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Drug Allergy
Published in Pudupakkam K Vedanthan, Harold S Nelson, Shripad N Agashe, PA Mahesh, Rohit Katial, Textbook of Allergy for the Clinician, 2021
Vancomycin allergies are rare, however about half of patients will experience cutaneous erythema, flushing and pruritus (red man syndrome) due to non-IgE mediated mast cell degranulation (Polk et al. 1988). This type of reaction is dependent on the infusion rate so treatment can often resume at a slower rate. Both type I and mild type IV hypersensitivity reactions to clindamycin and fluoroquinolones can occur, but the causative metabolites are not well defined and there are no validated diagnostic tests for these agents. Macrolide allergies are generally rare. Immunologic reactions to several antimycobacterial drugs including isoniazid, ethambutol, pyrazinamide and rifampicin are not rare and include a diverse number of the immunologic drug reactions.
Role of Plant-Based Bioflavonoids in Combating Tuberculosis
Published in Megh R. Goyal, Durgesh Nandini Chauhan, Assessment of Medicinal Plants for Human Health, 2020
Alka Pawar, Yatendra Kumar Satija
Various reports have shown anti-mycobacterial activity. But interestingly, a study reported that EGCG gets degraded within a day if kept in the medium containing MTB bacteria. However, the degradant molecules of EGCG are actually comprised of anti-mycobacterial property. Therefore, if green tea contains degradant molecules of EGCG, it could be considered as a potential prophylactic agent against the MTB bacteria.72
Drug-Resistant Tuberculosis
Published in Lloyd N. Friedman, Martin Dedicoat, Peter D. O. Davies, Clinical Tuberculosis, 2020
Keertan Dheda, Aliasgar Esmail, Anzaan Dippenaar, Robin Warren, Jennifer Furin, Christoph Lange
There is an ongoing debate about how long patients should be considered infectious on DST-guided antimycobacterial therapy. While infectiousness declines rapidly in response to adequate therapy,246 there is substantial concern for public health when discharging patients with MDR-TB from a hospital into the community when acid-fast bacilli are still detectable by sputum microscopy. In some countries, negative M. tuberculosis cultures are even required prior to hospital discharge of MDR-TB patients.247
Advances in the design of combination therapies for the treatment of tuberculosis
Published in Expert Opinion on Drug Discovery, 2023
Jonah Larkins-Ford, Bree B. Aldridge
The TB field has successfully developed new antimycobacterial drugs over the last 20 years ([61–63]). Though novel multidrug regimens have been found to be superior to the standard of care and a new regimen was approved for the treatment of MDR TB, the development of optimized combinations is not at the pace at which new compounds are developed. Nonetheless, the recent success of two clinical trials with new combinations, including those incorporating antibiotics already in use, points to the potential of the combination space to yield treatment-shortening regimens. On the other hand, the failure of some clinical trials, despite the supporting in vitro and preclinical animal data, highlights that we must improve these models and refine the metrics used to evaluate treatment outcomes.
Drug-induced Uveitis in HIV Patients with Ocular Opportunistic Infections
Published in Ocular Immunology and Inflammation, 2020
Ilaria Testi, Aniruddha Agarwal, Rupesh Agrawal, Sarakshi Mahajan, Alessandro Marchese, Elisabetta Miserocchi, Vishali Gupta
Rifabutin is commonly used for prophylaxis of Mycobacterium avium complex (MAC) in patients with AIDS and low CD4 + T cell count, and for treatment of non-tuberculous mycobacterial disease in combination with other drugs. Rifabutin is also recommended in the treatment of pulmonary tuberculosis in HIV patients. The activity of the drug is similar to that of rifampicin, another antimycobacterial agent derived from rifamycin, which is widely used in standard multidrug antitubercular treatment in combination with isoniazid, pyrazinamide, and ethambutol. Since HIV-infected patients on CART are at risk of drug–drug interaction, rifabutin is usually administered in place of rifampicin, being a less potent inducer of the cytochrome P450 drug metabolizing enzymes.33 Recommended dose of rifabutin for prophylaxis is 300 mg/daily, but it is increased to 450–600 mg/daily in the treatment of atypical micobacteria infections.
A retrospective study on tolerability and complications of bacillus Calmette-Guérin (BCG) instillations for non-muscle-invasive bladder cancer
Published in Scandinavian Journal of Urology, 2019
Antti Nummi, Riikka Järvinen, Jukka Sairanen, Kaisa Huotari
Patient characteristics, clinical presentations, and antimycobacterial therapy for the BCG infections are presented in Table 4. We found seven patients with systemic and five with local BCG infections. Persistent fever, reported on with five patients, was the most common manifestation among patients with systemic infections. Persistent cough without fever was reported in one patient with systemic infection, and one systemic infection diagnosis was an incidental radiological finding. Epididymitis, nephritis, or lymphadenitis were found in local infections. Isoniazid and rifampin combined with ethambutol was the antimycobacterial therapy for 10 patients. One patient received only isoniazid and rifampin as a treatment for BCG infection. Levofloxacin combined with isoniazid and rifampin was used in one patient. Two patients had received pyrazinamide even though the BCG strain is always resistant to pyrazinamide. Antimycobacterial therapy was combined with appropriate surgical therapy (orchiectomy, lymphadenectomy) for three patients who presented with local infections. All of the patients resolved, except for one, who died of a mycobacterial infection.