Flea product efficacy, pet owners' adherence and treatment failure: what's the connection?

2021 ◽  
Vol 26 (8) ◽  
pp. 182-190
Author(s):  
Serena Wong ◽  
Hany Elsheikha ◽  
Michael Dryden
Keyword(s):  
Treatment Failure ◽  
Treatment Success ◽  
Treatment Recommendations ◽  
Poor Compliance ◽  
Exclusion Criteria ◽  
Flea Control ◽  
Pet Owners

Successful flea control relies mainly on the use of effective anti-flea products and the adherence of pet owners to treatment recommendations. When flea infestations continue to persist, despite the application of a potent flea product, lack of efficacy may be suspected. This study evaluated whether common flea products are still effective. As compliance is also critical, the impacts of owners' adherence on treatment success were also investigated, with a view to giving recommendations for improvement. The authors tested the hypothesis that when treatment failure occurs, perceived inefficacy of anti-flea products is caused by poor compliance. Searches were carried out in PubMed and CAB Abstracts, with abstracts screened against predetermined inclusion and exclusion criteria. In total, eleven studies on efficacy and seven studies on adherence were included in the analysis. All anti-flea products included in the study, with the exception of fipronil-S methoprene and possibly selamectin, appear to be effective in treating and preventing flea infestations in dogs and cats. With the majority of pet owners failing to adhere to recommendations, all veterinary staff should be proactive in providing rationale for the use of anti-flea products and reassure owners of their effectiveness to maximise compliance.

Flea infestation: a snapshot on the common products and the reasons for treatment failure

2021 ◽  
Vol 12 (2) ◽  
pp. 58-65
Author(s):  
Hany Elsheikha ◽  
Serena Wong ◽  
Ian Wright
Keyword(s):  
Clinical Practice ◽  
Treatment Failure ◽  
Companion Animals ◽  
Treatment Recommendations ◽  
Flea Infestation ◽  
Flea Control ◽  
Pet Owners ◽  
The Common ◽  
And Control

The reasons why flea infestations remain frequent in companion animals despite the considerable number of anti-flea products is of interest. Successful flea control relies mainly on the use of effective anti-flea products and pet owners adhering to treatment recommendations. When flea infestations continue to persist despite the application of a potent anti-flea product, lack of efficacy may be suspected. In this article, the basics of flea biology and impact of flea infestation on the host are summarised. In addition, the factors that can result in ineffective treatment and control of flea infestation are discussed. Better understanding of the possible reasons can help to inform clinical practice and avoid treatment failures.

scholarly journals Prediction of Treatment Failure and Compliance in Patients with Tuberculosis

2020 ◽  
Author(s):  
Hyeon-Kyoung Koo ◽  
Jinsoo Min ◽  
Hyung Woo Kim ◽  
Joosun Lee ◽  
Ju Sang Kim ◽  
...  
Keyword(s):  
Risk Factors ◽  
Treatment Failure ◽  
Lung Disease ◽  
Treatment Success ◽  
Multivariable Analysis ◽  
Previous History ◽  
Treatment Compliance ◽  
Poor Compliance ◽  
Cross Sectional ◽  
History Of

Abstract Background To improve treatment outcomes for tuberculosis (TB) , efforts to reduce treatment failure are necessary. The aim of our study was to describe the characteristics of subjects who had failed treatment of tuberculosis and identify the risk factors for treatment failure and poor compliance using national data. Methods A multicenter cross-sectional study was performed on tuberculosis subjects whose final outcome was reported as treatment failure during 2015-2017. The same number of subjects with treatment success during the same study period were randomly selected for comparison. Demographics, microbiological, radiographic, and clinical data were collected based on in-depth interviews by TB nurse specialists at all Public Private Mix (PPM) participating hospitals in South Korea. Results A total of 52 tuberculosis patients with treatment failure were enrolled. In a multivariable analysis, the presence of diabetes, previous history of tuberculosis, and cavity were identified as risk factors for treatment failure; and Medicaid support was a favorable factor for treatment success (area under the curve [AUC]: 0.79). Age, low body mass index (BMI), presence of diabetes, preexisting lung disease, positive sputum acid-fast bacilli (AFB) smear result, and the presence of multidrug-resistant tuberculosis ( MDR-TB) were significantly associated with presence of cavities. Younger age, lower BMI and previous history of TB were associated with poor compliance during treatment (AUC: 0.76). Conclusion To reduce treatment failure, careful evaluation of the presence of diabetes, previous TB history, underlying lung disease, cavity, results of sputum AFB smears, and socioeconomic status are needed. To enhance treatment compliance, more attention should be paid to younger patients with lower BMIs during follow-up.

scholarly journals Prediction of Treatment Failure and Compliance in Patients with Tuberculosis

2020 ◽  
Author(s):  
Hyeon-Kyoung Koo ◽  
Jinsoo Min ◽  
Hyung Woo Kim ◽  
Joosun Lee ◽  
Ju Sang Kim ◽  
...  
Keyword(s):  
Risk Factors ◽  
Treatment Failure ◽  
Lung Disease ◽  
Treatment Success ◽  
Multivariable Analysis ◽  
Previous History ◽  
Treatment Compliance ◽  
Poor Compliance ◽  
Cross Sectional ◽  
History Of

Abstract Background: To improve treatment outcomes for tuberculosis (TB), efforts to reduce treatment failure are necessary. The aim of our study was to describe the characteristics of subjects who had failed treatment of tuberculosis and identify the risk factors for treatment failure and poor compliance using national data.Methods: A multicenter cross-sectional study was performed on tuberculosis subjects whose final outcome was reported as treatment failure during 2015-2017. The same number of subjects with treatment success during the same study period were randomly selected for comparison. Demographics, microbiological, radiographic, and clinical data were collected based on in-depth interviews by TB nurse specialists at all Public Private Mix (PPM) participating hospitals in South Korea. Results: A total of 52 tuberculosis patients with treatment failure were enrolled. In a multivariable analysis, the presence of diabetes, previous history of tuberculosis, and cavity were identified as risk factors for treatment failure; and Medicaid support was a favorable factor for treatment success (area under the curve [AUC]: 0.79). Age, low body mass index (BMI), presence of diabetes, preexisting lung disease, positive sputum acid-fast bacilli (AFB) smear result, and the presence of multidrug-resistant tuberculosis (MDR-TB) were significantly associated with presence of cavities. Younger age, lower BMI and previous history of TB were associated with poor compliance during treatment (AUC: 0.76). Conclusion: To reduce treatment failure, careful evaluation of the presence of diabetes, previous TB history, underlying lung disease, cavity, results of sputum AFB smears, and socioeconomic status are needed. To enhance treatment compliance, more attention should be paid to younger patients with lower BMIs during follow-up.

scholarly journals Clinical Profiles and Prediction of Treatment Failure in Patients with Tuberculosis

2020 ◽  
Author(s):  
Hyeon-Kyoung Koo ◽  
Jinsoo Min ◽  
Hyung Woo Kim ◽  
Joosun Lee ◽  
Ju Sang Kim ◽  
...  
Keyword(s):  
Risk Factors ◽  
Treatment Failure ◽  
Lung Disease ◽  
Treatment Success ◽  
Multivariable Analysis ◽  
Previous History ◽  
Area Under The Curve ◽  
Treatment Compliance ◽  
Poor Compliance ◽  
Cross Sectional

Abstract Background To improve the treatment outcomes for tuberculosis (TB) efforts to reduce treatment failure are necessary. The aim of our study was to describe the characteristics of subjects who had failed treatment of tuberculosis and identify the risk factors for treatment failure and poor compliance using national data.Methods A multicenter cross-sectional study was performed for tuberculosis subjects whose final outcome was reported as treatment failure during 2015–2017. The same number of subjects with treatment success during the same study period were randomly selected for comparison. Demographics, microbiological, radiographic, and clinical data were collected based on in-depth interviews by TB nurse specialists at all Public Private Mix (PPM) participating hospitals in South Korea.Results A total of 52 tuberculosis patients with treatment failure were enrolled. In a multivariable analysis, the presence of diabetes, previous history of tuberculosis, and cavity were identified as risk factors for treatment failure; and Medicaid support was a favorable factor for treatment success (area under the curve (AUC): 0.76). Age, diabetes, pre-existing lung disease, positive sputum acid-fast bacilli (AFB) smear result, and presence of multi-drug-resistant tuberculosis (MDR-TB) were significantly associated with presence of cavity. Younger age, and lower body mass index (BMI) were associated with poor compliance during treatment (AUC: 0.74).Conclusion To reduce treatment failure, careful evaluation for the presence of diabetes, underlying lung disease, cavity, results of sputum AFB smears, and socioeconomic status is needed. To enhance treatment compliance, more attention should be paid to younger patients with lower BMIs during follow-up.

Recalcitrant Periprosthetic Joint Infection With Iliac Fossa Abscess After Total Hip Arthroplasty

2021 ◽  
Author(s):  
Kuo-Ti Peng ◽  
Tsung-Yu Huang ◽  
Jiun-Liang Chen ◽  
Chiang-Wen Lee ◽  
Hsin-Nung Shih
Keyword(s):  
Total Hip Arthroplasty ◽  
Treatment Failure ◽  
Hip Arthroplasty ◽  
Periprosthetic Joint Infection ◽  
Iliac Fossa ◽  
Joint Infection ◽  
Treatment Success ◽  
Anterolateral Approach ◽  
Total Hip ◽  
Orthopedic Procedure

Abstract Background: Total hip arthroplasty (THA) is a widely used and successfully performed orthopedic procedure for treating severe hip osteoarthritis, rheumatoid arthritis, and avascular necrosis. However, periprosthetic joint infection (PJI) after THA is a devastating complication for patients and orthopedic surgeons. Although surgical technology has been advanced and antibiotic-loaded cemented spacers or beads have developed, the treatment failure rate of one- or two-stage exchange arthroplasty for PJI is reported to be high, with >10% rate of incidence. Therefore, determining the possible pathogenesis and increasing the treatment success rate is a clinically important and urgent issue. Methods: A total of 256 patients with PJI who had undergone THA from 2005 to 2015 were included in this retrospective review. Seven patients required combined ilioinguinal and anterlateoal approach for debridement of iliac fossa abscess and infected hip lesion, included five patients with intraoperative pus leakage from the acetabular inner wall and the other two patients who underwent pre-operative pelvic computed tomography (CT) because of repeat PJI treatment failure. All available data from the medical records from all patients were retrospectively analyzed.Results: Of the 256 patients, seven (3.1%) patients was combined iliac fossa abscess in our cohort. For the microbiologic analysis, a total of thirteen pathogens were isolated from seven recurrent PJI patients with iliac fossa abscess, and Staphylococus aureus was the most commomly pathogen (4 out of 7 cases). The serum white blood cell (WBC) count was decreased significantly two weeks after debridement with combined the ilioinguinal and anterolateral approach compared to the day before surgery (11840/μL vs. 7370/μL; p<0.01), and level of C-reactive protein (CRP) was decreased at postoperative one week (107 mg/dL vs. 47.31 mg/dL; p=0.03). Furthermore, no recurrent infection was found in six revision THA patient in a follow up of 7.1 year. Conclusion: This result suggests that pre-operative pelvic CT and cautious identification of uncertain pus leakage from the inner wall of the acetabulum is essential for the diagnosis of recurrent PJI. Radical debridement with combined ilioinguinal and anterlateoal approach may aviod treatment failure in recurrent PJI with iliac fossa abscess.

scholarly journals 1424. Association Between Erythrocyte Sedimentation Rate (ESR) Change and Treatment Failure in Patients with Osteomyelitis

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S519-S519
Author(s):  
Christopher D Pearson ◽  
Dorothy Holzum ◽  
Ryan P Moenster ◽  
Travis W Linneman
Keyword(s):  
Treatment Failure ◽  
Regression Model ◽  
Erythrocyte Sedimentation Rate ◽  
Sedimentation Rate ◽  
Surgical Intervention ◽  
Treatment Success ◽  
Univariate Analysis ◽  
Initial Therapy ◽  
Anatomical Site ◽  
Erythrocyte Sedimentation

Abstract Background Erythrocyte sedimentation rate (ESR) is monitored during therapy for osteomyelitis (OM) but the degree of reduction associated with treatment success remains unclear. Methods This retrospective cohort study evaluated patients treated for at least 2 weeks with intravenous (IV) antibiotics for OM through the VA St. Louis HCS from 1 January 2010 to 1 January 2018 with at least 2 ESR values during their therapy. Patients were excluded if they had comorbidities that could cause elevations in ESR. The primary outcome was the rate of treatment failure in patients achieving ≥50% decrease in ESR from baseline compared with those without a 50% decrease. Treatment failure was defined as a need for unplanned surgical intervention or re-initiation of antibiotic therapy for OM of the same anatomical site within 6-months after initial therapy was discontinued. The presence of diabetes, peripheral vascular disease (PVD), age >70, baseline creatinine clearance (CrCl) < 50 mL/minute, surgical intervention as part of initial therapy, and ESR reduction ≥50% from baseline were included in a univariate analysis with variables with a P < 0.2 included in a multivariate logistic regression model. Results A total of 143 patients were included; 74 patients with a ≥50% decrease in ESR and 69 patients with a decrease <50%. Mean initial ESRs were not different between groups (79.5±31 vs. 79.9 ± 32 mm/hour, P = 0.95), but end-of-treatment values were significantly higher in the <50% reduction group vs. ≥50% (20.6 ± 14 vs. 72.4 ± 42 mm/hour, P < 0.05, respectively). There were no baseline differences between groups in regards to age, rates of diabetes, PVD, CrCl < 50 mL/minute, initial surgical therapy management, or definitive vs. empiric therapy. Thirty percent (22/74) of patients with a ≥50% reduction in ESR failed treatment vs. 55% (38/69) in patients with a <50% reduction (P < 0.01). Only ESR reduction of ≥50% met criteria for inclusion in the multivariate regression model and was associated with a 65.5% relative risk reduction in treatment failure (OR 0.345; 95% CI 0.173–0.687; P = 0.002). Conclusion Achieving an ESR reduction of ≥50% from baseline during treatment for OM was independently associated with a significant reduction in risk of treatment failure. Disclosures All authors: No reported disclosures.

scholarly journals Relapsing Malaria: A Case Report of Primaquine Resistance

2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
Christopher Dijanic ◽  
Jillian Nickerson ◽  
Sunita Shakya ◽  
Amanda Dijanic ◽  
Marilyn Fabbri
Keyword(s):  
Case Report ◽  
Drug Metabolism ◽  
Treatment Failure ◽  
Successful Treatment ◽  
Drug Efficacy ◽  
Poor Compliance ◽  
Morbidity And Mortality ◽  
Repeated Treatment ◽  
Parasitic Resistance ◽  
Relapsing Malaria

Primaquine (an 8-aminoquinoline malarial therapy) is the only FDA-approved therapy to treat the hypnozoite stage of P. vivax. We think of relapse occurring because of parasitic resistance or poor compliance secondary to drug toxicities. However, in patients with repeated treatment failure, we must consider CYP-450 mutations affecting drug metabolism as an important cause of relapse. A 47-year-old man who travelled to a jungle in Venezuela was diagnosed with P. falciparum and P. vivax in July 2015. He was treated with seven rounds of primaquine-based therapy in the following year, all resulted in relapse without further exposure to endemic areas. On his eighth presentation, he was found to have CYP-4502D6 mutation that affected the metabolism and activation of primaquine. Thereafter, he was treated without relapse. Primaquine efficacy depends on many factors. Understanding the mechanism responsible for malaria relapse is paramount for successful treatment and reduction in morbidity and mortality. This case illustrates the importance of considering cytochrome mutations that affect drug efficacy in cases of relapsing malaria.

scholarly journals Tuberculosis Treatment Outcomes: A Fifteen Year Retrospective Study in Jos North and Mangu, Plateau State, North – Central Nigeria

2020 ◽  
Author(s):  
Comfort Nanbam Sariem ◽  
Patricia Odumosu ◽  
Maxwell Patrick Dapar ◽  
Jonah Musa ◽  
Luka Ibrahim ◽  
...  
Keyword(s):  
Treatment Failure ◽  
Treatment Outcomes ◽  
Descriptive Analysis ◽  
Treatment Success ◽  
Infectious Agent ◽  
Success Rates ◽  
North Central ◽  
Tuberculosis Patients ◽  
Tb Treatment ◽  
Plateau State

Abstract Background: Globally, tuberculosis (TB) is the leading cause of death from a single infectious agent. Adherence to TB therapy is an important factor in treatment outcomes, which is a critical indicator for evaluating TB treatment programs. This study assessed TB treatment outcomes using a fifteen-year record of tuberculosis patients who received treatment in Jos North and Mangu Local Government Areas of Plateau State, North-Central Nigeria. Methods: The retrospective facility based study was done in five TB treatment centers which account for more than half of data for tuberculosis patients in Plateau State. Data were collected from 10156 TB patient’s health records between 2001 and 2015. Treatment outcomes were categorized as successful (cured, treatment completed) or unsuccessful (non-adherent, treatment failure or death). A descriptive analysis was done to assess the factors associated with treatment outcomes. Relevant bivariable and multivariable logistic regression were done. All statistical analyses were performed on Stata version 11, College station, Texas, USA.Results: During the study period, 58.1% (5904/10156) of the TB patients who received treatment were males. The Mean age ±SD was 35.5 ±15.5 years. The overall treatment success rate was 67.4%; non-adherence/defaulting rate was 18.5%, with majority of patients defaulting at the end of intensive phase of treatment. The sputum conversion rate was 72.8% and mortality rate was 7.5%. A decrease in successful treatment outcomes rate from 83.8% in 2001 to 64.4% in 2015 was observed. After adjusting for sex, and TB category, being HIV positive was 2.8 times (95% CI: 1.11-6.83, p=0.028) more likely to be associated with treatment success than having an unknown status. Treatment after loss to follow-up, relapse and treatment failure were less likely associated with treatment success than newly diagnosed TB patients.Conclusion: With the decrease in treatment success rates, underlying reasons for medication non-adherence and treatment failure should be resolved through adherence counseling involving the patient and treatment supporters, with education on voluntary counseling and testing for HIV among TB patients.

scholarly journals TUBERCULOSIS TREATMENT OUTCOMES: A FIFTEEN YEAR COHORT STUDY IN JOS NORTH AND MANGU, PLATEAU STATE, NORTH - CENTRAL NIGERIA

2019 ◽  
Author(s):  
Comfort Nanbam Sariem ◽  
Patricia Odumosu ◽  
Maxwell Patrick Dapar ◽  
Jonah Musa ◽  
Luka Ibrahim ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Treatment Failure ◽  
Treatment Outcomes ◽  
Cause Of Death ◽  
Treatment Success ◽  
Tuberculosis Treatment ◽  
Patient Treatment ◽  
North Central ◽  
Unsuccessful Treatment ◽  
Plateau State

Abstract Background Tuberculosis (TB) is an infectious disease with a major global health problem; being the tenth leading cause of death worldwide, and the leading cause of death from a single infectious agent. Nigeria is among the countries with high burden of tuberculosis and the highest global mortality rate. Medication adherence has been shown to have profound effect on other treatment outcomes. Objective To examine a fifteen-year cohort of tuberculosis treatment outcomes in Jos North and Mangu Local Government Areas of Plateau State. Methods The study was done in five treatment centers which account for more than half of data for tuberculosis patients in Plateau State, North-Central Nigeria. The retrospective study was done from 2001 to 2015, where TB patient records who had completed treatment were evaluated. Treatment outcomes were classified as successful (cured, treatment completed) or unsuccessful (non-adherent, treatment failure or death) and analyzed using binomial logistic regression. Results Males composed 58.1% of the population (10,156). Mean age ±SD was 35.5±15.5 years. The overall treatment success rate was 67.4%; non-adherence/defaulting rate was 18.5%, with majority of patients defaulting at the end of intensive phase of treatment; sputum conversion rate was 72.8% and mortality rate was 7.5%. A decrease in successful treatment outcomes from 83.8% to 64.4%, with a corresponding increase in unsuccessful treatment outcomes was observed. The Predictors of medication non-adherence were patients with unknown HIV status (OR 4.29, 95% CI: 3.74-4.91, p < 0.001); being male (OR 1.15, CI: 1.37-1.66, p = 0.008) and having a history of non-adherence (OR 2.27, CI: 1.34-3.87, p = 0.002) and treatment failure (OR 2.83, CI: 0.98 – 8.19, p = 0.05). Conclusion Underlying reasons for medication non-adherence and treatment failure identified should be resolved by the patient, treatment supporter and health worker. Increased awareness and education on voluntary counseling and testing of HIV among TB patients is advocated, particularly among the male population.

scholarly journals Assessing Treatment Success or Failure as an Outcome in Randomised Clinical Trials of COPD Exacerbations. A Meta-Epidemiological Study

Biomedicines ◽  
2021 ◽  
Vol 9 (12) ◽  
pp. 1837
Author(s):  
Alexander G. Mathioudakis ◽  
Sachin Ananth ◽  
Thomas Bradbury ◽  
Balazs Csoma ◽  
Pradeesh Sivapalan ◽  
...  
Keyword(s):  
Systematic Review ◽  
Treatment Failure ◽  
Core Outcome Set ◽  
Treatment Success ◽  
Signs And Symptoms ◽  
Core Outcome ◽  
Copd Exacerbations ◽  
Outcome Set ◽  
Systemic Treatments ◽  
Methodological Studies

A recently published ERS core outcome set recommends that all trials of COPD exacerbation management should assess the treatment success (or “cure” of the exacerbation), defined as a dichotomous measure of the overall outcome of an exacerbation. This methodological systematic review describes and compares the instruments that were used to assess treatment success or failure in 54 such RCTs, published between 2006–2020. Twenty-three RCTs used composite measures consisting of several undesirable outcomes of an exacerbation, together defining an overall unfavourable outcome, to define treatment failure. Thirty-four RCTs used descriptive instruments that used qualitative or semi-quantitative descriptions to define cure, marked improvement, improvement of the exacerbation, or treatment failure. Treatment success and failure rates among patients receiving guidelines-directed treatments at different settings and timepoints are described and could be used to inform power calculations in future trials. Descriptive instruments appeared more sensitive to treatment effects compared to composite instruments. Further methodological studies are needed to optimise the evaluation of treatment success/failure. In the meantime, based on the findings of this systematic review, the ERS core outcome set recommends that cure should be defined as sufficient improvement of the signs and symptoms of the exacerbation such that no additional systemic treatments are required.

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