Guidelines on Urologic Infections
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Antibiotic Susceptibility of Bacterial Strains Causing Asymptomatic Bacteriuria in Pregnancy: a Cross- Sectional Study in Harare, Zimbabwe
MOJ Immunology Antibiotic Susceptibility of Bacterial Strains causing Asymptomatic Bacteriuria in Pregnancy: A Cross- Sectional Study in Harare, Zimbabwe Abstract Research Article Background and objective antibiotic susceptibility pattern: Effective among treatmentisolated bacterial of asymptomatic species among bacteriuria pregnant in Volume 6 Issue 1 - 2018 pregnancy requires susceptible drugs. The aim of this study was to determine womenMaterials with and asymptomatic Methods bacteriuria. : This study was conducted at 4 selected primary health 1Department of Nursing Science, University of Zimbabwe, care facilities in Harare, including pregnant women registering for antenatal Zimbabwe care at gestation between 6 and 22 weeks and without urinary tract infection 2Department of Medical Microbiology, University of Zimbabwe, symptoms. Asymptomatic bacteriuria was diagnosed by culture test of all Zimbabwe 3 midstream urine samples following screening by Griess nitrate test. Susceptibility Department of Obstetrics and Gynaecology, University of Zimbabwe, Zimbabwe test was done for all positive 24 hour old culture using the disk diffusion test. The resistant and intermediate. 4Institute of Clinical Medicine, University of Oslo, Norway minimum inhibitory concentration was measured and categorized as susceptible, Results *Corresponding author: : Tested antibiotics included gentamycin (88.2%), ceftriaxone (70.6%), Department of Nursing Science,Judith Mazoe Musona Street, Rukweza, PO Box nitrofurantoin (76.5%), ciprofloxacin (82.4%), ampicillin (67.6%) and norfloxacin University of Zimbabwe, College of Health Sciences, (61.8%). Prevalence of asymptomatic bacteriuria was 14.2% (95% CI, 10.28% to 19.22%). Coagulase negative staphylococcus was the most popular (29.4%) A198, Harare, Zimbabwe, Tel: 00263773917910; Email: bacteria followed by Escherichia coli (23.5%). Gentamycin (83.3%), ciprofloxacin Received: | Published: (75%) and ceftriaxone (70.8) overally had the highest sensitivity. -
Medical Review(S) Clinical Review
CENTER FOR DRUG EVALUATION AND RESEARCH APPLICATION NUMBER: 200327 MEDICAL REVIEW(S) CLINICAL REVIEW Application Type NDA Application Number(s) 200327 Priority or Standard Standard Submit Date(s) December 29, 2009 Received Date(s) December 30, 2009 PDUFA Goal Date October 30, 2010 Division / Office Division of Anti-Infective and Ophthalmology Products Office of Antimicrobial Products Reviewer Name(s) Ariel Ramirez Porcalla, MD, MPH Neil Rellosa, MD Review Completion October 29, 2010 Date Established Name Ceftaroline fosamil for injection (Proposed) Trade Name Teflaro Therapeutic Class Cephalosporin; ß-lactams Applicant Cerexa, Inc. Forest Laboratories, Inc. Formulation(s) 400 mg/vial and 600 mg/vial Intravenous Dosing Regimen 600 mg every 12 hours by IV infusion Indication(s) Acute Bacterial Skin and Skin Structure Infection (ABSSSI); Community-acquired Bacterial Pneumonia (CABP) Intended Population(s) Adults ≥ 18 years of age Template Version: March 6, 2009 Reference ID: 2857265 Clinical Review Ariel Ramirez Porcalla, MD, MPH Neil Rellosa, MD NDA 200327: Teflaro (ceftaroline fosamil) Table of Contents 1 RECOMMENDATIONS/RISK BENEFIT ASSESSMENT ......................................... 9 1.1 Recommendation on Regulatory Action ........................................................... 10 1.2 Risk Benefit Assessment.................................................................................. 10 1.3 Recommendations for Postmarketing Risk Evaluation and Mitigation Strategies ........................................................................................................................ -
“Ceftriaxone– Sulbactam–EDTA” and Various Antibiotics Against Gram
ORIGINAL ARTICLE A Comparative In Vitro Sensitivity Study of “Ceftriaxone– Sulbactam–EDTA” and Various Antibiotics against Gram- negative Bacterial Isolates from Intensive Care Unit Sweta Singh1, Chinmoy Sahu2, Sangram Singh Patel3, Abhay Singh4, Nidhi Yaduvanshi5 ABSTRACT Introduction: A rapid increase in multidrug-resistant (MDR) strains is being seen across the globe especially in the Southeast Asian region, including India. Carbapenems and colistin form the mainstay of treatment against gram-negative pathogens, especially extended-spectrum beta-lactamase (ESBL)- and metallo-beta-lactamse (MBL)-producing isolates. However, due to increased resistance to carbapenems and toxicity of colistin, especially in intensive care units (ICUs), carbapenem-sparing antibiotics like ceftriaxone–sulbactam–EDTA (CSE) combination needs to be evaluated. Materials and methods: Bacterial isolates cultured from various clinical samples from all ICUs for a period of 9 months were evaluated. Bacterial identification was performed by matrix assisted laser desorption ionization time of flight mass spectrometry (MALDI-TOF MS) and antibiotic susceptibility testing were performed by disk diffusion and E test method. Antibiogram of various antibiotics was noted. Extended-spectrum beta-lactamase- and MBL-producing bacteria were identified by phenotypic methods. Antibiotic sensitivity results of CSE were compared with the comparator drugs like colistin, carbapenems, and tigecycline in Enterobacteriaceae, Acinetobacter spp., and Pseudomonas spp. along with ESBL and MBL producers. Results: A total of 2,760 samples of blood, cerebrospinal fluid (CSF), respiratory samples, tissue, and pus were collected from ICUs with maximum isolates from pus (37%) followed by respiratory samples (31%) and blood (27%). Escherichia coli and Klebsiella pneumoniae were the predominant gram-negative pathogens accounting for 56% of the isolates followed by Acinetobacter spp. -
Cefalexin in the WHO Essential Medicines List for Children Reject
Reviewer No. 1: checklist for application of: Cefalexin In the WHO Essential Medicines List for Children (1) Have all important studies that you are aware of been included? Yes No 9 (2) Is there adequate evidence of efficacy for the proposed use? Yes 9 No (3) Is there evidence of efficacy in diverse settings and/or populations? Yes 9 No (4) Are there adverse effects of concern? Yes 9 No (5) Are there special requirements or training needed for safe/effective use? Yes No 9 (6) Is this product needed to meet the majority health needs of the population? Yes No 9 (7) Is the proposed dosage form registered by a stringent regulatory authority? Yes 9 No (8) What action do you propose for the Committee to take? Reject the application for inclusion of the following presentations of cefalexin: • Tablets/ capsules 250mg • Oral suspensions 125mg/5ml and 125mg/ml (9) Additional comment, if any. In order to identify any additional literature, the following broad and sensitive search was conducted using the PubMed Clinical Query application: (cephalexin OR cefalexin AND - 1 - pediatr*) AND ((clinical[Title/Abstract] AND trial[Title/Abstract]) OR clinical trials[MeSH Terms] OR clinical trial[Publication Type] OR random*[Title/Abstract] OR random allocation[MeSH Terms] OR therapeutic use[MeSH Subheading]) Only one small additional study was identified, which looked at the provision of prophylactic antibiotics in patients presenting to an urban children's hospital with trauma to the distal fingertip, requiring repair.1 In a prospective randomised control trial, 146 patients were enrolled, of which 69 were randomised to the no-antibiotic group, and 66 were randomised to the antibiotic (cefalexin) group. -
Suprapubic Puncture in the Treatment of Neurogenic Bladder
SUPRAPUBIC PUNCTURE IN THE TREATMENT OF NEUROGENIC BLADDER CHARLES C. HIGGINS, M.D. W. JAMES GARDNER, M.D. WM. A. NOSIK, M.D. The treatment of "cord bladder", a disturbance of bladder function from disease or trauma of the spinal cord, can be a difficult problem. Until the recent publications of Munro, there was little physiological basis for whatever treatment was instituted. With the advent of tidal drainage and recognition of the various types or stages of a given cord bladder, more satisfactory results have been obtained. In his excellent work on the cystometry of the bladder Munro1,2 classifies "cord bladders" into four groups: 1. Atonic — characterized by retention and extreme distention from lack of detrusor tone, lack of any activity of the external urethral sphincter, and complete lack of emptying contractions. 2. Autonomous — the detrusor and internal sphincter musculature show signs of reciprocal action of varying degree. There is an increase in detrusor muscle tone, and an inability to store an appreciable amount of urine without leakage. The condition of this bladder represents the end result in destructive lesions of the sacral segments or cauda equina. 3. Hypertonic — an expression of an uncontrolled spinal segmental reflex, characterized by a markedly increased detrusor muscle tone, almost constantly present emptying contractions, low residual urine, and impairment of control of the external sphincter. 4. Normal cord bladders — in transecting lesions above the sacral segments, consisting of two types which differ largely only in their cystometric findings: (a) Uninhibited cord bladder — an apparently normal bladder which empties itself quite regularly. The detrusor tone is still somewhat increased, emptying contractions are rhythmical, the residual is low, and the capacity is rather low. -
Investigation of Urine 2015
UK Standards for Microbiology Investigations Investigation of Urine 2015 OCTOBER 5 - SEPTEMBER 7 BETWEEN ON CONSULTED WAS DOCUMENT THIS - DRAFT Issued by the Standards Unit, Microbiology Services, PHE Bacteriology | B 41 | Issue no: dl+ | Issue date: dd.mm.yy <tab+enter> | Page: 1 of 46 © Crown copyright 2015 Investigation of Urine Acknowledgments UK Standards for Microbiology Investigations (SMIs) are developed under the auspices of Public Health England (PHE) working in partnership with the National Health Service (NHS), Public Health Wales and with the professional organisations whose logos are displayed below and listed on the website https://www.gov.uk/uk- standards-for-microbiology-investigations-smi-quality-and-consistency-in-clinical- laboratories. SMIs are developed, reviewed and revised by various working groups which are overseen by a steering committee (see https://www.gov.uk/government/groups/standards-for-microbiology-investigations- steering-committee). 2015 The contributions of many individuals in clinical, specialist and reference laboratories who have provided information and comments during the development of this document are acknowledged. We are grateful to the Medical Editors for editingOCTOBER the 5 medical content. - For further information please contact us at: Standards Unit Microbiology Services Public Health England SEPTEMBER 61 Colindale Avenue 7 London NW9 5EQ E-mail: [email protected] Website: https://www.gov.uk/uk-standards-forBETWEEN-microbiology -investigations-smi-quality- and-consistency-in-clinical-laboratories -
GERONTOLOGICAL NURSE PRACTITIONER Review and Resource M Anual
13 Male Reproductive System Disorders Vaunette Fay, PhD, RN, FNP-BC, GNP-BC GERIATRIC APPRoACH Normal Changes of Aging Male Reproductive System • Decreased testosterone level leads to increased estrogen-to-androgen ratio • Testicular atrophy • Decreased sperm motility; fertility reduced but extant • Increased incidence of gynecomastia Sexual function • Slowed arousal—increased time to achieve erection • Erection less firm, shorter lasting • Delayed ejaculation and decreased forcefulness at ejaculation • Longer interval to achieving subsequent erection Prostate • By fourth decade of life, stromal fibrous elements and glandular tissue hypertrophy, stimulated by dihydrotestosterone (DHT, the active androgen within the prostate); hyperplastic nodules enlarge in size, ultimately leading to urethral obstruction 398 GERONTOLOGICAL NURSE PRACTITIONER Review and Resource M anual Clinical Implications History • Many men are overly sensitive about complaints of the male genitourinary system; men are often not inclined to initiate discussion, seek help; important to take active role in screening with an approach that is open, trustworthy, and nonjudgmental • Sexual function remains important to many men, even at ages over 80 • Lack of an available partner, poor health, erectile dysfunction, medication adverse effects, and lack of desire are the main reasons men do not continue to have sex • Acute and chronic alcohol use can lead to impotence in men • Nocturia is reported in 66% of patients over 65 – Due to impaired ability to concentrate urine, reduced -
Simultaneous Determination of Amoxicillin and Clavulanic Acid in Pharmaceutical Preparations by Capillary Zone Electrophoresis
Brazilian Journal of Pharmaceutical Sciences vol. 52, n. 2, apr./jun., 2016 Article http://dx.doi.org/10.1590/S1984-82502016000200006 Simultaneous determination of amoxicillin and clavulanic acid in pharmaceutical preparations by capillary zone electrophoresis Gabriel Hancu1,*, Anamaria Neacşu1, Lajos Attila Papp1, Adriana Ciurba2 1Department of Pharmaceutical Chemistry, Faculty of Pharmacy, University of Medicine and Pharmacy, TîrguMureş, Romania, 2Department of PharmaceuticalTechnology, Faculty of Pharmacy, University of Medicine and Pharmacy, Tîrgu Mureş, Romania Clavulanic acid enhances the antibacterial spectrum of amoxicillin by rendering most β-lactamase producing isolates susceptible to the drug. A fast, simple and efficient capillary electrophoresis method was developed for the simultaneous determination of amoxicillin and clavulanic acid from complex mixtures. Using a 25 mM sodium tetraborate as background electrolyte at a pH of 9.30, + 25 kV applied voltage, 25 °C system temperature, UV determination at 230 nm; we succeeded in simultaneous separation of amoxicillin and clavulanic acid in approximately 2 minutes. The analytical performance of the method was evaluated in terms of reproducibility, precision, accuracy, and linearity. The optimized analytical method was applied for the determination of the two analytes from combined commercial pharmaceutical preparations. This CE method is fast, inexpensive, efficient, and environmentally friendly when compared with the more frequently used high performance liquid chromatography methods described in the literature. Uniterms: Amoxicillin/determination. Clavulanic acid/determination. Capillary electrophoresis/ quantitative analysis. Antibacterials/quantitative analysis. O ácido clavulânico acentua o espectro antibacteriano de amoxicilina, tornando a maioria dos isolados produtores de β-lactamase sensíveis ao fármaco. Desenvolveu-se um método rápido, simples e eficiente de electroforese capilar (EC) para a determinação simultânea de amoxicilina e de ácido clavulânico a partir de misturas complexas. -
Management of Male Lower Urinary Tract Symptoms (LUTS), Incl
Guidelines on the Management of Male Lower Urinary Tract Symptoms (LUTS), incl. Benign Prostatic Obstruction (BPO) M. Oelke (chair), A. Bachmann, A. Descazeaud, M. Emberton, S. Gravas, M.C. Michel, J. N’Dow, J. Nordling, J.J. de la Rosette © European Association of Urology 2013 TABLE OF CONTENTS PAGE 1. INTRODUCTION 6 1.1 References 7 2. ASSESSMENT 8 3. CONSERVATIVE TREATMENT 9 3.1 Watchful waiting - behavioural treatment 9 3.2 Patient selection 9 3.3 Education, reassurance, and periodic monitoring 9 3.4 Lifestyle advice 10 3.5 Practical considerations 10 3.6 Recommendations 10 3.7 References 10 4. DRUG TREATMENT 11 4.1 a1-adrenoceptor antagonists (a1-blockers) 11 4.1.1 Mechanism of action 11 4.1.2 Available drugs 11 4.1.3 Efficacy 12 4.1.4 Tolerability and safety 13 4.1.5 Practical considerations 14 4.1.6 Recommendation 14 4.1.7 References 14 4.2 5a-reductase inhibitors 15 4.2.1 Mechanism of action 15 4.2.2 Available drugs 16 4.2.3 Efficacy 16 4.2.4 Tolerability and safety 17 4.2.5 Practical considerations 17 4.2.6 Recommendations 18 4.2.7 References 18 4.3 Muscarinic receptor antagonists 19 4.3.1 Mechanism of action 19 4.3.2 Available drugs 20 4.3.3 Efficacy 20 4.3.4 Tolerability and safety 21 4.3.5 Practical considerations 22 4.3.6 Recommendations 22 4.3.7 References 22 4.4 Plant extracts - Phytotherapy 23 4.4.1 Mechanism of action 23 4.4.2 Available drugs 23 4.4.3 Efficacy 24 4.4.4 Tolerability and safety 26 4.4.5 Practical considerations 26 4.4.6 Recommendations 26 4.4.7 References 26 4.5 Vasopressin analogue - desmopressin 27 4.5.1 -
The Activity of Mecillinam Vs Enterobacteriaceae Resistant to 3Rd Generation Cephalosporins in Bristol, UK
The activity of mecillinam vs Enterobacteriaceae resistant to 3rd generation cephalosporins in Bristol, UK Welsh Antimicrobial Study Group Grŵp Astudio Wrthfiotegau Cymru G Weston1, KE Bowker1, A Noel1, AP MacGowan1, M Wootton2, TR Walsh2, RA Howe2 (1) BCARE, North Bristol NHS Trust, Bristol BS10 5NB (2) Welsh Antimicrobial Study Group, NPHS Wales, University Hospital of Wales, CF14 4XW Introduction Results Results Results Figure 1: Population Distributions of Mecillinam MICs for E. Figure 2: Population Distributions of MICs for ESBL- Resistance in coliforms to 3rd generation 127 isolates were identified by screening of which 123 were confirmed as resistant to CTX or coli (n=72), NON-E. coli Enterobacteriaceae (n=47) and multi- producing E. coli (n=67) against mecillinam or mecillinam + cephalosporins (3GC) is an increasing problem resistant strains (n=39) clavulanate CAZ by BSAC criteria. The majority of 3GC- both in hospitals and the community. Oral options MR Non-E. coli E. coli Mecalone Mec+Clav resistant strains were E. coli 60.2%, followed by for the treatment of these organisms is often 35 50 Enterobacter spp. 16.2%, Klebsiella spp. 12.2%, limited due to resistance to multiple antimicrobial 45 and others (Citrobacter spp., Morganella spp., 30 classes. Mecillinam, an amidinopenicillin that is 40 Pantoea spp., Serratia spp.) 11.4%. 25 available in Europe as the oral pro-drug 35 All isolates were susceptible to meropenem with s 20 30 e s pivmecillinam, is stable to many beta-lactamases. t e a t l a mecillinam the next most active agent with more l o 25 o s We aimed to establish the activity of mecillinam i s i 15 % than 95% of isolates susceptible (table). -
Medicines to Treat Bacterial Infections
Government of Western Australia North Metropolitan Health Service Women and Newborn Health Service Medicines to treat bacterial infections This brochure contains some information on Important: Antibiotic resistance can the medicines you may have been prescribed affect us all. to treat a bacterial infection either in hospital or on discharge. Please talk to your doctor or Help limit the development of antibiotic pharmacist if you would like more information resistance by using antibiotics correctly. on a specific antibiotic. Make sure you: Take antibiotics exactly as prescribed. What is an antibiotic? • Antibiotics are medicines used to treat • Follow instructions on how many times a infections caused by bacteria. They are not day and for how long to take them. effective against viral infections such as the • Do not stop treatment early, even if you common cold and the ‘flu’. feel better. Medicine Other information Amoxicillin May be taken with or without food. Amoxicillin/ Take with the first bite of a meal. clavulanic acid Cefalexin May be taken with or without food. Take on an empty stomach with a glass of water, 1 hour before or 2 hours after food. Ciprofloxacin Do not take dairy products, antacids, iron, zinc or calcium within 2 hours of the dose. Clindamycin Take with a full glass of water. May be taken with or without food. Take with food or milk. Remain upright for an hour after dose to prevent damage to the Doxycycline lining of your throat. Do not take dairy products, antacids, iron, zinc or calcium within 2 hours of the dose. Take on an empty stomach, 1 hour before or 2 hours after food. -
)&F1y3x PHARMACEUTICAL APPENDIX to THE
)&f1y3X PHARMACEUTICAL APPENDIX TO THE HARMONIZED TARIFF SCHEDULE )&f1y3X PHARMACEUTICAL APPENDIX TO THE TARIFF SCHEDULE 3 Table 1. This table enumerates products described by International Non-proprietary Names (INN) which shall be entered free of duty under general note 13 to the tariff schedule. The Chemical Abstracts Service (CAS) registry numbers also set forth in this table are included to assist in the identification of the products concerned. For purposes of the tariff schedule, any references to a product enumerated in this table includes such product by whatever name known. Product CAS No. Product CAS No. ABAMECTIN 65195-55-3 ACTODIGIN 36983-69-4 ABANOQUIL 90402-40-7 ADAFENOXATE 82168-26-1 ABCIXIMAB 143653-53-6 ADAMEXINE 54785-02-3 ABECARNIL 111841-85-1 ADAPALENE 106685-40-9 ABITESARTAN 137882-98-5 ADAPROLOL 101479-70-3 ABLUKAST 96566-25-5 ADATANSERIN 127266-56-2 ABUNIDAZOLE 91017-58-2 ADEFOVIR 106941-25-7 ACADESINE 2627-69-2 ADELMIDROL 1675-66-7 ACAMPROSATE 77337-76-9 ADEMETIONINE 17176-17-9 ACAPRAZINE 55485-20-6 ADENOSINE PHOSPHATE 61-19-8 ACARBOSE 56180-94-0 ADIBENDAN 100510-33-6 ACEBROCHOL 514-50-1 ADICILLIN 525-94-0 ACEBURIC ACID 26976-72-7 ADIMOLOL 78459-19-5 ACEBUTOLOL 37517-30-9 ADINAZOLAM 37115-32-5 ACECAINIDE 32795-44-1 ADIPHENINE 64-95-9 ACECARBROMAL 77-66-7 ADIPIODONE 606-17-7 ACECLIDINE 827-61-2 ADITEREN 56066-19-4 ACECLOFENAC 89796-99-6 ADITOPRIM 56066-63-8 ACEDAPSONE 77-46-3 ADOSOPINE 88124-26-9 ACEDIASULFONE SODIUM 127-60-6 ADOZELESIN 110314-48-2 ACEDOBEN 556-08-1 ADRAFINIL 63547-13-7 ACEFLURANOL 80595-73-9 ADRENALONE