution of acute appendicitis has already been observed over a hundred years ago. In CT-confirmed uncomplicated acute diverticulitis (left-sided appendicitis), studies have shown no benefit from antibiotics compared with symptomatic treatment, but this shift from antibiotics to symptomatic treatment has not yet been widely implemented in clinical practice. Recently, symptomatic treatment of uncomplicated acute appendicitis has been demonstrated in a Korean open-label study. However, a double-blinded placebo-controlled study to illustrate the role of antibiotics and spontaneous resolution of uncomplicated acute appendicitis is still lacking.Methods and analysisThe APPAC III (APPendicitis ACuta III) trial is a multicentre, double-blind, placebo-controlled, superiority randomised study comparing antibiotic therapy with placebo in the treatment CT scan-confirmed uncomplicated acute appendicitis aiming to evaluate the role of antibiotics in the resolution of uncomplicated acute appendicitis. Adult patients (18–60 years) with CT scan-confirmed uncomplicated acute appendicitis (the absence of appendicolith, abscess, perforation and tumour) will be enrolled in five Finnish university hospitals.Primary endpoint is success of the randomised treatment, defined as resolution of acute appendicitis resulting in discharge from the hospital without surgical intervention within 10 days after initiating randomised treatment (treatment efficacy). Secondary endpoints include postintervention complications, recurrent symptoms after treatment up to 1 year, late recurrence of acute appendicitis after 1 year, duration of hospital stay, sick leave, treatment costs and quality of life. A decrease of 15 percentage points in success rate is considered clinically important difference. The superiority of antibiotic treatment compared with placebo will be analysed using Fisher’s one-sided test and CI will be calculated for proportion difference.Ethics and disseminationThis protocol has been approved by the Ethics Committee of Turku University Hospital and the Finnish Medicines Agency (FIMEA). The findings will be disseminated in peer-reviewed academic journals.Trial registration numberNCT03234296; Pre-results.

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Severe eosinophilic bronchial asthma: new therapeutic options

Medical Council ◽

10.21518/2079-701x-2018-15-44-52 ◽

2018 ◽

pp. 44-52 ◽

Cited By ~ 2

Author(s):

N. M. Nenasheva

Keyword(s):

Monoclonal Antibodies ◽

Severe Asthma ◽

Bronchial Asthma ◽

Biological Agents ◽

Therapeutic Options ◽

Clinical Use ◽

Eosinophilic Asthma ◽

Interleukin 5 ◽

Severe Eosinophilic Asthma

Eosinophilic asthma is a common phenotype of severe asthma, occurring in at least half of patients. In recent years, there have been significant changes in the approaches to the treatment of severe bronchial asthma and, above all, eosinophilic asthma. The article discusses the role of eosinophils in the pathogenesis of severe asthma, the detection of the phenotype of severe eosinophilic asthma, and modern approaches to targeting severe asthma with an eosinophilic phenotype using biological agents. A special emphasis is placed on preparations of monoclonal antibodies to interleukin-5, in particular, mepolizumab, recently approved for clinical use in our country.

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