Consequences of delayed ciprofloxacin and doxycycline. treatment regimens against F. tularensis airway infection
|
|
- Tobias Fields
- 6 years ago
- Views:
Transcription
1 AAC Accepts, published online ahead of print on 30 July 2012 Antimicrob. Agents Chemother. doi: /aac Copyright 2012, American Society for Microbiology. All Rights Reserved. 1 2 Consequences of delayed ciprofloxacin and doxycycline treatment regimens against F. tularensis airway infection 3 4 Running title: Delayed antibiotic treatments of tularemia Shahar Rotem $, Erez Bar-Haim $, Hila Cohen, Uri Elia, Raphael Ber, Avigdor Shafferman # and Ofer Cohen Department of Biochemistry and Molecular Genetics, Israel Institute for Biological research, Ness-Ziona, Israel $ Equal contribution # Address correspondence to Avigdor Shafferman, avigdors@iibr.gov.il
2 This study examines the efficacy, bacterial load and humoral response of an extensively delayed ciprofloxacin or doxycycline treatments following airway exposure of mice to F.tularensis holarctica (LVS) or to the highly virulent F.tularensis tularensis (SchuS4) strains. A delay in onset of both antibiotic treatments allowed the rescue of all LVS infected animals. Yet, for animals infected with SchuS4, only ciprofloxacin was efficacious and prolongation of treatment rescued all animals. 20
3 Francisella tularensis, a Gram-negative facultative intra-cellular bacterium, is the etiological agent of tularemia and is classified as a category A biological warfare agent by the CDC (6, 13). Human infections are mainly caused by F. tularensis holarctica (type B) or by tularensis (type A) subspecies (19). The latter, especially when inhaled, is highly infectious and virulent in humans, (7, 19). Antibiotics usually provide curative therapy for tularemia. Mortality depends on the infection type, patient's health and treatment onset. Aminoglycosides offer good bactericidal properties and low relapse rates, yet due to their toxicity and the need for parenteral administration, they are not the drug of choice for prophylactic treatment. According to the CDC guidelines, in cases of F. tularensis epidemics or a bio-terror scenario, ciprofloxacin and doxycycline represent the treatment of choice (6). Tetracycline and doxycycline treatment have documented relapses (~ 10%), however, others indicate tetracycline to be as effective as streptomycin when a prolonged treatment is given (8, 16). Ciprofloxacin and other quinolones have been shown to be effective against experimental tularemia (14, 15, 20), as well as in clinical treatment of type B tularemia (1, 2, 10, 17) Efficacy of different ciprofloxacin and doxycycline treatment regimens against F. tularensis airway infection. Mice (female Balb/c) were inoculated intranasally with 100LD 50 of either F. tularensis LVS (10 5 CFU) or SchuS4 (10 2 CFU), a dose that initiates a rapidly fatal disease, resulting in death of all animals within 5-7 days (3). Treatments with ciprofloxacin (50mg/kg b.i.d, i.p.) or doxycycline (40mg/kg b.i.d, i.p.)
4 were initiated either at 24, 48 or 72 hours post-infection (p.i.), and consisted for 7 and 14 days respectively. Ciprofloxacin or doxycycline treatment rescued all LVS infected mice regardless of initiation time of treatment (Table 1). In the case of delayed treatment starting 72 hours p.i., clear clinical signs (weight loss, scruffy appearance, lethargy) were observed. At the end of the treatment all LVS exposed animals exhibited no clinical signs and significant anti-f.tularensis antibody titers were measured 45 days p.i. (Table 1). When ciprofloxacin treatment was initiated 72 hours post SchuS4 infection, ~30% of the mice appeared to be morbid and 4-5 days after cessation of treatment died, while treatment starting 24 or 48 hours p.i., rescued all animals. None of the SchuS4 infected mice that were treated with doxycycline 72 hours following infection survived this airway infection (Table 1), while survival of mice treated 24 or 48 hours p.i. were 90% and 30% respectively. During the treatment periods described above all mice survived irrespective of the antibiotic used. Similar systematic study performed by Russell et. al, (15) found that following SchuS4 intra-peritoneal exposure, treatment with either doxycycline or ciprofloxacin is efficient when initiated 24 hours p.i.. These results, of relatively early treatment p.i. are in complete agreement with our results, although we used a different route of infection airway exposure. However, when the onset of treatment was delayed to 48 or even 72 hours p.i., a scenario which could be relevant to bio-terror, we find a clear advantage of ciprofloxacin over doxycycline (Table 1). We quantified the bacterial loads in the lungs, liver and spleen of airway infected mice, during antibiotic treatment and following its cessation (as described in (4, 11)). As seen in Figure 1, in LVS exposed mice, all organs tested were clear of bacteria 4-7 days
5 after ciprofloxacin administration. Doxycycline reduced the bacterial load during the 14 days of treatment, albeit at a lower rate (Figure 1). Unlike the case for ciprofloxacin, two days after cessation of doxycycline (day 19 p.i.) bacteria re-emerged in all organs, reaching a level of approximately 10 3 CFU in the lungs, liver or spleen (note that the LD 50 for intranasal administration with LVS is 10 3 CFU and ~1 CFU for intra-peritoneal administration). The bacterial load in the organs remained for 7 days post-treatment, declining gradually below the limit of detection (Figure 1). No morbidity was observed, and all animals survived. The bacterial loads of SchuS4 in organs from animals that were treated with ciprofloxacin or doxycycline 72 hours p.i., was determined immediately after cessation of treatment and 2-3 days thereafter (Figures 2 and 3). Ten days p.i. (the last day of ciprofloxacin treatment), all the animals were devoid of bacteria (Figure 2). However, 3 days later (13 days p.i.) 30% of the animals exhibited considerable levels of bacteria in the lungs, liver and spleen (ca CFU equivalent to 10 3 LD 50 i.n. or i.p.), in agreement with the observation of survival shown in Table 1. Doxycycline treatment initiated 72 hours post SchuS4 infection was efficient as long as the animals received the antibiotic, yet the disease relapsed after treatment secession. At this stage approximately 10 2 CFU were found in the lungs, spleen and liver which further increased to CFU in all these organs two days later (Figure 3A). These results are in accordance with the inability to rescue animals from SchuS4 i.n. infection if treatment is initiated 72 hours p.i. (Table 1). The occurrence of infection relapse was documented in the treatment of human cases of tularemia, particularly when tetracycline, or doxycycline, were used (8, 12, 16, 17) underlying the poorly understood "depot effect" of F. tularensis infection (4, 5, 9, 18). Of
6 note, SchuS4 and LVS infected mice eventually exhibited similar levels of humoral response following doxycycline treatment, yet only LVS infected animals survived the high level of reemerging bacteria (equivalent lethal doses of over LD 50, see Figure 1). The data underline the importance of timely onset of antibiotic treatment as an efficient countermeasure against F. tularensis tularensis infection and clearly demonstrate the advantage of ciprofloxacin in cases of delayed onset of treatment Consequences of further extension of the period of antibiotic treatments of SchuS4 infected animals. To reduce and eventually eliminate bacterial relapse after termination of treatment, we examined the extension of ciprofloxacin and doxycycline treatment periods in the SchuS4 airway infection murine model. An extended treatment consisting of ten days of ciprofloxacin administration (instead of 7 days), increased survival (to 100%) even when treatment was initiated 72 hours p.i. without any disease relapse (Table 2). Conversely, prolongation of doxycycline treatment to 21 days yielded a marginal improvement, when the treatment was initiated 72 hours p.i. (Table 2). Following the extended treatment, no bacteria were found (limit of detection <5 CFU) in all inspected tissues (Figure 3B), however, 2 days after cessation of treatment a relapse occurred with bacterial counts reaching 10 4 CFU in all organs. The findings of this study establish that both ciprofloxacin and doxycycline are effective in preventing the development of tularemia in the mouse model following airway infection, but in the case of bacteriostatic antibiotic such as doxycycline there is a significant failure to achieve complete recovery unless treatment is initiated within a
7 short time window (24 hours p.i.). At later stages of the disease (72 hours p.i), prolonging ciprofloxacin treatment (to 10 days) but not doxycycline (to 21 days) appeared to be an effective strategy for successful therapy against the highly virulent F. tularensis SchuS4 strain. These observations have important implications for designing efficient therapeutic approaches for treatment of tularemia in various scenarios, where early treatment is not possible Acknowledgments: We thank Dr. T. Chitlaru, Dr. G. Zaide, I. Inbar, G. Fridman, S. Eherlich and S. Maoz for their assistance in performing some of the experiments and Dr. N. Ariel for fruitful discussions and critical reading of the manuscript. 123
8 References 1. Aranda, E. A Treatment of tularemia with levofloxacin. Clin Microbiol Infect 7: Arav-Boger, R Cat-bite tularemia in a seventeen-year-old girl treated with ciprofloxacin. Pediatr Infect Dis J 19: Bar-Haim, E., O. Gat, G. Markel, H. Cohen, A. Shafferman, and B. Velan Interrelationship between dendritic cell trafficking and Francisella tularensis dissemination following airway infection. PLoS Pathog 4: Bar-Haim, E., O. Gat, G. Markel, H. Cohen, A. Shafferman, and B. Velan Interrelationship between dendritic cell trafficking and Francisella tularensis dissemination following airway infection. PLoS Pathog 4:e Craven, R. R., J. D. Hall, J. R. Fuller, S. Taft-Benz, and T. H. Kawula Francisella tularensis invasion of lung epithelial cells. Infect Immun 76: Dennis, D. T., T. V. Inglesby, D. A. Henderson, J. G. Bartlett, M. S. Ascher, E. Eitzen, A. D. Fine, A. M. Friedlander, J. Hauer, M. Layton, S. R. Lillibridge, J. E. McDade, M. T. Osterholm, T. O'Toole, G. Parker, T. M. Perl, P. K. Russell, and K. Tonat Tularemia as a biological weapon: medical and public health management. Jama 285: Ellis, J., P. C. Oyston, M. Green, and R. W. Titball Tularemia. Clin Microbiol Rev 15: Enderlin, G., L. Morales, R. F. Jacobs, and J. T. Cross Streptomycin and alternative agents for the treatment of tularemia: review of the literature. Clin Infect Dis 19:42-7.
9 Horzempa, J., D. M. O'Dee, D. B. Stolz, J. M. Franks, D. Clay, and G. J. Nau Invasion of erythrocytes by Francisella tularensis. J Infect Dis 204: Limaye, A. P., and C. J. Hooper Treatment of tularemia with fluoroquinolones: two cases and review. Clin Infect Dis 29: Markel, G., E. Bar-Haim, E. Zahavy, H. Cohen, O. Cohen, A. Shafferman, and B. Velan The involvement of IL-17A in the murine response to sub-lethal inhalational infection with Francisella tularensis. PLoS One 5:e Overholt, E. L., W. D. Tigertt, P. J. Kadull, M. K. Ward, N. D. Charkes, R. M. Rene, T. E. Salzman, and M. Stephens An analysis of forty-two cases of laboratory-acquired tularemia. Treatment with broad spectrum antibiotics. Am J Med 30: Oyston, P. C., A. Sjostedt, and R. W. Titball Tularaemia: bioterrorism defence renews interest in Francisella tularensis. Nat Rev Microbiol 2: Piercy, T., J. Steward, M. S. Lever, and T. J. Brooks In vivo efficacy of fluoroquinolones against systemic tularaemia infection in mice. J Antimicrob Chemother 56: Russell, P., S. M. Eley, M. J. Fulop, D. L. Bell, and R. W. Titball The efficacy of ciprofloxacin and doxycycline against experimental tularaemia. J Antimicrob Chemother 41: Sawyer, W. D., H. G. Dangerfield, A. L. Hogge, and D. Crozier Antibiotic prophylaxis and therapy of airborne tularemia. Bacteriol Rev 30: Scheel, O., R. Reiersen, and T. Hoel Treatment of tularemia with ciprofloxacin. Eur J Clin Microbiol Infect Dis 11:447-8.
10 Sjostedt, A Intracellular survival mechanisms of Francisella tularensis, a stealth pathogen. Microbes Infect 8: Sjostedt, A Tularemia: history, epidemiology, pathogen physiology, and clinical manifestations. Ann N Y Acad Sci 1105: Steward, J., T. Piercy, M. S. Lever, A. J. Simpson, and T. J. Brooks Treatment of murine pneumonic Francisella tularensis infection with gatifloxacin, moxifloxacin or ciprofloxacin. Int J Antimicrob Agents 27:
11 179 Figure legends Figure 1. Bacterial counts of LVS during and following antibiotic treatment. LVS bacterial counts in the lungs (A) and liver (B) during and post antibiotic treatment with ciprofloxacin (gray diamonds) or doxycycline (black rectangle); Arrows indicate the onset and termination of the indicated treatment. The limit of detection was 5 CFU/organ. Values represent an average and standard-deviations of results from 3 animals per time point Figure 2. Bacterial counts of SchuS4 after cessation of ciprofloxacin treatment. Counts of residual bacteria were determined when ciprofloxacin treatment was initiated 72 hours p.i. and continued for 7 days (note that when treatment initiated 48 hours p.i. with ciprofloxacin, bacteria were not detected in any organ after cessation of treatment, see text). Bacterial counts, were measured in 10 animals, in the lungs (black bar), liver (grey bar) and spleen (white bar) at the end of the treatment (day 10 p.i.) and 3 days later (day 13 p.i.) in additional 10 different animals. The limit of detection was 5 CFU/organ. For survival data after ciprofloxacin treatment regimen, see Table 2. Values represent an average and standard-deviations of 3-10 (as indicated) animals per time point Figure 3. Bacterial counts of SchuS4 after cessation of doxycycline treatment. Bacterial counts following SchuS4 infection when doxycycline treatment was initiated 72 hours p.i. for a period of 14 days (upper panel) or 21 days (lower panel) days. Bacterial counts in the lungs (black bar), liver (grey bar) and spleen (white bar) where measured at
12 the end of the treatment (day 18 and 25 p.i. respectively) and 2 days later (day 20 and 27 p.i. respectively). The limit of detection was 5 CFU/organ. For survival data after doxycycline treatment regimen see Table 2. Values represent an average and standarddeviations of 3 animals per time point.
13 Table 1: Comparative efficacy of different regimens of treatment by ciprofloxacin and doxycycline, initiated at different times post airway (i.n.) infection of LVS or SchuS4. Treatment Onset of treatment (hours post infection) % Survival a (n=10) LVS infection SchuS4 infection Ab Titer of surviving animals b (GMT) LVS infection None n.a. 0 0 n.a. n.a. SchuS4 infection Ciprofloxacin (7 days treatment) Doxycycline (14 days treatment) n.a. a Significance from control was determined by the Fisher exact test (p<0.05) b Different animals were used for monitoring survival and for immunological parameters. Antibody (Ab) titer limit of detection<40. Antibody titers were calculated as reciprocal geometric mean titers (GMT), with geometric standard deviations not greater than 1.8. n.a: not applicable.
14 Table 2: The effect of duration of antibiotic treatment initiated 72 hours post airway infection by SchuS4. Treatment Onset of treatment (hours post infection) Duration of treatment (days) None % Survival SchuS4 infection a (n=10) Ciprofloxacin Doxycycline a Significance from control was determined by the Fisher exact test (p<0.05), except for the 21 days treated doxycycline group.
15
16
17
Antibiotics in vitro : Which properties do we need to consider for optimizing our therapeutic choice?
Antibiotics in vitro : Which properties do we need to consider for optimizing our therapeutic choice? With the support of Wallonie-Bruxelles-International 1-1 In vitro evaluation of antibiotics : the antibiogram
More informationBRUCELLOSIS BRUCELLOSIS. CPMP/4048/01, rev. 3 1/7 EMEA 2002
BRUCELLOSIS CPMP/4048/01, rev. 3 1/7 General points on treatment Four species are pathogenic to man: B. melitenis (acquired from goats), B. suis (pigs), B. abortus (cattle) and B. canis (dogs). The bacteria
More informationAppropriate antimicrobial therapy in HAP: What does this mean?
Appropriate antimicrobial therapy in HAP: What does this mean? Jaehee Lee, M.D. Kyungpook National University Hospital, Korea KNUH since 1907 Presentation outline Empiric antimicrobial choice: right spectrum,
More informationTularemia. Information for Health Care Providers. Physicians D Nurses D Laboratory Personnel D Infection Control Practitioners
Tularemia Information for Health Care Providers Physicians D Nurses D Laboratory Personnel D Infection Control Practitioners Tularemia Caused by Francisella tularensis, a small, pleomorphic, gram-negative
More informationClinical Manifestations and Treatment of Plague Dr. Jacky Chan. Associate Consultant Infectious Disease Centre, PMH
Clinical Manifestations and Treatment of Plague Dr. Jacky Chan Associate Consultant Infectious Disease Centre, PMH Update of plague outbreak situation in Madagascar A large outbreak since 1 Aug 2017 As
More informationOpen Access. Medical Branch, 301 University Blvd. Galveston, Texas Galveston, Texas
34 The Open Microbiology Journal, 2010, 4, 34-46 Open Access Protection Afforded by Fluoroquinolones in Animal Models of Respiratory Infections with Bacillus anthracis, Yersinia pestis, and Francisella
More informationANTHRAX. INHALATION, INTESTINAL and CUTANEOUS ANTHRAX
INHALATION, INTESTINAL and CUTANEOUS ANTHRAX CPMP/4048/01, rev. 3 1/7 General points on treatment Anthrax is an acute infectious disease caused by Bacillus anthracis, that may be infecting man via cutaneous
More informationNovel treatment opportunities for acute melioidosis and other infections caused by intracellular pathogens
Novel treatment opportunities for acute melioidosis and other infections caused by intracellular pathogens Jutta Heim, PhD Senior Advisor and Director of the Board of Evolva S/A and of Nuevolution S/A
More informationThe pharmacological and microbiological basis of PK/PD : why did we need to invent PK/PD in the first place? Paul M. Tulkens
The pharmacological and microbiological basis of PK/PD : why did we need to invent PK/PD in the first place? Paul M. Tulkens Cellular and Molecular Pharmacology Unit Catholic University of Louvain, Brussels,
More informationTITLE: Antibiotics for the Treatment of Tularemia: Clinical-Effectiveness, Cost- Effectiveness, and Guidelines
TITLE: Antibiotics for the Treatment of Tularemia: Clinical-Effectiveness, Cost- Effectiveness, and Guidelines DATE: 28 July 2009 RESEARCH QUESTIONS: 1. What is the clinical-effectiveness of antibiotics
More informationMedical Countermeasure Models Volume 4: Francisella tularensis
Medical Countermeasure Models Volume 4: Francisella tularensis Contract Number HDTRA1-10-C-0025 CDRL A004 Scientific & Technical Reports April 12, 2013 Prepared For Christopher Kiley Joint Science and
More informationمادة االدوية المرحلة الثالثة م. غدير حاتم محمد
م. مادة االدوية المرحلة الثالثة م. غدير حاتم محمد 2017-2016 ANTIMICROBIAL DRUGS Antimicrobial drugs Lecture 1 Antimicrobial Drugs Chemotherapy: The use of drugs to treat a disease. Antimicrobial drugs:
More informationGentamicin and Tetracyclines for the Treatment of Human Plague: Review of 75 Cases in New Mexico,
MAJOR ARTICLE Gentamicin and Tetracyclines for the Treatment of Human Plague: Review of 75 Cases in New Mexico, 1985 1999 L. Lucy Boulanger, 1,5 Paul Ettestad, 3 John D. Fogarty, 2,5 David T. Dennis, 6
More informationWelcome to Pathogen Group 9
Welcome to Pathogen Group 9 Yersinia pestis Francisella tularensis Borrelia burgdorferi Rickettsia rickettsii Rickettsia prowazekii Acinetobacter baumannii Yersinia pestis: Plague gram negative oval bacillus,
More informationVOL. XXIII NO. II THE JOURNAL OF ANTIBIOTICS 559. ANTIBIOTIC 6640.* Ill
VOL. XXIII NO. II THE JOURNAL OF ANTIBIOTICS 559 ANTIBIOTIC 6640.* Ill BIOLOGICAL STUDIES WITH ANTIBIOTIC 6640, A NEW BROAD-SPECTRUM AMINOGLYCOSIDE ANTIBIOTIC J. Allan Waitz, Eugene L. Moss, Jr., Edwin
More informationPneumonia considerations Galia Rahav Infectious diseases unit Sheba medical center
Pneumonia considerations 2017 Galia Rahav Infectious diseases unit Sheba medical center Sir William Osler (1849 1919) "Father of modern medicine Pneumonia: The old man's friend The captain of the men of
More informationAntimicrobial Pharmacodynamics
Antimicrobial Pharmacodynamics November 28, 2007 George P. Allen, Pharm.D. Assistant Professor, Pharmacy Practice OSU College of Pharmacy at OHSU Objectives Become familiar with PD parameters what they
More informationETX2514SUL (sulbactam/etx2514) for the treatment of Acinetobacter baumannii infections
ETX2514SUL (sulbactam/etx2514) for the treatment of Acinetobacter baumannii infections Robin Isaacs Chief Medical Officer, Entasis Therapeutics Dr. Isaacs is a full-time employee of Entasis Therapeutics.
More informationResponsible use of antimicrobials in veterinary practice
Responsible use of antimicrobials in veterinary practice Correct antimicrobial: as little as possible, as much as necessary This document provides more information to accompany our responsible use of antimicrobials
More informationACUTE EXACERBATIONS of COPD (AE-COPD) : The Belgian perspective
ACUTE EXACERBATIONS of COPD (AE-COPD) : The Belgian perspective Antwerpen 8 november 2002 Yvan Valcke MD PhD AZ Maria Middelares Sint-Niklaas ACUTE EXACERBATIONS of COPD (AE-COPD) Treatment of AECB Role
More informationAntibacterial Resistance: Research Efforts. Henry F. Chambers, MD Professor of Medicine University of California San Francisco
Antibacterial Resistance: Research Efforts Henry F. Chambers, MD Professor of Medicine University of California San Francisco Resistance Resistance Dose-Response Curve Antibiotic Exposure Anti-Resistance
More informationDevelopment and Characterization of Mouse Models of Infection with Aerosolized Brucella melitensis and Brucella suis
CLINICAL AND VACCINE IMMUNOLOGY, May 2009, p. 779 783 Vol. 16, No. 5 1556-6811/09/$08.00 0 doi:10.1128/cvi.00029-09 Development and Characterization of Mouse Models of Infection with Aerosolized Brucella
More information3 TREATMENT OF PLAGUE
3 TREATMENT OF PLAGUE Dr Jack D. Poland and Dr D. T. Dennis Case management: therapy and prevention of spread When a diagnosis of human plague is suspected on clinical and epidemiological grounds, appropriate
More informationTreatment for NTM: when how.and what next? Pr Claire Andréjak Respiratory and ICU Department University hospital, Amiens, France
Treatment for NTM: when how.and what next? Pr Claire Andréjak Respiratory and ICU Department University hospital, Amiens, France First step = To diagnose NTM disease One NTM positive sample NTM disease
More informationMarc Decramer 3. Respiratory Division, University Hospitals Leuven, Leuven, Belgium
AAC Accepts, published online ahead of print on April 0 Antimicrob. Agents Chemother. doi:./aac.0001- Copyright 0, American Society for Microbiology and/or the Listed Authors/Institutions. All Rights Reserved.
More informationAnimal models and PK/PD. Examples with selected antibiotics
Animal models and PK/PD PD Examples with selected antibiotics Examples of animal models Amoxicillin Amoxicillin-clavulanate Macrolides Quinolones Andes D, Craig WA. AAC 199, :375 Amoxicillin in mouse thigh
More informationBRUCELLOSIS. Morning report 7/11/05 Andy Bomback
BRUCELLOSIS Morning report 7/11/05 Andy Bomback Also called undulant, Mediterranean, or Mata fever, brucellosis is an acute and chronic infection of the reticuloendothelial system gram negative facultative
More informationOutline. Antimicrobial resistance. Antimicrobial resistance in gram negative bacilli. % susceptibility 7/11/2010
Multi-Drug Resistant Organisms Is Combination Therapy the Way to Go? Sutthiporn Pattharachayakul, PharmD Prince of Songkhla University, Thailand Outline Prevalence of anti-microbial resistance in Acinetobacter
More informationTyphoid fever - priorities for research and development of new treatments
Typhoid fever - priorities for research and development of new treatments Isabela Ribeiro, Manica Balasegaram, Christopher Parry October 2017 Enteric infections Enteric infections vary in symptoms and
More informationAppropriate Management of Common Pediatric Infections. Blaise L. Congeni M.D. Akron Children s Hospital Division of Pediatric Infectious Diseases
Appropriate Management of Common Pediatric Infections Blaise L. Congeni M.D. Akron Children s Hospital Division of Pediatric Infectious Diseases It s all about the microorganism The common pathogens Viruses
More informationTopical Antibiotic Update. Brad Sutton, O.D., F.A.A.O. Indiana University School of Optometry Indianapolis Eye Care Center No financial disclosures
Topical Antibiotic Update Brad Sutton, O.D., F.A.A.O. Indiana University School of Optometry Indianapolis Eye Care Center No financial disclosures What do we have? We currently have many highly effective
More informationAntimicrobial Susceptibility Patterns of Salmonella Typhi From Kigali,
In the name of God Shiraz E-Medical Journal Vol. 11, No. 3, July 2010 http://semj.sums.ac.ir/vol11/jul2010/88030.htm Antimicrobial Susceptibility Patterns of Salmonella Typhi From Kigali, Rwanda. Ashok
More informationP< cells/µl mg/dl P<0.01 P<0.01
Technical Reports Judicious Use of s for Pediatric Infection Global Strategies to Prevent the Increase of Bacterial Resistance Kazunobu OUCHI Principle of antimicrobial therapy in children is to select
More informationProblems associated with potential massive use of antimicrobial agents as prophylaxis or therapy of a bioterrorist attack E. Navas
REVIEW Problems associated with potential massive use of antimicrobial agents as prophylaxis or therapy of a bioterrorist attack E. Navas Servicio de Enfermedades Infecciosas, Hospital Ramón y Cajal, Madrid,
More informationTR DISTRIBUTION STATEMENT A: Approved for public release; distribution is unlimited.
1 stig.jensen.fn@mail.mil In Vitro and In Vivo Activity of Omadacycline Against Two Biothreat Pathogens: Bacillus anthracis and Yersinia pestis Judith Steenbergen, PhD 1 ; S. Ken Tanaka, PhD 1 ; Lynda
More informationPK/PD to fight resistance
PK/PD to fight resistance Eradicate Abnormal bacteria Mutations Efflux pumps Mutation-Preventing Concentration Breakpoint values for T > MIC and in practice With the support of Wallonie-Bruxelles-International
More informationComparative studies on pulse and continuous oral norfloxacin treatment in broilers and turkeys. Géza Sárközy
Comparative studies on pulse and continuous oral norfloxacin treatment in broilers and turkeys Géza Sárközy Department of Pharmacology and Toxicology Faculty of Veterinary Science Szent István University
More informationMethicillin-Resistant Staphylococcus aureus
Methicillin-Resistant Staphylococcus aureus By Karla Givens Means of Transmission and Usual Reservoirs Staphylococcus aureus is part of normal flora and can be found on the skin and in the noses of one
More informationAntibiotic therapy of acute gastroenteritis
Antibiotic therapy of acute gastroenteritis Potential goals Clinical improvement (vs control) Fecal eradication of the pathogen and decrease infectivity Prevent complications Acute gastroenteritis viruses
More informationMedical Bacteriology- Lecture 14. Gram negative coccobacilli. Zoonosis. Brucella. Yersinia. Francesiella
Medical Bacteriology- Lecture 14 Gram negative coccobacilli Zoonosis Brucella Yersinia Francesiella 1 Zoonosis: A disease, primarily of animals, which is transmitted to humans as a result of direct or
More informationUPDATE ON ANTIMICROBIAL STEWARDSHIP REGULATIONS AND IMPLEMENTATION OF AN AMS PROGRAM
UPDATE ON ANTIMICROBIAL STEWARDSHIP REGULATIONS AND IMPLEMENTATION OF AN AMS PROGRAM Diane Rhee, Pharm.D. Associate Professor of Pharmacy Practice Roseman University of Health Sciences Chair, Valley Health
More informationTitle: N-Acetylcysteine (NAC) Mediated Modulation of Bacterial Antibiotic
AAC Accepts, published online ahead of print on June 00 Antimicrob. Agents Chemother. doi:0./aac.0070-0 Copyright 00, American Society for Microbiology and/or the Listed Authors/Institutions. All Rights
More informationIDENTIFICATION: PROCESS: Waging the War against C. difficile Radical Multidisciplinary Approaches From a Community Hospital
Waging the War against C. difficile Radical Multidisciplinary Approaches From a Community Hospital Organization Name: St. Joseph Medical Center Type: Acute Care Hospital Contact Person: Leigh Chapman RN,
More informationShould we test Clostridium difficile for antimicrobial resistance? by author
Should we test Clostridium difficile for antimicrobial resistance? Paola Mastrantonio Department of Infectious Diseases Istituto Superiore di Sanità, Rome,Italy Clostridium difficile infection (CDI) (first
More informationSee Important Reminder at the end of this policy for important regulatory and legal information.
Clinical Policy: Doxycycline Hyclate (Acticlate, Doryx), Doxycline (Oracea), Minocycline (Solodyn, Ximino) Reference Number: CP.CPA.120 Effective Date: 11.16.16 Last Review Date: 11.17 Line of Business:
More informationCOMMITTEE FOR VETERINARY MEDICINAL PRODUCTS
The European Agency for the Evaluation of Medicinal Products Veterinary Medicines and Information Technology EMEA/MRL/728/00-FINAL April 2000 COMMITTEE FOR VETERINARY MEDICINAL PRODUCTS STREPTOMYCIN AND
More informationComparison of Clindamycin, Erythromycin, and Methicillin in Streptococcal Infections in Monkeys
ANTIbMCROBIAL AGENTS AND CHEMOTHERAPY, June 197, p. 460-465 Copyright 197 American Society for Microbiology Vol. 1, No. 6 Printed in U.S.A. Comparison of Clindamycin, Erythromycin, and Methicillin in Streptococcal
More informationSummary of unmet need guidance and statistical challenges
Summary of unmet need guidance and statistical challenges Daniel B. Rubin, PhD Statistical Reviewer Division of Biometrics IV Office of Biostatistics, CDER, FDA 1 Disclaimer This presentation reflects
More informationEFFICACY OF SOME SECOND- AND THIRD-GENERATION FLUOROQUINOLONES AGAINST BRUCELLA MELITENSIS 16M IN BALB/C MICE
Bulgarian Journal of Veterinary Medicine, 2014, 17, No 1, 42 49 ISSN 1311-1477; online at http://tru.uni-sz.bg/bjvm/bjvm.htm Original article EFFICACY OF SOME SECOND- AND THIRD-GENERATION FLUOROQUINOLONES
More informationTrust Guideline for the Management of: Antibiotic Prophylaxis in adults undergoing procedures in Interventional Radiology
Antibiotic Prophylaxis in adults undergoing procedures in Interventional Radiology A Clinical Guideline For use in: By: For: Division responsible for document: Key words: Interventional Radiology Prescribers
More informationA snapshot of polymyxin use around the world South America
A snapshot of polymyxin use around the world South America Alexandre P. Zavascki Infectious Diseases Service, Hospital de Clínicas de Porto Alegre Medical School, Federal University of Rio Grande do Sul
More informationTreatment of Respiratory Tract Infections Prof. Mohammad Alhumayyd Dr. Aliah Alshanwani
Treatment of Respiratory Tract Infections Prof. Mohammad Alhumayyd Dr. Aliah Alshanwani 30-1-2018 1 Objectives of the lecture At the end of lecture, the students should be able to understand the following:
More informationPrinciples of Anti-Microbial Therapy Assistant Professor Naza M. Ali. Lec 1
Principles of Anti-Microbial Therapy Assistant Professor Naza M. Ali Lec 1 28 Oct 2018 References Lippincott s IIIustrated Reviews / Pharmacology 6 th Edition Katzung and Trevor s Pharmacology / Examination
More informationBiology and Control of Insects and Rodents Workshop Vector Borne Diseases of Public Health Importance
Vector-Borne Diseases of Public Health Importance Rudy Bueno, Jr., Ph.D. Director Components in the Disease Transmission Cycle Pathogen Agent that is responsible for disease Vector An arthropod that transmits
More informationRunning head: PLAGUE: WHAT EVERY NURSE NEEDS TO KNOW 1
Running head: PLAGUE: WHAT EVERY NURSE NEEDS TO KNOW 1 Plague: What every nurse needs to know Nathon Kelley Ferris State University PLAGUE: WHAT EVERY NURSE NEEDS TO KNOW 2 Abstract Plague is not just
More informationPharm 262: Antibiotics. 1 Pharmaceutical Microbiology II DR. C. AGYARE
Pharm 262: 1 Pharmaceutical Microbiology II Antibiotics DR. C. AGYARE Reference Books 2 HUGO, W.B., RUSSELL, A.D. Pharmaceutical Microbiology. 6 th Ed. Malden, MA: Blackwell Science, 1998. WALSH, G. Biopharmaceuticals:
More informationAntimicrobial Stewardship 101
Antimicrobial Stewardship 101 Betty P. Lee, Pharm.D. Pediatric Infectious Disease/Antimicrobial Stewardship Pharmacist Lucile Packard Children s Hospital Stanford Disclosure I have no actual or potential
More informationCOMMITTEE FOR MEDICINAL PRODUCTS FOR VETERINARY USE (CVMP) REVISED GUIDELINE ON THE SPC FOR ANTIMICROBIAL PRODUCTS
European Medicines Agency Veterinary Medicines and Inspections London, 12 November 2007 EMEA/CVMP/SAGAM/383441/2005 COMMITTEE FOR MEDICINAL PRODUCTS FOR VETERINARY USE (CVMP) REVISED GUIDELINE ON THE SPC
More informationDrug-resistant TB therapy: the future is now
Drug-resistant TB therapy: the future is now Gary Maartens Thanks to Francesca Conradie for sharing slides Division of Clinical Pharmacology UNIVERSITY OF CAPE TOWN IYUNIVESITHI YASEKAPA UNIVERSITEIT VAN
More informationInappropriate Use of Antibiotics and Clostridium difficile Infection. Jocelyn Srigley, MD, FRCPC November 1, 2012
Inappropriate Use of Antibiotics and Clostridium difficile Infection Jocelyn Srigley, MD, FRCPC November 1, 2012 Financial Disclosures } No conflicts of interest } The study was supported by a Hamilton
More informationDATA COLLECTION SECTION BY FRONTLINE TEAM. Patient Identifier/ Medical Record number (for facility use only)
Assessment of Appropriateness of ICU Antibiotics (Patient Level Sheet) **Note this is intended for internal purposes only. Please do not return to PQC.** For this assessment, inappropriate antibiotic use
More informationDETERMINING CORRECT DOSING REGIMENS OF ANTIBIOTICS BASED ON THE THEIR BACTERICIDAL ACTIVITY*
44 DETERMINING CORRECT DOSING REGIMENS OF ANTIBIOTICS BASED ON THE THEIR BACTERICIDAL ACTIVITY* AUTHOR: Cecilia C. Maramba-Lazarte, MD, MScID University of the Philippines College of Medicine-Philippine
More informationAntibacterials. Recent data on linezolid and daptomycin
Antibacterials Recent data on linezolid and daptomycin Patricia Muñoz, MD. Ph.D. (pmunoz@micro.hggm.es) Hospital General Universitario Gregorio Marañón Universidad Complutense de Madrid. 1 GESITRA Reasons
More informationPrinciples of Antimicrobial therapy
Principles of Antimicrobial therapy Laith Mohammed Abbas Al-Huseini M.B.Ch.B., M.Sc, M.Res, Ph.D Department of Pharmacology and Therapeutics Antimicrobial agents are chemical substances that can kill or
More informationRational management of community acquired infections
Rational management of community acquired infections Dr Tanu Singhal MD, MSc Consultant Pediatrics and Infectious Disease Kokilaben Dhirubhai Ambani Hospital, Mumbai Why is rational management needed?
More informationControl emergence of drug-resistant. Reduce costs
...PRESENTATIONS... Guidelines for the Management of Community-Acquired Pneumonia Richard E. Chaisson, MD Presentation Summary Guidelines for the treatment of community-acquired pneumonia (CAP) have been
More informationImpact of Spores on the Comparative Efficacies of Five Antibiotics. Pharmacodynamic Model
AAC Accepts, published online ahead of print on 12 December 2011 Antimicrob. Agents Chemother. doi:10.1128/aac.01109-10 Copyright 2011, American Society for Microbiology and/or the Listed Authors/Institutions.
More informationGuidelines for the prudent use of veterinary antimicrobial drugs -with notes for guidance-
Guidelines for the prudent use of veterinary antimicrobial drugs -with notes for guidance- Revised version (as of July 2010) Guidelines on antibiotics Supplement to the German Veterinary Journal 10/2010
More informationAntimicrobial agents. are chemicals active against microorganisms
Antimicrobial agents are chemicals active against microorganisms Antibacterial Agents Are chemicals active against bacteria Antimicrobials Antibacterial Antifungal Antiviral Antiparasitic: -anti protozoan
More informationPIPERACILLIN- TAZOBACTAM INJECTION - SUPPLY PROBLEMS
PIPERACILLIN- TAZOBACTAM INJECTION - SUPPLY PROBLEMS The current supply of piperacillin- tazobactam should be reserved f Microbiology / Infectious Diseases approval and f neutropenic sepsis, severe sepsis
More informationManagement of MDR and XDR TB Prof. Martin Boeree
Management of MDR and XDR TB 1, MD, PhD Associate Professor Consultant Respiratory Medicine Department of Lung Diseases Radboud University Nijmegen Medical Centre TB Referral Hospital Dekkerswald Nijmegen,
More informationAntibiotic Abyss. Discussion Points. MRSA Treatment Guidelines
Antibiotic Abyss Fredrick M. Abrahamian, D.O., FACEP, FIDSA Professor of Medicine UCLA School of Medicine Director of Education Department of Emergency Medicine Olive View-UCLA Medical Center Sylmar, California
More informationOverview of C. difficile infections. Kurt B. Stevenson, MD MPH Professor Division of Infectious Diseases
Overview of C. difficile infections Kurt B. Stevenson, MD MPH Professor Division of Infectious Diseases Conflicts of Interest I have no financial conflicts of interest related to this topic and presentation.
More informationEvaluating the Role of MRSA Nasal Swabs
Evaluating the Role of MRSA Nasal Swabs Josh Arnold, PharmD PGY1 Pharmacy Resident Pharmacy Grand Rounds February 28, 2017 2016 MFMER slide-1 Objectives Identify the pathophysiology of MRSA nasal colonization
More informationRandall Singer, DVM, MPVM, PhD
ANTIBIOTIC RESISTANCE Randall Singer, DVM, MPVM, PhD Associate Professor of Epidemiology Department of Veterinary and Biomedical Sciences University of Minnesota Overview How does resistance develop? What
More informationPharmaceutical Care and the Pediatric/Neonatal Patient
Pharmaceutical Care and the Pediatric/Neonatal Patient Medication administration to pediatric and neonatal patients can have substantial differences from medicating adults. Pediatric patients should not
More informationAAC Accepts, published online ahead of print on 13 October 2008 Antimicrob. Agents Chemother. doi: /aac
AAC Accepts, published online ahead of print on 13 October 2008 Antimicrob. Agents Chemother. doi:10.1128/aac.01023-08 Copyright 2008, American Society for Microbiology and/or the Listed Authors/Institutions.
More informationAntibiotic Updates: Part II
Antibiotic Updates: Part II Fredrick M. Abrahamian, DO, FACEP, FIDSA Health Sciences Clinical Professor of Emergency Medicine David Geffen School of Medicine at UCLA Los Angeles, California Financial Disclosures
More informationDisclosures. Principles of Antimicrobial Therapy. Obtaining an Accurate Diagnosis Obtain specimens PRIOR to initiating antimicrobials
Disclosures Principles of Antimicrobial Therapy None Lori A. Cox MSN, ACNP-BC, ACNPC, FCCM Penn State Hershey Medical Center Neuroscience Critical Care Unit Obtaining an Accurate Diagnosis Determine site
More informationFungal Disease. What is a fungus?
Fungal Disease What is a fungus? A fungus is a living organism. It goes through a complicated life cycle and is able to spread in the environment by producing large numbers of spores that are easily dispersed
More informationPrinciples of Antimicrobial Therapy
Principles of Antimicrobial Therapy Doo Ryeon Chung, MD, PhD Professor of Medicine, Division of Infectious Diseases Director, Infection Control Office SUNGKYUNKWAN UNIVERSITY SCHOOL OF MEDICINE CASE 1
More informationAntimicrobial Cycling. Donald E Low University of Toronto
Antimicrobial Cycling Donald E Low University of Toronto Bad Bugs, No Drugs 1 The Antimicrobial Availability Task Force of the IDSA 1 identified as particularly problematic pathogens A. baumannii and
More informationETX0282, a Novel Oral Agent Against Multidrug-Resistant Enterobacteriaceae
ETX0282, a Novel Oral Agent Against Multidrug-Resistant Enterobacteriaceae Thomas Durand-Réville 02 June 2017 - ASM Microbe 2017 (Session #113) Disclosures Thomas Durand-Réville: Full-time Employee; Self;
More informationBaytril 100 (enrofloxacin) Injectable is FDA-approved for BRD control (metaphylaxis) in high-risk cattle.
Baytril 100 (enrofloxacin) Injectable is FDA-approved for BRD control (metaphylaxis) in high-risk cattle. Whether controlling or treating BRD, it s important to kill bacteria to let the calf s immune system
More informationAntimicrobial Selection to Combat Resistance
Antimicrobial Selection to Combat Resistance (Dead Bugs Don t Mutate!) Shelley C Rankin PhD Associate Professor CE Microbiology Head of Diagnostic Services & Chief of Clinical Microbiology Ryan Veterinary
More informationFederal Expert Select Agent Panel (FESAP) Deliberations
Federal Expert Select Agent Panel (FESAP) Deliberations FESAP and Biennial Review Established in 2010 and tasked with policy issues relevant to the security of biological select agents and toxins Per recommendations
More informationThe CARI Guidelines Caring for Australians with Renal Impairment. 10. Treatment of peritoneal dialysis associated fungal peritonitis
10. Treatment of peritoneal dialysis associated fungal peritonitis Date written: February 2003 Final submission: July 2004 Guidelines (Include recommendations based on level I or II evidence) The use of
More informationBiological Threat Fact Sheets
Biological Threat Fact Sheets Anthrax Agent: Bacillus anthracis There are three clinical forms of B. anthracis which are determined by route of entry: Pulmonary or Inhalation BT implications Cutaneous
More informationDetection and Quantitation of the Etiologic Agents of Ventilator Associated Pneumonia in Endotracheal Tube Aspirates From Patients in Iran
Letter to the Editor Detection and Quantitation of the Etiologic Agents of Ventilator Associated Pneumonia in Endotracheal Tube Aspirates From Patients in Iran Mohammad Rahbar, PhD; Massoud Hajia, PhD
More informationThe Effect of Perioperative Use of Prophylactic Antibiotics on Surgical Wound Infection
THE IRAQI POSTGRADUATE MEDICAL JOURNAL PROPHYLACTIC ANTIBIOTICS ON SURGICAL WOUND INFECTION The Effect of Perioperative Use of Prophylactic Antibiotics on Surgical Wound Infection Ahmed Hamid Jasim*, Nabeel
More informationProphylactic antibiotic timing and dosage. Dr. Sanjeev Singh AIMS, Kochi
Prophylactic antibiotic timing and dosage Dr. Sanjeev Singh AIMS, Kochi Meaning - Webster Medical Definition of prophylaxis plural pro phy lax es \-ˈlak-ˌsēz\play : measures designed to preserve health
More informationTHE COST OF COMPANIONSHIP
THE COST OF COMPANIONSHIP Jared Gillingham and Robert Burlage Concordia University School of Pharmacy Mequon, WI Synopsis: Infectious diseases are always a concern, but when you are a person in an at-risk
More informationCOMMITTEE FOR VETERINARY MEDICINAL PRODUCTS
The European Agency for the Evaluation of Medicinal Products Veterinary Medicines and Inspections EMEA/CVMP/627/01-FINAL COMMITTEE FOR VETERINARY MEDICINAL PRODUCTS GUIDELINE FOR THE DEMONSTRATION OF EFFICACY
More informationPrinciples of Animal Health
Unit 15: Principles of Animal Health Unit code: F/503/1686 QCF level: 5 Credit value: 15 Aim This unit aims to develop learners understanding of animal health. Learners will have the opportunity to investigate
More informationPinni Meedha Mojutho Ammanu Dengina Koduku Part 1 Kama Kathalu
Search for: Search Search Does levaquin cover anaerobes Pinni Meedha Mojutho Ammanu Dengina Koduku Part 1 Kama Kathalu Levofloxacin, sold under the trade names Levaquin among others, is an antibiotic.
More informationCOMMITTEE FOR MEDICINAL PRODUCTS FOR VETERINARY USE
European Medicines Agency Veterinary Medicines and Inspections EMEA/CVMP/211249/2005-FINAL July 2005 COMMITTEE FOR MEDICINAL PRODUCTS FOR VETERINARY USE DIHYDROSTREPTOMYCIN (Extrapolation to all ruminants)
More informationOther β-lactamase Inhibitor (BLI) Combinations: Focus on VNRX-5133, WCK 5222 and ETX2514SUL
Other β-lactamase Inhibitor (BLI) Combinations: Focus on VNRX-5133, WCK 5222 and ETX2514SUL David P. Nicolau, PharmD, FCCP, FIDSA Director, Center for Anti-Infective Research and Development Hartford Hospital
More informationSelective toxicity. Antimicrobial Drugs. Alexander Fleming 10/17/2016
Selective toxicity Antimicrobial Drugs Chapter 20 BIO 220 Drugs must work inside the host and harm the infective pathogens, but not the host Antibiotics are compounds produced by fungi or bacteria that
More informationMono- versus Bitherapy for Management of HAP/VAP in the ICU
Mono- versus Bitherapy for Management of HAP/VAP in the ICU Jean Chastre, www.reamedpitie.com Conflicts of interest: Consulting or Lecture fees: Nektar-Bayer, Pfizer, Brahms, Sanofi- Aventis, Janssen-Cilag,
More informationHUSK, LUNGWORMS AND CATTLE
Vet Times The website for the veterinary profession https://www.vettimes.co.uk HUSK, LUNGWORMS AND CATTLE Author : Alastair Hayton Categories : Vets Date : July 20, 2009 Alastair Hayton discusses how best
More information