Wednesday, February 29, 2012
Sunday, February 26, 2012
Reasons for inappropriate prescribing of in a high-complexity pediatric hospital
Promising antibiotic alternative to fight bacteria that causes strep throat
Researchers have discovered a promising alternative to common antibiotics used to fight the bacteria that causes strep throat. In an article published in the Proceedings of the National Academy of Sciences, the scientists discussed how their discovery could fight the infection with a reduced risk of antibiotic resistance.
By screening tens of thousands of small molecules, the team from the University of Missouri and University of Michigan identified a class of chemical compounds that significantly reduced the severity of group AStreptococcus (GAS) bacteria infection in mice. Their work suggests that the compounds might have therapeutic value in the treatment of strep and similar infections that affect an estimated 700 million people around the world each year. The newly identified compounds could work with conventional antibiotics, such as commonly prescribed penicillin, and result in more effective treatment.
"We know that 70 percent of bacteria causing infections in the hospital are resistant to at least one of the drugs commonly used for treatment," said Hongmin Sun, PhD, the article's first author and an assistant professor of internal medicine at the University of Missouri. "Rather than killing off the bacteria, this new compound changes the behavior of the bacteria and makes it less harmful."
Current antibiotics interfere with critical biological processes in the pathogen to kill it or stop its growth. But at the same time, stronger strains of harmful bacteria can sometimes resist the treatment and flourish.
"The widespread occurrence of antibiotic resistance among human pathogens is a major public health problem," said David Ginsburg, MD, a professor of internal medicine, human genetics, and pediatrics at the University of Michigan and a Howard Hughes Medical Institute investigator.
Chilean Avocado Could Combat Antibiotic-Resistant Bacteria, Study Suggests
Groups urge incentives for antibiotic research
The Infectious Diseases Society of America and a coalition of groups representing patients, providers and others are advocating for the inclusion of economic incentives for antibiotic research and development in the reauthorization of the Prescription Drug User Fee Act.
The organizations said in a news release that they are contacting members of Congress about the need for economic incentives for the research and development of antibiotics, as well as diagnostic tests.
“The simple fact is we haven't found the right combination of incentives to convince pharmaceutical companies to invest in developing the new antibiotics we desperately need, and PDUFA reauthorization is an opportunity to do so,” said Jeff Levi, executive director of the Trust for America's Health, an advocacy organization, in the news release. “Rich or poor, all of us are dependent on the development of effective new antibiotics.”
Some of the groups that signed the Feb. 22 letter (PDF) include the IDSA, the American College of Emergency Physicians, the Children's Hospital Association, the National Foundation for Infectious Diseases and Premier.
The organizations wrote that “a combination of push and pull incentives is needed to sufficiently raise the net present value of antibiotics so that they may compete on a level playing field with other drug categories for companies' R&
Read more: Groups urge incentives for antibiotic research - Healthcare business news and research | Modern
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Friday, February 24, 2012
Antibiotics Don't Help Most Sinus Infections
By: Formulary staff
Zinc used in addition to antibiotics significantly reduced mortality in children ages 6 months to 59 months with severe pneumonia when compared with antibiotics alone, according to the findings of a recent study done in Uganda.
The study, published online February 8 in BMC Medicine, also indicated that the adjunct therapy had a greater effect among HIV-infected children than those who were not infected with HIV.
The double-blind, randomized, placebo-controlled study was led by Maheswari G. Srinivasan, from the Department of Pediatrics and Child Health at the School of Medicine, in Uganda. Researchers enrolled 352 children, aged 6 months to 59 months, who were admitted to the Mulago Hospital pediatric emergency ward with severe pneumonia between September 2006 and March 2007.
"There are 2 key findings in this study: overall, zinc supplementation in these children significantly decreased case fatality, but did not reduce the time to normalization of the parameters for disease severity," the authors stated, noting that these findings come from the secondary objective rather than the primary objectives, which were to assess the effect of zinc as an adjunct therapy on time to normalization of respiratory rate, temperature, and oxygen saturation.
The investigators randomly assigned the children to receive standard antibiotic therapy plus zinc (10 mg for children aged under 12 months; 20 mg for children 12 months and older) or standard antibiotic therapy plus placebo daily. The children were assessed every 6 hours for the first 48 hours and then every 12 hours for 7 days of treatment.
The investigators found no evidence that zinc decreased length of time to recovery. They did, however, note the number of deaths was lower among the children who were treated with zinc (4.0% vs 11.9%; RR=0.33; 95% CI, 0.15-0.76).
In addition, the researchers noted that the effect of zinc supplementation appeared stronger among children infected with HIV. There were more deaths among HIV-positive children assigned to placebo compared with those who received zinc (25.9% vs 0%; RR=0.1; 95% CI, 0.0-1.0).
Among those children who were not infected with HIV and who received placebo, the death rate was 5.5% versus 3.9% among HIV-uninfected children who received zinc (RR=0.7; 95% CI, 0.2-2.2).
“Acute respiratory tract infections are the most common cause of morbidity and deaths in children less than 5 years,” the authors wrote in their background. “Given these results,” the authors stated, “zinc could be considered for use as adjunct therapy for severe pneumonia, especially among Highly Active Antiretroviral Therapy-naïve, HIV-infected children in our environment.”