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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.
Basic implantology – An American perspective
Published in John Dudley Langdon, Mohan Francis Patel, Robert Andrew Ord, Peter Brennan, Operative Oral and Maxillofacial Surgery, 2017
Antibiotics: Studies have shown similarly improved success rates in implant placement with the use of both pre-operative and post-operative antibiotic prophylaxis as compared to no antibiotics. Risks and benefits of antibiotic therapy must be evaluated for each case to determine whether specific indications exist for the use of antibiotic prophylaxis. If an infection develops postoperatively, a 1-week course of a broad-spectrum beta- lactam antibiotic should be prescribed.
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.
Rifampicin in periprosthetic joint infections: where do we stand and where are we headed?
Published in Expert Review of Anti-infective Therapy, 2023
Marjan Wouthuyzen-Bakker, Henk Scheper
The additional value of rifampicin for streptococcal PJIs was evaluated in a large cohort of 444 acute streptococcal PJIs treated with surgical debridement [24]. This study demonstrated a higher cure rate when using a beta lactam antibiotic for more than 21 days (before switching to an alternative antimicrobial). In addition, by adding rifampicin to the beta-lactam, an even higher cure rate was observed when using rifampicin for at least 14 days. After correcting for survival bias (i.e. excluding patients who failed within 30 days after debridement, 30% of the cohort), the benefit of rifampicin remained. However, the clinical significance of this difference in outcome appeared to be limited and suggests that long use of beta-lactams is most important. Three other retrospective smaller studies evaluated the effect of rifampicin in streptococcal PJIs, but the results of these studies showed inconsistent results [25–28]. In addition, all studies were hampered by selection bias, immortal time bias and confounding by indication. Based on these observational data, beta-lactam therapy is the preferred treatment strategy for streptococcal PJI. The routine use of rifampicin for streptococcal PJI is not recommended.
An expert opinion on respiratory delivery of high dose powders for lung infections
Published in Expert Opinion on Drug Delivery, 2022
Bishal Raj Adhikari, Jack Dummer, Keith C. Gordon, Shyamal C. Das
The antimicrobial efficacy of different drugs has been described as concentration and time dependent. For example, aminoglycosides such as tobramycin and fluoroquinolone such as ciprofloxacin primarily exhibit concentration dependent killing [113]. However, antimicrobial efficacy of beta lactam antibiotics is primarily time dependent. In case of inhalation, the concentration and time factors reflect pharmacokinetics of drugs upon inhalation. Following inhalation, the drugs are cleared via diffusion into blood within minutes to hours depending upon multiple factors such as hydrophilicity/lipophilicity and molecular mass, effectively reducing the drug concentration in the lung tissue/fluids negating the very reason inhalation route was selected to treat lung infections [114,115]. Strategies are being investigated to improve residence time of the drugs in lungs. Inhalable liposomes containing ciprofloxacin have been reported with the aim to potentially improve the half-time of the drug in the lungs [74]. Similarly, a crystalline adduct of moxifloxacin, an antitubercular drug, was prepared with cinnamic acid to reduce its dissolution rate to improve its residence time in the lungs to potentially improve its localized anti-tubercular action in the lungs [116].
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].