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[PMID]:28749949
[Au] Autor:Jeon AB; Obregón-Henao A; Ackart DF; Podell BK; Belardinelli JM; Jackson M; Nguyen TV; Blackledge MS; Melander RJ; Melander C; Johnson BK; Abramovitch RB; Basaraba RJ
[Ad] Endereço:Mycobacteria Research Laboratories, Department of Microbiology, Immunology, and Pathology, Colorado State University, Fort Collins, Colorado, United States of America.
[Ti] Título:2-aminoimidazoles potentiate ß-lactam antimicrobial activity against Mycobacterium tuberculosis by reducing ß-lactamase secretion and increasing cell envelope permeability.
[So] Source:PLoS One;12(7):e0180925, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:There is an urgent need to develop new drug treatment strategies to control the global spread of drug-sensitive and multidrug-resistant Mycobacterium tuberculosis (M. tuberculosis). The ß-lactam class of antibiotics is among the safest and most widely prescribed antibiotics, but they are not effective against M. tuberculosis due to intrinsic resistance. This study shows that 2-aminoimidazole (2-AI)-based small molecules potentiate ß-lactam antibiotics against M. tuberculosis. Active 2-AI compounds significantly reduced the minimal inhibitory and bactericidal concentrations of ß-lactams by increasing M. tuberculosis cell envelope permeability and decreasing protein secretion including ß-lactamase. Metabolic labeling and transcriptional profiling experiments revealed that 2-AI compounds impair mycolic acid biosynthesis, export and linkage to the mycobacterial envelope, counteracting an important defense mechanism reducing permeability to external agents. Additionally, other important constituents of the M. tuberculosis outer membrane including sulfolipid-1 and polyacyltrehalose were also less abundant in 2-AI treated bacilli. As a consequence of 2-AI treatment, M. tuberculosis displayed increased sensitivity to SDS, increased permeability to nucleic acid staining dyes, and rapid binding of cell wall targeting antibiotics. Transcriptional profiling analysis further confirmed that 2-AI induces transcriptional regulators associated with cell envelope stress. 2-AI based small molecules potentiate the antimicrobial activity of ß-lactams by a mechanism that is distinct from specific inhibitors of ß-lactamase activity and therefore may have value as an adjunctive anti-TB treatment.
[Mh] Termos MeSH primário: Anti-Infecciosos/farmacologia
Permeabilidade da Membrana Celular/efeitos dos fármacos
Imidazóis/farmacologia
Mycobacterium tuberculosis/citologia
Mycobacterium tuberculosis/enzimologia
beta-Lactamases/secreção
beta-Lactamas/farmacologia
[Mh] Termos MeSH secundário: Carbenicilina/farmacologia
Corantes/química
Lipídeos/análise
Testes de Sensibilidade Microbiana
Mycobacterium tuberculosis/efeitos dos fármacos
Mycobacterium tuberculosis/crescimento & desenvolvimento
Ácidos Nucleicos/metabolismo
Penicilina V/farmacologia
Dodecilsulfato de Sódio/farmacologia
Coloração e Rotulagem
Transcrição Genética/efeitos dos fármacos
Vancomicina/farmacologia
beta-Lactamases/metabolismo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Infective Agents); 0 (Coloring Agents); 0 (Imidazoles); 0 (Lipids); 0 (Nucleic Acids); 0 (beta-Lactams); 368GB5141J (Sodium Dodecyl Sulfate); 6Q205EH1VU (Vancomycin); 7720-39-0 (2-aminoimidazole); EC 3.5.2.6 (beta-Lactamases); G42ZU72N5G (Carbenicillin); Z61I075U2W (Penicillin V)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170929
[Lr] Data última revisão:
170929
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170728
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0180925


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[PMID]:28631307
[Au] Autor:Dalal A; Eskin-Schwartz M; Mimouni D; Ray S; Days W; Hodak E; Leibovici L; Paul M
[Ad] Endereço:Department of Dermatology, Beilinson Hospital, Rabin Medical Center, 39 Jabotinski Street, Petah Tikva, Israel, 49100.
[Ti] Título:Interventions for the prevention of recurrent erysipelas and cellulitis.
[So] Source:Cochrane Database Syst Rev;6:CD009758, 2017 06 20.
[Is] ISSN:1469-493X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Erysipelas and cellulitis (hereafter referred to as 'cellulitis') are common bacterial skin infections usually affecting the lower extremities. Despite their burden of morbidity, the evidence for different prevention strategies is unclear. OBJECTIVES: To assess the beneficial and adverse effects of antibiotic prophylaxis or other prophylactic interventions for the prevention of recurrent episodes of cellulitis in adults aged over 16. SEARCH METHODS: We searched the following databases up to June 2016: the Cochrane Skin Group Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, and LILACS. We also searched five trials registry databases, and checked reference lists of included studies and reviews for further references to relevant randomised controlled trials (RCTs). We searched two sets of dermatology conference proceedings, and BIOSIS Previews. SELECTION CRITERIA: Randomised controlled trials evaluating any therapy for the prevention of recurrent cellulitis. DATA COLLECTION AND ANALYSIS: Two authors independently carried out study selection, data extraction, assessment of risks of bias, and analyses. Our primary prespecified outcome was recurrence of cellulitis when on treatment and after treatment. Our secondary outcomes included incidence rate, time to next episode, hospitalisation, quality of life, development of resistance to antibiotics, adverse reactions and mortality. MAIN RESULTS: We included six trials, with a total of 573 evaluable participants, who were aged on average between 50 and 70. There were few previous episodes of cellulitis in those recruited to the trials, ranging between one and four episodes per study.Five of the six included trials assessed prevention with antibiotics in participants with cellulitis of the legs, and one assessed selenium in participants with cellulitis of the arms. Among the studies assessing antibiotics, one study evaluated oral erythromycin (n = 32) and four studies assessed penicillin (n = 481). Treatment duration varied from six to 18 months, and two studies continued to follow up participants after discontinuation of prophylaxis, with a follow-up period of up to one and a half to two years. Four studies were single-centre, and two were multicentre; they were conducted in five countries: the UK, Sweden, Tunisia, Israel, and Austria.Based on five trials, antibiotic prophylaxis (at the end of the treatment phase ('on prophylaxis')) decreased the risk of cellulitis recurrence by 69%, compared to no treatment or placebo (risk ratio (RR) 0.31, 95% confidence interval (CI) 0.13 to 0.72; n = 513; P = 0.007), number needed to treat for an additional beneficial outcome (NNTB) six, (95% CI 5 to 15), and we rated the certainty of evidence for this outcome as moderate.Under prophylactic treatment and compared to no treatment or placebo, antibiotic prophylaxis reduced the incidence rate of cellulitis by 56% (RR 0.44, 95% CI 0.22 to 0.89; four studies; n = 473; P value = 0.02; moderate-certainty evidence) and significantly decreased the rate until the next episode of cellulitis (hazard ratio (HR) 0.51, 95% CI 0.34 to 0.78; three studies; n = 437; P = 0.002; moderate-certainty evidence).The protective effects of antibiotic did not last after prophylaxis had been stopped ('post-prophylaxis') for risk of cellulitis recurrence (RR 0.88, 95% CI 0.59 to 1.31; two studies; n = 287; P = 0.52), incidence rate of cellulitis (RR 0.94, 95% CI 0.65 to 1.36; two studies; n = 287; P = 0.74), and rate until next episode of cellulitis (HR 0.78, 95% CI 0.39 to 1.56; two studies; n = 287). Evidence was of low certainty.Effects are relevant mainly for people after at least two episodes of leg cellulitis occurring within a period up to three years.We found no significant differences in adverse effects or hospitalisation between antibiotic and no treatment or placebo; for adverse effects: RR 0.87, 95% CI 0.58 to 1.30; four studies; n = 469; P = 0.48; for hospitalisation: RR 0.77, 95% CI 0.37 to 1.57; three studies; n = 429; P = 0.47, with certainty of evidence rated low for these outcomes. The existing data did not allow us to fully explore its impact on length of hospital stay.The common adverse reactions were gastrointestinal symptoms, mainly nausea and diarrhoea; rash (severe cutaneous adverse reactions were not reported); and thrush. Three studies reported adverse effects that led to discontinuation of the assigned therapy. In one study (erythromycin), three participants reported abdominal pain and nausea, so their treatment was changed to penicillin. In another study, two participants treated with penicillin withdrew from treatment due to diarrhoea or nausea. In one study, around 10% of participants stopped treatment due to pain at the injection site (the active treatment group was given intramuscular injections of benzathine penicillin).None of the included studies assessed the development of antimicrobial resistance or quality-of-life measures.With regard to the risks of bias, two included studies were at low risk of bias and we judged three others as being at high risk of bias, mainly due to lack of blinding. AUTHORS' CONCLUSIONS: In terms of recurrence, incidence, and time to next episode, antibiotic is probably an effective preventive treatment for recurrent cellulitis of the lower limbs in those under prophylactic treatment, compared with placebo or no treatment (moderate-certainty evidence). However, these preventive effects of antibiotics appear to diminish after they are discontinued (low-certainty evidence). Treatment with antibiotic does not trigger any serious adverse events, and those associated are minor, such as nausea and rash (low-certainty evidence). The evidence is limited to people with at least two past episodes of leg cellulitis within a time frame of up to three years, and none of the studies investigated other common interventions such as lymphoedema reduction methods or proper skin care. Larger, high-quality studies are warranted, including long-term follow-up and other prophylactic measures.
[Mh] Termos MeSH primário: Antibacterianos/uso terapêutico
Antibioticoprofilaxia
Celulite (Flegmão)/prevenção & controle
Erisipela/prevenção & controle
Prevenção Secundária/métodos
Selênio/uso terapêutico
[Mh] Termos MeSH secundário: Idoso
Antibacterianos/efeitos adversos
Antibioticoprofilaxia/efeitos adversos
Braço
Eritromicina/efeitos adversos
Eritromicina/uso terapêutico
Hospitalização/estatística & dados numéricos
Seres Humanos
Dermatoses da Perna/prevenção & controle
Meia-Idade
Penicilina G Benzatina/efeitos adversos
Penicilina G Benzatina/uso terapêutico
Penicilina V/efeitos adversos
Penicilina V/uso terapêutico
Ensaios Clínicos Controlados Aleatórios como Assunto
Recidiva
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; RESEARCH SUPPORT, NON-U.S. GOV'T; REVIEW
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 63937KV33D (Erythromycin); H6241UJ22B (Selenium); RIT82F58GK (Penicillin G Benzathine); Z61I075U2W (Penicillin V)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170901
[Lr] Data última revisão:
170901
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170621
[St] Status:MEDLINE
[do] DOI:10.1002/14651858.CD009758.pub2


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[PMID]:28219797
[Au] Autor:Shi P; Qiao P; Zhang Y; Li S; Feng X; Bian L
[Ad] Endereço:College of Life Science, Northwest University, Xi'an 710069, China.
[Ti] Título:Spectroscopy analysis and molecular dynamics studies on the binding of penicillin V and sulbactam to beta-lactamase II from Bacillus cereus.
[So] Source:J Pharm Biomed Anal;138:206-214, 2017 May 10.
[Is] ISSN:1873-264X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:The molecular recognition and interaction of beta-lactamase II from Bacillus cereus (Bc II) with penicillin V (PV) and sulbactam (Sul) especially conformational changes of Bc II in the binding process were studied through spectroscopy analysis in combination with molecular dynamics (MD) simulation. The results show that in the binding process, a new coordination bond is observed between the Zn of Bc II and the carboxyl-O of PV or Sul by replacing His204. Electrostatic interaction between Zn and the ligand provide main driving force for the binding affinity. Compared with apo Bc II, there are mainly four loops showing significant conformational changes in ligand-bound Bc II. A weak conformational transformation from ß-sheets to random coils is observed in the loop2 of ligand-bound Bc II. The conformational transformation may depend on the functional group and binding pose of the ligand, giving the binding pocket greater flexibility and accordingly allowing for an induced fit of the enzyme-ligand binding site around the newly introduced ligand. The change in the loop2 of ligand-bound Bc II may lead to the opening of the binding pocket of Bc II. Therefore, loop2 can be considered a gate for control of ligand access in Bc II, hence its dynamic response should be considered in new drug design and development.
[Mh] Termos MeSH primário: Bacillus cereus/metabolismo
Cefalosporinase/metabolismo
Penicilina V/metabolismo
Sulbactam/metabolismo
[Mh] Termos MeSH secundário: Sítios de Ligação/fisiologia
Simulação de Dinâmica Molecular
Ligação Proteica/fisiologia
Conformação Proteica em Folha beta
Análise Espectral/métodos
Eletricidade Estática
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
EC 3.5.2.- (Cephalosporinase); S4TF6I2330 (Sulbactam); Z61I075U2W (Penicillin V)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170628
[Lr] Data última revisão:
170628
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170222
[St] Status:MEDLINE


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[PMID]:28193184
[Au] Autor:Llor C; Vilaseca I; Lehrer-Coriat E; Boleda X; Cañada JL; Moragas A; Cots JM
[Ad] Endereço:Primary Healthcare Centre Via Roma, Barcelona, Spain. carles.llor@gmail.com.
[Ti] Título:Survey of Spanish general practitioners' attitudes toward management of sore throat: an internet-based questionnaire study.
[So] Source:BMC Fam Pract;18(1):21, 2017 Feb 14.
[Is] ISSN:1471-2296
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The management of sore throat varies widely in Europe. The objective of this study was to gain insight into clinicians' perceptions on the current management of sore throat in Spain. METHODS: Cross-sectional, internet-based questionnaire study answered from July to September 2013. General practitioners (GPs) affiliated with the two largest scientific societies of primary care were invited to participate in the study. Questions were asked about physician knowledge, the use of current national guidelines for sore throat management, and management in two clinical scenarios, depicting a young adult with sore throat and: 1. cough, coriza with or without fever, and 2. fever without cough and coriza. RESULTS: The questionnaire was completed by 1476 GPs (5%) and 12.7% declared using rapid antigen detection tests. Antibiotics were considered by 18.8% of the GPs in the first scenario and by 32% in the second scenario (p < 0.001). The antibiotics most commonly mentioned by GPs were amoxicillin and amoxicillin + clavulanate (52.7 and 31.2%, respectively) whereas penicillin V was only prescribed in 11.9% of the cases. The drugs most commonly considered in both scenarios were analgesics and anti-inflammatory drugs. Antitussives, decongestants and expectorants were more commonly prescribed in cases of suspected viral infection (p < 0.001). CONCLUSIONS: GPs have misconceptions as to the indications for using rapid antigen detection tests and prescribing drugs in the management of sore throat. These results suggest that guidelines are seldom followed since one in five GPs declared giving antibiotics for patients with a suspected viral infection and the use of second-choice antibiotics seems considerable.
[Mh] Termos MeSH primário: Analgésicos/uso terapêutico
Antibacterianos/uso terapêutico
Anti-Inflamatórios não Esteroides/uso terapêutico
Atitude do Pessoal de Saúde
Clínicos Gerais
Faringite/tratamento farmacológico
Padrões de Prática Médica
[Mh] Termos MeSH secundário: Amoxicilina/uso terapêutico
Combinação Amoxicilina e Clavulanato de Potássio/uso terapêutico
Antígenos de Bactérias
Estudos Transversais
Gerenciamento Clínico
Seres Humanos
Internet
Penicilina V/uso terapêutico
Faringite/diagnóstico
Espanha
Infecções Estreptocócicas/diagnóstico
Infecções Estreptocócicas/tratamento farmacológico
Streptococcus pyogenes
Inquéritos e Questionários
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Analgesics); 0 (Anti-Bacterial Agents); 0 (Anti-Inflammatory Agents, Non-Steroidal); 0 (Antigens, Bacterial); 74469-00-4 (Amoxicillin-Potassium Clavulanate Combination); 804826J2HU (Amoxicillin); Z61I075U2W (Penicillin V)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171024
[Lr] Data última revisão:
171024
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170215
[St] Status:MEDLINE
[do] DOI:10.1186/s12875-017-0597-1


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[PMID]:26986755
[Au] Autor:Avinash VS; Chauhan PD; Gaikwad S; Pundle A
[Ad] Endereço:a Division of Biochemical Sciences , CSIR-National Chemical Laboratory , Pune , India.
[Ti] Título:Biotransformation of penicillin V to 6-aminopenicillanic acid using immobilized whole cells of E. coli expressing a highly active penicillin V acylase.
[So] Source:Prep Biochem Biotechnol;47(1):52-57, 2017 Jan 02.
[Is] ISSN:1532-2297
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:The production of 6-aminopenicillanic acid (6-APA) is a key step in the manufacture of semisynthetic antibiotics in the pharmaceutical industry. The penicillin G acylase from Escherichia coli has long been utilized for this purpose. However, the use of penicillin V acylases (PVA) presents some advantages including better stability and higher conversion rates. The industrial application of PVAs has so far been limited due to the nonavailability of suitable bacterial strains and cost issues. In this study, whole-cell immobilization of a recombinant PVA enzyme from Pectobacterium atrosepticum expressed in E. coli was performed. Membrane permeabilization with detergent was used to enhance the cell-bound PVA activity, and the cells were encapsulated in calcium alginate beads and cross-linked with glutaraldehyde. Optimization of parameters for the biotransformation by immobilized cells showed that full conversion of pen V to 6-APA could be achieved within 1 hr at pH 5.0 and 35°C, till 4% (w/v) concentration of the substrate. The beads could be stored for 28 days at 4°C with minimal loss in activity and were reusable up to 10 cycles with 1-hr hardening in CaCl between each cycle. The high enzyme productivity of the PVA enzyme system makes a promising case for its application for 6-APA production in the industry.
[Mh] Termos MeSH primário: Biotransformação
Escherichia coli/genética
Ácido Penicilânico/análogos & derivados
Penicilina Amidase/metabolismo
Penicilina V/farmacocinética
[Mh] Termos MeSH secundário: Alginatos/química
Ácido Glucurônico/química
Ácidos Hexurônicos/química
Microscopia Eletrônica de Varredura
Ácido Penicilânico/metabolismo
Penicilina Amidase/genética
Permeabilidade
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Alginates); 0 (Hexuronic Acids); 87-53-6 (Penicillanic Acid); 8A5D83Q4RW (Glucuronic Acid); 8C3Z4148WZ (alginic acid); EC 3.5.1.11 (Penicillin Amidase); QR0C4R7XVN (aminopenicillanic acid); Z61I075U2W (Penicillin V)
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170406
[Lr] Data última revisão:
170406
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160318
[St] Status:MEDLINE
[do] DOI:10.1080/10826068.2016.1163580


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[PMID]:27966440
[Au] Autor:Kooi EJ; de Vries PJ; van Geloven AW; Stel HV; Kingma PJ
[Ad] Endereço:Departments of Internal Medicine and Department of Pathology, VU University Medical Center, Amsterdam, the Netherlands.
[Ti] Título:Actinomycosis of the abdominal wall after cholecystectomy: transferral theory.
[So] Source:Neth J Med;74(10):451-454, 2016 Dec.
[Is] ISSN:1872-9061
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:Abdominal actinomycosis is a rare disease caused by Gram-positive anaerobic Actinomyces bacteria. Here, we present a patient with an intrauterine contraceptive device who developed a long lasting and unexplained recurrent, painful abdominal swelling a few months after a laparoscopic cholecystectomy.
[Mh] Termos MeSH primário: Parede Abdominal/diagnóstico por imagem
Actinomicose/diagnóstico por imagem
Antibacterianos/uso terapêutico
Colecistectomia Laparoscópica
Colecistolitíase/cirurgia
Infecção da Ferida Cirúrgica/diagnóstico por imagem
[Mh] Termos MeSH secundário: Actinomicose/tratamento farmacológico
Actinomicose/patologia
Colo Descendente/diagnóstico por imagem
Colo Transverso/diagnóstico por imagem
Feminino
Seres Humanos
Linfonodos/diagnóstico por imagem
Meia-Idade
Penicilina V/análogos & derivados
Penicilina V/uso terapêutico
Sigmoidoscopia
Infecção da Ferida Cirúrgica/tratamento farmacológico
Infecção da Ferida Cirúrgica/patologia
Tomografia Computadorizada por Raios X
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); EFA30X554H (phenethicillin); Z61I075U2W (Penicillin V)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161215
[St] Status:MEDLINE


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[PMID]:27618925
[Au] Autor:Skoog G; Edlund C; Giske CG; Mölstad S; Norman C; Sundvall PD; Hedin K
[Ad] Endereço:Unit for Antibiotics and Infection Control, The Public Health Agency of Sweden, Solna, Sweden. gunilla.skoog@folkhalsomyndigheten.se.
[Ti] Título:A randomized controlled study of 5 and 10 days treatment with phenoxymethylpenicillin for pharyngotonsillitis caused by streptococcus group A - a protocol study.
[So] Source:BMC Infect Dis;16:484, 2016 Sep 13.
[Is] ISSN:1471-2334
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: In 2014 the Swedish government assigned to The Public Health Agency of Sweden to conduct studies to evaluate optimal use of existing antibiotic agents. The aim is to optimize drug use and dosing regimens to improve the clinical efficacy. The present study was selected following a structured prioritizing process by independent experts. METHODS: This phase IV study is a randomized, open-label, multicenter study with non-inferiority design regarding the therapeutic use of penicillin V with two parallel groups. The overall aim is to study if the total exposure with penicillin V can be reduced from 1000 mg three times daily for 10 days to 800 mg four times daily for 5 days when treating Streptococcus pyogenes (Lancefield group A) pharyngotonsillitis. Patients will be recruited from 17 primary health care centers in Sweden. Adult men and women, youth and children ≥6 years of age who consult for sore throat and is judged to have a pharyngotonsillitis, with 3-4 Centor criteria and a positive rapid test for group A streptococci, will be included in the study. The primary outcome is clinical cure 5-7 days after discontinuation of antibiotic treatment. Follow-up controls will be done by telephone after 1 and 3 months. Throat symptoms, potential relapses and complications will be monitored, as well as adverse events. Patients (n = 432) will be included during 2 years. DISCUSSION: In the era of increasing antimicrobial resistance and the shortage of new antimicrobial agents it is necessary to revisit optimal usage of old antibiotics. Old antimicrobial drugs are often associated with inadequate knowledge on pharmacokinetics and pharmacodynamics and lack of optimized dosing regimens based on randomized controlled clinical trials. If a shorter and more potent treatment regimen is shown to be equivalent with the normal 10 day regimen this can imply great advantages for both patients (adherence, adverse events, resistance) and the community (resistance, drug costs). TRIAL REGISTRATION: EudraCT number 2015-001752-30 . Protocol FoHM/Tonsillit2015 date 22 June 2015, version 2. Approved by MPA of Sweden 3 July 2015, Approved by Regional Ethical Review Board in Lund, 25 June 2015.
[Mh] Termos MeSH primário: Antibacterianos/uso terapêutico
Penicilina V/uso terapêutico
Faringite/tratamento farmacológico
Infecções Estreptocócicas/tratamento farmacológico
Streptococcus pyogenes
[Mh] Termos MeSH secundário: Adolescente
Adulto
Antibacterianos/administração & dosagem
Criança
Protocolos Clínicos
Feminino
Seres Humanos
Masculino
Penicilina V/administração & dosagem
Faringite/microbiologia
Projetos de Pesquisa
Infecções Estreptocócicas/microbiologia
Suécia
Resultado do Tratamento
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); Z61I075U2W (Penicillin V)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170705
[Lr] Data última revisão:
170705
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160914
[St] Status:MEDLINE
[do] DOI:10.1186/s12879-016-1813-7


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[PMID]:27520996
[Au] Autor:Pathak H; Marshall T
[Ad] Endereço:Department of Rheumatology, Norfolk and Norwich University Hospital, Norwich, UK.
[Ti] Título:Post-streptococcal reactive arthritis: where are we now.
[So] Source:BMJ Case Rep;2016, 2016 Aug 12.
[Is] ISSN:1757-790X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:A 35-year-old man presented with polyarthritis and constitutional symptoms, and a recent history of multiple tick bites and skin rash on trekking holiday. He did not respond to oral doxycycline and cephalexine for presumed Lyme's disease. Further investigation confirmed strongly positive streptococcal serology. There was absence of clinical or echocardiography evidence of heart involvement and immunological screening for inflammatory arthritis was negative. In the absence of other major Jones criteria for acute rheumatic fever, besides polyarthritis and the serological evidence of a recent streptococcal infection, a diagnosis of post-streptococcal reactive arthritis (PSRA) was also made. He responded well to penicillin therapy and has been started on oral penicillin prophylaxis as per available guidance. As streptococcal infections in the adult population are increasingly reported, it is a timely opportunity to revisit PSRA, and develop comprehensive treatment and antibiotic prophylaxis guidelines.
[Mh] Termos MeSH primário: Antibacterianos/administração & dosagem
Artrite Reativa/tratamento farmacológico
Artrite Reativa/microbiologia
Penicilina V/administração & dosagem
Infecções Estreptocócicas/diagnóstico
[Mh] Termos MeSH secundário: Adulto
Artrite Reativa/diagnóstico
Diagnóstico Diferencial
Seres Humanos
Masculino
Infecções Estreptocócicas/tratamento farmacológico
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); Z61I075U2W (Penicillin V)
[Em] Mês de entrada:1702
[Cu] Atualização por classe:170221
[Lr] Data última revisão:
170221
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160814
[St] Status:MEDLINE


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[PMID]:27101811
[Au] Autor:Filippova EV; Kieser KJ; Luan CH; Wawrzak Z; Kiryukhina O; Rubin EJ; Anderson WF
[Ad] Endereço:Department of Biochemistry and Molecular Genetics, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
[Ti] Título:Crystal structures of the transpeptidase domain of the Mycobacterium tuberculosis penicillin-binding protein PonA1 reveal potential mechanisms of antibiotic resistance.
[So] Source:FEBS J;283(12):2206-18, 2016 06.
[Is] ISSN:1742-4658
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:UNLABELLED: Mycobacterium tuberculosis is a human respiratory pathogen that causes the deadly disease tuberculosis. The rapid global spread of antibiotic-resistant M. tuberculosis makes tuberculosis infections difficult to treat. To overcome this problem new effective antimicrobial strategies are urgently needed. One promising target for new therapeutic approaches is PonA1, a class A penicillin-binding protein, which is required for maintaining physiological cell wall synthesis and cell shape during growth in mycobacteria. Here, crystal structures of the transpeptidase domain, the enzymatic domain responsible for penicillin binding, of PonA1 from M. tuberculosis in the inhibitor-free form and in complex with penicillin V are reported. We used site-directed mutagenesis, antibiotic profiling experiments, and fluorescence thermal shift assays to measure PonA1's sensitivity to different classes of ß-lactams. Structural comparison of the PonA1 apo-form and the antibiotic-bound form shows that binding of penicillin V induces conformational changes in the position of the loop ß4'-α3 surrounding the penicillin-binding site. We have also found that binding of different antibiotics including penicillin V positively impacts protein stability, while other tested ß-lactams such as clavulanate or meropenem resulted in destabilization of PonA1. Our antibiotic profiling experiments indicate that the transpeptidase activity of PonA1 in both M. tuberculosis and M. smegmatis mediates tolerance to specific cell wall-targeting antibiotics, particularly to penicillin V and meropenem. Because M. tuberculosis is an important human pathogen, these structural data provide a template to design novel transpeptidase inhibitors to treat tuberculosis infections. DATABASE: Structural data are available in the PDB database under the accession numbers 5CRF and 5CXW.
[Mh] Termos MeSH primário: Mycobacterium tuberculosis/enzimologia
Penicilina V/química
Proteínas de Ligação às Penicilinas/química
Peptidil Transferases/química
[Mh] Termos MeSH secundário: Sítios de Ligação
Cristalografia por Raios X
Resistência Microbiana a Medicamentos/genética
Seres Humanos
Mutagênese Sítio-Dirigida
Mycobacterium tuberculosis/efeitos dos fármacos
Mycobacterium tuberculosis/patogenicidade
Penicilina V/uso terapêutico
Proteínas de Ligação às Penicilinas/antagonistas & inibidores
Proteínas de Ligação às Penicilinas/genética
Peptidil Transferases/antagonistas & inibidores
Peptidil Transferases/genética
Tuberculose/tratamento farmacológico
Tuberculose/enzimologia
Tuberculose/microbiologia
beta-Lactamas/química
beta-Lactamas/uso terapêutico
[Pt] Tipo de publicação:EDITORIAL; RESEARCH SUPPORT, NON-U.S. GOV'T; RESEARCH SUPPORT, U.S. GOV'T, NON-P.H.S.; RESEARCH SUPPORT, N.I.H., EXTRAMURAL
[Nm] Nome de substância:
0 (Penicillin-Binding Proteins); 0 (beta-Lactams); EC 2.3.2.12 (Peptidyl Transferases); Z61I075U2W (Penicillin V)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:171117
[Lr] Data última revisão:
171117
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160423
[St] Status:MEDLINE
[do] DOI:10.1111/febs.13738


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[PMID]:27054812
[Au] Autor:Dyrkorn R; Gjelstad S; Espnes KA; Lindbæk M
[Ad] Endereço:a Department of Clinical Pharmacology , St. Olavs Hospital , Trondheim , Norway ;
[Ti] Título:Peer academic detailing on use of antibiotics in acute respiratory tract infections. A controlled study in an urban Norwegian out-of-hours service.
[So] Source:Scand J Prim Health Care;34(2):180-5, 2016 Jun.
[Is] ISSN:1502-7724
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To analyse if peer academic detailing by experienced general practitioners (GPs) could be a useful way to change Medical Doctors, (MDs) prescription of antibiotics for acute respiratory tract infections (ARTIs) in out-of-hours service. METHOD: An educational Intervention study based on prescription data among MDs working in an out-of-hours service from June 2006 through October 2008. Specially trained GPs lectured a peer educational program (3 × 45 minutes) about use of antibiotics for ARTIs according to national recommendations. OUTCOME MEASURES: The type and frequency of antibiotics prescribed for different ARTIs before and after intervention comparing the intervention group with the control group. SUBJECTS: 22 MDs in the intervention group and 31 MDs in the control group. RESULTS: The intervention group showed an overall statistically significantly absolute increase in the use of penicillin V (Penicillin V) of 9.8% (95% CI: 2.3%-17.4% p < 0.05), and similarly an statistically significantly absolute decrease in the use of macrolides and lincosamides of 8.8% (95% CI: 2.6%-14.9.2% p < 0.05) for all diagnoses. For subgroups of ARTIs we found a significant increase in the use of Penicillin V for acute otitis media, sinusitis, pneumonia and upper ARTIs. There was no significant changes in total prescription rates in the two groups. 41% of all consultations with respiratory tract infections resulted in antibiotic prescription. CONCLUSIONS: Using trained GPs to give peer academic detailing to colleagues in combination with open discussion on prescription, showed a significant change in prescription of antibiotics towards national guidelines. Key points Phenoxymethylpenicillin is the first choice for the most of respiratory tract infections when indicated. Despite the guidelines for the choice of antibiotics in Norway, general practitioners' choice often differs from these. We showed that a session of three times 45 min of peer academic detailing changed significantly the choice of antibiotics towards the National Guidelines in an urban Norwegian out-of-hours service.
[Mh] Termos MeSH primário: Antibacterianos/uso terapêutico
Uso de Medicamentos/estatística & dados numéricos
Padrões de Prática Médica/estatística & dados numéricos
Infecções Respiratórias/tratamento farmacológico
[Mh] Termos MeSH secundário: Adulto
Plantão Médico
Feminino
Clínicos Gerais
Seres Humanos
Masculino
Meia-Idade
Noruega
Grupo Associado
Penicilina V/uso terapêutico
Análise de Regressão
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); Z61I075U2W (Penicillin V)
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160408
[St] Status:MEDLINE
[do] DOI:10.3109/02813432.2016.1163035



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