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Antimicrobial Agents and Neurotoxicity
Published in Firza Alexander Gronthoud, Practical Clinical Microbiology and Infectious Diseases, 2020
One of the adverse events that antibiotics are linked to is neurotoxicity, with seizures being the most reported neurological adverse event. However, based on current evidence, it is unclear how strong this association is and avoiding use of a particular antibiotic because of a potential risk of neurotoxicity leads to use of more broad-spectrum antibiotics or antibiotics with inferior effectiveness. This ultimately increases risk of antimicrobial resistance and compromises patient safety and outcome. Neurotoxicity, on the other hand, can have severe complications, and some may go unrecognized for a prolonged time. It is therefore worthwhile to consider the following.
The NHS of the future: resilient, adaptive and united
Published in Gina Johnson, Ian Hill-Smith, Chirag Bakhai, The Minor Illness Manual, 2018
Gina Johnson, Ian Hill-Smith, Chirag Bakhai
The sharing of medical records is merely one element of how technology will transform the way in which we work. Though more specific predictions here would be unwise, and indeed the most revolutionary developments may be largely unexpected, it is probably safe to say that we will see pioneering innovation with new investigations and treatments. One area where such development is crucially needed is to address the increasing problem of antimicrobial resistance.
Acts, circulars, reports and inquiries
Published in Tony White, John Black, The Doctor's Handbook, Part 2, 2018
This document identifies surveillance, prudent antimicrobial use and infection control as the key elements to controlling antimicrobial resistance. The strategy and plan specifies eight areas for action. The aims are to minimise morbidity and mortality due to antimicrobial resistant infection and maintain the effectiveness of antimicrobial agents used in the treatment of humans and animals.
Phytochemical and biological activities of some Iranian medicinal plants
Published in Pharmaceutical Biology, 2022
Salome Dini, Qihe Chen, Faezeh Fatemi, Younes Asri
Over the past few years, antimicrobial resistance has become one of the most serious international public health concerns that threatens the effective prevention and treatment of infections resulting from a wide range of pathogens, viz., bacteria, fungi and viruses (Avaei et al. 2015; Prestinaci et al. 2015). Additionally, reducing the popularity of synthetic compounds among consumers has caused a higher discovery of natural antimicrobial agents. Generally, the mechanism of essential oil inhibiting pathogens growth is associated with essential oil type and microbial strains tested (Pauli and Kubeczka 2010). Gram-positive bacteria are generally more susceptible to essential oils than Gram-negative bacteria (Borges et al. 2013, 2014), because they are surrounded by an outer membrane which has a more complex and assisting penetration of hydrophobic compounds through it. In other words, minute antimicrobial agents can easily access the cell membrane of Gram-positive bacterial strains (Zinoviadou et al. 2009; Hyldgaard et al. 2012). Furthermore, Gram-positive bacteria may ease the infiltration of essential oils of hydrophobic compounds due to lipophilic ends of lipoteichoic acid present in the cell membrane (Cox et al. 2000). The antimicrobial activity of essential oils is commonly evaluated via minimum bactericidal concentration (MBC) or minimum inhibitory concentration (MIC) (Balouiri et al. 2016), and agar well diffusion (Rao et al. 2019).
Therapeutic drug monitoring (TDM) in real-time: a need for the present future
Published in Expert Review of Anti-infective Therapy, 2022
A common unresolved problem that arises in the treatment of severe infections is to determine the right dose [6]. First and foremost, recommendations are mainly based on nonspecific populations and mainly healthy volunteers in very controlled clinical conditions. Interestingly, patient’s doses should consider clinical disease patterns, varying levels of antimicrobial resistance or drug availability. We have learnt over the years that patients with sepsis and septic shock are often at risk of underdosing due to an increased volume of distribution (Vd), which is probably one of the most unknown pharmacokinetic (PK) parameters that we consider when treating a critical care patient. More specifically, Vd represents the individual antimicrobial’s propensity to either remain in the plasma or redistribute to other tissue compartments. By measuring antibiotic plasma concentrations, physicians can adjust antimicrobial dosing in individual patients through the application of therapeutic drug monitoring (TDM) [7]. This approach has two potential benefits: to improve clinical outcome from infections and to reduce the development of antimicrobial resistance. The benefit of TDM focuses on two specific parameters: PK and pharmacodynamics (PD) to define the antimicrobial exposure necessary for maximizing the killing or inhibition of bacterial growth, determined by the minimum inhibitory concentration (MIC). As plasma concentrations are paramount to eradicating the cause of the infection by sterilizing the affected tissue, the concentration of antimicrobials should be adequately measured and controlled during treatment [8,9].
Antibiotic use in Australian and Swedish primary care: a cross-country comparison
Published in Scandinavian Journal of Primary Health Care, 2022
Konny Andersson, Mieke van Driel, Katarina Hedin, Samantha Hollingworth, Gregory Merlo
Antimicrobial resistance has important implications for healthcare systems all over the world in terms of increased morbidity, mortality, and healthcare expenditure [1]. Each year in the European Union and the European Economic Area, there are over 670,000 infections due to antibiotic-resistant bacteria and 33,000 people die from these infections. If antimicrobial resistance follows the projected trends, the annual costs for these infections are estimated to have an economic impact of up to €1.1 billion by 2050 in the European Union [2]. The OECD has estimated that between 2015 and 2050 antimicrobial resistance will lead to a combined economic burden of $75 billion for United States, Canada, and Australia [3]. A 2014 review on antimicrobial resistance estimated that if resistance trends continued there would be a global economic impact in terms of lost productivity of US$100 trillion [4].