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[PMID]:28832488
[Au] Autor:Committee on Obstetric Practice
[Ti] Título:Committee Opinion No. 717: Sulfonamides, Nitrofurantoin, and Risk of Birth Defects.
[So] Source:Obstet Gynecol;130(3):e150-e152, 2017 09.
[Is] ISSN:1873-233X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The evidence regarding an association between the nitrofuran and sulfonamide classes of antibiotics and birth defects is mixed. As with all patients, antibiotics should be prescribed for pregnant women only for appropriate indications and for the shortest effective duration. During the second and third trimesters, sulfonamides and nitrofurantoins may continue to be used as first-line agents for the treatment and prevention of urinary tract infections and other infections caused by susceptible organisms. Prescribing sulfonamides or nitrofurantoin in the first trimester is still considered appropriate when no other suitable alternative antibiotics are available. Pregnant women should not be denied appropriate treatment for infections because untreated infections can commonly lead to serious maternal and fetal complications.
[Mh] Termos MeSH primário: Anormalidades Induzidas por Medicamentos/epidemiologia
Anti-Infecciosos Urinários/efeitos adversos
Deformidades Congênitas dos Membros/epidemiologia
Nitrofurantoína/efeitos adversos
Sulfonamidas/efeitos adversos
[Mh] Termos MeSH secundário: Feminino
Seres Humanos
Deformidades Congênitas dos Membros/induzido quimicamente
Obstetrícia
Gravidez
Fatores de Risco
Sociedades Médicas
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE; PRACTICE GUIDELINE
[Nm] Nome de substância:
0 (Anti-Infective Agents, Urinary); 0 (Sulfonamides); 927AH8112L (Nitrofurantoin)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170908
[Lr] Data última revisão:
170908
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170824
[St] Status:MEDLINE
[do] DOI:10.1097/AOG.0000000000002300


  2 / 2538 MEDLINE  
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[PMID]:28832479
[Ti] Título:Committee Opinion No. 717 Summary: Sulfonamides, Nitrofurantoin, and Risk of Birth Defects.
[So] Source:Obstet Gynecol;130(3):666-667, 2017 Sep.
[Is] ISSN:1873-233X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The evidence regarding an association between the nitrofuran and sulfonamide classes of antibiotics and birth defects is mixed. As with all patients, antibiotics should be prescribed for pregnant women only for appropriate indications and for the shortest effective duration. During the second and third trimesters, sulfonamides and nitrofurantoins may continue to be used as first-line agents for the treatment and prevention of urinary tract infections and other infections caused by susceptible organisms. Prescribing sulfonamides or nitrofurantoin in the first trimester is still considered appropriate when no other suitable alternative antibiotics are available. Pregnant women should not be denied appropriate treatment for infections because untreated infections can commonly lead to serious maternal and fetal complications.
[Mh] Termos MeSH primário: Anormalidades Induzidas por Medicamentos/epidemiologia
Anti-Infecciosos Urinários/efeitos adversos
Deformidades Congênitas dos Membros/epidemiologia
Nitrofurantoína/efeitos adversos
Sulfonamidas/efeitos adversos
[Mh] Termos MeSH secundário: Feminino
Seres Humanos
Deformidades Congênitas dos Membros/induzido quimicamente
Obstetrícia
Gravidez
Fatores de Risco
Sociedades Médicas
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE; PRACTICE GUIDELINE
[Nm] Nome de substância:
0 (Anti-Infective Agents, Urinary); 0 (Sulfonamides); 927AH8112L (Nitrofurantoin)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170908
[Lr] Data última revisão:
170908
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170824
[St] Status:MEDLINE
[do] DOI:10.1097/AOG.0000000000002290


  3 / 2538 MEDLINE  
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[PMID]:28632788
[Au] Autor:Wambaugh MA; Shakya VPS; Lewis AJ; Mulvey MA; Brown JCS
[Ad] Endereço:Division of Microbiology and Immunology, Pathology Department, University of Utah School of Medicine, Salt Lake City, Utah, United States of America.
[Ti] Título:High-throughput identification and rational design of synergistic small-molecule pairs for combating and bypassing antibiotic resistance.
[So] Source:PLoS Biol;15(6):e2001644, 2017 Jun.
[Is] ISSN:1545-7885
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Antibiotic-resistant infections kill approximately 23,000 people and cost $20,000,000,000 each year in the United States alone despite the widespread use of small-molecule antimicrobial combination therapy. Antibiotic combinations typically have an additive effect: the efficacy of the combination matches the sum of the efficacies of each antibiotic when used alone. Small molecules can also act synergistically when the efficacy of the combination is greater than the additive efficacy. However, synergistic combinations are rare and have been historically difficult to identify. High-throughput identification of synergistic pairs is limited by the scale of potential combinations: a modest collection of 1,000 small molecules involves 1 million pairwise combinations. Here, we describe a high-throughput method for rapid identification of synergistic small-molecule pairs, the overlap2 method (O2M). O2M extracts patterns from chemical-genetic datasets, which are created when a collection of mutants is grown in the presence of hundreds of different small molecules, producing a precise set of phenotypes induced by each small molecule across the mutant set. The identification of mutants that show the same phenotype when treated with known synergistic molecules allows us to pinpoint additional molecule combinations that also act synergistically. As a proof of concept, we focus on combinations with the antibiotics trimethoprim and sulfamethizole, which had been standard treatment against urinary tract infections until widespread resistance decreased efficacy. Using O2M, we screened a library of 2,000 small molecules and identified several that synergize with the antibiotic trimethoprim and/or sulfamethizole. The most potent of these synergistic interactions is with the antiviral drug azidothymidine (AZT). We then demonstrate that understanding the molecular mechanism underlying small-molecule synergistic interactions allows the rational design of additional combinations that bypass drug resistance. Trimethoprim and sulfamethizole are both folate biosynthesis inhibitors. We find that this activity disrupts nucleotide homeostasis, which blocks DNA replication in the presence of AZT. Building on these data, we show that other small molecules that disrupt nucleotide homeostasis through other mechanisms (hydroxyurea and floxuridine) also act synergistically with AZT. These novel combinations inhibit the growth and virulence of trimethoprim-resistant clinical Escherichia coli and Klebsiella pneumoniae isolates, suggesting that they may be able to be rapidly advanced into clinical use. In sum, we present a generalizable method to screen for novel synergistic combinations, to identify particular mechanisms resulting in synergy, and to use the mechanistic knowledge to rationally design new combinations that bypass drug resistance.
[Mh] Termos MeSH primário: Antibacterianos/farmacologia
Anti-Infecciosos Urinários/farmacologia
Farmacorresistência Bacteriana Múltipla
Escherichia coli/efeitos dos fármacos
Klebsiella pneumoniae/efeitos dos fármacos
[Mh] Termos MeSH secundário: Animais
Antibacterianos/química
Antibacterianos/uso terapêutico
Anti-Infecciosos Urinários/química
Anti-Infecciosos Urinários/uso terapêutico
Proteínas de Bactérias/antagonistas & inibidores
Proteínas de Bactérias/genética
Proteínas de Bactérias/metabolismo
Bioensaio
Biologia Computacional
Desenho de Drogas
Sinergismo Farmacológico
Quimioterapia Combinada
Embrião não Mamífero/efeitos dos fármacos
Embrião não Mamífero/metabolismo
Embrião não Mamífero/microbiologia
Escherichia coli/crescimento & desenvolvimento
Escherichia coli/metabolismo
Infecções por Escherichia coli/tratamento farmacológico
Infecções por Escherichia coli/metabolismo
Infecções por Escherichia coli/microbiologia
Antagonistas do Ácido Fólico/química
Antagonistas do Ácido Fólico/farmacologia
Antagonistas do Ácido Fólico/uso terapêutico
Ensaios de Triagem em Larga Escala
Infecções por Klebsiella/tratamento farmacológico
Infecções por Klebsiella/metabolismo
Infecções por Klebsiella/microbiologia
Klebsiella pneumoniae/crescimento & desenvolvimento
Klebsiella pneumoniae/metabolismo
Testes de Sensibilidade Microbiana
Mutação
Taxa de Mutação
Reconhecimento Automatizado de Padrão
Inibidores da Transcriptase Reversa/química
Inibidores da Transcriptase Reversa/farmacologia
Inibidores da Transcriptase Reversa/uso terapêutico
Bibliotecas de Moléculas Pequenas
Sulfametizol/agonistas
Sulfametizol/química
Sulfametizol/farmacologia
Sulfametizol/uso terapêutico
Trimetoprima/agonistas
Trimetoprima/química
Trimetoprima/farmacologia
Trimetoprima/uso terapêutico
Peixe-Zebra/embriologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; VALIDATION STUDIES
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (Anti-Infective Agents, Urinary); 0 (Bacterial Proteins); 0 (Folic Acid Antagonists); 0 (Reverse Transcriptase Inhibitors); 0 (Small Molecule Libraries); 25W8454H16 (Sulfamethizole); AN164J8Y0X (Trimethoprim)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170926
[Lr] Data última revisão:
170926
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170621
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pbio.2001644


  4 / 2538 MEDLINE  
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[PMID]:28493770
[Au] Autor:Davis C; Rantell A
[Ad] Endereço:Clinical Nurse Specialist in Urogynaecology, King's College Hospital, London.
[Ti] Título:Lower urinary tract infections in women.
[So] Source:Br J Nurs;26(9):S12-S19, 2017 May 11.
[Is] ISSN:0966-0461
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:In her lifetime, a woman is highly likely to develop at least one lower urinary tract infection. Early detection and treatment are key. Being aware of predisposing factors for infection and understanding appropriate diagnosis and treatment regimens will help nurses in both primary and acute care manage these patients correctly. This will not only benefit patients but will also help prevent incorrect antimicrobial management and avoid unplanned admissions. This aim of this article is to provide nurses with the information they need to best advise both colleagues and patients on how to manage lower urinary tract infections in women.
[Mh] Termos MeSH primário: Antibacterianos/uso terapêutico
Infecções Assintomáticas
Farmacorresistência Bacteriana
Infecções Urinárias/tratamento farmacológico
[Mh] Termos MeSH secundário: Fatores Etários
Anti-Infecciosos Urinários/uso terapêutico
Vaginite Atrófica/tratamento farmacológico
Vaginite Atrófica/epidemiologia
Bacteriúria/diagnóstico
Bacteriúria/tratamento farmacológico
Bacteriúria/prevenção & controle
Bacteriúria/urina
Anticoncepção
Técnicas de Cultura
Terapia de Reposição de Estrogênios
Feminino
Hipuratos/uso terapêutico
Seres Humanos
Metenamina/análogos & derivados
Metenamina/uso terapêutico
Nitritos/urina
Educação de Pacientes como Assunto
Probióticos/uso terapêutico
Recidiva
Fatores de Risco
Comportamento Sexual
Infecções Urinárias/diagnóstico
Infecções Urinárias/prevenção & controle
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (Anti-Infective Agents, Urinary); 0 (Hippurates); 0 (Nitrites); J50OIX95QV (Methenamine); M329791L57 (methenamine hippurate)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170713
[Lr] Data última revisão:
170713
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:170512
[St] Status:MEDLINE
[do] DOI:10.12968/bjon.2017.26.9.S12


  5 / 2538 MEDLINE  
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[PMID]:28341436
[Au] Autor:Pinart M; Kranz J; Jensen K; Proctor T; Naber K; Kunath F; Wagenlehner F; Schmidt S
[Ad] Endereço:UroEvidence@Deutsche Gesellschaft für Urologie, Nestorstraße 8/9 (1. Hof), 10709 Berlin, Germany.
[Ti] Título:Optimal dosage and duration of pivmecillinam treatment for uncomplicated lower urinary tract infections: a systematic review and meta-analysis.
[So] Source:Int J Infect Dis;58:96-109, 2017 May.
[Is] ISSN:1878-3511
[Cp] País de publicação:Canada
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To compare the efficacy and safety of different pivmecillinam (PIV) regimes for uncomplicated lower urinary tract infections (UTIs). METHODS: The MEDLINE, Embase, and Cochrane Library databases were searched. Randomized controlled clinical trials (RCTs) involving adults or children with symptoms suggestive of uncomplicated UTI and that compared different PIV regimes or PIV versus other antibiotics were included. Meta-analyses were conducted to obtain direct and indirect efficacy estimates. PIV regimes were categorized into high total dosage, moderate total dosage, and low total dosage. The risk of bias was evaluated using the Cochrane tool. RESULTS: Twenty-four RCTs were identified. No difference in clinical cure was found for the high vs. moderate (short-term: risk ratio (RR) 1.01, p=0.813; long term: RR 1.09, p=0.174) or high vs. low dosage comparisons (mean difference 0, 95% confidence interval -0.44 to 0.45, p=1). For bacteriological cure, comparisons of high vs. moderate dosage (short term: RR 1.05, p=0.056; long term: RR 1.05, p=0.131) and high vs. low dosage (short term: RR 1.02, p=0.759; long term: RR 1.13, p=0.247) showed a trend in favor of the high dosage treatment. Results for relapse, re-infection, and failure were inconclusive and not statistically significant. Patients treated with high dosages were 40% (p=0.062) and 44% (p=0.293) more likely to report mild to moderate adverse events. CONCLUSIONS: There is insufficient evidence to support the use of an optimal combination of dosage, frequency, and duration of PIV therapy for the treatment of uncomplicated lower UTI. Evidence is limited due to the high risk of bias, poor reporting, and heterogeneous study data.
[Mh] Termos MeSH primário: Andinocilina Pivoxil/administração & dosagem
Anti-Infecciosos Urinários/administração & dosagem
Infecções Urinárias/tratamento farmacológico
[Mh] Termos MeSH secundário: Relação Dose-Resposta a Droga
Esquema de Medicação
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Nm] Nome de substância:
0 (Anti-Infective Agents, Urinary); 1WAM1OQ30B (Amdinocillin Pivoxil)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171012
[Lr] Data última revisão:
171012
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170326
[St] Status:MEDLINE


  6 / 2538 MEDLINE  
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[PMID]:28306135
[Au] Autor:Claussen K; Stocks E; Bhat D; Fish J; Rubin CD
[Ad] Endereço:Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas.
[Ti] Título:How Common Are Pulmonary and Hepatic Adverse Effects in Older Adults Prescribed Nitrofurantoin?
[So] Source:J Am Geriatr Soc;65(6):1316-1320, 2017 Jun.
[Is] ISSN:1532-5415
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: To determine the frequency of serious pulmonary and hepatic adverse events (AEs) in persons aged 65 and older prescribed nitrofurantoin. DESIGN: Retrospective electronic health record (EHR) audit of nitrofurantoin prescriptions and associated AEs. SETTING: Urban academic medical center. PARTICIPANTS: All inpatients and outpatients aged 65 and older prescribed nitrofurantoin from January 1, 2010, to December 31, 2014. MEASUREMENTS: The number of nitrofurantoin prescriptions and pulmonary and hepatic AEs associated with nitrofurantoin use was acquired by data extraction from EHRs. RESULTS: Of 3,400 individuals aged 65 and older prescribed nitrofurantoin during the study period, 641 were identified as possibly having one of five targeted symptoms or disease complications (pulmonary and hepatic) associated with nitrofurantoin. After a detailed chart audit, 89% were deemed to have no adverse reaction, 7% had a minor side effect or allergy, and 3.9% met criteria for suspicion of a nitrofurantoin-induced AE, five of whom were rated as being highly suspicious for nitrofurantoin toxicity; four of the five were identified with pulmonary toxicity and one with hepatotoxicity. Four of five of these individuals used nitrofurantoin chronically. CONCLUSION: Nitrofurantoin was prescribed for 3,400 individuals aged 65 and older during the 5-year study period. Serious side effects appeared to be uncommon, but chronic use appeared to be at greater risk.
[Mh] Termos MeSH primário: Anti-Infecciosos Urinários/efeitos adversos
Doença Hepática Induzida por Substâncias e Drogas
Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos
Pneumopatias/induzido quimicamente
Nitrofurantoína/efeitos adversos
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Anti-Infecciosos Urinários/uso terapêutico
Registros Eletrônicos de Saúde/utilização
Feminino
Seres Humanos
Doença Iatrogênica
Masculino
Nitrofurantoína/uso terapêutico
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Infective Agents, Urinary); 927AH8112L (Nitrofurantoin)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170808
[Lr] Data última revisão:
170808
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170318
[St] Status:MEDLINE
[do] DOI:10.1111/jgs.14796


  7 / 2538 MEDLINE  
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[PMID]:28272565
[Au] Autor:Alberg T; Holen Ø; Blix HS; Lindbæk M; Bentele H; Eriksen HM
[Ad] Endereço:Avdeling for resistens- og infeksjonsforebygging Avdeling for smittevernregistre Folkehelseinstituttet.
[Ti] Título:Antibiotic use and infections in nursing homes.
[Ti] Título:Antibiotikabruk og infeksjoner i sykehjem..
[So] Source:Tidsskr Nor Laegeforen;137(5):357-361, 2017 Mar.
[Is] ISSN:0807-7096
[Cp] País de publicação:Norway
[La] Idioma:eng; nor
[Mh] Termos MeSH primário: Antibacterianos/uso terapêutico
Infecções Bacterianas
Infecção Hospitalar
Prescrições de Medicamentos/estatística & dados numéricos
Casas de Saúde
[Mh] Termos MeSH secundário: Idoso
Anti-Infecciosos Urinários/uso terapêutico
Infecções Bacterianas/tratamento farmacológico
Infecções Bacterianas/epidemiologia
Infecções Bacterianas/prevenção & controle
Bacteriúria/tratamento farmacológico
Bacteriúria/epidemiologia
Bacteriúria/prevenção & controle
Infecção Hospitalar/tratamento farmacológico
Infecção Hospitalar/epidemiologia
Infecção Hospitalar/prevenção & controle
Estudos Transversais
Prescrições de Medicamentos/normas
Uso de Medicamentos
Fidelidade a Diretrizes
Seres Humanos
Metenamina/uso terapêutico
Noruega/epidemiologia
Infecções Urinárias/tratamento farmacológico
Infecções Urinárias/epidemiologia
Infecções Urinárias/prevenção & controle
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (Anti-Infective Agents, Urinary); J50OIX95QV (Methenamine)
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170920
[Lr] Data última revisão:
170920
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170309
[St] Status:MEDLINE
[do] DOI:10.4045/tidsskr.16.0621


  8 / 2538 MEDLINE  
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[PMID]:28216442
[Au] Autor:Fox MT; Melia MT; Same RG; Conley AT; Tamma PD
[Ad] Endereço:Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Md.
[Ti] Título:A Seven-Day Course of TMP-SMX May Be as Effective as a Seven-Day Course of Ciprofloxacin for the Treatment of Pyelonephritis.
[So] Source:Am J Med;130(7):842-845, 2017 Jul.
[Is] ISSN:1555-7162
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The Infectious Diseases Society of America guidelines recommend either 14 days of trimethoprim-sulfamethoxazole (TMP-SMX) or 7 days of ciprofloxacin for the treatment of pyelonephritis. Antibiotic courses of 7 days of TMP-SMX vs 7 days of ciprofloxacin for pyelonephritis have not been previously compared. We evaluated the odds of a subsequent, symptomatic urinary tract infection (UTI) for women with Escherichia coli pyelonephritis receiving a 7-day course of TMP-SMX vs a 7-day course of ciprofloxacin. METHODS: Women ages 16 years and older with E. coli pyelonephritis presenting to 5 health care facilities in the greater Maryland area between 2010 and 2016 receiving either TMP-SMX or ciprofloxacin were included. Patients were excluded if they met any of the following criteria: (a) pregnancy, (b) dialysis dependency, (c) E. coli not susceptible to the treatment prescribed, (d) polymicrobial urine culture, or (e) >48 hours of antibiotic therapy other than TMP-SMX or ciprofloxacin. RESULTS: Of 272 women meeting eligibility criteria, 81 (30%) and 191 (70%) received 7 days of TMP-SMX and 7 days of ciprofloxacin, respectively. In an adjusted model, the likelihood of a recurrent UTI within 30 days for the TMP-SMX and ciprofloxacin groups was similar (adjusted odds ratio 2.30; 95% confidence interval, 0.72-7.42). CONCLUSIONS: Our findings suggest that 7 days of TMP-SMX therapy may result in similar clinical outcomes compared with 7 days of ciprofloxacin for the treatment of pyelonephritis. Considering the frequency of pyelonephritis and risks of antibiotic resistance and associated toxicities, decreasing the duration of antibiotic therapy for pyelonephritis may impact a large number of women.
[Mh] Termos MeSH primário: Antibacterianos/administração & dosagem
Anti-Infecciosos Urinários/administração & dosagem
Ciprofloxacino/administração & dosagem
Infecções por Escherichia coli/tratamento farmacológico
Pielonefrite/tratamento farmacológico
Combinação Trimetoprima e Sulfametoxazol/administração & dosagem
[Mh] Termos MeSH secundário: Adulto
Antibacterianos/efeitos adversos
Antibacterianos/uso terapêutico
Anti-Infecciosos Urinários/efeitos adversos
Anti-Infecciosos Urinários/uso terapêutico
Ciprofloxacino/efeitos adversos
Ciprofloxacino/uso terapêutico
Esquema de Medicação
Farmacorresistência Bacteriana
Feminino
Seres Humanos
Meia-Idade
Recidiva
Estudos Retrospectivos
Fatores de Risco
Resultado do Tratamento
Combinação Trimetoprima e Sulfametoxazol/efeitos adversos
Combinação Trimetoprima e Sulfametoxazol/uso terapêutico
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; OBSERVATIONAL STUDY
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (Anti-Infective Agents, Urinary); 5E8K9I0O4U (Ciprofloxacin); 8064-90-2 (Trimethoprim, Sulfamethoxazole Drug Combination)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:171010
[Lr] Data última revisão:
171010
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170221
[St] Status:MEDLINE


  9 / 2538 MEDLINE  
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[PMID]:28110918
[Au] Autor:Abouelhassan Y; Yang Q; Yousaf H; Nguyen MT; Rolfe M; Schultz GS; Huigens RW
[Ad] Endereço:Department of Medicinal Chemistry, College of Pharmacy, University of Florida, 1600 SW Archer Road, Gainesville, FL 32610, USA.
[Ti] Título:Nitroxoline: a broad-spectrum biofilm-eradicating agent against pathogenic bacteria.
[So] Source:Int J Antimicrob Agents;49(2):247-251, 2017 Feb.
[Is] ISSN:1872-7913
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:Bacterial biofilms are surface-attached communities of slow-growing or non-replicating bacteria tolerant to conventional antibiotic therapies. Although biofilms are known to occur in ca. 80% of all bacterial infections, no therapeutic agent has been developed to eradicate bacteria housed within biofilms. We have discovered that nitroxoline, an antibacterial agent used to treat urinary tract infections, displays broad-spectrum biofilm-eradicating activities against major human pathogens, including drug-resistant Staphylococcus aureus and Acinetobacter baumannii strains. In this study, the effectiveness of nitroxoline to eradicate biofilms was determined using an in vitro [minimum biofilm eradication concentration (MBEC) = 46.9 µM against A. baumannii] and ex vivo porcine skin model (2-3 log reduction in viable biofilm cells). Nitroxoline was also found to eradicate methicillin-resistant S. aureus (MRSA) persister cells in non-biofilm (stationary) cultures, whereas vancomycin and daptomycin were found to be inactive. These findings could lead to effective, nitroxoline-based therapies for biofilm-associated infections.
[Mh] Termos MeSH primário: Acinetobacter baumannii/efeitos dos fármacos
Anti-Infecciosos Urinários/farmacologia
Biofilmes/efeitos dos fármacos
Nitroquinolinas/farmacologia
Staphylococcus/efeitos dos fármacos
Enterococos Resistentes à Vancomicina/efeitos dos fármacos
[Mh] Termos MeSH secundário: Acinetobacter baumannii/fisiologia
Seres Humanos
Staphylococcus/fisiologia
Enterococos Resistentes à Vancomicina/fisiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Infective Agents, Urinary); 0 (Nitroquinolines); A8M33244M6 (nitroxoline)
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170306
[Lr] Data última revisão:
170306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170124
[St] Status:MEDLINE


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[PMID]:28108978
[Au] Autor:Ren H; Li X; Ni ZH; Niu JY; Cao B; Xu J; Cheng H; Tu XW; Ren AM; Hu Y; Xing CY; Liu YH; Li YF; Cen J; Zhou R; Xu XD; Qiu XH; Chen N
[Ad] Endereço:Department of Nephrology, Rui Jin Hospital Shanghai Jiao Tong University School of Medicine, No. 197 Rui Jin Er Road, Shanghai, 200025, China.
[Ti] Título:Treatment of complicated urinary tract infection and acute pyelonephritis by short-course intravenous levofloxacin (750 mg/day) or conventional intravenous/oral levofloxacin (500 mg/day): prospective, open-label, randomized, controlled, multicenter, non-inferiority clinical trial.
[So] Source:Int Urol Nephrol;49(3):499-507, 2017 Mar.
[Is] ISSN:1573-2584
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To compare the efficacy and safety of short-course intravenous levofloxacin (LVFX) 750 mg with a conventional intravenous/oral regimen of LVFX 500 mg in patients from China with complicated urinary tract infections (cUTIs) and acute pyelonephritis (APN). METHODS: This was a prospective, open-label, randomized, controlled, multicenter, non-inferiority clinical trial. Patients with cUTI and APN were randomly assigned to a short-course therapy group (intravenous LVFX at750 mg/day for 5 days) or a conventional therapy group (intravenous/oral regimen of LVFX at 500 mg/day for 7-14 days). The clinical, laboratory, and microbiological results were evaluated for efficacy and safety. RESULTS: The median dose of LVFX was 3555.4 mg in the short-course therapy group and 4874.2 mg in the conventional therapy group. Intention-to-treat analysis indicated the clinical effectiveness in the short-course therapy group (89.87%, 142/158) was non-inferior to that in the conventional therapy group (89.31%, 142/159). The microbiological effectiveness rates were also similar (short-course therapy: 89.55%, 60/67; conventional therapy: 86.30%, 63/73; p > 0.05). There were no significant differences in other parameters, including clinical and microbiological recurrence rates. The incidence of adverse effects and drug-related adverse effects were also similar for the short-course therapy group (21.95%, 36/164; 18.90%, 31/164) and the conventional therapy group (23.03%, 38/165; 15.76%, 26/165). CONCLUSION: Patients with cUTIs and APN who were given short-course LVFX therapy and conventional LVFX therapy had similar outcomes in clinical and microbiological efficacy, tolerance, and safety. The short-course therapy described here is a more convenient alternative to the conventional regimen with potential implication in anti-resistance and cost saving.
[Mh] Termos MeSH primário: Anti-Infecciosos Urinários/administração & dosagem
Levofloxacino/administração & dosagem
Pielonefrite/tratamento farmacológico
Infecções Urinárias/tratamento farmacológico
[Mh] Termos MeSH secundário: Doença Aguda
Administração Intravenosa
Administração Oral
Adulto
Idoso
Anti-Infecciosos Urinários/efeitos adversos
Feminino
Seres Humanos
Análise de Intenção de Tratamento
Levofloxacino/efeitos adversos
Masculino
Meia-Idade
Pielonefrite/microbiologia
Resultado do Tratamento
Infecções Urinárias/microbiologia
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Anti-Infective Agents, Urinary); 6GNT3Y5LMF (Levofloxacin)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171013
[Lr] Data última revisão:
171013
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170122
[St] Status:MEDLINE
[do] DOI:10.1007/s11255-017-1507-0



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