Journal articles on the topic 'Antibiotic delivery'
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Karr, Jeffrey C. "Management in the Wound-care Center Outpatient Setting of a Diabetic Patient with Forefoot Osteomyelitis Using Cerament Bone Void Filler Impregnated with Vancomycin." Journal of the American Podiatric Medical Association 101, no. 3 (May 1, 2011): 259–64. http://dx.doi.org/10.7547/1010259.
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Several nonbiodegradable and biodegradable antibiotic cement delivery systems are available for the delivery of antibiotics for adjunctive therapy in the management of osteomyelitis. A major nonbiodegradable delivery system is polymethylmethacrylate beads. Antibiotics that can be incorporated into this delivery system are limited to the heat-stable antibiotics vancomycin and aminoglycosides, tobramycin being the most popular. Calcium sulfate and hydroxyapatite (Cerament Bone Void Filler) is a unique biocompatible and biodegradable ceramic bone void filler that can successfully deliver heat-stable and heat-unstable antibiotics in musculoskeletal infections. The use of Cerament as antibiotic beads has not been previously reported. An off-label case of diabetic foot osteomyelitis successfully managed with surgical bone resection and vancomycin Cerament antibiotic beads is presented. Subsequent surgery for the bone infection and staged removal of the antibiotic beads was not necessary. (J Am Podiatr Med Assoc 101(3): 259–264, 2011)
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Khazi-Syed, Afeefah, Md Tanvir Hasan, Elizabeth Campbell, Roberto Gonzalez-Rodriguez, and Anton V. Naumov. "Single-Walled Carbon Nanotube-Assisted Antibiotic Delivery and Imaging in S. epidermidis Strains Addressing Antibiotic Resistance." Nanomaterials 9, no. 12 (November 25, 2019): 1685. http://dx.doi.org/10.3390/nano9121685.
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Although conventional antibiotics have evolved as a staple of modern medicine, increasing antibiotic resistance and the lack of antibiotic efficacy against new bacterial threats is becoming a major medical threat. In this work, we employ single-walled carbon nanotubes (SWCNTs) known to deliver and track therapeutics in mammalian cells via intrinsic near-infrared fluorescence as carriers enhancing antibacterial delivery of doxycycline and methicillin. SWCNTs dispersed in water by antibiotics without the use of toxic bile salt surfactants facilitate efficacy enhancement for both antibiotics against Staphylococcus epidermidis strain showing minimal sensitivity to methicillin. Doxycycline to which the strain did not show resistance in complex with SWCNTs provides only minor increase in efficacy, whereas the SWCNTs/methicillin complex yields up to 40-fold efficacy enhancement over antibiotics alone, suggesting that SWCNT-assisted delivery may circumvent antibiotic resistance in that bacterial strain. At the same time SWCNT/antibiotic formulations appear to be less toxic to mammalian cells than antibiotics alone suggesting that nanomaterial platforms may not restrict potential biomedical applications. The improvement in antibacterial performance with SWCNT delivery is tested via 3 independent assays—colony count, MIC (Minimal Inhibitory Concentration) turbidity and disk diffusion, with the statistical significance of the latter verified by ANOVA and Dunnett’s method. The potential mechanism of action is attributed to SWCNT interactions with bacterial cell wall and adherence to the membrane, as substantial association of SWCNT with bacteria is observed—the near-infrared fluorescence microscopy of treated bacteria shows localization of SWCNT fluorescence in bacterial clusters, scanning electron microscopy verifies SWCNT association with bacterial surface, whereas transmission electron microscopy shows individual SWCNT penetration into bacterial cell wall. This work characterizes SWCNTs as novel advantageous antibiotic delivery/imaging agents having the potential to address antibiotic resistance.
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Yalamanchi, Pratyusha, Ashley Parent, and Marc Thorne. "Optimization of Delivery of Pediatric Otolaryngology Surgical Antibiotic Prophylaxis." Otolaryngology–Head and Neck Surgery 163, no. 2 (June 23, 2020): 275–79. http://dx.doi.org/10.1177/0194599820933191.
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Objectives There is limited evidence regarding use of routine perioperative antibiotics for pediatric otolaryngologic procedures. The objectives of this quality improvement study were (1) to characterize the otolaryngology case mix for which antibiotics were delivered and (2) determine the percentage of surgical encounters with appropriate timing of antibiotic administration. Methods Pediatric otolaryngology procedures meeting criteria from 2015 to 2019 were evaluated as a component of an institution-wide pediatric surgical antibiotic prophylaxis study using A3 problem solving to identify and roll out interventions for appropriate antibiotic administration. Descriptive statistical analysis of the interrupted time-series data was used to describe the otolaryngology case mix for which antibiotics were delivered. The primary outcome measure was percentage of surgical encounters with appropriate timing of antibiotic administration in minutes relative to incision. Results In total, 1520 pediatric otolaryngology procedures with perioperative antibiotic delivery were performed from July 2015 to September 2019. While surgical site infection number (n = 2/year) was stable, administration of timely prophylactic antibiotics significantly improved: 27.5% of cases per month at baseline and 86.9% at the conclusion of the rollout of the sequential interventions ( P < .001). Discussion Given the exceedingly low infection rate of clean otolaryngology surgery, there is limited evidence in favor of perioperative antibiotics for the majority of procedures. Prophylactic antibiotics were most commonly used in otologic surgery involving cochlear implantation or in the setting of draining ears or cholesteatoma and in clean-contaminated head and neck surgery cases. Implications for Practice Iterative continuous performance improvement can optimize evidence-based delivery of preoperative prophylactic antibiotics. Additional interventions to ensure antimicrobial stewardship in pediatric otolaryngology are indicated.
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Shukla, Shashank, and Anita Shukla. "Tunable antibiotic delivery from gellan hydrogels." Journal of Materials Chemistry B 6, no. 40 (2018): 6444–58. http://dx.doi.org/10.1039/c8tb00980e.
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Skwarczynski, Mariusz, Sahra Bashiri, Ye Yuan, Zyta M. Ziora, Osama Nabil, Keita Masuda, Mattaka Khongkow, et al. "Antimicrobial Activity Enhancers: Towards Smart Delivery of Antimicrobial Agents." Antibiotics 11, no. 3 (March 18, 2022): 412. http://dx.doi.org/10.3390/antibiotics11030412.
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The development of effective treatments against infectious diseases is an extensive and ongoing process due to the rapid adaptation of bacteria to antibiotic-based therapies. However, appropriately designed activity enhancers, including antibiotic delivery systems, can increase the effectiveness of current antibiotics, overcoming antimicrobial resistance and decreasing the chance of contributing to further bacterial resistance. The activity/delivery enhancers improve drug absorption, allow targeted antibiotic delivery, improve their tissue and biofilm penetration and reduce side effects. This review provides insights into various antibiotic activity enhancers, including polymer, lipid, and silver-based systems, designed to reduce the adverse effects of antibiotics and improve formulation stability and efficacy against multidrug-resistant bacteria.
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R, Priyanka, and Sayani Bhattacharyya. "A REVIEW ON PROMISING ANTIBIOTIC THERAPY BY NOVEL DELIVERY SYSTEMS." Asian Journal of Pharmaceutical and Clinical Research 11, no. 5 (May 1, 2018): 18. http://dx.doi.org/10.22159/ajpcr.2018.v11i5.23999.
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The introduction of a new moiety of drugs for antibiotics in the market is getting declined. Antibiotic resistance is a major threat to human health worldwide. Many life-saving antibiotic drugs are rendered ineffective. Resistant bacterial infections are difficult to treat because of the poor response to antibiotics. Hence, utilizing the novel methods/approaches for the development of formulation into its novel delivery can prevent bacterial resistance. This review article explores the various promising approaches for delivery of antibiotics in the form of liposomes, solid lipid nanoparticles, microspheres, dendrimers, inhaled antibiotics, and polymeric particles. These approaches of delivery have been proven to provide innovative and novel delivery of antibiotic by enhancing the therapeutic effectiveness, targeting at the site of action, enhanced activity, and penetrability at intracellular pathogens, thereby reducing side effects, toxicity, and the chances of bacterial resistance.
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Wong, Wendy S. W., Priya Sabu, Varsha Deopujari, Shira Levy, Ankit A. Shah, Nicole Clemency, Marina Provenzano, et al. "Prenatal and Peripartum Exposure to Antibiotics and Cesarean Section Delivery Are Associated with Differences in Diversity and Composition of the Infant Meconium Microbiome." Microorganisms 8, no. 2 (January 27, 2020): 179. http://dx.doi.org/10.3390/microorganisms8020179.
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The meconium microbiome may provide insight into intrauterine and peripartum exposures and the very earliest intestinal pioneering microbes. Prenatal antibiotics have been associated with later obesity in children, which is thought to be driven by microbiome dependent mechanisms. However, there is little data regarding associations of prenatal or peripartum antibiotic exposure, with or without cesarean section (CS), with the features of the meconium microbiome. In this study, 16S ribosomal RNA gene sequencing was performed on bacterial DNA of meconium samples from 105 infants in a birth cohort study. After multivariable adjustment, delivery mode (p = 0.044), prenatal antibiotic use (p = 0.005) and peripartum antibiotic use (p < 0.001) were associated with beta diversity of the infant meconium microbiome. CS (vs. vaginal delivery) and peripartum antibiotics were also associated with greater alpha diversity of the meconium microbiome (Shannon and Simpson, p < 0.05). Meconium from infants born by CS (vs. vaginal delivery) had lower relative abundance of the genus Escherichia (p < 0.001). Prenatal antibiotic use and peripartum antibiotic use (both in the overall analytic sample and when restricting to vaginally delivered infants) were associated with differential abundance of several bacterial taxa in the meconium. Bacterial taxa in the meconium microbiome were also differentially associated with infant excess weight at 12 months of age, however, sample size was limited for this comparison. In conclusion, prenatal and peripartum antibiotic use along with CS delivery were associated with differences in the diversity and composition of the meconium microbiome. Whether or not these differences in the meconium microbiome portend risk for long-term health outcomes warrants further exploration.
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Karr, Jeffrey C. "Lower-Extremity Osteomyelitis Treatment Using Calcium Sulfate/Hydroxyapatite Bone Void Filler with Antibiotics." Journal of the American Podiatric Medical Association 108, no. 3 (May 1, 2018): 210–14. http://dx.doi.org/10.7547/16-096.
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Background: Over a 74-month period (∼6 years), 143 lower-extremity osteomyelitis locations in 125 patients were treated with a calcium sulfate/hydroxyapatite liquid bone void filler with antibiotic(s). Methods: The osteomyelitis locations were treated with a percutaneous antibiotic delivery technique delivering intraosseous antibiotic followed by either oral or intravenous antibiotics for 4 weeks. Results: There was no recurrence of osteomyelitis in 96.15% of the treatable patients. Outcomes classified by the Cierny-Mader clinical classification are discussed as well. Conclusions: A bone void filler with antibiotic(s) using the percutaneous antibiotic delivery technique is a safe, reliable, and effective means to treat lower-extremity osteomyelitis with either oral or intravenous antibiotics for 4 weeks.
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Karmila, Ariesti, Mohammad Zulkarnain, Abarham Martadiansyah, Putri Mirani, Nuswil Bernolian, Joseph C. Gardiner, and Lixin Zhang. "The Prevalence and Factors Associated with Prophylactic Antibiotic Use during Delivery: A Hospital-Based Retrospective Study in Palembang, Indonesia." Antibiotics 10, no. 8 (August 19, 2021): 1004. http://dx.doi.org/10.3390/antibiotics10081004.
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Prophylactic antibiotic usage during delivery is a common practice worldwide, especially in low- to middle-income countries. Guidelines have been published to reduce antibiotic overuse; however, data describing the use of prophylactic antibiotics and clinician adherence to guidelines in low- to middle-income countries remain limited. This study aimed to describe the prevalence of prophylactic antibiotic use, factors associated with its use, and clinician adherence to guidelines. A retrospective review was conducted for all deliveries from 1 January 2016 to 31 December 2018 at a tertiary level hospital in Indonesia. The prevalence of prophylactic antibiotic use during delivery was 47.1%. Maternal education level, Ob/Gyn specialist-led delivery, a history of multiple abortions, C-section, premature membrane rupture, and antepartum hemorrhage were independently associated with prophylactic antibiotic use. Clinician adherence to the guidelines was 68.9%. Adherence to guidelines was the lowest in conditions where the patient had only one indication for prophylactic antibiotics (aOR 0.36, 95% CI 0.24–0.54). The findings showed that the prevalence of prophylactic antibiotic use during delivery was moderate to high. Adherence to local guidelines was moderate. Updating the local prescribing guidelines may improve clinician adherence.
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Kumar, TS Sampath, and K. Madhumathi. "Antibiotic delivery by nanobioceramics." Therapeutic Delivery 7, no. 8 (August 2016): 573–88. http://dx.doi.org/10.4155/tde-2016-0025.
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Hanssen, Arlen D., Douglas R. Osmon, and Robin Patel. "Local Antibiotic Delivery Systems." Clinical Orthopaedics and Related Research &NA;, no. 437 (August 2005): 111–14. http://dx.doi.org/10.1097/01.blo.0000175122.50804.ce.
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El-Husseiny, M., S. Patel, R. J. MacFarlane, and F. S. Haddad. "Biodegradable antibiotic delivery systems." Journal of Bone and Joint Surgery. British volume 93-B, no. 2 (February 2011): 151–57. http://dx.doi.org/10.1302/0301-620x.93b2.24933.
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Grujic, Zorica, Jovan Popovic, Mirjana Bogavac, and Ilija Grujic. "Preoperative administration of cephalosporins for elective caesarean delivery." Srpski arhiv za celokupno lekarstvo 138, no. 9-10 (2010): 600–603. http://dx.doi.org/10.2298/sarh1010600g.
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Introduction. Antibiotic prophylaxis means administration of antibiotics in prevention of infections. Objective. To investigate the efficacy of a single dose preoperative administration of ceftriaxone and cefazolin in the prevention of intra- and postoperative infections in the parturients without high risk of inflammation. Methods. The first group of 45 pregnant and 4 non-pregnant women were preoperatively administered ceftriaxone in a dose of 2 g, i.v., 10 minutes before the planned surgery. The second group of 45 pregnant and 4 non-pregnant women were preoperatively administered cefazolin in a dose of 2 g i.v., 10 minutes before the planned surgery. The concentrations of antibiotics were estimated immediately and 6 hours following the operation, as well as in the amniotic fluid and umbilical cord in the group of pregnant women. The estimation of antibiotic concentration was done by the method of liquid chromatography. Results. The mean concentrations of antibiotics in the patients following the elective caesarean section were as follows: ceftriaxone - 22.7 ?g/l. vs cefazolin - 44.8 ?g/l. Six hours later, the concentration of antibiotic decreased, but the concentration of cefazolin was still over the MIC for sensitive bacteria. The mean concentrations of antibiotics following gynaecological surgery in the non-pregnant patients were as follows: ceftriaxone - 12.0 ?g/l vs cefazolin - 30.1 ?g/l. Six hours later, the concentration of antibiotic decreased. Conclusion. It is most optimal to administer a single-dose of the first generation cephalosporins-cefazolin-immediately following the clamping of the umbilical cord as well as in preoperative prophylaxis in gynaecological operations.
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Tang, Jie, Qiuhong Ouyang, Yanyan Li, Peisen Zhang, Weihua Jin, Shuang Qu, Fengmei Yang, Zhanlong He, and Meng Qin. "Nanomaterials for Delivering Antibiotics in the Therapy of Pneumonia." International Journal of Molecular Sciences 23, no. 24 (December 12, 2022): 15738. http://dx.doi.org/10.3390/ijms232415738.
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Bacterial pneumonia is one of the leading causes of death worldwide and exerts a significant burden on health-care resources. Antibiotics have long been used as first-line drugs for the treatment of bacterial pneumonia. However, antibiotic therapy and traditional antibiotic delivery are associated with important challenges, including drug resistance, low bioavailability, and adverse side effects; the existence of physiological barriers further hampers treatment. Fortunately, these limitations may be overcome by the application of nanotechnology, which can facilitate drug delivery while improving drug stability and bioavailability. This review summarizes the challenges facing the treatment of bacterial pneumonia and also highlights the types of nanoparticles that can be used for antibiotic delivery. This review places a special focus on the state-of-the-art in nanomaterial-based approaches to the delivery of antibiotics for the treatment of pneumonia.
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Harartasyahrani, Rangti Annisa, and Sarmalina Simamora. "EVALUASI PENGGUNAAN ANTIBIOTIK PROFILAKSIS PADA PASIEN BEDAH KATEGORI HIGHLY RECOMMENDED DI RUMAH SAKIT “X” KOTA PRABUMULIH." Jurnal Muara Sains, Teknologi, Kedokteran dan Ilmu Kesehatan 5, no. 1 (May 4, 2021): 121. http://dx.doi.org/10.24912/jmstkik.v5i1.9039.
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Based on Permenkes RI No.2406 / Menkes / per / XII / 2011 on General Guidelines for the Use of Antibiotics that prophylaxis antibiotics intended to reduce and prevent to occurrence of Surgical Site Infection (SSI), inhibiting the emergence of resistance, reduce the morbidity and mortality of patients, as well as to minimize the value of health care and prophylaxis antibiotics in highly recommended surgical procedures has been proven to be firm and effective. However, from several studies there are still many discrepancies in the use of prophylaxis antibiotics and there are several cases in patients with highly recommended surgical procedures that are not given prophylaxis antibiotics, so this research aims to evaluate the use of prophylaxis antibiotics in highly recommended surgical patients. This research was observational research. The data was obtained retrospectively by searching the medical record data of highly recommended surgical patient in Hospital”X” Prabumulih period of January-December 2019 using the Purposive sampling method which is further analyzed descriptively using the applicable guidelines. From 77 medical records of patients collected found 1 patient (1.30%) who did not get antibiotics and from 76 medical record data that met the inclusion criteria there were 119 prophylaxis antibiotic use and overall there were 8 uses (6.72%). Suitability based on antibiotic type as much as 110 (92.44%), antibiotic doses as many as 95 (86.36%), delivery route as much as 110 (100%), delivery time as much as 103 (93.64%), delivery interval of 8 (7.27%), and length of delivery as much as 44 (40%). Overall, the using of prophylaxis antibiotics is not fully appropriate and the most common discrepancies are found at the interval of administration. Keywords: Prophylaxis antibiotics; Surgery; Evaluation; Highly Recommended AbstrakBerdasarkan Permenkes RI No.2406/Menkes/per/XII/2011 tentang Pedoman Umum Penggunaan Antibiotik bahwa pemberian antibiotik profilaksis ditujukan untuk menurunkan dan mencegah terjadinya Infeksi Luka Operasi (ILO), menghambat munculnya resistensi, menurunkan morbiditas dan mortalitas pasien, serta untuk meminimalkan biaya pelayanan kesehatan dan pemberian antibiotik profilaksis pada prosedur bedah kategori highly recommended telah terbukti tegas dan efektif. Namun, dari beberapa penelitian masih banyak dijumpai ketidaksesuaian dalam penggunaan antibiotik profilaksis serta terdapat beberapa kasus pada pasien prosedur bedah kategori highly recommended yang tidak diberikan antibiotik profilaksis maka penelitian ini bertujuan untuk mengevaluasi penggunaan antibiotik profilaksis pada pasien bedah kategori highly recommended. Penelitian ini merupakan penelitian observasional. Data diperoleh secara retrospektif melalui penelusuran data rekam medik pasien bedah kategori highy recommended di Rumah Sakit “X” Kota Prabumulih periode Januari-Desember 2019 dengan menggunakan metode purposive sampling yang selanjutnya dianalisis secara deskriptif menggunakan pedoman yang berlaku. Dari 77 rekam medik pasien yang terkumpul ditemukan 1 pasien (1,30%) yang tidak mendapat antibiotik profilaksis dan dari 76 data rekam medik yang memenuhi kriteria inklusi terdapat 119 penggunaan antibiotik profilaksis dan secara keseluruhan didapat kesesuaian sebanyak 8 penggunaan (6,72%). Kesesuaian berdasarkan jenis antibiotik sebanyak 110 (92,44%), dosis antibiotik sebanyak 95 (86,36%), rute pemberian sebanyak 110 (100%), waktu pemberian sebanyak 103 (93,64%), interval pemberian sebanyak 8 (7,27%), dan lama pemberian sebanyak 44 (40%). Secara keseluruhan, penggunaan antibiotik profilaksis belum sepenuhnya sesuai dan ketidaksesuaian yang paling banyak ditemukan yaitu pada interval pemberian.
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Fuller, Melanie A., Ashley Carey, Harriet Whiley, Rio Kurimoto, Mitsuhiro Ebara, and Ingo Köper. "Nanoparticles in an antibiotic-loaded nanomesh for drug delivery." RSC Advances 9, no. 52 (2019): 30064–70. http://dx.doi.org/10.1039/c9ra06398f.
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Marson, B. A., S. R. Deshmukh, D. J. C. Grindlay, B. J. Ollivere, and B. E. Scammell. "A systematic review of local antibiotic devices used to improve wound healing following the surgical management of foot infections in diabetics." Bone & Joint Journal 100-B, no. 11 (November 2018): 1409–15. http://dx.doi.org/10.1302/0301-620x.100b11.bjj-2018-0720.
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Aims Local antibiotics are used in the surgical management of foot infection in diabetic patients. This systematic review analyzes the available evidence of the use of local antibiotic delivery systems as an adjunct to surgery. Materials and Methods Databases were searched to identify eligible studies and 13 were identified for inclusion. Results Overall, the quality of the studies was poor. A single trial suggested that wound healing is quicker when a gentamicin-impregnated collagen sponge was implanted at time of surgery, with no difference in length of stay or rate of amputation. Results from studies with high risk of bias indicated no change in wound healing when a gentamicin-impregnated sponge was implanted during transmetatarsal amputation, but a reduction in the incidence of wound breakdown (8% vs 25%, not statistically significant) was identified. A significant cost reduction was identified when using an antimicrobial gel to deliver antibiotics and anti-biofilm agents (quorum-sensing inhibitors) compared with routine dressings and systemic antibiotics. Analyses of case series identified 485 patients who were treated using local antibiotic delivery devices. The rates of wound healing, re-operation, and mortality were comparable to those that have been previously reported for the routine management of these infections. Conclusion There is a lack of good-quality evidence to support the use of local antibiotic delivery devices in the treatment of foot infections in patients with diabetes. Cite this article: Bone Joint J 2018;100-B:1409–15.
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Yan, Weirong, Anna Machowska, Amphoy Sihavong, Vanphanom Sychareun, Kongmany Chaleunvong, Bounxou Keohavong, Jaran Eriksen, et al. "Antibiotic Prescribing in Connection to Childbirth: An Observational Study in Two Districts in Lao PDR." Antibiotics 11, no. 4 (March 25, 2022): 448. http://dx.doi.org/10.3390/antibiotics11040448.
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Overuse and misuse of antibiotics has frequently been reported for obstetric conditions and procedures, which may impact both the mother and the unborn baby and increase antibiotic resistance. This study aimed to investigate the antibiotic prescribing pattern in connection to childbirth in two districts in Lao PDR. It is a cross-sectional observational study. Antibiotic prescription data related to childbirth was collected via reviews of medical records in two district hospitals and five health centers in Lao PDR from September 2019 to November 2020. In total, antibiotic prescription data for 1777 women were extracted from their medical records. It was found that all women received antibiotics during in-patient care irrespective of delivery mode. When in hospital, 85.5% of the women who underwent a caesarean section got antibiotic treatment for 5 days and women who had a vaginal delivery usually had antibiotic treatment for one day or less. All the women got oral antibiotics for an additional 4–5 days upon discharge. Antibiotic prescription rate in connection to childbirth was very high in comparison with the WHO guidelines, and antibiotics were used extensively in the participating health facilities. Interventions to guide appropriate prescribing behavior in relation to childbirth are urgently needed in Lao PDR.
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Vassallo, Antonio, Maria Francesca Silletti, Immacolata Faraone, and Luigi Milella. "Nanoparticulate Antibiotic Systems as Antibacterial Agents and Antibiotic Delivery Platforms to Fight Infections." Journal of Nanomaterials 2020 (September 12, 2020): 1–31. http://dx.doi.org/10.1155/2020/6905631.
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Today’s human society, product of decades of progress in all fields of knowledge, would have been unimaginable without the discovery of antibiotics and more generally of antimicrobials. However, from the beginning, the scientific community was aware that microorganisms through various strategies were able to hinder and render vain antibiotic action. Common examples are the phenomena of persistence, tolerance, and resistance, up to the creation of the feared bacterial biofilms. Antibiotics are a precious but equally labile resource that must be preserved but at the same time reinforced to safeguard their effectiveness. Nanoparticulate systems such as nanobactericides, with their inherent antibacterial activity, and nanocarriers, which operate as drug delivery systems for conventional antibiotics, are innovative therapies made available by nanotechnology. Inorganic nanoparticles are effective both as nanobactericides (AgNPs, ZnONPs, and TiO2NPs) and as nanocarriers (AgNPs, AuNPs, ZnONPs, and TiO2NPs) against sensitive and multi-drug-resistant bacterial strains. Liposomes are among the most studied and flexible antibiotic delivery platforms: conventional liposomes allow passive targeting at the mononuclear phagocytic system (MPS); “stealth” liposomes prevent macrophage uptake so as to eradicate infections in tissues and organs outside MPS; thanks to their positive charge, cationic liposomes interact preferentially with bacterial and biofilm surfaces, acting as innate antibacterials as well as drug delivery systems (DDS); fusogenic liposomes have fluid bilayers that promote fusion with microbial membranes; and finally, ligand-targeted liposomes provide active targeting at infection sites. Dendrimers are among the most recent and attractive nanoparticulate systems, thanks to their multibranched nanoarchitecture, which equipped them with multiple active sites for loading antibiotics and also interacting with bacteria. Finally, nanoantibiotics represent a new hopeful generation of antibiotic candidates capable of increasing or even restoring the clinical efficacy of “old” antibiotics rendered useless by the resistance phenomena.
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Trinh, Nhung Thi Hong, Sarah Hjorth, and Hedvig Marie Egeland Nordeng. "Use of interrupted time-series analysis to characterise antibiotic prescription fills across pregnancy: a Norwegian nationwide cohort study." BMJ Open 11, no. 12 (December 2021): e050569. http://dx.doi.org/10.1136/bmjopen-2021-050569.
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ObjectivesAntibiotics are the most frequently prescribed medications for pregnant and breastfeeding women. We applied interrupted time-series analysis (ITSA) to describe antibiotic prescription fills patterns in pregnant women and examined recurrent antibiotic fills in subsequent pregnancies.DesignsA population-based drug utilisation study.SettingNorwegian primary care.Participants653 058 pregnancies derived from Medical Birth Registry of Norway linked to the Norwegian Prescription Database (2006–2016).Main outcome measureProportion of pregnancies exposed to antibiotics aggregated by week in pregnancy time windows.Statistical analysesWe descriptively analysed antibiotic prescription fills patterns and components in pregnant women. The changes in antibiotic fills in pregnancy time windows were assessed using ITSA. Interruptions points at week 4 to week 7 into pregnancy and delivery were used. Factors associated with antibiotic fills during pregnancy were identified using generalised estimating equations for Poisson regression. Recurrent antibiotic use was estimated using proportion of women who filled antibiotic prescription in a subsequent pregnancy.ResultsAntibiotics were filled in 27.6% pregnancies. The ITSA detected an immediate decrease of 0.07 percentage points (95% CI −0.13 to –0.01) in the proportion of exposed pregnancies at 4 weeks after conception, mainly among women taking folic acid before pregnancy. This proportion increased shortly after delivery (immediate change=1.61 percentage points (95% CI 0.31 to 2.91)) then decreased gradually afterwards (change in slope=−0.19 percentage points, 95% CI −0.34 to –0.05)). The strongest factor associated with antibiotic fills during pregnancy was having recurrent urinary tract infections (adjusted OR=2.65, 95% CI 2.59 to 2.72). Women who had filled antibiotics during a pregnancy were up to three times more likely to fill antibiotics in the subsequent pregnancies.ConclusionsITSA highlighted important impact of pregnancy and delivery on antibiotic fillings. Having antibiotic fills in a pregnancy was associated with recurrent antibiotic fills in subsequent ones.
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Machowska, Anna, Amphoy Sihavong, Jaran Eriksen, Manivanh Vongsouvath, Gaetano Marrone, Vanphanom Sychareun, Claudia Hanson, et al. "Containment of Antibiotic REsistance—measures to improve antibiotic use in pregnancy, childbirth and young children (CAREChild): a protocol of a prospective, quasiexperimental interventional study in Lao PDR." BMJ Open 10, no. 11 (November 2020): e040334. http://dx.doi.org/10.1136/bmjopen-2020-040334.
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IntroductionAntibiotics are essential to treat infections during pregnancy and to reduce both maternal and infant mortality. Overall use, but especially non-indicated use, and misuse of antibiotics are drivers of antibiotic resistance (ABR). High non-indicated use of antibiotics for uncomplicated vaginal deliveries is widespread in many parts of the world. Similarly, irrational use of antibiotics is reported for children. There is scarcity of evidence regarding antibiotic use and ABR in Lao PDR (Laos). The overarching aim of this project is to fill those knowledge gaps and to evaluate a quality improvement intervention. The primary objective is to estimate the proportion of uncomplicated vaginal deliveries where antibiotics are used and to compare its trend before and after the intervention.Methods and analysisThis 3-year, prospective, quasiexperimental study without comparison group includes a formative and interventional phase. Data on antibiotic use during delivery will be collected from medical records. Knowledge, attitudes and reported practices on antibiotic use in pregnancy, during delivery and for children, will be collected from women through questionnaires. Healthcare providers’ knowledge, attitudes and practices of antibiotics administration for pregnant women, during delivery and for children, will be collected via adapted questionnaires. Perceptions regarding antibiotics will be explored through focus group discussions with women and individual interviews with key stakeholders. Faecal samples for culturing of Escherichia coli and Klebsiella spp. and antibiotic susceptibility testing will be taken before, during and 6 months after delivery to determine colonisation of resistant strains. The planned intervention will comprise training workshops, educational materials and social media campaign and will be evaluated using interrupted time series analysis.Ethics and disseminationThe project received ethical approval from the National Ethics Committee for Health Research, Ministry of Health, Laos. The results will be disseminated via scientific publications, conference presentations and communication with stakeholders.Trail registration numberISRCTN16217522; Pre-results.
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Setiawati, Yuani, and Azmi Farhadi. "The Use of Prophylactic Antibiotics on Orthopaedic Procedures in an Academic Hospital in Indonesia." International Islamic Medical Journal 2, no. 2 (July 28, 2021): 88–94. http://dx.doi.org/10.33086/iimj.v2i2.2155.
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Background: Surgical site infections (SSIs) are common surgical complications that will increase cost of treatment. The incidence of SSI can be prevented with antibiotic prophylactic. Uncompliance using of prophylactic antibiotics is one of the factors leading to the occurrence a microbes resistance. The data on the using of prophylactic antibiotics in Indonesia is still limited. Objective: This study aims to analyze the using of prophylactic antibiotic guideline on orthopaedic surgery. Methods: The study was conducted retrospectively using data from medical records on patients who had clean and clean-contaminated orthopedic procedures from 2013 to 2016 in the standard operating room of Dr. Soetomo hospital Surabaya. We analyzed the use of prophylactic antibiotics in terms of antibiotic selection, timing of administration, and the compliance to the prophylactic antibiotic local guidelines on orthopaedic surgery. Results: Overall, patient data from 2013 to 2016 was 5246 patients. The compliance rate of prophylactic antibiotics from 2013 to 2016 was 48.3%. This level of compliance uses a selection of antibiotics, dose of administration, delivery mode, delivery time, and route of administration. Conclusion: The results of this study have shown that the prophylactic antibiotic compliance rate on orthophaedic procedures in Soetomo Hospital from 2013 to 2016 was 48,3%. Antibiotic resistance control program quite effective at increasing compliance with the use of the prophylaxis antibiotics.
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Labbaf, Sheyda, Harry Horsley, Ming-Wei Chang, Eleanor Stride, James Malone-Lee, Mohan Edirisinghe, and Jennifer L. Rohn. "An encapsulated drug delivery system for recalcitrant urinary tract infection." Journal of The Royal Society Interface 10, no. 89 (December 6, 2013): 20130747. http://dx.doi.org/10.1098/rsif.2013.0747.
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One of the hallmarks of urinary tract infection, a serious global disease, is its tendency to recur. Uropathogenic bacteria can invade cells lining the bladder, where they form longer-term intracellular reservoirs shielded from antibiotics, re-emerging at a later date to initiate flare-ups. In these cases, only lengthy systemic antibiotic treatment can eradicate all the reservoirs. Yet, long courses of antibiotics are not ideal, as they can lead to side effects and an increase in antibiotic resistance. Moreover, most antibiotics lose some potency by the time they reach the bladder, and many cannot permeate cells, so they cannot access intracellular reservoirs. Here, using coaxial electrohydrodynamic forming, we developed novel core–shell capsules containing antibiotics as a prototype for a future product that could be infused directly into the bladder. Gentamicin was encapsulated in a polymeric carrier (polymethylsilsesquioxane) and these capsules killed Enterococcus faecalis , a common chronic uropathogen, in vitro in a dose-responsive, slow-release manner. Capsules containing a fluorescent tracer dye in place of gentamicin penetrated human bladder cells and released their dye cargo with no apparent toxicity, confirming their ability to successfully permeate cells. These results suggest that such antibiotic capsules could prove useful in the treatment of recalcitrant UTI.
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Donowitz, Leigh Grossman, and Sandra M. Norris. "The Efficacy of Antibiotic Prophylaxis in the Prevention of Post-Cesarean Section Endometritis." Infection Control 6, no. 5 (May 1985): 189–93. http://dx.doi.org/10.1017/s0195941700061403.
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AbstractEndometritis is an infectious complication in 9% to 65% of patients delivered by cesarean section. The risk of developing endometritis is greater in the high-risk emergent patient as compared to routine repeat abdominal deliveries. This study describes the incidence of endometritis following cesarean section delivery in different patient groups at the University of Virginia Hospital during a 1-year period and reviews the literature on the efficacy and risks of prophylactic antibiotics in this setting. Of patients not receiving antibiotic prophylaxis, 11 (<1%) of 1,461 normal spontaneous vaginal delivery patients, 7 (16.7%) of 42 repeat and 39 (29.8%) of 131 emergent cesarean section patients developed endometritis. This contrasts to none of the 24 emergent patients who received antibiotic prophylaxis. The literature review shows multiple prospective well-designed and executed studies that demonstrate reliable decreases in the incidence of endometritis with short course antibiotic prophylaxis. Our conclusion is that short course antibiotic prophylaxis is a safe, reproducible, cost-effective and indicated method of reducing the incidence of this costly and serious postoperative infection.
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Stern-Ascher, Conrad N., Yongmei Huang, Cassandra R. Duffy, Maria Andrikopoulou, Jason D. Wright, Dena Goffman, Mary E. D'Alton, and Alexander M. Friedman. "Antibiotics for 3rd and 4th Degree Vaginal Lacerations, Uterine Tamponade, and Manual Placental Extraction." American Journal of Perinatology 37, no. 01 (November 22, 2019): 092–103. http://dx.doi.org/10.1055/s-0039-3400306.
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Abstract Objective Trends in use of antibiotics during delivery hospitalizations complicated by (1) 3rd/4th degree vaginal lacerations, (2) manual placenta extraction, and (3) uterine tamponade are not well characterized. The objective of this study was to analyze trends in antibiotic use during vaginal delivery hospitalizations complicated by these three clinical scenarios. Study Design An administrative inpatient database was used to perform a serial cross-sectional analysis of antibiotic administration during delivery hospitalizations in the United States from January 2006 to March 2015. The primary outcome was receipt of antibiotics during vaginal delivery hospitalizations complicated by (1) 3rd and 4th degree vaginal lacerations, (2) manual placenta extraction, and (3) uterine tamponade. Patients with other indications for antibiotics were excluded. The Cochran–Armitage test was used to assess trends. Adjusted log linear regression analyses including demographic, hospital, and obstetric factors were performed to analyze factors associated with antibiotic receipt for each of these three clinical scenarios in both primary and sensitivity analyses. Results From 2006 to 2015 the rate of antibiotic administration during delivery hospitalizations decreased from 43.1% in 2006 to 25.5% for 3rd and 4th degree lacerations and from 59.6% to 49.2% for manual extraction (p < 0.01). Administration of antibiotics in the setting of uterine tamponade decreased from 48.6% in 2006 to 27.6% in 2009 before rising to 62.5% in the first quarter of 2015. In adjusted analyses, comparing the first quarter of 2015 to 2006 adjusted risk ratios for antibiotic administration were 0.61 (95% confidence interval [CI] 0.56–0.66) for 3rd and 4th degree vaginal lacerations, 0.76 (95% CI 0.53–1.09) for manual placental extraction, and 0.83 (95% CI 0.76–0.92) for uterine tamponade. Conclusion Antibiotics are not used consistently during vaginal deliveries complicated by 3rd/4th degree lacerations, manual placenta extraction, and uterine tamponade. These findings support that a significant opportunity exists for comparative effectiveness research to assist in characterizing best practices.
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Thompson, Wendy, Sagar Shah, Valerie Wordley, and David Edwards. "Understanding the impact of COVID-19 on dental antibiotic prescribing across England: 'it was a minefield'." British Dental Journal 233, no. 8 (October 28, 2022): 653–58. http://dx.doi.org/10.1038/s41415-022-5104-y.
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AbstractIntroduction The COVID-19 pandemic impacted significantly on dental service delivery across England.Objective To explore how and why the pandemic affected antibiotic prescribing by primary care dentists.Methods Mixed-methods study: secondary analysis of routinely collected NHS dental antibiotic prescribing data from before and during the pandemic; and an online survey of dentists (NHS and private) across England's regions.Results Dental antibiotic prescribing increased 22% in the pandemic's first year, with regional variation from a 12.1% increase in London to 29.1% in East of England. Of 159 dentists surveyed, 60% had prescribed 'many more' antibiotics. Some urgent dental centres required antibiotics before accepting referrals, irrespective of clinical appropriateness. Diagnosing remotely was hard. Antibiotics were used to delay aerosol generating procedures and fill gaps in services. Widespread frustration existed.Discussion Maintaining access to urgent dental care during a future pandemic would include availability of high-grade personal protective equipment for dental teams. Everyone must understand the impact of restricted dental access on antibiotic overprescribing and hence antibiotic resistance.Conclusion Reduced dental access and changes in dental service delivery because of the pandemic increased antibiotic prescribing. Ensuring uninterrupted access for all to effective urgent dental care is an important element of global efforts to tackle antibiotic resistance.
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Akkineni, Ashwini Rahul, Janina Spangenberg, Michael Geissler, Saskia Reichelt, Hubert Buechner, Anja Lode, and Michael Gelinsky. "Controlled and Local Delivery of Antibiotics by 3D Core/Shell Printed Hydrogel Scaffolds to Treat Soft Tissue Infections." Pharmaceutics 13, no. 12 (December 14, 2021): 2151. http://dx.doi.org/10.3390/pharmaceutics13122151.
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Soft tissue infections in open fractures or burns are major cause for high morbidity in trauma patients. Sustained, long-term and localized delivery of antimicrobial agents is needed for early eradication of these infections. Traditional (topical or systemic) antibiotic delivery methods are associated with a variety of problems, including their long-term unavailability and possible low local concentration. Novel approaches for antibiotic delivery via wound coverage/healing scaffolds are constantly being developed. Many of these approaches are associated with burst release and thus seldom maintain long-term inhibitory concentrations. Using 3D core/shell extrusion printing, scaffolds consisting of antibiotic depot (in the core composed of low concentrated biomaterial ink 3% alginate) surrounded by a denser biomaterial ink (shell) were fabricated. Denser biomaterial ink (composed of alginate and methylcellulose or alginate, methylcellulose and Laponite) retained scaffold shape and modulated antibiotic release kinetics. Release of antibiotics was observed over seven days, indicating sustained release characteristics and maintenance of potency. Inclusion of Laponite in shell, significantly reduced burst release of antibiotics. Additionally, the effect of shell thickness on release kinetics was demonstrated. Amalgamation of such a modular delivery system with other biofabrication methods could potentially open new strategies to simultaneously treat soft tissue infections and aid wound regeneration.
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Spinnato, Joseph A., Brad Youkilis, Vernon D. Cook, Marcello Pietrantoni, Ann L. Clark, and Stanley A. Gall. "Antibiotic prophylaxis at cesarean delivery." Journal of Maternal-Fetal and Neonatal Medicine 9, no. 6 (January 2000): 348–50. http://dx.doi.org/10.3109/14767050009018424.
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Weinstein, R. A., and K. M. Boyer. "Antibiotic Prophylaxis for Cesarean Delivery." Obstetric Anesthesia Digest 37, no. 2 (June 2017): 60. http://dx.doi.org/10.1097/01.aoa.0000515724.44437.a9.
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Spinnato, Joseph A., Brad Youkilis, Vernon D. Cook, Marcello Pietrantoni, Ann L. Clark, and Stanley A. Gall. "Antibiotic prophylaxis at cesarean delivery." Journal of Maternal-Fetal Medicine 9, no. 6 (November 2000): 348–50. http://dx.doi.org/10.1002/1520-6661(200011/12)9:6<348::aid-mfm1005>3.0.co;2-4.
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Ene, Razvan, Mihai Nica, Dragos Ene, Adrian Cursaru, and Catalin Cirstoiu. "Review of calcium-sulphate-based ceramics and synthetic bone substitutes used for antibiotic delivery in PJI and osteomyelitis treatment." EFORT Open Reviews 6, no. 5 (May 2021): 297–304. http://dx.doi.org/10.1302/2058-5241.6.200083.
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Infection in orthopaedic and trauma surgery remains a destructive complication with particularly challenging diagnosis and treatment due to bacterial antibiotic resistance and biofilm formation. Along with surgical debridement and systemic antibiotics, an important type of adjuvant therapy is local antibiotic delivery, with the purpose of eliminating bacterial colonization and biofilm development. Calcium sulphate, as a synthetic absorbable biomaterial used for local antibiotic delivery, has experienced an increasing popularity during the last decade, with multiple promoted advantages such as predictable antibiotic elution kinetics, complete and quick biodegradation, good biocompatibility, and limited associated complications. A series of commercially available antibiotic-delivery systems based on calcium sulphate are under investigation and in clinical use, with different presentations, compositions, and application techniques. The current article presents the main available calcium-sulphate-based products and the existing data about the clinical and preclinical research results, stemming from their implementation as local antibiotic carriers for surgical site and implant-associated infections treatment and prevention. Cite this article: EFORT Open Rev 2021;6:297-304. DOI: 10.1302/2058-5241.6.200083
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Rehmani, Rifat S., Javed I. Memon, and Ayman Al-Gammal. "Implementing a Collaborative Sepsis Protocol on the Time to Antibiotics in an Emergency Department of a Saudi Hospital: Quasi Randomized Study." Critical Care Research and Practice 2014 (2014): 1–6. http://dx.doi.org/10.1155/2014/410430.
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Background. The objective of this study is to evaluate the impact of an ED sepsis protocol on the time to antibiotics for emergency department (ED) patients with severe sepsis.Methods. Quasiexperimental prospective study was conducted at the emergency department. Consecutive patients with severe sepsis were included before and after the implementation of a sepsis protocol. The outcome measures were time from recognition of severe sepsis/septic shock to first antibiotic dose delivery and the appropriateness of initial choice of antibiotics based on the presumed source of infection.Results. There were 47 patients in preintervention group and 112 patients in postintervention group. Before implementation, mean time from severe sepsis recognition to delivery of antibiotics was 140 ± 97 minutes. During the intervention period, the mean time was 68 ± 67 minutes, with an overall reduction of 72 minutes. The protocol resulted in an overall improvement of 37% in the compliance, as 62% received appropriate initial antibiotics for the presumed source of infection as compared to 25% before the start of protocol.Conclusion. Implementation of ED sepsis protocol improved the time from recognition of severe sepsis/septic shock to first antibiotic dose delivery as well as the appropriateness of initial antibiotic therapy.
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Vigata, Margaux, Cathal D. O’Connell, Silvia Cometta, Dietmar W. Hutmacher, Christoph Meinert, and Nathalie Bock. "Gelatin Methacryloyl Hydrogels for the Localized Delivery of Cefazolin." Polymers 13, no. 22 (November 16, 2021): 3960. http://dx.doi.org/10.3390/polym13223960.
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The tuneability of hydrogels renders them promising candidates for local drug delivery to prevent and treat local surgical site infection (SSI) while avoiding the systemic side-effects of intravenous antibiotic injections. Here, we present a newly developed gelatin methacryloyl (GelMA)-based hydrogel drug delivery system (GelMA-DDS) to locally deliver the broad-spectrum antibiotic cefazolin for SSI prophylaxis and treatment. Antibiotic doses from 3 µg to 90 µg were loaded in photocrosslinked GelMA hydrogel discs with 5 to 15% w/v polymer concentration and drug encapsulation efficiencies, mechanical properties, crosslinking and release kinetics, as well as bacterial growth inhibition were assessed. Our results demonstrate that all GelMA groups supported excellent drug encapsulation efficiencies of up to 99%. Mechanical properties of the GelMA-DDS were highly tuneable and unaffected by the loading of small to medium doses of cefazolin. The diffusive and the proteolytic in vitro drug delivery of all investigated cefazolin doses was characterized by a burst release, and the delivered cefazolin amount was directly proportional to the encapsulated dose. Accelerated enzymatic degradation of the GelMA-DDS followed zero-order kinetics and was dependent on both the cefazolin dose and GelMA concentration (3–13 h). Finally, we demonstrate that cefazolin delivered from GelMA induced a dose-dependent antibacterial efficacy against S. aureus, in both a broth and a diffusive assay. The cefazolin-loaded GelMA-DDS presented here provides a highly tuneable and easy-to-use local delivery system for the prophylaxis and treatment of SSI.
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Cristescu, Ioan, Lucian Marina, Daniel Vilcioiu, F. Safta, M. Istodorescu, and A. Stere. "The Potential of Antibiotic Collagen Based Biocomposites for the Treatment of Bone Defects." Key Engineering Materials 587 (November 2013): 404–11. http://dx.doi.org/10.4028/www.scientific.net/kem.587.404.
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Antibiotic delivery systems used in the past have consisted primarily of impregnated cement beads that required routine removal once the antibiotic had eluded completely. With the development of collagen scaffolds that could be used to fill bony defects the antibiotic cold be delivered from the scaffold used to sustain local bone growth. Over the course of two years antibiotic loaded collagen scaffolds were used in the local treatment of 21patients suffering of complicated fractures including bone defects, infections or pseudoarthrosis, all of them of traumatic nature. At the time of the initial surgical debridement or at subsequent second look procedures once local tissue viability was observed the antibiotic loaded collagen scaffold was inserted in the tissue defect and never removed. Excellent results were obtained and the infection was brought under control by use of both surgical and antibiotic modalities. Bone grafting was used in 6 cases where the defects were extensive. Where there was less extensive bone destruction the scaffold was a good adjuvant in new bone formation. Use of antibiotic loaded collagen scaffolds is a reliable and effective means of local antibiotic delivery system combining both the new bone formation capacity of the scaffold to hold osteoblasts with the ability to deliver high doses of antibiotic in the local tissue environment and thus avoiding the systemic toxicity.
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Tigabu, Bekele, and Alamnie Getachew. "Treatment of antibiotic-resistant bacteria by nanoparticles: Current approaches and prospects." Annals of Advances in Chemistry 6, no. 1 (June 8, 2022): 001–9. http://dx.doi.org/10.29328/journal.aac.1001025.
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Antibiotic-resistant bacteria are emerging pathogens whose resistance profiles generate a serious health crisis by holding their impact on human health. Misuse of antibiotics has directed the emergence of microbes immune to presently accessible drugs. Pathogenic bacteria become resistant by employing various mechanisms, such as; antibiotic modification, target site alteration, and biofilm formation, increasing the time they spend in the intracellular environment where antibiotics are unable to succeed at therapeutic levels. Due to this, attempts are being made to develop new alternative nanoantibiotics as a promising approach to treat multidrug resistance disease-causing bacteria. Accordingly, there is considerable contemporary attention to the use of nanoparticles (NPs) as antibacterial agents against different pathogens and as target drug delivery toward specific tissues therefore microbes are eliminated by the biocidal properties of nanoantibiotics. Additionally, the utilization of nanoencapsulation systems can help to beat the issues of, those with toxicity natures, and target drug delivery problems. This review encompasses the antibiotic resistance prevalence, mechanisms, and therefore the use of nanoparticles as antibacterial and drug delivery systems to overcome the antibiotic resistance challenges of bacteria. Overall, this review paper provides a conceptual framework for understanding the complexity of the matter of emergence of antibiotic resistance bacteria even for brand spanking new synthesized antibiotics. Therefore the availability of such knowledge will allow researchers to supply detailed studies about the applications of nanoparticles in the treatment of multidrug-resistant bacteria.
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Ganz, Cornelia, and Thomas Gerber. "Bone Substitutes as a Drug Delivery of Antibiotics." Key Engineering Materials 631 (November 2014): 321–25. http://dx.doi.org/10.4028/www.scientific.net/kem.631.321.
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The aim of the present study was the in vitro investigation of a synthetic bone graft substitute loaded with individual antibiotics for the treatment of osteomyelitis and infectious bone disease. The elution of gentamicin, an aminoglycoside antibiotic, from the NanoBone® products NanoBone® S granules (NBG) and lyophilized NanoBone® (NBP) putty was tested over a period of one week. An indirect photometrically-based detection system was used to measure the released antibiotic concentration. Both materials showed very different release behaviour. After one day lyophilized NanoBone® putty delivered 100% of the gentamicin value, whereas NanoBone® S granules released one-fifth of the used gentamicin level.
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Bezuidenhout, Martin B., Dimitar M. Dimitrov, Anton D. van Staden, Gert A. Oosthuizen, and Leon M. T. Dicks. "Titanium-Based Hip Stems with Drug Delivery Functionality through Additive Manufacturing." BioMed Research International 2015 (2015): 1–11. http://dx.doi.org/10.1155/2015/134093.
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Postoperative infections are a major concern in patients that receive implants. These infections generally occur in areas with poor blood flow and pathogens do not always respond to antibiotic treatment. With the latest developments in nanotechnology, the incorporation of antibiotics into prosthetic implants may soon become a standard procedure. The success will, however, depend on the ability to control the release of antibiotics at concentrations high enough to prevent the development of antibiotic-resistant strains. Through additive manufacturing, antibiotics can be incorporated into cementless femoral stems to produce prosthetic devices with antimicrobial properties. With the emerging increase in resistance to antibiotics, the incorporation of antimicrobial compounds other than antibiotics, preferably drugs with a broader spectrum of antimicrobial activity, will have to be explored. This review highlights the microorganisms associated with total hip arthroplasty (THA), discusses the advantages and disadvantages of the latest materials used in hip implants, compares different antimicrobial agents that could be incorporated, and addresses novel ideas for future research.
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Kotrange, Harshada, Agnieszka Najda, Aarti Bains, Robert Gruszecki, Prince Chawla, and Mansuri M. Tosif. "Metal and Metal Oxide Nanoparticle as a Novel Antibiotic Carrier for the Direct Delivery of Antibiotics." International Journal of Molecular Sciences 22, no. 17 (September 4, 2021): 9596. http://dx.doi.org/10.3390/ijms22179596.
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In addition to the benefits, increasing the constant need for antibiotics has resulted in the development of antibiotic bacterial resistance over time. Antibiotic tolerance mainly evolves in these bacteria through efflux pumps and biofilms. Leading to its modern and profitable uses, emerging nanotechnology is a significant field of research that is considered as the most important scientific breakthrough in recent years. Metal nanoparticles as nanocarriers are currently attracting a lot of interest from scientists, because of their wide range of applications and higher compatibility with bioactive components. As a consequence of their ability to inhibit the growth of bacteria, nanoparticles have been shown to have significant antibacterial, antifungal, antiviral, and antiparasitic efficacy in the battle against antibiotic resistance in microorganisms. As a result, this study covers bacterial tolerance to antibiotics, the antibacterial properties of various metal nanoparticles, their mechanisms, and the use of various metal and metal oxide nanoparticles as novel antibiotic carriers for direct antibiotic delivery.
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Stout, Susan A., and Hartmut Derendorf. "Local Treatment of Respiratory Infections with Antibiotics." Drug Intelligence & Clinical Pharmacy 21, no. 4 (April 1987): 322–29. http://dx.doi.org/10.1177/106002808702100402.
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Local administration of antibiotics for the treatment of respiratory infections has the potential advantage of reduced systemic toxicity and increased drug concentration at the site of infection. This article reviews the basic principles of pulmonary drug delivery using aerosols and the clinical efficacy of local antibiotic therapy of respiratory infections. Clinical studies have been conducted with locally administered aminoglycosides, penicillins, cephalosporins, and polypeptides. The results of these investigations and the pharmacokinetic aspects of pulmonary antibiotic delivery are summarized.
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Sychareun, Vanphanom, Amphoy Sihavong, Anna Machowska, Xanded Onthongdee, Kongmany Chaleunvong, Bounxou Keohavong, Jaran Eriksen, et al. "Knowledge, Attitudes, Perception and Reported Practices of Healthcare Providers on Antibiotic Use and Resistance in Pregnancy, Childbirth and Children under Two in Lao PDR: A Mixed Methods Study." Antibiotics 10, no. 12 (November 27, 2021): 1462. http://dx.doi.org/10.3390/antibiotics10121462.
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Background: Overuse and misuse of antibiotics contribute unnecessarily to antibiotic resistance (ABR), and are thereby global health threats. Inappropriate prescriptions of antibiotics during pregnancy, delivery and early childhood are widespread across the world. This study aimed to assess knowledge, attitudes, and reported practices of healthcare providers (HCPs) and to explore their perceptions regarding antibiotic use and ABR related to pregnancy, childbirth, and children under two in Lao PDR. Methods: This is a mixed methods study with data collection in 2019 via structured interviews among 217 HCPs (medical doctors/assistant doctors, midwives/nurses, pharmacists/assistant pharmacists and drug sellers), who prescribed/dispensed antibiotics in one rural and one urban district in Vientiane province and individual qualitative interviews with 30 HCPs and stakeholders. Results: Of the HCPs, 36% had below average knowledge regarding antibiotic use and ABR, and 67% reported prescribing antibiotics for uncomplicated vaginal delivery. Half of the HCPs did not believe that their prescribing contributed to ABR, and only 9% had participated in antibiotic education. Conclusion: A substantial number of HCPs had suboptimal knowledge and prescribed antibiotics unnecessarily, thereby contributing to ABR. Continuous education and regular supervision of HCPs is recommended to improve the use of antibiotics related to pregnancy, childbirth, and young children.
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Mahmutaj, Dafina, Shaip Krasniqi, Bedri Braha, Dalip Limani, and Burim Neziri. "The Predictive Role of Procalcitonin On the Treatment of Intra-Abdominal Infections." Open Access Macedonian Journal of Medical Sciences 5, no. 7 (November 24, 2017): 909–14. http://dx.doi.org/10.3889/oamjms.2017.194.
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Aim: This study aims to evaluate the algorithm of procalcitonin (PCT) and its role on the duration of antibiotics prescription for intra-abdominal infections.Materials and Methods: This study is a prospective controlled study that is conducted in groups of 50 hospitalised patients and 50 controlled group patients.Results: The results indicated that the average duration of antibiotic delivery to the PCT group was -10.6 days (SD ± 6.6 days), while in the control group -13.2 days (SD ± 4.2 days). These data showed a significant difference in the duration of antibiotic therapy and the monitoring role of PCTs in the prediction success of antibiotic treatment. The antibiotic delivery was longer in the septic shock 17 (SD ± 11.7) that corresponds to high PCT values of 67.8 (SD ± 50.9). Recurrence of the infection after the cessation of antibiotics occurred in 2 cases (4%) in the standard group, while it occurred in 3 cases (6%) in the control group.Conclusion: The treatment of the intra-abdominal infections based on the PCT algorithm shortens the duration of antibiotic treatment and does not pose a risk for the recurrence of the infection.
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Cross, S. E., M. J. Thompson, and M. S. Roberts. "Distribution of systemically administered ampicillin, benzylpenicillin, and flucloxacillin in excisional wounds in diabetic and normal rats and effects of local topical vasodilator treatment." Antimicrobial Agents and Chemotherapy 40, no. 7 (July 1996): 1703–10. http://dx.doi.org/10.1128/aac.40.7.1703.
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The present study assessed the suitability of the streptozotocin-treated diabetic rat as a model for the study of diabetes-impaired wound healing. The distribution of three antibiotics, ampicillin, benzylpenicillin, and flucloxacillin, in wound and adjacent tissue sites on the abdomens and legs of normal and diabetic rats was determined 30 min after intravenous administration of a single bolus containing 50 mg of all three antibiotics per kg of body weight. Tissue/plasma ratios showed that antibiotic tissue penetration appeared to be related to protein binding. The treatment of wound sites with vasodilators (1% solution) to increase local blood flow and antibiotic delivery to the site was then determined and appeared to be more effective with endothelium-independent sodium nitroprusside than with endothelium-dependent acetylcholine in diabetic rats. These results suggest that coadministration of topical vasodilators to wound sites in neuropathic diabetic patients undergoing antibiotic therapy for infected ulcers could increase antibiotic delivery to wound tissue sites.
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Koebnick, Corinna, Margo A. Sidell, Darios Getahun, Sara Y. Tartof, Emily Rozema, Brianna Taylor, Anny H. Xiang, et al. "Intrapartum Antibiotic Exposure and Body Mass Index in Children." Clinical Infectious Diseases 73, no. 4 (January 25, 2021): e938-e946. http://dx.doi.org/10.1093/cid/ciab053.
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Abstract Background Intrapartum antibiotic prophylaxis (IAP) reduces a newborn’s risk of group B streptococcal infection (GBS) but may lead to an increased childhood body mass index (BMI). Methods This was a retrospective cohort study of infants (n = 223 431) born 2007–2015 in an integrated healthcare system. For vaginal delivery, we compared children exposed to GBS-IAP and to any other type or duration of intrapartum antibiotics to no antibiotic exposure. For cesarean delivery, we compared children exposed to GBS-IAP to those exposed to all other intrapartum antibiotics, including surgical prophylaxis. BMI over 5 years was compared using nonlinear multivariate models with B-spline functions, stratified by delivery mode and adjusted for demographics, maternal factors, breastfeeding, and childhood antibiotic exposure. Results In vaginal deliveries, GBS-IAP was associated with higher BMI from 0.5 to 5.0 years of age compared to no antibiotics (P < .0001 for all time points, ΔBMI at age 5 years 0.12 kg/m2, 95% confidence interval [CI]: .07–.16 kg/m2). Other antibiotics were associated with higher BMI from 0.3 to 5.0 years of age. In cesarean deliveries, GBS-IAP was associated with increased BMI from 0.7 years to 5.0 years of age (P < .05 for 0.7–0.8 years, P < .0001 for all other time points) compared to other antibiotics (ΔBMI at age 5 years 0.24 kg/m2, 95% CI: .14–.34 kg/m2). Breastfeeding did not modify these associations. Conclusions GBS-IAP was associated with a small but sustained increase in BMI starting at very early age. This association highlights the need to better understand the effects of perinatal antibiotic exposure on childhood health.
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Shen, Rene, Nicholas Embleton, Julie Lyng Forman, Chris Gale, Gorm Griesen, Per Torp Sangild, Sabita Uthaya, and Janet Berrington. "Early antibiotic use and incidence of necrotising enterocolitis in very preterm infants: a protocol for a UK based observational study using routinely recorded data." BMJ Open 12, no. 11 (November 2022): e065934. http://dx.doi.org/10.1136/bmjopen-2022-065934.
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IntroductionNecrotising enterocolitis (NEC) remains a major contributor to preterm mortality and morbidity. Prolonged duration of antibiotic therapy after delivery is associated with later NEC development but recent evidence suggests that absence of antibiotic treatment after delivery may also increase NEC risk. We will explore this controversy using a large pre-existing dataset of preterm infants in the UK.Methods and analysisThis is a retrospective cohort study using data from UK National Neonatal Research Database (NNRD) for infants born 1 January 2012 to 31 December 2020. Eligible infants will be <32 weeks gestation, alive on day 3. Primary outcome is development of severe NEC, compared in infants receiving early antibiotics (days 1–2 after birth) and those not. Subgroup analysis on duration of early antibiotic exposure will also occur. Secondary outcomes are: late onset sepsis, total antibiotic use, predischarge mortality, retinopathy of prematurity, intraventricular haemorrhage, bronchopulmonary dysplasia, focal intestinal perforation and any abdominal surgery. To address competing risks, incidence of death before day 7, 14 and 28 will be analysed. We will perform logistic regression and propensity score matched analyses. Statistical analyses will be guided by NEC risk factors, exposures and outcome presented in a causal diagram. These covariates include but are not limited to gestational age, birth weight, small for gestational age, sex, ethnicity, delivery mode, delivery without labour, Apgar score, early feeding and probiotic use. Sensitivity analyses of alternate NEC definitions, specific antibiotics and time of initiation will occur.Ethics and disseminationWe will use deidentified data from NNRD, which holds permissions for the original data, from which parents can opt out and seek study-specific research ethics approval. The results will help to determine optimal use of early antibiotics for very preterm infants.ImplicationsThis data will help optimise early antibiotic use in preterm infants.Trial registration numberISRCTN55101779.
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Edgar, Rotem, Nir Friedman, Shahar Molshanski-Mor, and Udi Qimron. "Reversing Bacterial Resistance to Antibiotics by Phage-Mediated Delivery of Dominant Sensitive Genes." Applied and Environmental Microbiology 78, no. 3 (November 23, 2011): 744–51. http://dx.doi.org/10.1128/aem.05741-11.
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ABSTRACTPathogen resistance to antibiotics is a rapidly growing problem, leading to an urgent need for novel antimicrobial agents. Unfortunately, development of new antibiotics faces numerous obstacles, and a method that resensitizes pathogens to approved antibiotics therefore holds key advantages. We present a proof of principle for a system that restores antibiotic efficiency by reversing pathogen resistance. This system uses temperate phages to introduce, by lysogenization, the genesrpsLandgyrAconferring sensitivity in a dominant fashion to two antibiotics, streptomycin and nalidixic acid, respectively. Unique selective pressure is generated to enrich for bacteria that harbor the phages carrying the sensitizing constructs. This selection pressure is based on a toxic compound, tellurite, and therefore does not forfeit any antibiotic for the sensitization procedure. We further demonstrate a possible way of reducing undesirable recombination events by synthesizing dominant sensitive genes with major barriers to homologous recombination. Such synthesis does not significantly reduce the gene's sensitization ability. Unlike conventional bacteriophage therapy, the system does not rely on the phage's ability to kill pathogens in the infected host, but instead, on its ability to deliver genetic constructs into the bacteria and thus render them sensitive to antibiotics prior to host infection. We believe that transfer of the sensitizing cassette by the constructed phage will significantly enrich for antibiotic-treatable pathogens on hospital surfaces. Broad usage of the proposed system, in contrast to antibiotics and phage therapy, will potentially change the nature of nosocomial infections toward being more susceptible to antibiotics rather than more resistant.
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Saleh, Chusun, and Maya Kurniasari. "POLA PERESEPAN ANTIBIOTIK PROFILAKSIS PRE BEDAH SECTIO CAESAREA DI RUMAH SAKIT." Jurnal Riset Kefarmasian Indonesia 3, no. 1 (January 22, 2021): 65–76. http://dx.doi.org/10.33759/jrki.v3i1.117.
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Caesarean section is a surgery to give birth to a child through surgery on the abdominal wall and uterus. Prophylactic antibiotics are preventive antibiotics in Sectio Caesarean surgery. This study aims to determine the pattern of prescribing prophylactic antibiotics in preoperative caesarean section patients which are grouped into 4 specific objectives, namely: patient characteristics such as (age, parity status, payment status), antibiotic class, type of antibiotic, and to determine surgical wound indication ILO, This study used a descriptive method by retrospectively taking data by looking at the prescription (e-prescription), patient medical record data and SOAP (Subjective, Objective, Assessment, Planning). The results showed that out of 300 patients who were parturient, 52 patients (17.3%) had normal delivery and 248 patients with caesarean delivery (82.7%). Most of the ages were between 20-30 years as many as 123 patients (49.6%) and aged > 30-40 years as many as 120 patients (48.38%). As for the status of the most payments in cash, namely 176 patients (71%). The most frequently used antibiotic class is the Cephalosporin group, namely 246 patients (99.6%), the most commonly used type of antibiotic is Ceftriaxon, which is 175 patients (70.6%). The study on Surgical Wound Infection was found in only 1 patient (0,4%) with the antibiotic Ceftriaxon.
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Ferreira, Magda, Maria Ogren, Joana N. R. Dias, Marta Silva, Solange Gil, Luís Tavares, Frederico Aires-da-Silva, Maria Manuela Gaspar, and Sandra Isabel Aguiar. "Liposomes as Antibiotic Delivery Systems: A Promising Nanotechnological Strategy against Antimicrobial Resistance." Molecules 26, no. 7 (April 2, 2021): 2047. http://dx.doi.org/10.3390/molecules26072047.
Full textAbstract:
Antimicrobial drugs are key tools to prevent and treat bacterial infections. Despite the early success of antibiotics, the current treatment of bacterial infections faces serious challenges due to the emergence and spread of resistant bacteria. Moreover, the decline of research and private investment in new antibiotics further aggravates this antibiotic crisis era. Overcoming the complexity of antimicrobial resistance must go beyond the search of new classes of antibiotics and include the development of alternative solutions. The evolution of nanomedicine has allowed the design of new drug delivery systems with improved therapeutic index for the incorporated compounds. One of the most promising strategies is their association to lipid-based delivery (nano)systems. A drug’s encapsulation in liposomes has been demonstrated to increase its accumulation at the infection site, minimizing drug toxicity and protecting the antibiotic from peripheral degradation. In addition, liposomes may be designed to fuse with bacterial cells, holding the potential to overcome antimicrobial resistance and biofilm formation and constituting a promising solution for the treatment of potential fatal multidrug-resistant bacterial infections, such as methicillin resistant Staphylococcus aureus. In this review, we aim to address the applicability of antibiotic encapsulated liposomes as an effective therapeutic strategy for bacterial infections.
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Lupescu, Olivera, Mihail Nagea, Cristina Patru, Alexandru Dimitriu, Nicolae Ciurea, Doriana Lupescu, Gheorghe Ion Popescu, and Narcis Marcov. "Treatment of Chronic Bone Infections Using the Collagen Based Haemostatic - Collatamp G." Key Engineering Materials 695 (May 2016): 133–38. http://dx.doi.org/10.4028/www.scientific.net/kem.695.133.
Full textAbstract:
Treating chronic bone infection is challenging, requiring complete excision of the affected areas and antimicrobial therapy. Acquiring active concentrations of antibiotics is difficult, as well as filling up bone defects resulting from sequestrectomy, and very few methods of treatment address both issues simultaneously. The authors describe the clinical results after using Collatamp G, a collagen-based, antibiotic filled sponge with two actions: local delivery of high antibiotic doses without systemic side effects and enhancement of healing due to collagen, thus covering the bone defect without any further osteoplastic surgery. This paper thus identifies Collatamp G as a biomaterial able to solve the above mentioned problems in treating bone infections.Keywords: bone infections, collagen matrix, gentamicine, antibiotic delivery
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Le, Hung, Carole Karakasyan, Thierry Jouenne, Didier Le Cerf, and Emmanuelle Dé. "Application of Polymeric Nanocarriers for Enhancing the Bioavailability of Antibiotics at the Target Site and Overcoming Antimicrobial Resistance." Applied Sciences 11, no. 22 (November 12, 2021): 10695. http://dx.doi.org/10.3390/app112210695.
Full textAbstract:
Antimicrobial resistance is one of the greatest threats to global health. Although the efforts in antibiotic drug discovery continue to play a pivotal role, this solution alone probably will not be enough to ensure the required level of infection control in the future. New strategies and innovative modes of action are desperately needed to preserve the effectiveness of antimicrobials. Accordingly, antibiotic delivery based on polymeric nanoparticles is one of the possible methods that has been recently explored to improve their pharmacokinetic profile. Through optimized access of antibiotics to their sites of action, nanocarriers can unlock the full potential of the antibiotic cargoes, extend the antimicrobial spectrum, and reduce the required dose of antibiotic while preserving efficacy. Additionally, the use of an antibiotic-loaded nanocarrier is also considered a steady solution as novel molecules can be continuously developed and incorporated into the delivery platform. This review describes the present state of polymeric nanocarriers in enhancing antibiotic treatment, including improved pharmacokinetic properties and restored antibiotic efficacy against drug-resistant bacteria. Additionally, the current challenges and the future direction of this field are discussed.
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Paccione, Kimberly A., and Harold C. Wiesenfeld. "Guideline Adherence for Intrapartum Group B Streptococci Prophylaxis in Penicillin-Allergic Patients." Infectious Diseases in Obstetrics and Gynecology 2013 (2013): 1–6. http://dx.doi.org/10.1155/2013/917304.
Full textAbstract:
Objective. To investigate adherence to the 2002 Centers for Disease Control and Prevention (CDC) guidelines for perinatal group B streptococci (GBS) prevention in penicillin-allergic obstetric patients.Methods. This is a retrospective cohort study of penicillin-allergic obstetric patients who tested positive for GBS and delivered at our institution in 2010. Electronic medical records were reviewed for the nature of the penicillin allergy, documentation of having previously tolerated cephalosporins, gestational age at delivery, type of delivery, antimicrobial sensitivity testing, and antibiotics administered. Antimicrobial sensitivity testing and “appropriate” antibiotic choice, which was determined using 2002 CDC guidelines, were analyzed.Results. Intrapartum antibiotic prophylaxis was administered in 97.8% (95% confidence interval [CI] 93.5–99.5%) of patients, but it was considered appropriate in only 62.2% (95% CI 53.8–70.0%) of patients. Clindamycin was the most commonly used antibiotic, but 26.4% (95% CI 16.3–39.7%) of patients who received clindamycin did not have confirmation of susceptibility via antimicrobial sensitivity testing. Overall, the sensitivity testing was performed in only 65.5% (95% CI 56.2–73.7%) of patients in whom it was indicated.Conclusion. Compliance with CDC guidelines for performing antimicrobial sensitivity testing and choosing an appropriate antibiotic in GBS-positive penicillin-allergic women continues to be suboptimal. Institution of measures to increase adherence is necessary.