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Monographs of Topical Drugs that Have Caused Contact Allergy/Allergic Contact Dermatitis
Published in Anton C. de Groot, Monographs in Contact Allergy, 2021
Penicillin is the generic name of the whole group of natural and semi-synthetic penicillins. Penicillin was originally obtained from the fungus Penicillium chrysogenum (old name: Penicillium notatum) and was discovered in 1928 by Sir Alexander Fleming, a Scottish researcher. All penicillins contain 6-aminopenicillanic acid with a side chain attached to the 6-amino group, which determines many of the antibacterial and pharmacological characteristics. As this is a historical topical allergen, the subject, of which there is abundant (often early) literature, will be discussed only very briefly.
Infectious Diseases
Published in Lyle D. Broemeling, Bayesian Analysis of Infectious Diseases, 2021
Certain antibiotics such as penicillin, streptomycin, and tetracycline are very effective against bacterial infections. The designation “antibiotic” is based on the concept of antibiosis, or the use of substances made by one living thing to kill another. Antibiotics are made by bacteria and molds that are specially cultured by commercial drug laboratories. Antibiotics kill bacteria and other disease organisms in a variety of ways. For example, some destroy cell walls, while others interfere with the multiplication of bacteria or fatally alter the way the bacteria manufacture vital proteins. Still others mix up the genetic plan of the bacteria. Ordinarily, an antibiotic tricks bacteria into using the antibiotic’s chemicals instead of closely related ones that organisms really need for making the key enzymes required for their growth and reproduction. With the antibiotic assimilated into their systems, instead of vital chemicals, an essential activity or structure of the pathogens is lacking and they die.
Antibiotics: The Need for Innovation
Published in Nathan Keighley, Miraculous Medicines and the Chemistry of Drug Design, 2020
Despite been discovered in 1928, it was not until 1941 that effective methods of isolating penicillin were developed by Florey and Chain. This drug revolutionised the battle against infection. However, penicillin is not effective against all types of infections. Since it was discovered that penicillin is a toxic fungal metabolite that kills bacteria and allows the fungi to compete for nutrients, it encouraged scientists to investigate microbial cultures from across the globe in search of other possible therapeutic agents. In 1944, the systematic search of soil microbes revealed the antibiotic streptomycin, which extended the range of therapy to the tubercle bacillus and a variety of gram-negative bacteria. Continued research led to the discovery of the other major classes of antibiotic: peptide antibiotics, tetra-cycline antibiotics, macrolide, and cyclic peptide; and synthetic agents including cephalosporin C, isoniazid, nalidixic acide, ciprofloxacin, and many others.
Medicine’s Commitment to Science and the Duties That Bind Clinicians
Published in The American Journal of Bioethics, 2023
Rosamond Rhodes, Daniel A. Moros
Furthermore, there are consequential issues concerning social benefit that require investigation. Today, for example, antibiotic stewardship is an ongoing issue with serious ethical implications. Inadequately treated bacterial infections encourage the emergence of antibiotic resistance, ultimately reducing the efficacy of today’s antibiotic armamentarium. Thus, we need to study when an older antibiotic like penicillin is sufficient, and for how long, and at what dose antibiotics should it be prescribed. Cost containment is another social issue that requires ongoing research in the setting of health care delivery to answer medical questions. Because needlessly spending money diverts needed funding from other uses, research on the adequacy and limitations of less expensive alternatives becomes an ethical imperative. Undertaking or collaborating in comparative effectiveness studies to determine when a less expensive test is sufficient can become a moral requirement. Again, those who casually resist involvement in studies are failing to fulfill a medical duty.
Amoxicillin-associated Stevens-Johnson syndrome or toxic epidermal necrolysis: systematic review
Published in Journal of Chemotherapy, 2023
Ana V. Pejcic, Milos N. Milosavljevic, Marko Folic, Diana Fernandes, João Bentes, Miralem Djesevic, Slobodan Jankovic
Two patients (3.1%) had reported previous history of allergic reaction to penicillin. Testing for drug hypersensitivity was performed in 4 patients (6.3%) with variable results: one patient had positive patch test and LTT for amoxicillin and negative for mefenamic acid [23]; one patient had negative patch test, intradermal test and LTT for amoxicillin/clavulanic acid, while ampicillin-specific T-cell lines (TCLs) proliferated against penicillin and carboxyfluorescein diacetate succinimidyl ester (CFDA-SE) assay results were positive for amoxicillin in CD4+ cells exclusively [26]; one patient had negative intradermal test for amoxicillin/clavulanic acid, negative LTT for penicillin, ampicillin, amoxicillin and amoxicillin/clavulanic acid, and negative TCLs for amoxicillin and amoxicillin/clavulanic acid [50]; one patient had negative patch and intradermal test for amoxicillin/clavulanic acid, negative LTT for penicillin, ampicillin, amoxicillin and amoxicillin/clavulanic acid, while TCLs were positive for penicillin and negative for ampicillin, amoxicillin and amoxicillin/clavulanic acid [50]. None of the patients was re-challenged with the drug. Confirmation of diagnosis by skin biopsy was reported in 14 patients (21.9%).
Strategies to increase access to basic sickle cell disease care in low- and middle-income countries
Published in Expert Review of Hematology, 2022
Meghna Dua, Halima Bello-Manga, Yvonne M. Carroll, Aisha Amal Galadanci, Umma Abdulsalam Ibrahim, Allison A. King, Ayobami Olanrewaju, Jeremie H. Estepp
Current guidelines from the National Heart, Lung, and Blood Institute (NHLBI) have endorsed oral penicillin-V prophylaxis twice daily in all children with SCD [57]. The guidelines recommend the discontinuation of penicillin prophylaxis at five years of age if there is no history of invasive pneumococcal infection or surgical splenectomy as long as pneumococcal vaccinations have been given [57]. It still remains uncertain whether penicillin prophylaxis should be continued throughout childhood and adulthood [16]. However, the majority of pediatric hematologists recommend termination of prophylaxis at five years of age [43], though some pediatricians may elect to continue it for a longer period of time [43]. Therefore, standard practice for preventing bacterial disease in SCD should include the initiation of daily prophylactic penicillin by two months of age and the completion of the pneumococcal vaccine series (consisting of both PCV13 and PCV23) by five years of age, after which prophylactic penicillin can be discontinued [16]. In addition to pneumococcal vaccines, salmonella, and meningococcal vaccines may be useful in patients with SCD, especially in tropical settings where these diseases are endemic [58,59]. However, the availability of these vaccinations is limited and routine penicillin prophylaxis is unavailable in the majority of medical centers in SSA. In a recent study conducted across 18 SCD clinics in Nigeria, only eight of them routinely gave prophylactic penicillin [60]. This is in contrast to a study conducted in Brazil where 76.1% of patients with SCD received penicillin prophylaxis [61].