Pharmacotherapy for pneumococcal infections: an update.

Dec 2012

Esposito S, Principi N.

Source

Pediatric Clinic 1, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico , Via Commenda 9, 20122 Milano , Italy +39 02 55032498 ; +39 02 50320206 ; susanna.esposito@unimi.it.

Abstract

Introduction: 

The management of pneumococcal diseases still places a significant burden on medical and economic resources. The subjects at greatest risk of pneumococcal infections are children. Areas covered: The aim of this review is to analyse the best current therapeutic approach to pneumococcal resistance, taking into account the level of susceptibility of Streptococcus pneumoniae, and the pharmacokinetics and pharmacodynamics of different antibiotics in the various pneumococcal diseases. Expert opinion: Antibiotic treatment of a number of pneumococcal diseases remains difficult or impossible due to the presence of strains resistant to commonly used antibiotics. In children the problem is significantly more important than in adults due to the reduced number of licenced drugs for subjects in the first years of life. The new conjugate pneumococcal vaccines containing 10 (PCV10) and 13 serotypes (PCV13), which include most of the recently emerging strains, might reduce the incidence of pneumococcal infections and the circulation of resistant pathogens. However, it is likely that optimal results will only be reached after the development of effective vaccines based on conserved proteins that are capable of preventing all pneumococcal infections, regardless of the serotype of the causative organism.

PubMed

Treatment of Mycoplasma contamination in cell cultures with plasmocin.

2012

Uphoff CC, Denkmann SA, Drexler HG.

Source

Department of Human and Animal Cell Lines, Leibniz Institute DSMZ-German Collection of Microorganisms and Cell Cultures, 38124 Braunschweig, Germany.

Abstract

A high percentage of cell lines are chronically infected with various mycoplasma species. The addition of antibiotics that are particularly effective against these contaminants to the culture medium during a limited period of time is a simple, inexpensive, and very practical approach for decontaminating cell cultures. Here, we examined the effectiveness of the new antimycoplasma compound Plasmocin that has been employed routinely to cleanse chronically infected cell lines. In a first round of treatment 45 out of 58 (78%) mycoplasma-positive cell lines could be cured. In a second attempt using back-up cryopreserved original cells, four additional cell lines were cured; thus, the overall cure rate was 84%. Even if the mycoplasma contamination was not eradicated by Plasmocin, the parallel treatment with several other antibiotics (Baytril, BM-Cyclin, Ciprobay, MRA, or MycoZap) led to the cure of all 58 cell lines. The successful decontamination was permanent as mycoplasmas were no longer detected at day +14 posttreatment and at later time points as examined by PCR which is the most sensitive and specific mycoplasma detection method. Collectively, our results highlight certain antibiotics as effective antimycoplasma reagents and support the therapeutic rationale for their use in the eradication of this notorious cell culture contaminant.

PubMed

Appendicitis could be treated with antibiotics rather than surgery 

Friday Sept 28, 2012

Eight out of ten cases of appendicitis could be treated with antibiotics rather than surgery, a trial suggests.

A study found that although the standard approach to appendicitis is to remove the appendix, treatment with antibiotics can be just as effective.

Jeanette Hansson, of the University of Gothenburg, examined two clinical studies of adult patients with acute appendicitis.

She compared those who had received treatment with just antibiotics to those who had surgery with antibiotic therapy.

Ms Hansson says in her thesis, carried out at Sahlgrenska University Hospital and Kungälv Hospital, that treatment with antibiotics was just as effective as surgery for the majority of patients.

She said: "Some patients are so ill that the operation is absolutely necessary, but 80 percent of those who can be treated with antibiotics recover and return to full health," says Jeanette Hansson.

The thesis also showed that patients who are treated with antibiotics are at risk of fewer complications than those who undergo surgery.

The risk of reoccurence within 12 months of antibiotic treatment is between ten and 15 per cent, but Ms Hansson said the medicine is still a viable alternative to surgery.

She said: "It's important to note that our studies show that patients who need surgery because of recurrences, or because the antibiotics haven't worked, are not at risk of any additional complications relative to those operated on in the first place."

The Telegraph

New treatments for bacterial keratitis.

2012

Wong RL, Gangwani RA, Yu LW, Lai JS.

Source

Eye Institute, The University of Hong Kong, Room 301, Level 3, Block B, 100 Cyberport Road, Cyberport 4, Hong Kong.

Abstract

Purpose. 

To review the newer treatments for bacterial keratitis. 

Data Sources. 

PubMed literature search up to April 2012. Study Selection. Key words used for literature search: "infectious keratitis", "microbial keratitis", "infective keratitis", "new treatments for infectious keratitis", "fourth generation fluoroquinolones", "moxifloxacin", "gatifloxacin", "collagen cross-linking", and "photodynamic therapy". 

Data Extraction. 

Over 2400 articles were retrieved. Large scale studies or publications at more recent dates were selected. 

Data Synthesis. 

Broad spectrum antibiotics have been the main stay of treatment for bacterial keratitis but with the emergence of bacterial resistance; there is a need for newer antimicrobial agents and treatment methods. Fourth-generation fluoroquinolones and corneal collagen cross-linking are amongst the new treatments. In vitro studies and prospective clinical trials have shown that fourth-generation fluoroquinolones are better than the older generation fluoroquinolones and are as potent as combined fortified antibiotics against common pathogens that cause bacterial keratitis. Collagen cross-linking was shown to improve healing of infectious corneal ulcer in treatment-resistant cases or as an adjunct to antibiotics treatment. 

Conclusion. 

Fourth-generation fluoroquinolones are good alternatives to standard treatment of bacterial keratitis using combined fortified topical antibiotics. Collagen cross-linking may be considered in treatment-resistant infectious keratitis or as an adjunct to antibiotics therapy.

PubMed

15th Annual State of GA Lymphedema Education Program

Winship Cancer Institute of Emory University

and The Lighthouse Lymphedema Network

Cordially invite you to the

15th State of Georgia Lymphedema Education & Awareness Conference

Saturday, October 27, 2012

Emory University Hospital Midtown, 550 Peachtree Street, Atlanta, GA 30308

7:30am-4:30pm

Speakers include: Jane Armer, PhD, Richard Mistretta, DPM,

Joseph Feldman, MD, and David W. Chang, MD

The Conference Brochure may be viewed by clicking here:

http://lighthouselymphedema.org/announcements/15th-annual-state-of-georgia-lymph\
edema-education-and-awareness-program

You may register online by clicking here:

http://lighthouselymphedema.org/get-involved/secureregistration.htm

INFO PAGE:

http://lighthouselymphedema.org/announcements/15th-annual-state-of-georgia-lymph\
edema-education-and-awareness-program

Pediatric musculoskeletal infection: trends and antibiotic recommendations.

Pediatric musculoskeletal infection: trends and antibiotic

recommendations

J Am Acad Orthop Surg. 2009 Oct

Copley LA.

Dr. Copley is Assistant Professor of Orthopaedic Surgery, University of Texas Southwestern, Dallas, TX.

Neither Dr. Copley nor a member of his immediate family has received anything of value from or owns stock in a commercial company or institution directly or indirectly related to the subject of this article.

In the past decade, the incidence of methicillin-resistant Staphylococcus aureus infections in children has increased. This phenomenon has led to a rise in complex, deep infections involving the musculoskeletal system for which a comprehensive approach of evaluation and treatment has become necessary. Whenever possible, cultures should be obtained to guide specific antibiotic selection. The potential for infections involving multiple tissue locations within the same patient and the risk for complications such as deep vein thrombosis necessitate a thorough, often multidisciplinary, approach in the care of these children. MRI is valuable in defining the anatomic and spatial extent of infection as well as in guiding the decision and approach for surgery. Most patients have favorable outcomes with sequential parenteral to oral antibiotic therapy after adequate surgical débridement of the infection. Close outpatient follow-up is essential to ensure antibiotic compliance and to identify late consequences of the infection.

American Academy of Orthopaedic Surgeons