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[PMID]:29197331
[Au] Autor:Addo KK; Addo SO; Mensah GI; Mosi L; Bonsu FA
[Ad] Endereço:Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, P.O. Box LG 581, Legon, Ghana. kaddo@noguchi.ug.edu.gh.
[Ti] Título:Genotyping and drug susceptibility testing of mycobacterial isolates from population-based tuberculosis prevalence survey in Ghana.
[So] Source:BMC Infect Dis;17(1):743, 2017 12 02.
[Is] ISSN:1471-2334
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Mycobacterium tuberculosis complex (MTBC) and Non-tuberculosis Mycobacterium (NTM) infections differ clinically, making rapid identification and drug susceptibility testing (DST) very critical for infection control and drug therapy. This study aims to use World Health Organization (WHO) approved line probe assay (LPA) to differentiate mycobacterial isolates obtained from tuberculosis (TB) prevalence survey in Ghana and to determine their drug resistance patterns. METHODS: A retrospective study was conducted whereby a total of 361 mycobacterial isolates were differentiated and their drug resistance patterns determined using GenoType Mycobacterium Assays: MTBC and CM/AS for differentiating MTBC and NTM as well MTBDRplus and NTM-DR for DST of MTBC and NTM respectively. RESULTS: Out of 361 isolates, 165 (45.7%) MTBC and 120 (33.2%) NTM (made up of 14 different species) were identified to the species levels whiles 76 (21.1%) could not be completely identified. The MTBC comprised 161 (97.6%) Mycobacterium tuberculosis and 4 (2.4%) Mycobacterium africanum. Isoniazid and rifampicin monoresistant MTBC isolates were 18/165 (10.9%) and 2/165(1.2%) respectively whiles 11/165 (6.7%) were resistant to both drugs. Majority 42/120 (35%) of NTM were M. fortuitum. DST of 28 M. avium complex and 8 M. abscessus complex species revealed that all were susceptible to macrolides (clarithromycin, azithromycin) and aminoglycosides (kanamycin, amikacin, and gentamicin). CONCLUSION: Our research signifies an important contribution to TB control in terms of knowledge of the types of mycobacterium species circulating and their drug resistance patterns in Ghana.
[Mh] Termos MeSH primário: Mycobacterium tuberculosis/efeitos dos fármacos
Mycobacterium tuberculosis/genética
Micobactérias não Tuberculosas/genética
Tuberculose/microbiologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Claritromicina/farmacologia
Farmacorresistência Bacteriana/efeitos dos fármacos
Feminino
Genótipo
Gana
Seres Humanos
Isoniazida/farmacologia
Masculino
Testes de Sensibilidade Microbiana
Meia-Idade
Infecções por Micobactéria não Tuberculosa/microbiologia
Mycobacterium tuberculosis/isolamento & purificação
Micobactérias não Tuberculosas/efeitos dos fármacos
Micobactérias não Tuberculosas/isolamento & purificação
Prevalência
Estudos Retrospectivos
Rifampina/farmacologia
Inquéritos e Questionários
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
H1250JIK0A (Clarithromycin); V83O1VOZ8L (Isoniazid); VJT6J7R4TR (Rifampin)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171204
[St] Status:MEDLINE
[do] DOI:10.1186/s12879-017-2853-3


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[PMID]:29390522
[Au] Autor:Ko J; Kim SK; Yong DE; Kim TI; Kim EK
[Ad] Endereço:Department of Ophthalmology, Corneal Dystrophy Research Institute, Institute of Vision Research, Yonsei University College of Medicine.
[Ti] Título:Delayed onset Mycobacterium intracellulare keratitis after laser in situ keratomileusis: A case report and literature review.
[So] Source:Medicine (Baltimore);96(51):e9356, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Infectious keratitis is a relatively uncommon but potentially sight-threatening complication of laser in situ keratomileusis (LASIK). Mycobacterial keratitis is usually regarded as late onset keratitis among post-LASIK keratitis. There has been no documented case of Mycobacterium intracellulare post-LASIK keratitis of a long-latent period. PATIENT CONCERNS: A 36-year-old man was referred to our out-patient clinic, for persistent corneal epithelial defect with intrastromal infiltration. He had undergone uneventful bilateral LASIK procedure 4 years before. He complained decreased vision, accompanied by ocular pain, photophobia, and redness in his left eye for 7 months. DIAGNOSIS: Lamellar keratectomy was taken using femtosecond laser. Bacterial culture with sequenced bacterial 16s ribosomal DNA confirmed the organism to be M intracellulare. INTERVENTIONS: After 3 months of administration of topical clarithromycin, amikacin, and moxifloxacin, the corneal epithelial defect was resolved and the infiltration was much improved. However, newly developed diffuse haziness with surrounding granular infiltration in the central cornea was noted. Drug toxicity was suspected and topical moxifloxacin was discontinued, resulting in resolution of the diffuse haze with infiltration. OUTCOME: The patient was followed up regularly without medication thereafter and recurrence was not found for 7 years. LESSONS: This case presents the first case of M intracellulare keratitis after LASIK. LASIK surgeons should aware that post-LASIK keratitis can develop long after the operation and careful suspicion of infectious disease with meticulous diagnostic test is needed.
[Mh] Termos MeSH primário: Antibacterianos/uso terapêutico
Infecções Oculares Bacterianas/diagnóstico
Ceratite/microbiologia
Ceratomileuse Assistida por Excimer Laser In Situ/efeitos adversos
Complexo Mycobacterium avium/isolamento & purificação
[Mh] Termos MeSH secundário: Administração Tópica
Adulto
Amicacina/uso terapêutico
Claritromicina/uso terapêutico
Quimioterapia Combinada
Infecções Oculares Bacterianas/tratamento farmacológico
Infecções Oculares Bacterianas/etiologia
Fluoroquinolonas/uso terapêutico
Seguimentos
Seres Humanos
Ceratite/tratamento farmacológico
Ceratite/etiologia
Ceratomileuse Assistida por Excimer Laser In Situ/métodos
Masculino
Índice de Gravidade de Doença
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (Fluoroquinolones); 84319SGC3C (Amikacin); H1250JIK0A (Clarithromycin); U188XYD42P (moxifloxacin)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180219
[Lr] Data última revisão:
180219
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009356


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[PMID]:29328644
[Au] Autor:Grgov S; Tasic T; Radovanovic-Dinic B; Benedeto-Stojanov D
[Ti] Título:Can probiotics improve efficiency and safety profile of triple Helicobacter pylori eradication therapy? A prospective randomized study.
[So] Source:Vojnosanit Pregl;73(11):1044-9, 2016 Nov.
[Is] ISSN:0042-8450
[Cp] País de publicação:Serbia
[La] Idioma:eng
[Ab] Resumo:Background/Aim: Some studies suggest the benefit of applying different probiotic strains in combination with antibiotics in the eradication of Helicobacter pylori (H. pylori) infection. The aim of this study was to evaluate the effect of co-administration of multiple probiotic strains with triple H. pylori eradication therapy.This prospective study included 167 patients with dyspeptic symptoms and chronic gastritis who were diagnosed with H. pylori infection and randomized into two groups. The group I of 77 patients underwent triple eradication therapy, for 7 days, with lansoprazole, 2 × 30 mg half an hour before the meal, amoxicillin 2 × 1.000 mg per 12 hours and clarithromycin 2 × 500 mg per 12 hours. After the 7th day of the therapy, lansoprazole continued at a dose of 30 mg for half an hour before breakfast for 4 weeks. The group II of 90 patients received the same treatment as the patients of the group I, with the addition of the probiotic cultures in the form of a capsule comprising Lactobacillus Rosell-52, Lactobacillus Rosell-11, Bifidobacterium Rosell-1755 and Saccharomyces boulardii, since the beginning of eradication for 4 weeks. Eradication of H. pylori infection control was performed 8 weeks after the therapy by rapid urease test and histopathologic evaluation of endoscopic biopsies or by stool antigen test for H. pylori.Eradication of H. pylori infection was achieved in 93.3% of the patients who received probiotics with eradication therapy and in 81.8% of patients who were only on eradication therapy without probiotics. The difference in eradication success was statistically significant, (p < 0.05). The incidence of adverse effects of eradication therapy was higher in the group of patients who were not on probiotic (28.6%) than in the group that received probiotic (17.7%), but the difference was not statistically significant.Multiple probiotic strains addition to triple eradication therapy of H. pylori achieves a significantly better eradication success, with fewer side effects of antibiotics.
[Mh] Termos MeSH primário: Amoxicilina/uso terapêutico
Antibacterianos/uso terapêutico
Claritromicina/uso terapêutico
Gastrite/tratamento farmacológico
Infecções por Helicobacter/tratamento farmacológico
Helicobacter pylori/efeitos dos fármacos
Lansoprazol/uso terapêutico
Probióticos/uso terapêutico
Inibidores da Bomba de Prótons/uso terapêutico
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Amoxicilina/efeitos adversos
Antibacterianos/efeitos adversos
Biópsia
Doença Crônica
Claritromicina/efeitos adversos
Quimioterapia Combinada
Feminino
Gastrite/diagnóstico
Gastrite/microbiologia
Gastroscopia
Infecções por Helicobacter/diagnóstico
Infecções por Helicobacter/microbiologia
Helicobacter pylori/patogenicidade
Seres Humanos
Lansoprazol/efeitos adversos
Masculino
Meia-Idade
Probióticos/efeitos adversos
Estudos Prospectivos
Inibidores da Bomba de Prótons/efeitos adversos
Sérvia
Fatores de Tempo
Resultado do Tratamento
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (Proton Pump Inhibitors); 0K5C5T2QPG (Lansoprazole); 804826J2HU (Amoxicillin); H1250JIK0A (Clarithromycin)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180213
[Lr] Data última revisão:
180213
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180113
[St] Status:MEDLINE
[do] DOI:10.2298/VSP150415127G


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[PMID]:29227218
[Au] Autor:Yoshida S; Tsuyuguchi K; Kobayashi T; Tomita M; Inoue Y; Hayashi S; Suzuki K
[Ad] Endereço:1​Clinical Research Center, National Hospital Organization Kinki-chuo Chest Medical Center, 1180 Nagasone-cho, Kita-ku, Sakai-shi, Osaka 591-8555, Japan.
[Ti] Título:Association between sequevar and antibiotic treatment outcome in patients with Mycobacterium abscessus complex infections in Japan.
[So] Source:J Med Microbiol;67(1):74-82, 2018 Jan.
[Is] ISSN:1473-5644
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:PURPOSE: Macrolide susceptibility differs between subspecies in the Mycobacterium abscessus complex, likely due to differences in erm(41) sequevars. Patients with M. abscessus complex infection generally show poor clinical outcomes in response to antibiotic treatment. Here, the association between genotype and treatment outcome was investigated. METHODOLOGY: We collected 69 isolates from 35 patients with non-cystic fibrosis bronchiectasis: 24 had M. abscessus complex lung disease and non-cystic fibrosis bronchiectasis, and 11 were colonized. Outcome analysis was performed in the 24 infected patients. Molecular analyses, including erm(41) and rrl sequencing, and variable-number tandem-repeat (VNTR) analysis of 69 isolates, from 24 infected and 11 colonized patients, were performed to elucidate the influence of genotype on antibiotic susceptibility. RESULTS: Among the 24 patients, 18 (14 infected with M. abscessus subsp. abscessus and 4 with M. abscessus subsp. massiliense) showed unfavourable outcomes; six (three infected with M. abscessus subsp. abscessus and three with M. abscessus subsp. massiliense) exhibited favourable outcomes. Patients with unfavourable outcomes showed acquired clarithromycin resistance (33.3 vs 0 %), mixed sequevars (38.9 vs 16.7 %) and differing VNTR patterns between initial and serial isolates (33.3 vs 16.7 %). In contrast, in the 11 colonized patients, M. abscessus subsp. abscessus C28 (sequevar 02) and M. abscessus subsp. massiliense were the most prevalent subspecies. CONCLUSION: Patients infected with multiple sequevars and genotypes were more likely to exhibit treatment failure and/or recurrence. The precise identification of subspecies and analyses of mycobacterial characteristics may help to predict treatment outcomes in patients with M. abscessus complex lung disease.
[Mh] Termos MeSH primário: Antibacterianos/uso terapêutico
Infecções por Micobactéria não Tuberculosa/tratamento farmacológico
Infecções por Micobactéria não Tuberculosa/microbiologia
Mycobacterium abscessus/efeitos dos fármacos
Mycobacterium abscessus/isolamento & purificação
[Mh] Termos MeSH secundário: Claritromicina/uso terapêutico
Farmacorresistência Bacteriana/efeitos dos fármacos
Genótipo
Seres Humanos
Japão
Macrolídeos/uso terapêutico
Testes de Sensibilidade Microbiana/métodos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (Macrolides); H1250JIK0A (Clarithromycin)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171227
[Lr] Data última revisão:
171227
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171212
[St] Status:MEDLINE
[do] DOI:10.1099/jmm.0.000661


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[PMID]:29258111
[Au] Autor:Adachi T; Matsui S; Watanabe T; Okamoto K; Okamoto A; Kono M; Yamada M; Nagai T; Komeda Y; Minaga K; Kamata K; Yamao K; Takenaka M; Asakuma Y; Sakurai T; Nishida N; Kashida H; Kudo M
[Ad] Endereço:Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan.
[Ti] Título:Comparative Study of Clarithromycin- versus Metronidazole-Based Triple Therapy as First-Line Eradication for Helicobacter pylori.
[So] Source:Oncology;93 Suppl 1:15-19, 2017.
[Is] ISSN:1423-0232
[Cp] País de publicação:Switzerland
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Clarithromycin (CAM)-based triple therapy comprising proton pump inhibitors and amoxicillin is administered as first-line eradication treatment against Helicobacter pylori infection. However, the eradication rate achieved with CAM-based triple therapy has decreased to <80% owing to the emergence of CAM-resistant strains. This prospective randomized study aimed to compare the efficacy of CAM-based and metronidazole (MNZ)-based triple therapy in terms of H. pylori eradication. METHODS: H. pylori-positive patients were treated with CAM-based triple therapy comprising esomeprazole and amoxicillin (EAC group) or with MNZ-based triple therapy comprising esomeprazole and amoxicillin (EAM group). RESULTS: H. pylori eradication rates achieved in the intention-to-treat (ITT) and per protocol (PP) analyses were 70.6 and 72.7%, respectively, in the EAC group. Eradication rates obtained via ITT and PP analyses were 91.7 and 94.3%, respectively, in the EAM group. In the EAC group, eradication rates were significantly lower in patients harboring CAM-resistant strains than in those harboring CAM-sensitive strains. In contrast, eradication rates were comparable between patients harboring CAM-resistant strains and those harboring CAM-sensitive strains in the EAM group. CONCLUSION: MNZ-based triple therapy consisting of esomeprazole and amoxicillin is superior to CAM-based triple therapy containing esomeprazole and amoxicillin as first-line eradication treatment against H. pylori.
[Mh] Termos MeSH primário: Claritromicina/uso terapêutico
Infecções por Helicobacter/tratamento farmacológico
Helicobacter pylori/efeitos dos fármacos
Metronidazol/uso terapêutico
[Mh] Termos MeSH secundário: Idoso
Amoxicilina/uso terapêutico
Antibacterianos
Quimioterapia Combinada
Esomeprazol/uso terapêutico
Feminino
Infecções por Helicobacter/microbiologia
Helicobacter pylori/isolamento & purificação
Seres Humanos
Masculino
Meia-Idade
Estudos Prospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 140QMO216E (Metronidazole); 804826J2HU (Amoxicillin); H1250JIK0A (Clarithromycin); N3PA6559FT (Esomeprazole)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171221
[Lr] Data última revisão:
171221
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171220
[St] Status:MEDLINE
[do] DOI:10.1159/000481224


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[PMID]:28990461
[Au] Autor:Oikawa R; Watanabe Y; Miyamoto S; Sato Y; Ono S; Mabe K; Yamamoto H; Kato M; Itoh F
[Ad] Endereço:1 Division of Gastroenterology and Hepatology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan.
[Ti] Título:Enrichment of Helicobacter pylori mutant strains after eradication therapy analyzed by gastric wash-based quantitative pyrosequencing.
[So] Source:Tumour Biol;39(10):1010428317734865, 2017 Oct.
[Is] ISSN:1423-0380
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The eradication of Helicobacter pylori reduces the risk of gastric cancer. A clear understanding of the factors underlying mixed infection with multiple clarithromycin-susceptible and clarithromycin-resistant H. pylori strains is necessary to design more effective therapies against H. pylori. We aimed to assess how the abundance and prevalence of H. pylori strains vary after clarithromycin-based eradication therapy. Using gastric wash samples, which represent the entire stomach, we sequentially analyzed the abundance and prevalence of H. pylori DNA by 23S ribosomal RNA pyrosequencing before and 1, 2, and 3 years after eradication therapy. Low levels of H. pylori DNA were still detectable at the first-year follow-up in all samples with negative post-treatment urea breath test results. The abundance of H. pylori DNA decreased significantly until the 2-year follow-up, but it switched to an increase at the 3-year follow-up. Importantly, the ratio of the prevalence of mutant strains to the prevalence of wild-type strains had already increased at the first-year follow-up and continued to increase, suggesting the selection and growth of clarithromycin-resistant strains during the follow-up periods. Being sensitive and representative, our assay will be useful in effectively addressing gastric cancer development by enhancing the long-term success of intervention strategies and consecutive surveillance for H. pylori eradication.
[Mh] Termos MeSH primário: Infecções por Helicobacter/microbiologia
Helicobacter pylori/genética
Neoplasias Gástricas/microbiologia
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Antibacterianos/uso terapêutico
Líquidos Corporais/microbiologia
Claritromicina/uso terapêutico
DNA Bacteriano/análise
Feminino
Seguimentos
Infecções por Helicobacter/tratamento farmacológico
Seres Humanos
Masculino
Meia-Idade
RNA Ribossômico 23S/análise
Reação em Cadeia da Polimerase em Tempo Real
Irrigação Terapêutica
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (DNA, Bacterial); 0 (RNA, Ribosomal, 23S); H1250JIK0A (Clarithromycin)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171017
[Lr] Data última revisão:
171017
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171010
[St] Status:MEDLINE
[do] DOI:10.1177/1010428317734865


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[PMID]:28945804
[Au] Autor:Radzikowska E; Wiatr E; Langfort R; Bestry I; Skoczylas A; Szczepulska-Wójcik E; Gawryluk D; Rudzinski P; Chorostowska-Wynimko J; Roszkowski-Sliz K
[Ad] Endereço:III Department of Lung Disease National Tuberculosis and Lung Diseases Research Institute, Warsaw, Poland.
[Ti] Título:Cryptogenic organizing pneumonia-Results of treatment with clarithromycin versus corticosteroids-Observational study.
[So] Source:PLoS One;12(9):e0184739, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Cryptogenic organizing pneumonia (COP) is a clinicopathological syndrome of unknown origin. Corticosteroids are the standard treatment, but clarithromycin (CAM) is also effective. The aim of this observational retrospective study was to compare the results of CAM versus prednisone (PRE) treatment in patients with biopsy-proven OP without respiratory insufficiency. MATERIAL AND METHODS: In a 15-year period, 40 patients were treated with CAM (500 mg twice daily orally for 3 months) and 22 with PRE (mean initial dose of 0.67 ± 0.24 mg/kg/d for a mean of 8.59 ± 3.05 months). RESULTS: The clinical presentation, laboratory, and radiological findings did not differ markedly between patients treated with CAM and PRE, with the exception of a higher frequency of sweats (55% vs. 23%; p < 0.015), ground glass opacities (95% vs. 50%; p <0.0001) and nodular lesions (45% vs. 18%; p = 0.036) in the CAM group. A complete response was achieved in 35(88%) patients treated with CAM and in all treated with PRE. Patients treated with PRE relapsed more frequently than those treated with CAM (54.5% vs. 10%; p < 0.0001). Corticosteroid-related adverse events were noticed in 8(6.5%) patients (with one death), but CAM caused only one (2.5%) allergic reaction. A FVC >80% identified patients who might be successfully treated with CAM with a sensitivity of 60% and a specificity of 88.57% (AUC 0.869; 95% CI 0.684-1; p = 0.008); the figures for the FEV1 were >70%, a sensitivity of 60%, and a specificity of 91.43% (AUC 0.809; 95%CI 0.609-1; p = 0.027). CONCLUSIONS: CAM can be used to treat COP patients in whom the pulmonary function parameters are within normal limits. Such therapy is shorter, better tolerated, and associated with fewer adverse events and relapses than is PRE. However, the therapy is ineffective in some patients.
[Mh] Termos MeSH primário: Corticosteroides/uso terapêutico
Antibacterianos/uso terapêutico
Claritromicina/uso terapêutico
Pneumonia em Organização Criptogênica/tratamento farmacológico
[Mh] Termos MeSH secundário: Adulto
Idoso
Pneumonia em Organização Criptogênica/patologia
Feminino
Seres Humanos
Pulmão/patologia
Masculino
Meia-Idade
Estudos Retrospectivos
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
0 (Adrenal Cortex Hormones); 0 (Anti-Bacterial Agents); H1250JIK0A (Clarithromycin)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171017
[Lr] Data última revisão:
171017
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170926
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0184739


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[PMID]:28874233
[Au] Autor:Chew KL; Cheng JWS; Hudaa Osman N; Lin RTP; Teo JWP
[Ad] Endereço:1​National University Hospital, Department of Laboratory Medicine, Division of Microbiology, Singapore 119074, Republic of Singapore.
[Ti] Título:Predominance of clarithromycin-susceptible Mycobacterium massiliense subspecies: Characterization of the Mycobacterium abscessus complex at a tertiary acute care hospital.
[So] Source:J Med Microbiol;66(10):1443-1447, 2017 Oct.
[Is] ISSN:1473-5644
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:To characterize members of the Mycobacterium abscessus complex, with an emphasis on the correlation between species identification and clarithromycin associated genetic polymorphisms that contribute to inducible and constitutive macrolide resistance. PCR and sequencing analysis was used to elucidate the subspecies, erm(41) genotypes and the presence of rrl mutations. M. abscessus subsp. massiliense was the dominant subspecies (70.2 %), followed by M. abscessus subsp. abscessus (23.8 %) and M. abscessus subsp. bolletii (5.9 %). The majority of M. abscessus and M. bolletii isolates possessed T28 erm(41) sequevar and were inducibly resistant to clarithromycin. All M. massiliense carried the truncated erm(41) and were largely clarithromycin-susceptible (98.3 %). Constitutive resistance involving rrl mutations was rare and seen in only 2 isolates (2.2 %). Subspecies identification was insufficient to predict clarithromycin susceptibility and required the genetic resistance to be determined via sequencing. In our context, rrl mutations were uncommon and may not be an essential test.
[Mh] Termos MeSH primário: Antibacterianos/farmacologia
Claritromicina/farmacologia
Infecções por Mycobacterium/microbiologia
Mycobacterium/classificação
Mycobacterium/efeitos dos fármacos
Centros de Atenção Terciária
[Mh] Termos MeSH secundário: Seres Humanos
Mycobacterium/genética
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); H1250JIK0A (Clarithromycin)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171018
[Lr] Data última revisão:
171018
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170907
[St] Status:MEDLINE
[do] DOI:10.1099/jmm.0.000576


  9 / 5705 MEDLINE  
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[PMID]:28860442
[Au] Autor:Miura S; Kuroda H; Yamada M; Sato K; Ameda S; Sakano H; Shibata T; Uemura N; Abe T; Fujii S; Maeda M; Kobune M; Kato J
[Ad] Endereço:Dept. of Gastroenterology and Hematology/Clinical Oncology, Internal Medicine, Steel Memorial Muroran Hospital.
[Ti] Título:[Effective BiRd Therapy after the Addition of Clarithromycin for Lenalidomide and Dexamethasone Resistant Multiple Myeloma Ineligible for Stem Cell Transplantation].
[So] Source:Gan To Kagaku Ryoho;44(8):689-693, 2017 Aug.
[Is] ISSN:0385-0684
[Cp] País de publicação:Japan
[La] Idioma:jpn
[Ab] Resumo:BiRd combination therapy, which comprises clarithromycin(CAM: Biaxin®), lenalidomide(LEN: Revlimid®), and dexamethasone( DEX), is a highly effective treatment for newly diagnosed symptomatic multiple myeloma(MM). However, its efficacy against recurrent myeloma refractory to LEN and DEX combination therapy(Rd therapy)remains unclear. In this study, we retrospectively analyzed the data of 7 patients(4 men and 3 women, median age of 76 years)with MM, who had clarithromycin added to their Rd regimen. In all patients, the starting dose of clarithromycin was 400 mg daily and the median number of prior therapies was 3(range, 1-4). Patients received a median of 9 cycles of Rd(range, 6-27 cycles)for a median duration of 8 months. Then, patients received a median of 14 cycles of BiRd(range 2-36 cycles). One patient showed partial response(PR), which was the best response, while the others showed stable disease(SD). Our results demonstrated that the addition of clarithromycin to Rd could overcome resistance to Rd and lead to durable responses, without exacerbating hematological or non-hematological toxicities. Thus, BiRd therapy may represent a therapeutic option for symptomatic MM resist- ant to Rd therapy.
[Mh] Termos MeSH primário: Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico
Claritromicina/administração & dosagem
Resistência a Medicamentos Antineoplásicos
Mieloma Múltiplo/tratamento farmacológico
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Dexametasona/administração & dosagem
Feminino
Seres Humanos
Masculino
Transplante de Células-Tronco
Talidomida/administração & dosagem
Talidomida/análogos & derivados
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
4Z8R6ORS6L (Thalidomide); 7S5I7G3JQL (Dexamethasone); F0P408N6V4 (lenalidomide); H1250JIK0A (Clarithromycin)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171020
[Lr] Data última revisão:
171020
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170902
[St] Status:MEDLINE


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[PMID]:28828759
[Au] Autor:McCallum GB; Plumb EJ; Morris PS; Chang AB
[Ad] Endereço:Child Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia, 0810.
[Ti] Título:Antibiotics for persistent cough or wheeze following acute bronchiolitis in children.
[So] Source:Cochrane Database Syst Rev;8:CD009834, 2017 08 22.
[Is] ISSN:1469-493X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Bronchiolitis is a common acute respiratory condition with high prevalence worldwide. This clinically diagnosed syndrome is manifested by tachypnoea (rapid breathing), with crackles or wheeze in young children. In the acute phase of bronchiolitis (≤ 14 days), antibiotics are not routinely prescribed unless the illness is severe or a secondary bacterial infection is suspected. Although bronchiolitis is usually self-limiting, some young children continue to have protracted symptoms (e.g. cough and wheezing) beyond the acute phase and often re-present to secondary care. OBJECTIVES: To compare the effectiveness of antibiotics versus controls (placebo or no treatment) for reducing or treating persistent respiratory symptoms following acute bronchiolitis within six months of acute illness. SEARCH METHODS: We searched the following databases: the Cochrane Airways Group Register of Trials, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (Ovid), Embase (Ovid), the World Health Organization (WHO) trial portal, the Australian and New Zealand Clinical Trials Registry, and ClinicalTrials.gov, up to 26 August 2016. SELECTION CRITERIA: We included randomised controlled trials (RCTs) comparing antibiotics versus controls (placebo or no treatment) given in the post-acute phase of bronchiolitis (> 14 days) for children younger than two years with a diagnosis of bronchiolitis. DATA COLLECTION AND ANALYSIS: Two review authors independently assessed studies against predefined criteria, and selected, extracted, and assessed data for inclusion. We contacted trial authors for further information. MAIN RESULTS: In this review update, we added one study with 219 children. A total of two RCTs with 249 children (n = 240 completed) were eligible for inclusion in this review. Both studies contributed to our primary and secondary outcomes, but we assessed the quality of evidence for our three primary outcomes as low, owing to the small numbers of studies and participants; and high attrition in one of the studies. Data show no significant differences between treatment groups for our primary outcomes: proportion of children (n = 249) who had persistent symptoms at follow-up (odds ratio (OR) 0.69, 95% confidence interval (CI) 0.37 to 1.28; fixed-effect model); and number of children (n = 240) rehospitalised with respiratory illness within six months (OR 0.54, 95% CI 0.05 to 6.21; random-effects model). We were unable to analyse exacerbation rate because studies used different methods to report this information. Data showed no significant differences between treatment groups for our secondary outcome: proportion of children (n = 240) with wheeze at six months (OR 0.47, 95% CI 0.06 to 3.95; random-effects model). One study reported bacterial resistance, but only at 48 hours (thus with limited applicability for this review). Another study reported adverse events from which all children recovered and remained in the study. AUTHORS' CONCLUSIONS: Current evidence is insufficient to inform whether antibiotics should be used to treat or prevent persistent respiratory symptoms in the post-acute bronchiolitis phase. Future RCTs are needed to evaluate the efficacy of antibiotics for reducing persistent respiratory symptoms. This is particularly important in populations with high acute and post-acute bronchiolitis morbidity (e.g. indigenous populations in Australia, New Zealand, and the USA).
[Mh] Termos MeSH primário: Antibacterianos/uso terapêutico
Bronquiolite/complicações
Claritromicina/uso terapêutico
Tosse/tratamento farmacológico
Sons Respiratórios/efeitos dos fármacos
Infecções por Vírus Respiratório Sincicial/tratamento farmacológico
[Mh] Termos MeSH secundário: Doença Aguda
Bronquiolite/virologia
Tosse/etiologia
Seres Humanos
Lactente
Ensaios Clínicos Controlados Aleatórios como Assunto
Sons Respiratórios/etiologia
Infecções por Vírus Respiratório Sincicial/complicações
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; RESEARCH SUPPORT, NON-U.S. GOV'T; REVIEW
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); H1250JIK0A (Clarithromycin)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170919
[Lr] Data última revisão:
170919
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170823
[St] Status:MEDLINE
[do] DOI:10.1002/14651858.CD009834.pub3



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