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Traumatic CSF rhinorrhea
Published in Jyotirmay S. Hegde, Hemanth Vamanshankar, CSF Rhinorrhea, 2020
Hemanth Vamanshankar, Jyotirmay S Hegde
The use of prophylactic antibiotics during this period remains controversial. The British Society of Antimicrobial Chemotherapy proposed the following arguments against the use of antibiotics. Inflamed meninges may not permit the entry of commonly used antibiotics into brain, and such treatment may lead to colonization of resistant strains; also, potential pathogens like pneumococci may not be successfully eradicated by antibiotics.22 No significant difference in the risk of meningitis was found between groups receiving and not receiving antibiotics in CSF fistulas, according to a retrospective study by Eljamel.23
Critical Appraisal of Animal Models for Antibiotic Toxicity
Published in Adorjan Aszalos, Modern Analysis of Antibiotics, 2020
Patricia D. Williams, Girard H. Hottendorf
Antibiotics represent a group of chemical substances that kill or suppress the growth of microorganisms. By definition such substances are themselves produced entirely or in part by various species of microorganisms (bacteria, fungi, or Actinomycetes) [1]. Not surprisingly, they differ significantly in chemical and physical properties, as well as in antimicrobial spectrum and mechanisms of action. This heterogeneity is also reflected in the diversity of toxic reactions produced clinically by antibiotics. With roughly 30% of all hospitalized patients receiving antimicrobial chemotherapy, the spectrum of toxicities produced by these compounds is a significant factor in the clinical management of microbial disease [1].
Gastrointestinal and liver infections
Published in Michael JG Farthing, Anne B Ballinger, Drug Therapy for Gastrointestinal and Liver Diseases, 2019
The treatment of infectious diarrhoea can be considered at three levels, namely: General supportive therapy in the form of fluid and electrolyte replacement and then maintenance of hydration;Symptomatic treatment to reduce bowel frequency and other symptoms such as abdominal pain; andSpecific therapeutic interventions in the form of antimicrobial chemotherapy, which might alter the natural history of the infection and thereby reduce the duration and severity of the illness.
The war against bacteria, from the past to present and beyond
Published in Expert Review of Anti-infective Therapy, 2022
Lucrezia Bottalico, Ioannis Alexandros Charitos, Maria Assunta Potenza, Monica Montagnani, Luigi Santacroce
The wider definition of antimicrobial agent, on the other hand, is reserved for any chemical substance – natural or synthetic – that can inhibit the growth of both bacteria and other microorganisms [4,6]. Although the terms antibiotics and antimicrobial agents are sometimes utilized interchangeably in a common language, the difference is relevant and must be underlined: while antibiotics specifically target bacteria, antimicrobials encompass a broader range of products able to act on bacteria, fungi, protozoa, and viruses. Antimicrobial chemotherapy is a strategy to counteract infections intended to selectively destroy or inhibit pathological microbial development, without altering the function or damaging the structure of host cells (selective cell toxicity) (Figure 1). Ideally, the appropriate antimicrobial agent should: a) show selective toxicity (enhanced activity toward target microorganisms, not harmful to humans), b) not induce hypersensitivity reactions in the host, c) not extensively alter the host microbiota’s eubiosis, d) display appropriate pharmacokinetic properties (absorption, distribution, metabolism, and excretion) when administered systemically, and g) have affordable costs [7–11].
Carbapenemase producing Klebsiella pneumoniae: implication on future therapeutic strategies
Published in Expert Review of Anti-infective Therapy, 2022
Ilias Karaiskos, Irene Galani, Vassiliki Papoutsaki, Lamprini Galani, Helen Giamarellou
iv. Currently a major issue in antimicrobial chemotherapy is the application of antimicrobial stewardship in hospitals, a lifesaving effort to preserve antibiotic efficacy. The latter policy aims in the usage of the most appropriate antibiotic, dose, and duration of therapy, targeting the escape of resistance development, as well as lowering the existing resistance rates. How soon carbapenemase producing Enterobacterales become resistant to the β-lactam/β-lactamase inhibitors combinations and the forthcoming novel antibiotics? This is a challenging question, since lifetime of officially launched novel antibiotics is still short, whereas in most phase 3 clinical trials microbiological failures based on the emergence of resistance is not reported. In the ‘Greek Ceftazidime-avibactam Registry’, a prospective observational study in 147 patients, performed in 2018–2019, resistance development was observed only in two patients attributed to the emergence of the KPC-3 variant. However, meropenem-vaborbactam and imipenem-cilastatin-relebactam could overcome ceftazidime-avibactam resistance to isolates carrying the KPC-3 enzyme without major OmpK36 mutations. On the other hand, will cefiderocol, possessing stability against clones resistant to ceftazidime-avibactam, escape resistance development?
Current and promising pharmacotherapeutic options for candidiasis
Published in Expert Opinion on Pharmacotherapy, 2021
Liliana Scorzoni, Beth Burgwyn Fuchs, Juliana Campos Junqueira, Eleftherios Mylonakis
To improve the therapeutic approaches for candidiasis, many researchers have explored alternative means to deploy the available arsenal. Among them, recent studies have investigated different drug delivery systems for polyenes, azoles or echinocandins that provide localized targeted delivery that consequentially results in reductions antifungal dosages. The development of new liposomal, colloidal, and polymeric carriers represents a promising approach to increase the effectiveness and to counteract emerging resistance for all antifungal classes. In addition, new ways of approaching targets are coming into focus, such as the capacity of polyenes to extract sterols from the fungal cell membrane (sterol sponge model) and the ability of echinocandins to increase fungal cell wall chitin exposure. Approaches that remodel fungal cell surfaces suggest that these antifungals can have an important role provoking immune responses so cells are not so stealth in the body. Thus, bolstering antimicrobial chemotherapy with enhanced or altered immune responses.