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Antimicrobials during Pregnancy
Published in “Bert” Bertis Britt Little, Drugs and Pregnancy, 2022
Gonorrhea is a common sexually transmitted disease encountered during pregnancy, and complicated infections may be treated with amoxicillin, ampicillin, aqueous procaine penicillin G, or ceftriaxone. For women with known strains of Neisseria gonorrhoeae that are penicillinase-producing, therapy should consist of either ceftriaxone, 250 mg intramuscular (IM) as a single dose, spectinomycin, 2 g IM as a single dose, or cefixime, 400 mg orally in a single dose. In fact, the CDC (2021) recommends these last three regimens for the treatment of uncomplicated gonococcal infections during pregnancy. Chlamydia trachomatis may be isolated in up to 30 percent of women of lower socioeconomic status (unpublished observations, 1990). Erythromycin base or stearate in a dose of 500 mg four times a day for 7–10 days will generally prove satisfactory for the treatment of chlamydial infections during pregnancy. Tetracycline is generally not recommended for use in pregnant women. Other antimicrobial agents such as amoxicillin (with or without clavulanic acid), clindamycin, or azithromycin (1 g single oral dose), may prove satisfactory in eradicating chlamydial infections in pregnant women who are unable to tolerate erythromycin because of its gastrointestinal side effects.
Paper 3
Published in Aalia Khan, Ramsey Jabbour, Almas Rehman, nMRCGP Applied Knowledge Test Study Guide, 2021
Aalia Khan, Ramsey Jabbour, Almas Rehman
Side-effects of tetracycline include all of the following except which one? Oesophageal irritationImpotenceNausea and vomitingPhotosensitivity rashDiarrhoea
Tetracycline
Published in Anton C. de Groot, Monographs in Contact Allergy, 2021
Tetracycline is a broad-spectrum naphthacene antibiotic produced semisynthetically from chlortetracycline, an antibiotic isolated from the bacterium Streptomyces aureofaciens. It exerts a bacteriostatic effect on bacteria by binding reversibly to the bacterial 30S ribosomal subunit and blocking incoming aminoacyl tRNA from binding to the ribosome acceptor site. It also binds to some extent to the bacterial 50S ribosomal subunit and may alter the cytoplasmic membrane causing intracellular components to leak from bacterial cells. Tetracycline is used to treat a wide variety of infections caused by susceptible bacteria and is also widely utilized in the treatment of acne vulgaris and acne conglobata. In pharmaceutical products, tetracycline is employed as tetracycline hydrochloride (CAS number 64-75-5, EC number 200-593-8, molecular formula C22H25CIN2O8) (1).
Detection of co-infection with Orientia tsutsugamushand and hemorrhagic fever with renal syndrome by next-generation sequencing
Published in International Journal of Neuroscience, 2023
Qianhui Xu, Wenyi Zhang, Qian Wang, Xuejun Fu, Jing Han, Ying Huang
The symptoms in our patient quickly decreased after the administration of tetracycline. However, antibiotics, such as tetracycline, needed for the treatment of scrub typhus, are generally not advised for the empirical treatment of central nervous system (CNS) infections. These severely neglected infections represent a potentially large proportion of treatable CNS disease burden across vast endemic areas and require more attention [7]. Our patients failed to have a confirmed diagnosis before admission for 13 days, suggesting the necessity of improving the knowledge of scrub typhus for all doctors in the epidemic area. For epidemic hemorrhagic fever, although specific antibacterial treatment is not required, supportive care and close monitoring are vital for the prevention of shock or bleeding complications.
Re-establishing the utility of tetracycline-class antibiotics for current challenges with antibiotic resistance
Published in Annals of Medicine, 2022
Kerry L. LaPlante, Abhay Dhand, Kelly Wright, Melanie Lauterio
Use of tetracycline-class drugs in pregnancy and for children under 8 years of age should be avoided, unless the benefit outweighs the risk, due to the risk of permanent tooth discolouration, enamel hypoplasia, and inhibition of bone growth. No dosage adjustments are needed for any of the third-generation tetracyclines in patients with renal impairment or mild-to-moderate hepatic impairment. However, dosage adjustments are required for eravacycline and tigecycline in patients with severe hepatic impairment (Child–Pugh Class C). Patient weight can impact PK and outcomes for some antibiotics, which may therefore require patient-specific dosing. Studies in most third-generation tetracycline-class antibiotics indicate that no adjustments are needed based on body weight [84], although dosing of eravacycline is based on 1 mg/kg body weight [12]. Efficacy of omadacycline and eravacycline is consistent across body mass index (BMI) groupings [57,85,86], and the PK of tigecycline is similar in patients with class III obesity (BMI ≥40 kg/m2) or healthy weight [87]. Additionally, safety data indicate tolerance of higher-dose eravacycline in patients with increased BMI [85].
Alopecia syphilitica, from diagnosis to treatment
Published in Baylor University Medical Center Proceedings, 2022
Mojahed Mohammad K. Shalabi, Brooke Burgess, Samiya Khan, Eric Ehrsam, Amor Khachemoune
The drug of choice to treat all stages of syphilis is benzathine penicillin G. Because AS is a manifestation of secondary syphilis, the treatment follows the same guidelines as for secondary syphilis. Adults are given a single dose of 2.4 million units intramuscularly, while infants and children receive 50,000 units/kg with a limit of 2.4 million units in a single dose.15 For patients with documented penicillin allergy, alternatives include doxycycline 100 mg orally twice daily for 2 to 4 weeks or tetracycline 500 mg orally four times a day for 2 to 4 weeks.16 Tetracycline administration involves more frequent dosing and side effects such as nausea, vomiting, and diarrhea; therefore, compliance might be an issue. Limited clinical trials suggest that ceftriaxone 1 to 2 g intramuscularly or intravenously for 10 to 14 days has been effective in treating secondary syphilis.17 Patients with penicillin allergy who have issues with follow-up or compliance with medications should be desensitized and treated with benzathine penicillin.15