DOCSLIB.ORG

T Serotypes and Antimicrobial Susceptibilities of Group A

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
T Serotypes and Antimicrobial Susceptibilities of Group A Jpn. J. Infect. Dis., 61, 454-456, 2008 Original Article T Serotypes and Antimicrobial Susceptibilities of Group A Streptococcus Isolates from Pediatric Pharyngotonsillitis Keiji Funahashi*, Kazumasa Nakane, Naoko Yasuda, Michio Suzuki1, Atushi Narita1, Naoko Arai1, Jaekun Ahn1, Norio Koyama1, Hajime Ushida1, Naoko Nishimura1 and Takao Ozaki1 Department of Clinical Laboratory and 1Department of Pediatrics, Konan Kosei Hospital, Aichi 483-8704, Japan (Received April 1, 2008. Accepted August 25, 2008) SUMMARY: Group A streptococcus (GAS) is a major cause of pediatric pharyngotonsillitis. In this study we determined the T serotype and antimicrobial susceptibility of GAS isolates from Japanese children. From January to December 2006, a total of 438 isolates of GAS were obtained from pharyngeal swabs of 438 children with pharyngotonsillitis. The commonest T serotype was type 1 (110 strains, 25.1%), followed by type 12 (107, 24.4%) and type 4 (77, 17.6%). All GAS isolated from pharyngeal swabs were susceptible to β-lactams (benzylpenicillin, amoxicillin, cefotaxime, ceftriaxone, imipenem, panipenem, and cefditoren) and vancomycin, but 19.6, 19.6, 3.2, 11.6, and 27.6% were resistant to erythromycin, clarithromycin, clindamycin, minocycline, and norfloxacin, respectively. Resistance varied considerably with the T serotype. In particular, type 4 isolates had the highest resistance (67.5, 67.5, 26.0, and 53.2% were resistant to erythromycin, clarithromycin, minocycline, and norfloxacin, respectively). bated on Trypticase Soy Agar II plates with 5% sheep blood INTRODUCTION (Nippon Becton Dickinson Co., Ltd., Tokyo, Japan) for 24 Group A streptococcus (GAS) is a major causative agent h. Colonies with diameters between 1 and 2 mm showing of pharyngotonsillitis and impetigo, which can be transmitted β hemolysis on culture media were identified, and pure from human to human. Droplet transmission in a communal cultures were then performed on the same culture media. living setting such as schools and nursery centers or within a Lancefield serogrouping (4) was performed using Streptex family is the major route of GAS transmission (1). Further- (Remel Inc., Lenexa, Kans., USA) to identify GAS. more, GAS is known to occasionally cause group infections. T serotyping: T serotyping was performed using GAS T- Since the late 1970s, the incidences of acute glomerulone- typing antisera (Denka Seiken Co., Ltd., Tokyo, Japan). phritis and rheumatic fever, which are important complica- Antimicrobial susceptibility testing: The minimal inhibi- tions of GAS pharyngotonsillitis, have decreased markedly. tory concentrations (MICs) of 14 antimicrobial agents, i.e., However, in the late 1980s, cases of streptococcal toxic shock benzylpenicillin (PCG), amoxicillin (AMPC), cefotaxime syndrome (STSS), a septic condition associated with fatal (CTX), ceftriaxone (CTRX), cefditoren (CDTR), cefcapene multiple organ failure, were reported in several places, draw- (CFPN), panipenem (PAPM), imipenem (IPM), erythromy- ing renewed attention to GAS infections (2,3). cin (EM), clarithromycin (CAM), clindamycin (CLDM), To understand the current status of GAS, we investigated minocycline (MINO), norfloxacin (NFLX), and vancomycin T serotypes and antimicrobial susceptibilities of GAS iso- (VCM), were measured by the broth microdilution method. lates obtained from pediatric patients with pharyngotonsilli- Isolates were determined to be susceptible (S), intermediate tis. (I), or resistant (R) with respect to each agent according to the criteria of the Clinical and Laboratory Standards Insti- tute (CLSI) (5). Because there were no CLSI streptococcal MATERIALS AND METHODS breakpoints for MINO or NFLX, we substituted those of Sample collection: Our study targets were 438 GAS strains tetracycline and levofloxacin, respectively. Isolates classified isolated from pharyngeal swabs obtained from 438 patients into category I or R were analyzed as resistant strains. with pharyngotonsillitis (mean age, 6.0 years; range, 6 months to 15.8 years) who visited the pediatric department of Konan RESULTS Kosei Hospital from January to December 2006. The strains re-isolated within 3 months after the first isolation from a T serotypes: Among 438 strains examined, the T serotype single patient were excluded from the analysis, since they most frequently isolated was type 1 (110 strains, 25.1%), fol- would likely be identical to strains already collected. lowed by type 12 (107 strains, 24.4%) and type 4 (77 strains, Isolation and identification of GAS: Pharyngeal swabs 17.6%). These three epidemic forms accounted for 67.1% of obtained from patients with pharyngotonsillitis were incu- the total isolates. Antimicrobial susceptibility: The MICs of PCG, AMPC, *Corresponding author: Mailing address: Department of Clinical CTX, CTRX, CDTR, CFPN, PAPM, and IPM for all strains Laboratory, Konan Kosei Hospital, 137 Ohmatsubara, Takaya- were ≤0.12 μg/mL. All strains were susceptible to β-lactams. cho, Konan-shi, Aichi 483-8704, Japan. Tel: +81-587-51-3333, In addition, all strains showed high susceptibilities to CDTR, Fax: +81-587-51-3300, E-mail: [email protected]. CFPN, PAPM, and IPM. On the other hand, 86 (19.6%), 86 or.jp (19.6%), 14 (3.2%), 51 (11.6%), and 121 (27.6%) strains 454 Table 1. Cross resistance rates for 5 antimicrobials Cross resistance rates Antimicrobial Resistant strains Resistant strains Resistant strains Resistant strains Resistant strains to EM (n = 86) to CAM (n = 86) to CLDM (n = 14) to MINO (n = 51) to NFLX (n = 121) EM – 100% (86/86) 100% (14/14) 27.5% (14/51) 27.3% (33/121) CAM 100% (86/86) – 100% (14/14) 27.5% (14/51) 27.3% (33/121) CLDM 16.3% (14/86) 16.3% (14/86) – 21.6% (11/51) 0% (0/121) MINO 16.3% (14/86) 16.3% (14/86) 78.6% (11/14) – 19.0% (23/121) NFLX 38.4% (33/86) 38.4% (33/86) 0% (0/14) 49.0% (25/51) – EM, erythromycin; CAM, clarithromycin; CLDM, clindamycin; MINO, minocycline, NFLX, norfloxacin. Table 2. Major T serotypes and antimicrobial resistance rates T serotype Antimicrobial 1 (n = 110) 4 (n = 77) 12 (n = 107) EM 3.6% (4/110) 67.5% (52/77) 19.6% (21/107) CAM 3.6% (4/110) 67.5% (52/77) 19.6% (21/107) MINO 3.6% (4/110) 26.0% (20/77) 10.3% (11/107) CLDM 0.9% (1/110) 0% (0/77) 11.2% (12/107) NFLX 22.7% (25/110) 53.2% (41/77) 6.5% (7/107) Abbreviations are in Table 1. Table 3. Resistance rates of GAS isolates obtained from pediatric patients with pharyngotonsillitis at Konan Kosei Hospital between 1996 and 2006 Years that the surveys were conducted Antimicrobial 1996* (n = 431) 2001* (n = 317) 2003* (n = 295) 2006 (n = 438) EM 8.6% (37/431) 13.6% (43/317) 20.0% (59/295) 19.6% (86/438) CAM 13.2% (42/317) 19.7% (58/295) 19.6% (86/438) CLDM 1.6% (5/317) 5.4% (16/295) 3.2% (14/438) MINO 13.2% (57/431) 6.0% (19/317) 10.5% (31/295) 11.6% (51/438) *: Data in 1996 from reference (6), 2001 from reference (7), and 2003 from reference (8). Abbreviations are in Table 1. were resistant to EM, CAM, CLDM, MINO, and NFLX, face of GAS. In a serotype survey, the typing of M-protein respectively. Cross resistance was seen among the five anti- (which is a virulence factor) is important, but in Japan, anti- microbials, except for between CLDM and NFLX (Table 1). sera for M typing are not commercially available. On the other The strains resistant to EM were the same as the strains resist- hand, T typing is widely used as a survey tool, although T- ant to CAM, and the 14 strains resistant to CLDM were all protein is not a virulence factor, because it can be performed resistant to both EM and CAM. with commercially available antisera, correlates with M typ- T serotypes and resistance rates to antimicrobial agents: ing to some extent, is not affected by subculture, and is rela- Table 2 shows the three major T serotypes and their resist- tively easy to perform (11,12). T1, T4, and T12 account for ance rates to antimicrobial agents. Antimicrobial suscepti- the majority of the T serotypes of GAS isolates in Japan (11). bilities varied depending on the T serotype. In particular, type Our present results showed the isolation of T1, T12, and T4 4 serotype tends to be highly resistant, with 67.5, 67.5, 26.0, in decreasing order of frequency, and approximately agreed and 53.2% showing resistance to EM, CAM, MINO, and with the results of the nationwide survey. NFLX, respectively. Penicillins and macrolides are recommended for the treat- Changes in resistance rates to antimicrobial agents: We ment of GAS pharyngotonsillitis (1,13). However, macrolide- previously conducted three surveys of the same type as the resistant GAS strains have increased worldwide (14), and one present survey (6-8), allowing us to make comparisons of possible cause of such resistance is a mutation at position resistance rates over time. The number of strains showing 2058 of 23S rRNA. In the present study, there were no strains resistance to EM and CAM have gradually increased since with resistance to penicillin, cephem, and carbapenem anti- 1996, and these two currently account for approximately 20% bacterials, or to VCM, but the rates of resistance to EM and of total strains. Resistance rates to CLDM and MINO changed CAM or NFLX were as high as 20 and 28%, respectively. within ranges of 1.6-5.4% and 6.0-13.2%, respectively (Table The resistance of serotype T4 to EM, CAM, MINO, and 3). NFLX was high. We have previously performed similar surveys three times (in 1996, 2001, and 2003) (6-8). The iso- lation rate of type 12 was high in all of the surveys, including DISCUSSION the present one, but the isolation rates of other types have Pediatric pharyngotonsillitis is one of the diseases that we varied between surveys.
Load more

Recommended publications
  • Redalyc.Patterns of Antimicrobial Therapy in Acute Tonsillitis: a Cross
    Anais da Academia Brasileira de Ciências ISSN: 0001-3765 [email protected] Academia Brasileira de Ciências Brasil JOHN, LISHA J.; CHERIAN, MEENU; SREEDHARAN, JAYADEVAN; CHERIAN, TAMBI Patterns of Antimicrobial therapy in acute tonsillitis: A cross-sectional Hospital-based study from UAE Anais da Academia Brasileira de Ciências, vol. 86, núm. 1, enero-marzo, 2014, pp. 451-457 Academia Brasileira de Ciências Rio de Janeiro, Brasil Available in: http://www.redalyc.org/articulo.oa?id=32730090032 How to cite Complete issue Scientific Information System More information about this article Network of Scientific Journals from Latin America, the Caribbean, Spain and Portugal Journal's homepage in redalyc.org Non-profit academic project, developed under the open access initiative Anais da Academia Brasileira de Ciências (2014) 86(1): 451-457 (Annals of the Brazilian Academy of Sciences) Printed version ISSN 0001-3765 / Online version ISSN 1678-2690 http://dx.doi.org/10.1590/0001-3765201420120036 www.scielo.br/aabc Patterns of Antimicrobial therapy in acute tonsillitis: A cross-sectional Hospital-based study from UAE LISHA J. JOHN1, MEENU CHERIAN2, JAYADEVAN SREEDHARAN3 and TAMBI CHERIAN2 1Department of Pharmacology, Gulf Medical University, 4184, Ajman, United Arab Emirates 2Department of ENT, Gulf Medical College Hospital, 4184, Ajman, United Arab Emirates 3Statistical Support Facility, Centre for Advanced Biomedical Research and Innovation, Gulf Medical University, 4184, Ajman, United Arab Emirates Manuscript received on December 20, 2012; accepted for publication on October 14, 2013 ABSTRACT Background: Diseases of the ear, nose and throat (ENT) are associated with significant impairment of the daily life and a major cause for absenteeism from work.
    [Show full text]
  • AMR Surveillance in Pharma: a Case-Study for Data Sharingauthor by Professor Barry Cookson
    AMR Open Data Initiative AMR Surveillance in Pharma: a case-study for data sharingauthor by Professor Barry Cookson External Consultant to Project eLibrary • Division of Infection and Immunity, Univ. College London ESCMID• Dept. of Microbiology, © St Thomas’ Hospital Background of “90 day Project” Addressed some recommendations of the first Wellcome funded multi-disciplinary workshop (included Pharma Academia & Public Health invitees: 27thauthor July 2017 (post the Davos Declaration): by 1) Review the landscape of existing Pharma AMR programmes, their protocols,eLibrary data standards and sets 2) Develop a "portal" (register/platform) to access currently available AMR Surveillance data ESCMID Important ©to emphasise that this is a COLLABORATION between Pharma and others Overview of Questionnaire Content • General information - including name,author years active, countries, antimicrobials, microorganisms.by • Methodology - including accreditation, methodology for; surveillance, isolate collection, organism identification, breakpointseLibrary used, • Dataset - including data storage methodology, management and how accessed. ESCMID © 13 Company Responses author 7 by 3 3 eLibrary ESCMID © Structure of register Companies can have different ways of referring to their activities: We had to choose a consistent framework. author Companies Companyby 1 Programmes Programme A Programme B eLibrary Antimicrobials 1 2 3 4 5 company’s product comparator company’s product antimicrobials Programmes canESCMID contain multiple studies (e.g. Pfizer has© single
    [Show full text]
  • Consideration of Antibacterial Medicines As Part Of
    Consideration of antibacterial medicines as part of the revisions to 2019 WHO Model List of Essential Medicines for adults (EML) and Model List of Essential Medicines for children (EMLc) Section 6.2 Antibacterials including Access, Watch and Reserve Lists of antibiotics This summary has been prepared by the Health Technologies and Pharmaceuticals (HTP) programme at the WHO Regional Office for Europe. It is intended to communicate changes to the 2019 WHO Model List of Essential Medicines for adults (EML) and Model List of Essential Medicines for children (EMLc) to national counterparts involved in the evidence-based selection of medicines for inclusion in national essential medicines lists (NEMLs), lists of medicines for inclusion in reimbursement programs, and medicine formularies for use in primary, secondary and tertiary care. This document does not replace the full report of the WHO Expert Committee on Selection and Use of Essential Medicines (see The selection and use of essential medicines: report of the WHO Expert Committee on Selection and Use of Essential Medicines, 2019 (including the 21st WHO Model List of Essential Medicines and the 7th WHO Model List of Essential Medicines for Children). Geneva: World Health Organization; 2019 (WHO Technical Report Series, No. 1021). Licence: CC BY-NC-SA 3.0 IGO: https://apps.who.int/iris/bitstream/handle/10665/330668/9789241210300-eng.pdf?ua=1) and Corrigenda (March 2020) – TRS1021 (https://www.who.int/medicines/publications/essentialmedicines/TRS1021_corrigenda_March2020. pdf?ua=1). Executive summary of the report: https://apps.who.int/iris/bitstream/handle/10665/325773/WHO- MVP-EMP-IAU-2019.05-eng.pdf?ua=1.
    [Show full text]
  • WO 2010/025328 Al
    (12) INTERNATIONAL APPLICATION PUBLISHED UNDER THE PATENT COOPERATION TREATY (PCT) (19) World Intellectual Property Organization International Bureau (10) International Publication Number (43) International Publication Date 4 March 2010 (04.03.2010) WO 2010/025328 Al (51) International Patent Classification: (81) Designated States (unless otherwise indicated, for every A61K 31/00 (2006.01) kind of national protection available): AE, AG, AL, AM, AO, AT, AU, AZ, BA, BB, BG, BH, BR, BW, BY, BZ, (21) International Application Number: CA, CH, CL, CN, CO, CR, CU, CZ, DE, DK, DM, DO, PCT/US2009/055306 DZ, EC, EE, EG, ES, FI, GB, GD, GE, GH, GM, GT, (22) International Filing Date: HN, HR, HU, ID, IL, IN, IS, JP, KE, KG, KM, KN, KP, 28 August 2009 (28.08.2009) KR, KZ, LA, LC, LK, LR, LS, LT, LU, LY, MA, MD, ME, MG, MK, MN, MW, MX, MY, MZ, NA, NG, NI, (25) Filing Language: English NO, NZ, OM, PE, PG, PH, PL, PT, RO, RS, RU, SC, SD, (26) Publication Language: English SE, SG, SK, SL, SM, ST, SV, SY, TJ, TM, TN, TR, TT, TZ, UA, UG, US, UZ, VC, VN, ZA, ZM, ZW. (30) Priority Data: 61/092,497 28 August 2008 (28.08.2008) US (84) Designated States (unless otherwise indicated, for every kind of regional protection available): ARIPO (BW, GH, (71) Applicant (for all designated States except US): FOR¬ GM, KE, LS, MW, MZ, NA, SD, SL, SZ, TZ, UG, ZM, EST LABORATORIES HOLDINGS LIMITED [IE/ ZW), Eurasian (AM, AZ, BY, KG, KZ, MD, RU, TJ, —]; 18 Parliament Street, Milner House, Hamilton, TM), European (AT, BE, BG, CH, CY, CZ, DE, DK, EE, Bermuda HM12 (BM).
    [Show full text]
  • Computational Antibiotics Book
    Andrew V DeLong, Jared C Harris, Brittany S Larcart, Chandler B Massey, Chelsie D Northcutt, Somuayiro N Nwokike, Oscar A Otieno, Harsh M Patel, Mehulkumar P Patel, Pratik Pravin Patel, Eugene I Rowell, Brandon M Rush, Marc-Edwin G Saint-Louis, Amy M Vardeman, Felicia N Woods, Giso Abadi, Thomas J. Manning Computational Antibiotics Valdosta State University is located in South Georgia. Computational Antibiotics Index • Computational Details and Website Access (p. 8) • Acknowledgements (p. 9) • Dedications (p. 11) • Antibiotic Historical Introduction (p. 13) Introduction to Antibiotic groups • Penicillin’s (p. 21) • Carbapenems (p. 22) • Oxazolidines (p. 23) • Rifamycin (p. 24) • Lincosamides (p. 25) • Quinolones (p. 26) • Polypeptides antibiotics (p. 27) • Glycopeptide Antibiotics (p. 28) • Sulfonamides (p. 29) • Lipoglycopeptides (p. 30) • First Generation Cephalosporins (p. 31) • Cephalosporin Third Generation (p. 32) • Fourth-Generation Cephalosporins (p. 33) • Fifth Generation Cephalosporin’s (p. 34) • Tetracycline antibiotics (p. 35) Computational Antibiotics Antibiotics Covered (in alphabetical order) Amikacin (p. 36) Cefempidone (p. 98) Ceftizoxime (p. 159) Amoxicillin (p. 38) Cefepime (p. 100) Ceftobiprole (p. 161) Ampicillin (p. 40) Cefetamet (p. 102) Ceftoxide (p. 163) Arsphenamine (p. 42) Cefetrizole (p. 104) Ceftriaxone (p. 165) Azithromycin (p.44) Cefivitril (p. 106) Cefuracetime (p. 167) Aziocillin (p. 46) Cefixime (p. 108) Cefuroxime (p. 169) Aztreonam (p.48) Cefmatilen ( p. 110) Cefuzonam (p. 171) Bacampicillin (p. 50) Cefmetazole (p. 112) Cefalexin (p. 173) Bacitracin (p. 52) Cefodizime (p. 114) Chloramphenicol (p.175) Balofloxacin (p. 54) Cefonicid (p. 116) Cilastatin (p. 177) Carbenicillin (p. 56) Cefoperazone (p. 118) Ciprofloxacin (p. 179) Cefacetrile (p. 58) Cefoselis (p. 120) Clarithromycin (p. 181) Cefaclor (p.
    [Show full text]
  • Different Antibiotic Treatments for Group a Streptococcal Pharyngitis (Review)
    Different antibiotic treatments for group A streptococcal pharyngitis (Review) van Driel ML, De Sutter AIM, Keber N, Habraken H, Christiaens T This is a reprint of a Cochrane review, prepared and maintained by The Cochrane Collaboration and published in The Cochrane Library 2010, Issue 10 http://www.thecochranelibrary.com Different antibiotic treatments for group A streptococcal pharyngitis (Review) Copyright © 2011 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. TABLE OF CONTENTS HEADER....................................... 1 ABSTRACT ...................................... 1 PLAINLANGUAGESUMMARY . 2 BACKGROUND .................................... 2 OBJECTIVES ..................................... 3 METHODS ...................................... 3 RESULTS....................................... 5 DISCUSSION ..................................... 8 AUTHORS’CONCLUSIONS . 11 ACKNOWLEDGEMENTS . 11 REFERENCES ..................................... 12 CHARACTERISTICSOFSTUDIES . 16 DATAANDANALYSES. 43 Analysis 1.1. Comparison 1 Cephalosporin versus penicillin, Outcome 1 Resolution of symptoms post-treatment (ITT analysis). ................................... 45 Analysis 1.2. Comparison 1 Cephalosporin versus penicillin, Outcome 2 Resolution of symptoms post-treatment (evaluable participants)................................... 46 Analysis 1.3. Comparison 1 Cephalosporin versus penicillin, Outcome 3 Resolution of symptoms within 24 hours of treatment(ITTanalysis).. 47 Analysis 1.4. Comparison 1 Cephalosporin versus penicillin, Outcome
    [Show full text]
  • Antibiotics Therapy for Acute Bacterial Tonsillitis
    Pract Otol(Kyoto) 96:11;983～987, 2003 983 Antibiotics Therapy for Acute Bacterial Tonsillitis Shinya Takano and Hideki Kurihara Tokyo Women's Medical University Daini Hospital We reviewed the treatment of 96 patients with acute bacterial tonsillitis. Using multivariate analysis, we examined whether oral or intravenous administration of antibiotics (cephems, penicillin, other ƒÀ-lactams, tetracycline, clindamycin, new quinolones, and macrorides) had an influence on the treatment period. We found that the best class of oral antibiotics for acute bacterial tonsillitis was cefcapene pivoxil (CFPN-PI) and the best intravenous agent was sulbactum/cefoperazone (SBT/CPZ). Key words:retrospective study, acute bacterial tonsillitis, antibiotics, oral administration, intravenous injection Introduction tis such as infectious mononucleosis were excluded by Acute bacterial tonsillitis is one form of upper respira- blood tests. tory tract infection, in which bacteria invade the palatine We selected the administration of antibiotics at ran- tonsil and cause fever, sore throat, pus, and pain on swal- dom. lowing. The day when symptoms resolved and the WBC and In Europe and The United States, the drug of first CRP were normalized was defined as a "the day of cure" choice for acute bacterial tonsillitis is penicillin. How- and the treatment period defined as the interval between ever, there have been no reports on the first line treat- the first examination and this day. Using multivariate ment for acute tonsillitis in Japan, and only new analysis, we examined whether oral administration antibiotics have been examined for effectiveness against (levofloxacin (LVFX), clarithromycin (CAM), minocy- acute tonsillitis. cline (MIND), cefcapene pivoxil (CFPN-PI), ampicillin Penicillin is contraindicated in patients with infectious (ABPC), faropenem (FRPM), and no medication) or mononucleosis because it causes an exacerbation of their intravenous administration (cefepirome (CPR), clinda- rash1).
    [Show full text]
  • A Thesis Entitled an Oral Dosage Form of Ceftriaxone Sodium Using Enteric
    A Thesis entitled An oral dosage form of ceftriaxone sodium using enteric coated sustained release calcium alginate beads by Darshan Lalwani Submitted to the Graduate Faculty as partial fulfillment of the requirements for the Master of Science Degree in Pharmaceutical Sciences with Industrial Pharmacy Option _________________________________________ Jerry Nesamony, Ph.D., Committee Chair _________________________________________ Sai Hanuman Sagar Boddu, Ph.D, Committee Member _________________________________________ Youssef Sari, Ph.D., Committee Member _________________________________________ Patricia R. Komuniecki, PhD, Dean College of Graduate Studies The University of Toledo May 2015 Copyright 2015, Darshan Narendra Lalwani This document is copyrighted material. Under copyright law, no parts of this document may be reproduced without the expressed permission of the author. An Abstract of An oral dosage form of ceftriaxone sodium using enteric coated sustained release calcium alginate beads by Darshan Lalwani Submitted to the Graduate Faculty as partial fulfillment of the requirements for the Master of Science Degree in Pharmaceutical Sciences with Industrial Pharmacy option The University of Toledo May 2015 Purpose: Ceftriaxone (CTZ) is a broad spectrum semisynthetic, third generation cephalosporin antibiotic. It is an acid labile drug belonging to class III of biopharmaceutical classification system (BCS). It can be solvated quickly but suffers from the drawback of poor oral bioavailability owing to its limited permeability through
    [Show full text]
  • BMJ Open Is Committed to Open Peer Review. As Part of This Commitment We Make the Peer Review History of Every Article We Publish Publicly Available
    BMJ Open is committed to open peer review. As part of this commitment we make the peer review history of every article we publish publicly available. When an article is published we post the peer reviewers’ comments and the authors’ responses online. We also post the versions of the paper that were used during peer review. These are the versions that the peer review comments apply to. The versions of the paper that follow are the versions that were submitted during the peer review process. They are not the versions of record or the final published versions. They should not be cited or distributed as the published version of this manuscript. BMJ Open is an open access journal and the full, final, typeset and author-corrected version of record of the manuscript is available on our site with no access controls, subscription charges or pay-per-view fees (http://bmjopen.bmj.com). If you have any questions on BMJ Open’s open peer review process please email [email protected] BMJ Open Pediatric drug utilization in the Western Pacific region: Australia, Japan, South Korea, Hong Kong and Taiwan Journal: BMJ Open ManuscriptFor ID peerbmjopen-2019-032426 review only Article Type: Research Date Submitted by the 27-Jun-2019 Author: Complete List of Authors: Brauer, Ruth; University College London, Research Department of Practice and Policy, School of Pharmacy Wong, Ian; University College London, Research Department of Practice and Policy, School of Pharmacy; University of Hong Kong, Centre for Safe Medication Practice and Research, Department
    [Show full text]
  • Revision of Precautions
    Published by Translated by Ministry of Health, Labour and Welfare Pharmaceuticals and Medical Devices Agency This English version is intended to be a reference material to provide convenience for users. In the event of inconsistency between the Japanese original and this English translation, the former shall prevail. Revision of Precautions Cefmenoxime hydrochloride (preparations for otic and nasal use), chloramphenicol (solution for topical use, oral dosage form), tetracycline hydrochloride (powders, capsules), polymixin B sulfate (powders), clindamycin hydrochloride, clindamycin phosphate (injections), benzylpenicillin potassium, benzylpenicillin benzathine hydrate, lincomycin hydrochloride hydrate, aztreonam, amoxicillin hydrate, ampicillin hydrate, ampicillin sodium, potassium clavulanate/amoxicillin hydrate, dibekacin sulfate (injections), sultamicillin tosilate hydrate, cefaclor, cefazolin sodium, cefazolin sodium hydrate, cephalexin (oral dosage form with indications for otitis media), cefalotin sodium, cefixime hydrate, cefepime dihydrochloride hydrate, cefozopran hydrochloride, cefotiam hydrochloride (intravenous injections), cefcapene pivoxil hydrochloride hydrate, cefditoren pivoxil, cefdinir, ceftazidime hydrate, cefteram pivoxil, ceftriaxone sodium hydrate, cefpodoxime proxetil, cefroxadine hydrate, cefuroxime axetil, tebipenem pivoxil, doripenem hydrate, bacampicillin hydrochloride, panipenem/betamipron, faropenem sodium hydrate, flomoxef sodium, fosfomycin calcium hydrate, meropenem hydrate, chloramphenicol sodium succinate,
    [Show full text]
  • European Surveillance of Healthcare-Associated Infections in Intensive Care Units
    TECHNICAL DOCUMENT European surveillance of healthcare-associated infections in intensive care units HAI-Net ICU protocol Protocol version 1.02 www.ecdc.europa.eu ECDC TECHNICAL DOCUMENT European surveillance of healthcare- associated infections in intensive care units HAI-Net ICU protocol, version 1.02 This technical document of the European Centre for Disease Prevention and Control (ECDC) was coordinated by Carl Suetens. In accordance with the Staff Regulations for Officials and Conditions of Employment of Other Servants of the European Union and the ECDC Independence Policy, ECDC staff members shall not, in the performance of their duties, deal with a matter in which, directly or indirectly, they have any personal interest such as to impair their independence. This is version 1.02 of the HAI-Net ICU protocol. Differences between versions 1.01 (December 2010) and 1.02 are purely editorial. Suggested citation: European Centre for Disease Prevention and Control. European surveillance of healthcare- associated infections in intensive care units – HAI-Net ICU protocol, version 1.02. Stockholm: ECDC; 2015. Stockholm, March 2015 ISBN 978-92-9193-627-4 doi 10.2900/371526 Catalogue number TQ-04-15-186-EN-N © European Centre for Disease Prevention and Control, 2015 Reproduction is authorised, provided the source is acknowledged. TECHNICAL DOCUMENT HAI-Net ICU protocol, version 1.02 Table of contents Abbreviations ...............................................................................................................................................
    [Show full text]
  • Update on the Management of Antibiotic Allergy Bernard Yu-Hor Thong*
    Review Allergy Asthma Immunol Res. 2010 April;2(2):77-86. doi: 10.4168/aair.2010.2.2.77 pISSN 2092-7355 • eISSN 2092-7363 Update on the Management of Antibiotic Allergy Bernard Yu-Hor Thong* Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Drug allergy to antibiotics may occur in the form of immediate or non-immediate (delayed) hypersensitivity reactions. Immediate reactions are usual- ly IgE-mediated whereas non-immediate hypersensitivity reactions are usually non-IgE or T-cell mediated. The clinical manifestations of antibiotic allergy may be cutaneous, organ-specific (e.g., blood dyscracias, hepatitis, interstitial nephritis), systemic (e.g., anaphylaxis, drug induced hypersen- sitivity syndrome) or various combinations of these. Severe cutaneous adverse reactions manifesting as Stevens Johnson syndrome or toxic epider- mal necrolysis (TEN) may be potentially life-threatening. The management of antibiotic allergy begins with the identification of the putative antibiot- ic from a detailed and accurate drug history, complemented by validated in-vivo and in-vitro allergological tests. This will facilitate avoidance of the putative antibiotic through patient education, use of drug alert cards, and electronic medical records with in-built drug allergy/adverse drug reaction prescription and dispensing checks. Knowledge of the evidence for specific antibiotic cross-reactivities is also important in patient education. Apart from withdrawal of the putative antibiotic, immunomodulatory agents like high-dose intravenous immunoglobulins may have a role in TEN.
    [Show full text]