scholarly journals Optimizing Antibiotic Treatment Strategies for Neonates and Children: Does Implementing Extended or Prolonged Infusion Provide any Advantage?

Antibiotics ◽  
2020 ◽  
Vol 9 (6) ◽  
pp. 329
Author(s):  
Paola Costenaro ◽  
Chiara Minotti ◽  
Elena Cuppini ◽  
Elisa Barbieri ◽  
Carlo Giaquinto ◽  
...  
Keyword(s):  
Bacterial Infections ◽  
Pediatric Population ◽  
Relevant Literature ◽  
Treatment Strategies ◽  
Intermittent Infusion ◽  
Target Attainment ◽  
Free Concentration ◽  
Dosing Strategy ◽  
Further Development ◽  
Antibiotic Infusion

Optimizing the use of antibiotics has become mandatory, particularly for the pediatric population where limited options are currently available. Selecting the dosing strategy may improve overall outcomes and limit the further development of antimicrobial resistance. Time-dependent antibiotics optimize their free concentration above the minimal inhibitory concentration (MIC) when administered by continuous infusion, however evidences from literature are still insufficient to recommend its widespread adoption. The aim of this review is to assess the state-of-the-art of intermittent versus prolonged intravenous administration of antibiotics in children and neonates with bacterial infections. We identified and reviewed relevant literature by searching PubMed, from 1 January 1 2000 to 15 April 2020. We included studies comparing intermittent versus prolonged/continuous antibiotic infusion, among the pediatric population. Nine relevant articles were selected, including RCTs, prospective and retrospective studies focusing on different infusion strategies of vancomycin, piperacillin/tazobactam, ceftazidime, cefepime and meropenem in the pediatric population. Prolonged and continuous infusions of antibiotics showed a greater probability of target attainment as compared to intermittent infusion regimens, with generally good clinical outcomes and safety profiles, however its impact in terms on efficacy, feasibility and toxicity is still open, with few studies led on children and adult data not being fully extendable.

scholarly journals Bacteriophages for the Treatment of Graft Infections in Cardiovascular Medicine

Antibiotics ◽  
2021 ◽  
Vol 10 (12) ◽  
pp. 1446
Author(s):  
Simon Junghans ◽  
Sebastian V. Rojas ◽  
Romy Skusa ◽  
Anja Püschel ◽  
Eberhard Grambow ◽  
...  
Keyword(s):  
Bacterial Infections ◽  
Cardiovascular Surgery ◽  
Individualized Medicine ◽  
Antibacterial Properties ◽  
Treatment Strategies ◽  
Time Lapse ◽  
Bacteriophage Therapy ◽  
Cardiovascular Medicine ◽  
Therapy Success ◽  
Further Development

Bacterial infections of vascular grafts represent a major burden in cardiovascular medicine, which is related to an increase in morbidity and mortality. Different factors that are associated with this medical field such as patient frailty, biofilm formation, or immunosuppression negatively influence antibiotic treatment, inhibiting therapy success. Thus, further treatment strategies are required. Bacteriophage antibacterial properties were discovered 100 years ago, but the focus on antibiotics in Western medicine since the mid-20th century slowed the further development of bacteriophage therapy. Therefore, the experience and knowledge gained until then in bacteriophage mechanisms of action, handling, clinical uses, and limitations were largely lost. However, the parallel emergence of antimicrobial resistance and individualized medicine has provoked a radical reassessment of this approach and cardiovascular surgery is one area in which phages may play an important role to cope with this new scenario. In this context, bacteriophages might be applicable for both prophylactic and therapeutic use, serving as a stand-alone therapy or in combination with antibiotics. From another perspective, standardization of phage application is also required. The ideal surgical bacteriophage application method should be less invasive, enabling highly localized concentrations, and limiting bacteriophage distribution to the infection site during a prolonged time lapse. This review describes the latest reports of phage therapy in cardiovascular surgery and discusses options for their use in implant and vascular graft infections.

scholarly journals Efficacy and Safety of Continuous Infusion of Vancomycin in Children: A Systematic Review

Antibiotics ◽  
2021 ◽  
Vol 10 (8) ◽  
pp. 912
Author(s):  
Marta Alonso-Moreno ◽  
Marta Mejías-Trueba ◽  
Laura Herrera-Hidalgo ◽  
Walter Alfredo Goycochea-Valdivia ◽  
María Victoria Gil-Navarro
Keyword(s):  
Continuous Infusion ◽  
Clinical Efficacy ◽  
Pediatric Population ◽  
Intermittent Infusion ◽  
Target Population ◽  
Population Characteristics ◽  
Efficacy And Safety ◽  
Target Attainment ◽  
Bibliographic Search ◽  
Administration Method

Vancomycin is used to treat a wide variety of infections within the pediatric population. In adults, continuous infusion of vancomycin (CIV) has been evaluated as an alternative to intermittent infusion of vancomycin (IIV) with potential advantages. In children, the use of CIV is increasing; however, data is currently limited. The objective is to provide efficacy and safety evidence for CIV within this population. The review was carried out following PRISMA guidelines. A bibliographic search was performed for studies on PubMed and EMBASE. Clinical trials and observational studies that reported clinical efficacy and/or target attainment of CIV in pediatrics were included. Articles were reviewed to assess their design and target population, characteristics of vancomycin treatment and the main findings in terms of safety and efficacy. A total of 359 articles were identified, of which seven met the inclusion criteria. All of them evaluated the target attainment, six assessed safety but only three assessed clinical efficacy. The best administration method for this antibiotic within the pediatric population is still unknown due to limited evidence. However, studies conducted thus far suggest pharmacokinetic advantages for CIV. Further investigation is required, in particular for studies comparing IIV with CIV for clinical efficacy and toxicity outcomes.

Development of Peptides that Inhibit Aminoglycoside-Modifying Enzymes and β-Lactamases for Control of Resistant Bacteria

2020 ◽  
Vol 21 (10) ◽  
pp. 1011-1026
Author(s):  
Bruna O. Costa ◽  
Marlon H. Cardoso ◽  
Octávio L. Franco
Keyword(s):  
Drug Target ◽  
Bacterial Infections ◽  
Antimicrobial Agents ◽  
Treatment Strategies ◽  
Resistance Mechanisms ◽  
Resistant Bacteria ◽  
Specific Chemical ◽  
Target Interaction ◽  
Multiresistant Bacteria ◽  
Acute Bacterial Infections

: Aminoglycosides and β-lactams are the most commonly used antimicrobial agents in clinical practice. This occurs because they are capable of acting in the treatment of acute bacterial infections. However, the effectiveness of antibiotics has been constantly threatened due to bacterial pathogens producing resistance enzymes. Among them, the aminoglycoside-modifying enzymes (AMEs) and β-lactamase enzymes are the most frequently reported resistance mechanisms. AMEs can inactivate aminoglycosides by adding specific chemical molecules in the compound, whereas β-lactamases hydrolyze the β-lactams ring, preventing drug-target interaction. Thus, these enzymes provide a scenario of multidrug-resistance and a significant threat to public health at a global level. In response to this challenge, in recent decades, several studies have focused on the development of inhibitors that can restore aminoglycosides and β-lactams activity. In this context, peptides appear as a promising approach in the field of inhibitors for future antibacterial therapies, as multiresistant bacteria may be susceptible to these molecules. Therefore, this review focused on the most recent findings related to peptide-based inhibitors that act on AMEs and β-lactamases, and how these molecules could be used for future treatment strategies.

scholarly journals Paroxysmal Neuralgia in Pediatric Population- A Diagnostic Dilemma for Physicians and Dental Practioners

2014 ◽  
Vol 10 (4) ◽  
pp. 74-77 ◽  
Author(s):  
A Dubey ◽  
S Mujoo ◽  
SB Sakarde ◽  
AK Dubey
Keyword(s):  
Neuropathic Pain ◽  
Orofacial Pain ◽  
Pediatric Population ◽  
Treatment Strategies ◽  
Diagnostic Dilemma ◽  
Dental Pathology ◽  
Dental Intervention

Paroxysmal neuralgia is relatively uncommon in children. Neuropathic orofacial pain is a challenge for the clinician, as no obvious dental pathology exists either clinically or radiographically. Dentist and physician should be able to recognize the characteristics of neuropathic pain so as to correctly diagnose these conditions hence avoid unnecessary dental intervention. This article reviews the conditions with paroxysmal neuralgia in children and available treatment strategies. DOI: http://dx.doi.org/10.3126/kumj.v10i4.11000 Kathmandu Univ Med J 2012;10(4):74-77

scholarly journals Teacher Education, Teacher Preparation and Professional Development of Secondary Schoolteachers in Light of Recent Global Trends

2019 ◽  
Vol 7 (11) ◽  
pp. 91
Author(s):  
Banaga Taha El-Zubair ◽  
El-Rusheed Habob Mohammed ◽  
Huda Salem Alkubaisi
Keyword(s):  
Professional Development ◽  
Teacher Education ◽  
Arab World ◽  
Relevant Literature ◽  
Scholarly Work ◽  
Preparation Programs ◽  
Global Trends ◽  
Financial Costs ◽  
Comprehensive Picture ◽  
Further Development

The purpose of this study is to present a brief overview of the nature of teacher education and preparation programs, and the professional development of secondary schoolteachers in the Arab world, and to offer insights into recent global trends in the matter.By examining some of the relevant literature and scholarly work, this study’s main objective is to provide a comprehensive picture of the teacher-program-related policies offered by education colleges/institutions in the region in the light of global trends. To achieve this, the researchers surveyed most of the existing related studies conducted in the region. This was pursued through analysis of evidence, methodologies, underlying ideologies, and indicators of examined literature. Similarly, an analysis of publications relating to recent global trends was undertaken.Results suggest that a comprehensive “five-year” teacher programs is ideal to be integrated into higher education in the Arab world due to its feasibility, affordability as well as lower financial costs. It was found that that the components of existing teacher programs must be subject to evaluation and review for further development. However, the results indicate not only that the strategy of candidate admission and enrollment in colleges are not based on appropriate criteria, but also that a clear policy for teaching licensure is ignored.The study emphasizes the need to establish fully equipped teacher training centers. To attain this, we strongly suggest selecting or creating well-equipped and administratively affiliated schools to the colleges to provide an experimental environment for candidates to practice what they have learned. Achieving a balance between different course packages should be considered.

scholarly journals Pathogenesis and management of gastrointestinal inflammation and fibrosis: from inflammatory bowel diseases to endoscopic surgery

2021 ◽  
Vol 41 (1) ◽  
Author(s):  
Kentaro Iwata ◽  
Yohei Mikami ◽  
Motohiko Kato ◽  
Naohisa Yahagi ◽  
Takanori Kanai
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Tissue Repair ◽  
Relevant Literature ◽  
Surgical Techniques ◽  
Treatment Strategies ◽  
Extended Resection ◽  
Bowel Diseases ◽  
Technical Advances ◽  
Inflammatory Bowel

AbstractGastrointestinal fibrosis is a state of accumulated biological entropy caused by a dysregulated tissue repair response. Acute or chronic inflammation in the gastrointestinal tract, including inflammatory bowel disease, particularly Crohn’s disease, induces fibrosis and strictures, which often require surgical or endoscopic intervention. Recent technical advances in endoscopic surgical techniques raise the possibility of gastrointestinal stricture after an extended resection. Compared to recent progress in controlling inflammation, our understanding of the pathogenesis of gastrointestinal fibrosis is limited, which requires the development of prevention and treatment strategies. Here, we focus on gastrointestinal fibrosis in Crohn’s disease and post-endoscopic submucosal dissection (ESD) stricture, and we review the relevant literature.

scholarly journals Beta-Lactam market research: Progress, challenges and prospects

2020 ◽  
Vol 11 (3) ◽  
pp. 4879-4883
Author(s):  
Bhavana B Bhat ◽  
Pavithra Pradeep Prabhu ◽  
Manisha Joshel Lobo ◽  
Anusha ◽  
Prathvi ◽  
...  
Keyword(s):  
Market Share ◽  
Bacterial Infections ◽  
Pediatric Population ◽  
Global Market ◽  
Asia Pacific ◽  
Research Progress ◽  
Beta Lactam ◽  
Drug Usage ◽  
Capita Health Expenditure ◽  
Resistant Strains

Antibiotics are robust medicines that are widely used from centuries together to treat bacterial infections such as UTI, Typhoid, and Cholera etc. The similarity between viral and bacterial infection has resulted in the misuse of these antibiotics, the result of which is the development of resistant strains. Such indiscriminate drug usage has been increasing in a vulnerable geriatric and pediatric population. The increase in per capita health expenditure has enhanced the global market of these class of drugs, and the scope is likely to shoot up in the coming years, paving the way for young investors to emerging. The Global market for antibiotics is highly competitive and has a large number of significant players dominating the market share. During the forecast period experts in the field have evaluated and segment to dominate in LAMEA (Latin America, Middle East and Africa) holding the majority of the Market share. However, Asia Pacific was found to be the highest region for contributing more revenues. Detailed market analysis for / was conducted by doing secondary research where the market segments were compared for antibiotics. The paper discusses several issues related to the area of medicines.

scholarly journals Use of carbapenems and glycopeptides increases risk for Clostridioides difficile infections in acute myeloid leukemia patients undergoing intensive induction chemotherapy

2020 ◽  
Vol 99 (11) ◽  
pp. 2547-2553
Author(s):  
Olivier Ballo ◽  
Eva-Maria Kreisel ◽  
Fagr Eladly ◽  
Uta Brunnberg ◽  
Jan Stratmann ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Myeloid Leukemia ◽  
Induction Chemotherapy ◽  
Myeloid Leukemia ◽  
Bacterial Infections ◽  
Treatment Strategies ◽  
Length Of Hospital Stay ◽  
Infectious Complications ◽  
Clostridioides Difficile ◽  
Acute Myeloid

Abstract Patients with acute myeloid leukemia (AML) are often exposed to broad-spectrum antibiotics and thus at high risk of Clostridioides difficile infections (CDI). As bacterial infections are a common cause for treatment-related mortality in these patients, we conducted a retrospective study to analyze the incidence of CDI and to evaluate risk factors for CDI in a large uniformly treated AML cohort. A total of 415 AML patients undergoing intensive induction chemotherapy between 2007 and 2019 were included in this retrospective analysis. Patients presenting with diarrhea and positive stool testing for toxin-producing Clostridioides difficile were defined to have CDI. CDI was diagnosed in 37 (8.9%) of 415 AML patients with decreasing CDI rates between 2013 and 2019 versus 2007 to 2012. Days with fever, exposition to carbapenems, and glycopeptides were significantly associated with CDI in AML patients. Clinical endpoints such as length of hospital stay, admission to ICU, response rates, and survival were not adversely affected. We identified febrile episodes and exposition to carbapenems and glycopeptides as risk factors for CDI in AML patients undergoing induction chemotherapy, thereby highlighting the importance of interdisciplinary antibiotic stewardship programs guiding treatment strategies in AML patients with infectious complications to carefully balance risks and benefits of anti-infective agents.

scholarly journals The Role of TLR4 Asp299Gly and TLR4 Thr399Ile Polymorphisms in the Pathogenesis of Urinary Tract Infections: First Evaluation in Infants and Children of Greek Origin

2019 ◽  
Vol 2019 ◽  
pp. 1-9 ◽  
Author(s):  
Panagiota Karananou ◽  
Despoina Tramma ◽  
Socrates Katafigiotis ◽  
Anastasia Alataki ◽  
Alexandros Lambropoulos ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Bacterial Infections ◽  
Pediatric Population ◽  
Infants And Children ◽  
Healthy Children ◽  
Healthy Infants ◽  
Tract Infections ◽  
In Infants And Children

Urinary tract infections are one of the most common and serious bacterial infections in a pediatric population. So far, they have mainly been related to age, gender, ethnicity, socioeconomic level, and the presence of underlying anatomical or functional, congenital, or acquired abnormalities. Recently, both innate and adaptive immunities and their interaction in the pathogenesis and the development of UTIs have been studied. The aim of this study was to assess the role and the effect of the two most frequent polymorphisms of TLR4 Asp299Gly and Thr399Ile on the development of UTIs in infants and children of Greek origin. We studied 51 infants and children with at least one episode of acute urinary tract infection and 109 healthy infants and children. We found that 27.5% of patients and 8.26% of healthy children carried the heterozygote genotype for TLR4 Asp299Gly. TLR4 Thr399Ile polymorphism was found to be higher in healthy children and lower in the patient group. No homozygosity for both studied polymorphisms was detected in our patients. In the group of healthy children, a homozygote genotype for TLR4 Asp299Gly (G/G) as well as for TLR4 Thr399Ile (T/T) was showed (1.84% and 0.92 respectively). These results indicate the role of TLR4 polymorphism as a genetic risk for the development of UTIs in infants and children of Greek origin.

Incorporating Immunotherapy Into the Treatment Strategies of B-Cell Adult Acute Lymphoblastic Leukemia: The Role of Blinatumomab and Inotuzumab Ozogamicin

2018 ◽  
pp. 574-578 ◽  
Author(s):  
Hagop Kantarjian ◽  
Elias Jabbour
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Pediatric Population ◽  
Lymphoblastic Leukemia ◽  
Treatment Strategies ◽  
Clinical Activity ◽  
Inotuzumab Ozogamicin ◽  
Term Survival ◽  
Drug Conjugates ◽  
Cure Rates

Monoclonal antibodies and bispecific antibody constructs hold considerable promise in improving the outcomes of patients with acute lymphoblastic leukemia (ALL). Antibody-drug conjugates such as inotuzumab ozogamicin and the bispecific T-cell engager blinatumomab represent novel antibody constructs that have shown substantial clinical activity in ALL. Although most studies have focused on the use of these agents in the salvage setting, incorporation of these antibodies into the frontline regimens is imperative to improve long-term survival for patients with ALL and to increase the cure rates of adult ALL to the levels achieved in the pediatric population.

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