scholarly journals Sulfonamide Allergies

Pharmacy ◽  
2019 ◽  
Vol 7 (3) ◽  
pp. 132 ◽  
Author(s):  
Amber Giles ◽  
Jaime Foushee ◽  
Evan Lantz ◽  
Giuseppe Gumina
Keyword(s):  
Risk Factors ◽  
Drug Allergy ◽  
Antimicrobial Agents ◽  
Treatment Options ◽  
Cross Reactivity ◽  
Definitive Treatment ◽  
Factors Associated ◽  
Immunodeficiency Virus ◽  
The Common ◽  
Immunocompetent Patients

As one of the earliest developed antimicrobial classes, sulfonamides remain important therapeutic options for the empiric and definitive treatment of various infectious diseases. In the general population, approximately 3–8% of patients are reported to experience a sulfonamide allergy. Sulfonamide allergies can result in various physical manifestations; however, rash is reported as the most frequently observed. In patients with human immunodeficiency virus (HIV), dermatologic reactions to sulfonamide antimicrobial agents occur 10 to 20 times more frequently compared to immunocompetent patients. This article describes the incidence, manifestations, and risk factors associated with sulfonamide allergies. The potential for cross-reactivity of allergies to sulfonamide antimicrobials with nonantimicrobial sulfonamide medications is also reviewed. Data suggest that substitutions at the N1 and N4 positions are the primary determinants of drug allergy instead of the common sulfonamide moiety. For patients with an indication for a sulfonamide antimicrobial with a listed allergy, it is important for healthcare practitioners to adequately assess the allergic reaction to determine appropriate management. Rechallenge and desensitization strategies may be appropriate for patients with delayed maculopapular eruptions, while alternative treatment options may be prudent for more severe reactions. Available data suggests a low risk of cross-allergenicity between sulfonamide antimicrobial and nonantimicrobial agents.

scholarly journals 945. Prevalence of HIV Associated Non-AIDS Conditions and Associated Risk Factors among Hospitalized HIV-infected Patients in India

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S504-S505
Author(s):  
Amyeo A Jereen ◽  
Celia Kucera ◽  
Saniya Pervin ◽  
Muralidhar Varma ◽  
Radhakrishnan Rajesh ◽  
...  
Keyword(s):  
Risk Factors ◽  
Transmitted Disease ◽  
Multivariate Logistic Regression Analysis ◽  
Patient Risk ◽  
Sexually Transmitted ◽  
Factors Associated ◽  
Immunodeficiency Virus ◽  
History Of ◽  
Artery Disease ◽  
Associated Risk Factors

Abstract Background HIV-associated non-AIDS (HANA) conditions are becoming common as People Living with Human Immunodeficiency Virus (PLWHIV) age. However, data estimating the prevalence of HANA conditions and associated risk factors is lacking in developing countries. This study evaluates reasons for hospitalizations among PLWHIV in Udupi, India in the antiretroviral era, and describes associated risk factors. Methods Demographic and clinical data were extracted from medical charts of 1280 HIV-infected patients 18 years and older who were admitted to Kasturba Hospital, Manipal, India between January 1, 2013 and December 31, 2017, for a total of 2157 hospitalizations. Primary reasons for hospitalization were categorized into AIDS-defining vs Non-AIDS-defining and HANA vs Non-HANA conditions (Fig 1). Multivariate logistic regression analysis was performed to estimate demographic and clinical factors associated with hospitalizations due to AIDS-defining illness and HANA conditions. Categorization of Reasons for Hospitalization Results Patients’ median age was 45 (18-80) years; 70% male. Median age of patients with AIDS-defining illness (45% of hospitalizations) was lower at 44 (18-75) years compared with HANA (15% of hospitalizations) at 48 (21-80) years. Age (OR, 95% CI) (0.985, 0.974-0.995), admission CD4 (0.998, 0.997 - 0.998), history of hypertension (HTN) (0.59, 0.42-0.82), stroke (0.49, 0.24 - 0.93), diabetes (1.56, 1.10 - 2.19), and AIDS-defining cancers (1.74, 1.05 - 2.89) were associated with AIDS-defining hospitalizations (Fig 2). Additionally, age (1.016, 1.001 - 1.031), history of HTN (1.70, 1.16 - 2.46), coronary artery disease (CAD) (4.02, 1.87- 9.02), chronic kidney disease (CKD) (2.30, 1.15 - 4.61), stroke (2.93, 1.46 - 5.96), Hepatitis B (3.32, 1.66- 6.72), Hepatitis C (16.1, 2.84 - 314), sexually transmitted disease (STD) (3.76, 1.38- 10.8), and HANA-associated cancer (2.44, 1.28- 6.42) were associated with HANA hospitalizations (Fig 3). Patient Risk Factors for AIDS-related Hospitalization Patient Risk Factors for HANA-related Hospitalization Conclusion Prevalence of HANA conditions was lower than AIDS-defining illnesses possibly because of a younger population. Patients with AIDS-defining illnesses were also likely to have HANA conditions. Early detection and effective treatment of both HIV and HANA conditions is essential to decrease hospitalizations in low-resource settings. Disclosures All Authors: No reported disclosures

AN OVERVIEW OF XEROSTOMIA

2021 ◽  
pp. 13-14
Author(s):  
Nanditha Kumar.M. ◽  
Raghavendraswamy . K.N. ◽  
Thippeswamy. H.M
Keyword(s):  
Risk Factors ◽  
Oral Cavity ◽  
General Health ◽  
Treatment Options ◽  
Subjective Feeling ◽  
Factors Associated

Xerostomia is a subjective feeling of oral dryness.The effects are limited to the oral cavity or have ramications on the general health of the patients. Recognition of the symptoms and risk factors associated with xerostomia early by the dentist can help relieve the discomfort of the patient. Although many treatment options have been proposed currently there is not any one specic solution for the condition. This review outlines the prevalence,risk factors, symptoms and treatment options of xerostomia.

P5338Atherosclerotic cardiovascular events in people living with Human Immunodeficiency Virus

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
F Boccara ◽  
S Lang ◽  
S Ederhy ◽  
L Soulat-Dufour ◽  
S Adavane-Scheuble ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Human Immunodeficiency Virus ◽  
Coronary Artery ◽  
High Risk ◽  
Vascular Risk ◽  
Factors Associated ◽  
Immunodeficiency Virus ◽  
Observational Cohort ◽  
Artery Disease

Abstract Background People living with Human Immunodeficiency Virus (PLWHIV) under antiretrovirals have an increased risk of atherosclerotic cardiovascular disease (ASCVD) events. The risk factors associated with ASCVD events in this high risk population are various including traditional vascular risk factors and specific HIV-related factors. However their respective influence is questionable. Purpose Our aim was to determine the incidence of ASCVD events in a large cohort of PLWHIV and to identify the risk factors associated. Methods We conducted a longitudinal observational cohort study of asymptomatic PLWHIV at high risk of ASCVD addressed to our preventive cardiovascular unit for non-invasive cardiovascular evaluation. The first ASCVD event was censored and included CV death, acute coronary syndromes, coronary and peripheral revascularizations (PCI or CABG or endarterectomy or limb procedures) and ischemic strokes. Results From January 2003 to December 2014, 763 consecutive asymptomatic PLWHIV were enrolled (mean age of 51.3±8.3 years, 87% men, 90% were free of known coronary artery disease, mean Left ventricular ejection fraction 60%). At baseline, traditional CV risk factors were as follow: 54% had dyslipidemia, 43% hypertension, 35% were active smokers, 22% had family history of CAD and 11% were diabetics. Statins were prescribed in 38% of the cohort, aspirin in 14%, clopidogrel in 14% betablockers in 14%, RAS blockers in 32%, Calcium channel blockers in 8%. At baseline, median duration of HIV seropositivity was 19.8 years (14.0–23.6), 94% were under ARV predominantly protease inhibitors (68%). Median CD4 cell count was 545/mm3 (404–745) and 92% had undetectable HIV viral load. During a median follow up of 5.8 years (3.7–8.7), 58 (7.3%) subjects had a first ASCVD event (incidence of 12.70 [9.78–16.51] per 1000 persons-years) including 5 cardiovascular deaths, 14 ACS, 20 coronary revascularizations, 13 peripheral vascular procedures and 6 strokes) with a median time of occurrence of 3.1 years (1.5–5.1). CV death (first and second ASCVD events) occurred in 8 patients (22%) after CV death related to malignancies (33%) but before deaths related to unexplained causes (21%), infectious disease (13%), liver disease (8%) and suicides (3%). Coronary events including coronary death, MI, and coronary revascularization occurred in 39 patients (5.2%); Incidence of 8.28 [6.00–11.43] per 1000 persons-years. Conventional multivariate Cox model shows that age and tobacco were the independent risk factors associated with ACSVD events [Hazard ratio (HR) 1.04, 95% CI 0.99–1.09, p=0.05 and HR 2.17, 95% CI 1.07–4.38, p=0.03]. Conclusion Traditional vascular risk factors (age and active smoking) are associated with the occurrence of ASCVD events predominantly coronary artery disease in our observational cohort of asymptomatic PLWIHV at high risk for ASCVD. Cardiovascular prevention including tobacco cease action is mandatory in the aging HIV population.

scholarly journals Carbapenem-Sparing Antibiotic Treatment Options in Children with Extended-Spectrum β-Lactamase (ESBL) Producing Bacteria

2018 ◽  
Vol 10 (1) ◽  
pp. 9-14
Author(s):  
Marisol Fernandez ◽  
Rachel D. Quick ◽  
Kathryn G. Merkel ◽  
Sarah Casey ◽  
Patrick Boswell ◽  
...  
Keyword(s):  
Risk Factors ◽  
Antibiotic Resistance ◽  
Treatment Options ◽  
Retrospective Chart Review ◽  
Oral Antibiotic ◽  
Factors Associated ◽  
Amoxicillin Clavulanate ◽  
Critical Patients ◽  
Resistance Data ◽  
Culture Positive

Introduction: This is a single-site retrospective chart review study that sought to assess risk factors associated with antibiotic resistance and the likelihood of susceptibility to non-carbapenem antibiotics in ESBL-producing bacteria in positive cultures in pediatric patients. Materials and methods: ESBL-producing bacteria were present in 222 culture-positive cases. Among 177 isolates tested, 85.9% had susceptible breakpoint to piperacillin-tazobactam. Aminoglycoside susceptibility varied with low percentages among tobramycin and gentamicin (36.9% and 50.9%, respectively), but high susceptibility for amikacin (95.5%). Most isolates (77%) were susceptible to at least one oral option, but individual susceptibilities were low. Risk factors associated with ESBL acquisition were not independently associated with antibiotic resistance to amikacin, piperacillin-tazobactam, or combined oral options, sulfamethoxazole-trimethoprim, ciprofloxacin, and amoxicillin-clavulanate. Conclusion: When determining empiric treatment, for an isolate identified as ESBL prior to finalized susceptibilities, piperacillin-tazobactam may be a carbapenem-sparing antibiotic option to consider based on local resistance data. Oral antibiotic options may be appropriate in non-critical patients.

scholarly journals Occurrence of feline immunodeficiency virus infection in cats

2008 ◽  
Vol 38 (8) ◽  
pp. 2245-2249 ◽  
Author(s):  
Valéria Maria Lara ◽  
Sueli Akemi Taniwaki ◽  
João Pessoa Araújo Júnior
Keyword(s):  
Risk Factors ◽  
Health Status ◽  
Virus Infection ◽  
Feline Immunodeficiency Virus ◽  
Domestic Cats ◽  
Blood Samples ◽  
Factors Associated ◽  
Paulo State ◽  
Feline Immunodeficiency Virus Infection ◽  
Immunodeficiency Virus

The occurrence of feline immunodeficiency virus (FIV) in Brazil has been previously described. This study aimed to investigate the frequency of FIV infection in 454 blood samples from healthy and sick domestic cats from 13 cities of São Paulo State, Brazil as well as to evaluate the risk factors associated with the infection. The results showed that 14.7% (67/454) of the cats were infected with FIV. The clinical evaluation showed that 29.2% of the FIV-positive animals were sick, while 7.3% did not show any type of clinical manifestation. In addition, the vast majority (23.1%) of positive cases corresponded to free-roaming owned cats. The incidence of FIV infection was higher in males (20.3%) than in females (9.7%). The results suggest that certain characteristics such as gender, health status and lifestyle may be associated with the risk of being infected with FIV in the population of cats studied.

scholarly journals Drug risk Factors Associated with a Sustained Outbreak ofClostridium difficileDiarrhea in a Teaching Hospital

1994 ◽  
Vol 5 (6) ◽  
pp. 270-275 ◽  
Author(s):  
Swapan K Nath ◽  
Suzette Salama ◽  
Devia Persaud ◽  
James H Thornley ◽  
Ian Smith ◽  
...  
Keyword(s):  
Risk Factors ◽  
Antimicrobial Agents ◽  
Hospitalized Patients ◽  
Control Group ◽  
Case Group ◽  
Factors Associated ◽  
Outbreak Period ◽  
Drug Risk ◽  
Restricted Use ◽  
Oncology Unit

A case-control study was undertaken to identify and quantify antimicrobial and nonantimicrobial drug risk factors associated with a sustained outbreak ofClostridium difficilediarrhea on two medical (teaching and nonteaching) units and an oncology unit. In total, 80 cases associated with an endemic clone of toxigenicC difficilewere compared with controls. Eighty controls were selected from a group of 290 controls randomly chosen from the outbreak period. The controls were matched to cases according to age, admitting diagnosis and unit of admission. Seventy (88%) patients in the case group received at least one antibiotic before diarrhea, compared with 37 (46%) patients in the control group. Major risk factors implicated in the development ofC difficilediarrhea in hospitalized patients were the following antimicrobial agents: ceftazidime (adjusted odds ratio [aor]=26.01, 95%ci5.67 to 119.19, P=0.0001); cefuroxime (aor=5.17,ci1.86 to 14.36, P=0.005); ciprofloxacin(aor=3.81,ci1.05 to 13.79, P=0.04); and clindamycin(aor=15.16,ci2.93 to 78.44, P=0.004). This is the first time that the use of ciprofloxacin has been linked to the development ofC difficilediarrhea. Use of gastrointestinal drugs (ranitidine, famotidine, cimetidine, omeprazole and sucralfate) was also an added risk(aor=3.20,ci1.39 to 7.34, P=0.01); however, antineoplastic therapy was not significant (P<0.53). Recognition of the specific high risk drugs may spur more restricted use of these agents, which may help in controllingC difficilediarrhea in hospitalized patients.

scholarly journals Risk Factors Associated with Vancomycin-ResistantEnterococcusin Intensive Care Unit Settings in Saudi Arabia

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Mahmoud Shorman ◽  
Jaffar A. Al-Tawfiq
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Saudi Arabia ◽  
Intensive Care ◽  
Antimicrobial Agents ◽  
Multiorgan Failure ◽  
Tertiary Hospital ◽  
Oral Contrast ◽  
Factors Associated ◽  
Icu Admission

Background. Vancomycin-resistant enterococci (VRE) are significant nosocomial pathogens worldwide. There is one report about the epidemiology of VRE in Saudi Arabia.Objective. To determine the risk factors associated with VRE infection or colonization in intensive care unit (ICU) settings.Design. This is a descriptive, epidemiologic hospital-based case-control study of patients with VRE from February 2006 to March 2010 in ICU in a tertiary hospital in Saudi Arabia.Methods. Data were collected from hospital records of patients with VRE. The main outcome measure was the adjusted odds ratio estimates of potential risk factors for VRE.Results. Factors associated with VRE included ICU admission for multiorgan failure, chronic renal failure, prior use of antimicrobial agents in the past three months and before ICU admission, gastrointestinal oral contrast procedure, and hemodialysis. Being located in a high risk room (roommate of patients colonized or infected with VRE) was found to be protective.Conclusions. Factors associated with VRE acquisition are often complex and may be confounded by local variables.

Serotyping and Antibiotic Resistance Profiling of Salmonella in Feedlot and Nonfeedlot Beef Cattle

2002 ◽  
Vol 65 (11) ◽  
pp. 1694-1699 ◽  
Author(s):  
JOHN C. BEACH ◽  
ELSA A. MURANO ◽  
GARY R. ACUFF
Keyword(s):  
Risk Factors ◽  
Beef Cattle ◽  
Environmental Samples ◽  
Antimicrobial Agents ◽  
Susceptibility Testing ◽  
Feedlot Cattle ◽  
The Other ◽  
Factors Associated ◽  
Carcass Contamination ◽  
Salmonella Senftenberg

As part of a larger study to assess risk factors associated with hide and carcass contamination of beef cattle during transport to slaughter, a total of 281 salmonellae were isolated from 1,050 rectal, hide, carcass, and environmental samples. For feedlot cattle, salmonellae were recovered from 4.0% of rectal samples, 37.5% of hide samples, 19.0% of carcass samples, and 47.4% of environmental samples. For nonfeedlot cattle, salmonellae were recovered from 10.9% of rectal samples, 37.5% of hide samples, 54.2% of carcass samples, and 50.0% of environmental samples. Overall, the five serotypes most commonly associated with feedlot cattle and their environment were Salmonella Anatum (18.3% of the isolates), Salmonella Kentucky (17.5%), Salmonella Montevideo (9.2%), Salmonella Senftenberg (8.3%), and Salmonella Mbandaka (7.5%). The five serotypes most commonly associated with nonfeedlot cattle and their environment were Salmonella Kentucky (35.4%), Salmonella Montevideo (21.7%), Salmonella Cerro (7.5%), Salmonella Anatum (6.8%), and Salmonella Mbandaka (5.0%). Antimicrobial susceptibility testing of all of the isolates associated with feedlot cattle revealed that 21.7% were resistant to tetracycline, compared with 11.2% of the isolates associated with nonfeedlot cattle. None of the other isolates from feedlot cattle were resistant to any of other antimicrobial agents tested, whereas 6.2% of nonfeedlot cattle isolates were resistant to more than four of the antimicrobial agents tested.

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