China
Africa
Explore chapters and articles related to this topic
Allergic Diseases
Published in Stephan Strobel, Lewis Spitz, Stephen D. Marks, Great Ormond Street Handbook of Paediatrics, 2019
Adam Fox, George Du Toit, Stephan Strobel
It is the large group of beta-lactam antibiotics that are commonly used to treat bacterial infections and are most commonly associated with allergic reactions. In 80–90% adverse drug reactions affect the skin. Cutaneus presentations classically occur at the time of viral infections and so it can be very difficult to determine whether associated rashes (drug allergies usually present with cutaneous manifestations) arise due to the index infection for which the antibiotic was administrated or due to the antibiotic itself. If such a diagnosis is not taken forward this may cause unnecessary patient anxiety and compromise health care in the future.
Cefoxitin, Cefotetan, and Other Cephamycins
Published in M. Lindsay Grayson, Sara E. Cosgrove, Suzanne M. Crowe, M. Lindsay Grayson, William Hope, James S. McCarthy, John Mills, Johan W. Mouton, David L. Paterson, Kucers’ The Use of Antibiotics, 2017
Structurally, the cephamycins are related to but distinct from cephalosporin C. Both contain a 7-alpha-methoxy group (Komiya et al., 1981; Ayers et al., 1982). Cefotetan possesses an N-methylthiotetrazole side chain (Cohen et al., 1987; Ward and Richards, 1989; Figure 24.1). These antibiotics act on bacteria in a manner similar to other beta-lactam antibiotics.
Problematic Beta-Lactamases: An Update
Published in Robert C. Owens, Lautenbach Ebbing, Antimicrobial Resistance, 2007
Marion S. Helfand, Louis B. Rice
Beta-lactam antibiotics arguably remain the safest and most effective antimicrobial agents used today. Unfortunately, beta-lactamases are, and will continue to be, formidable adversaries in the clinical arena when beta-lactams are used. Detailed knowledge of the epidemiology, microbiology, kinetic, and mechanistic details of their functioning, and genetic aspects of their dissemination, have already led to changes in clinical detection and treatment and infection control practices. In the future, as newer and more challenging enzymes emerge, this knowledge will be critical in the design of new beta-lactam antibiotics and beta-lactamase inhibitors, particularly for the Class B, C, and D enzymes. Rapid detection of resistance determinants in the clinical setting will allow for appropriate initial antibiotic use, thereby limiting the number of instances where potent broad-spectrum agents, such as carbapenems or colisitin, need to be administered. This will improve patient outcomes and limit the emergence of new resistance in the healthcare setting.
The democratization of de-labeling: a review of direct oral challenge in adults with low-risk penicillin allergy
Published in Expert Review of Anti-infective Therapy, 2020
Morgan Thomas Rose, Monica Slavin, Jason Trubiano
Antibiotic allergy labels (AALs) are patient-reported antibiotic allergies and are extremely common, reported in 10–20% of hospitalized patients [1–3]. Beta-lactam antibiotics and more specifically penicillin is the most commonly implicated drug and is reported in up to 15% of adult inpatients [4–6]. AALs are associated with numerous negative health and health system outcomes, including increased mortality [7,8], increased hospital length of stay [4,7,8], increased readmission rates [2,8–10], increased ICU admission [7], delays in antimicrobial therapy [11], increased antibiotic duration [6,8,9], increase in broad-spectrum and restricted antimicrobial use [1,3,4,9–14], and deviation from antimicrobial guidelines [1,9]. Furthermore, AALs are associated with higher rates of colonization/infection with multi-resistant organisms including Clostridioides difficile, methicillin-resistant Staphylococcus aureus (MRSA) [15], and vancomycin-resistant Enterococcus faecium (VRE) [16].
The role of PK/PD–based strategies to preserve new molecules against multi-drug resistant gram-negative strains
Published in Journal of Chemotherapy, 2020
Chiara Adembri, Iacopo Cappellini, Andrea Novelli
All 5 molecules belong to the beta-lactam antibiotic class and share some characteristics. Being hydrophilic molecules, there is the risk that if prescribed according to the manufacturer’s dose they are under-dosed in critically ill septic patients, in whom permeability and volume of distribution are increased.44 The risk of underexposure (which affects clinical cure and favors resistances) must be considered in ICU patients in whom renal function is altered. Renal function can be not only reduced, but also increased in a certain subset of ICU patients; moreover, kidney function is not static, and changes (both increasing and decreasing) can occur very rapidly.15 Therefore, increased doses during increased renal clearances should be proposed, while even in the case of reduced renal function some authors suggest not reducing doses, at least for the first 48 hrs of treatment.15 A keen revision of dosing according to CrCl formulas validated for ICU patients must also be applied. Finally, data on the probability of reaching PK/PD targets in ICU patients undergoing RRT are also necessary.
A 2018–2019 patent review of metallo beta-lactamase inhibitors
Published in Expert Opinion on Therapeutic Patents, 2020
Nakita Reddy, Mbongeni Shungube, Per I Arvidsson, Sooraj Baijnath, Hendrik G Kruger, Thavendran Govender, Tricia Naicker
Beta-lactam antibiotics are the most widely prescribed class of antimicrobial drugs around the world [1]. The therapeutic benefits offered by this class of antimicrobials include accessibility, safety, and a unique mechanism of action against specific prokaryotic cell structures [2], making it the ideal antimicrobial drug of choice. However, with increased consumption, inappropriate prescribing practices, and misuse of beta-lactams to treat minor infections, beta-lactam resistance has escalated to uncontrollable rates [3]. Gram-negative bacteria are the main protagonists responsible for the rise in resistance, facilitated by genes carried on plasmids or other mobile genetic elements, which confer resistance to beta-lactam drugs [4]. Carbapenems are beta-lactam drugs that are often referred to as the last line of defense in the treatment of bacterial infections [4]. However, the emergence of carbapenem-resistant Enterobacteriaceae (CRE), along with carbapenem-resistant Acinetobacter baumannii (CRAB) and carbapenem-resistant Pseudomonas aeruginosa (CRPA) have emerged as urgent threats, requiring immediate intervention, as stated by the World Health Organization [5].