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Ethambutol

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1. Longitudinal evaluation of visual function and structure for detection of subclinical Ethambutol-induced optic neuropathy. (PubMed)

Longitudinal evaluation of visual function and structure for detection of subclinical Ethambutol-induced optic neuropathy. To longitudinally evaluate the visual function and structure of patients taking ethambutol by various modalities and identify useful tests for detection of subclinical ethambutol-induced optic toxicity.This retrospective study enrolled 84 patients with newly diagnosed tuberculosis treated with ethambutol. Best-corrected visual acuity (BCVA), color vision, contrast

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2019 PLoS ONE

2. The use of optical coherence tomography for the detection of ocular toxicity by ethambutol. (PubMed)

The use of optical coherence tomography for the detection of ocular toxicity by ethambutol. To evaluate, through (OCT), alterations in retinal thickness, secondary to use of ethambutol in the treatment of patients with tuberculosis. In addition to studying the use of simpler semiological tools, such as Amsler and Ishihara, in the screening of these cases.Thirty patients with ethambutol were recruited from the reference service of tuberculosis treatment at the Federal University of Espírito (...) Santo from May 2015 to July 2016. After clinical history, the following parameters were analyzed; best corrected visual acuity, biomicroscopy, tonometry, photomotor reflex testing, Ishihara test, Amsler's grid test, color digital retinography and optical coherence tomography with CIRRUS HD-OCT (Humphrey-Zeiss) every 2 months during treatment with ethambutol. They were divided into two groups according to the treatment: (1) standard group, two months of ethambutol; (2) extended group, nine to twelve

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2018 PLoS ONE

3. The combination rifampin-nitazoxanide, but not rifampin-isoniazid-pyrazinamide-ethambutol, kills dormant <i>Mycobacterium tuberculosis</i> in hypoxia at neutral pH. (PubMed)

The combination rifampin-nitazoxanide, but not rifampin-isoniazid-pyrazinamide-ethambutol, kills dormant Mycobacterium tuberculosis in hypoxia at neutral pH. The activities of rifampin, nitazoxanide, PA-824, sutezolid, were tested against dormant Mycobacterium tuberculosis under conditions mimicking caseous granulomas (hypoxia at pH 7.3), in comparison with the combination rifampin-isoniazid-pyrazinamide-ethambutol (R-I-Z-E), used for human therapy. Mycobacterial viability was monitored

2019 Antimicrobial Agents and Chemotherapy

4. Ganglion Cell Layer and Inner Plexiform Layer as Predictors of Vision Recovery in Ethambutol-Induced Optic Neuropathy: A Longitudinal OCT Analysis. (PubMed)

Ganglion Cell Layer and Inner Plexiform Layer as Predictors of Vision Recovery in Ethambutol-Induced Optic Neuropathy: A Longitudinal OCT Analysis. To describe changes in the retina during ethambutol-induced optic neuropathy (EON) progression, and determine the retinal layer thickness as a predictive factor for vision recovery after stoppage of ethambutol (EMB) in EON.A total of 42 eyes in 21 patients with EON underwent Spectralis optical coherence tomography after the onset of symptoms

2018 Investigative Ophthalmology & Visual Science

5. Synergy between circular bacteriocin AS-48 and ethambutol against <i>Mycobacterium tuberculosis</i>. (PubMed)

Synergy between circular bacteriocin AS-48 and ethambutol against Mycobacterium tuberculosis. The increasing incidence of multidrug-resistant Mycobacterium tuberculosis strains and the very few drugs available for treatment are promoting the discovery and development of new molecules that could help in the control of this disease. Bacteriocin AS-48 is an antibacterial peptide produced by Enterococcus faecalis and is active against several Gram-positive bacteria. We have found that AS-48 (...) was active against Mycobacterium tuberculosis, including H37Rv and other reference and clinical strains, and also against some nontuberculous clinical mycobacterial species. The combination of AS-48 with either lysozyme or ethambutol (commonly used in the treatment of drug-susceptible tuberculosis) increased the antituberculosis action of AS-48, showing a synergic interaction. Under these conditions, AS-48 exhibits a MIC close to some MICs of the first-line antituberculosis agents. The inhibitory

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2018 Antimicrobial Agents and Chemotherapy

6. Substitution of ethambutol with linezolid during the intensive phase of treatment of pulmonary tuberculosis: a prospective, multicentre, randomised, open-label, phase 2 trial. (PubMed)

Substitution of ethambutol with linezolid during the intensive phase of treatment of pulmonary tuberculosis: a prospective, multicentre, randomised, open-label, phase 2 trial. Linezolid improves the treatment outcomes of multidrug-resistant tuberculosis substantially. We investigated whether use of linezolid instead of ethambutol increases the proportion of sputum culture conversion at 8 weeks of treatment in patients with pulmonary tuberculosis.We did a phase 2, multicentre, randomised, open (...) -label trial for patients with pulmonary tuberculosis at the three affiliated hospitals to Seoul National University and National Medical Center (Seoul-Seongnam, South Korea). Patients, aged 20-80 years, with a positive sputum for pulmonary tuberculosis, but without resistance to rifampicin, and current treatment administered for 7 days or fewer, were randomly assigned at a 1:1:1 ratio into three groups. The control group received ethambutol (2 months) with isoniazid, rifampicin, and pyrazinamide

2018 Lancet infectious diseases

7. Immediate type hypersensitivity and late phase reaction occurred consecutively in a patient receiving ethambutol and levofloxacin (PubMed)

Immediate type hypersensitivity and late phase reaction occurred consecutively in a patient receiving ethambutol and levofloxacin We experienced a rare case of immediate type hypersensitivity and late phase reaction to anti-tubercular therapy consisting of ethambutol and levofloxacin, which occurred in close succession, giving the appearance of a single, continuous reaction to one drug.The patient was a man in his 70's who began therapy consisting of isoniazide, rifampicin, and ethambutol (...) for pulmonary tuberculosis. Since the patient had a drug eruption within several hours after the start of his treatment, his reaction to ethambutol was assessed first among the three suspected drugs using an oral challenge test. Levofloxacin, which was not among the suspected drugs, was administered with ethambutol in order to avoid drug resistance resulting from the administration of a single drug. The patient experienced pruritus within 1 h. We observed a well-defined, edematous erythema with induration

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2018 Allergy, asthma, and clinical immunology : official journal of the Canadian Society of Allergy and Clinical Immunology

8. Therapeutic implications of nano-encapsulated rifabutin, azithromycin & ethambutol against experimental Mycobacterium avium infection in mice (PubMed)

Therapeutic implications of nano-encapsulated rifabutin, azithromycin & ethambutol against experimental Mycobacterium avium infection in mice Mycobacterium avium causes atypical infection in both immunocompetent and immunocompromised individuals. Conventional chemotherapy for M. avium infection is not efficient due to lengthy course of treatment and drug-associated toxic side effects. The present study was aimed at reducing dosing frequency of antimicrobial regimen consisting of azithromycin (...) (AZM), rifabutin (RBT) and ethambutol (EMB) by encapsulation of drugs in nanoparticles (NPs) in experimental M. avium infection in mice.Poly (DL-lactide-co-glycolide) NPs containing anti-M. avium drugs were prepared, characterized and studied for their pharmacokinetics and pharmacodynamics parameters. Drug-loaded NPs were further analyzed for their therapeutic efficacy against experimental M. avium infection in mice.Drug-loaded NPs were of size 227.3±16.4 for RBT, 334.35±11.7 for AZM and 509.85

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2018 The Indian journal of medical research

9. <i>In vitro</i> minimal inhibitory concentrations of rifampin and ethambutol, and treatment outcome in <i>Mycobacterium avium</i> complex lung disease. (PubMed)

In vitro minimal inhibitory concentrations of rifampin and ethambutol, and treatment outcome in Mycobacterium avium complex lung disease. Although it is known that the in vitro MICs of rifampin and ethambutol are poorly correlated with the clinical response in Mycobacterium avium complex (MAC) lung disease (MAC-LD), evidence for this is limited. This study investigated the association between treatment outcome and the in vitro MICs of rifampin and ethambutol in patients with MAC (...) ) and tended to decrease with increasing MICs of rifampin and ethambutol, particularly at MICs of ≥8 μg/ml. Treatment success rate was significantly different between MAC isolates with MICs of ≥8 μg/ml for rifampin and ethambutol and those with MICs of <8 μg/ml for rifampin and/or ethambutol (64.9% versus 85.3%, P < 0.001). Multivariate analysis showed that an MIC of ≥8 μg/ml for both drugs and initial sputum acid-fast bacillus (AFB) smear positivity were independent risk factors for an unfavorable

2018 Antimicrobial Agents and Chemotherapy

10. A diagnostic algorithm to investigate pyrazinamide and ethambutol resistance in rifampicin resistant <i>Mycobacterium tuberculosis</i> isolates in a low incidence setting. (PubMed)

A diagnostic algorithm to investigate pyrazinamide and ethambutol resistance in rifampicin resistant Mycobacterium tuberculosis isolates in a low incidence setting. Phenotypic drug susceptibility testing (DST) for the two first-line tuberculosis drugs ethambutol and pyrazinamide is known to yield unreliable and inaccurate results. In this prospective study, we propose a diagnostic algorithm combining phenotypic DST with Sanger sequencing to inform clinical decision-making for drug (...) -resistant Mycobacterium tuberculosis complex isolates. Sequencing results were validated using whole-genome sequencing (WGS) of the isolates. Resistance-conferring mutations obtained by pncA sequencing correlated well with phenotypic DST results for pyrazinamide. Phenotypic resistance to ethambutol was only partly explained by mutations in the embB 306 codon. Additional resistance-conferring mutations were found in the embB gene at codons 354, 406, and 497. In several isolates that tested ethambutol

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2018 Antimicrobial Agents and Chemotherapy

11. Diagnostic value of ganglion cell-inner plexiform layer for early detection of ethambutol-induced optic neuropathy. (PubMed)

Diagnostic value of ganglion cell-inner plexiform layer for early detection of ethambutol-induced optic neuropathy. To evaluate the diagnostic value of macular ganglion cell-inner plexiform layer (mGCIPL) thickness versus peripapillary retinal nerve fibre layer (pRNFL) thickness for the early detection of ethambutol-induced optic neuropathy (EON).Twenty-eight eyes of 15 patients in the EON group and 100 eyes of 53 healthy subjects in the control group were included. All patients with EON

2018 British Journal of Ophthalmology

12. The rare ethambutol-induced optic neuropathy: A case-report and literature review. (PubMed)

The rare ethambutol-induced optic neuropathy: A case-report and literature review. Ethambutol-induced optic neuropathy (EON) is a well-known complication that results from the use of ethambutol. The ocular manifestations of EON include painless loss of central vision and cecocentral scotomas in the visual field.A 75-year-old Chinese Han man suffered from this rare ocular disorder because he took ethambutol for about 8 months.He was diagnosed as EON based on series of ophthalmic examinations (...) performed.Since he has stopped taking this drug for 3 months, we just offered some neurotrophic agents to him.One month later, he came back for return visit. The ophthalmic examinations indicated recovery of the visual function very well.The EON is a reversible optic neuropathy if the ocular toxicity is monitored closely among the tuberculosis patients that take ethambutol.

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2017 Medicine

13. Failure of the azithromycin and ethambutol combination regimen in the hollow-fibre system model of pulmonary Mycobacterium avium infection is due to acquired resistance. (PubMed)

Failure of the azithromycin and ethambutol combination regimen in the hollow-fibre system model of pulmonary Mycobacterium avium infection is due to acquired resistance. To investigate the performance of the two backbone drugs in the standard combination therapy regimen in the hollow-fibre system (HFS) model of pulmonary Mycobacterium avium complex (MAC) infection.Six HFS were inoculated with human-derived monocytes infected with MAC, and treated with 15 mg/kg of ethambutol and 500 mg (...) -treated control HFS, MAC grew from 5.0 to 8.53 log10 cfu/mL in 28 days. The dual therapy killed a maximum of 1.52 ± 0.43 log10 cfu/mL during the first 7 days, after which it failed. By day 28 there was no difference in MAC burden between the combination-therapy-treated and non-treated systems. Failure arose in parallel with the emergence of acquired ethambutol resistance. By day 28, 100% of the bacterial population was ethambutol resistant in the combination-therapy-treated HFS replicates.The backbone

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2017 Journal of Antimicrobial Chemotherapy

14. Mutations within <i>embCAB</i> are associated with variable level of ethambutol resistance in <i>Mycobacterium tuberculosis</i> isolates from China. (PubMed)

Mutations within embCAB are associated with variable level of ethambutol resistance in Mycobacterium tuberculosis isolates from China. The EmbCAB proteins have been considered a target for ethambutol (EMB). Mutations in embCAB are known to confer most EMB resistance. However, the knowledge about the effects of embCAB mutations on the EMB resistance level and about the role of mutation-mutation interactions is limited in China. Here, we sequenced embCAB among 125 Mycobacterium

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2017 Antimicrobial Agents and Chemotherapy

15. Ethambutol partitioning in tuberculous pulmonary lesions explains its clinical efficacy. (PubMed)

Ethambutol partitioning in tuberculous pulmonary lesions explains its clinical efficacy. Clinical trials and practice have shown that ethambutol is an important component of the first-line tuberculosis (TB) regime. This contrasts the drug's rather modest potency and lack of activity against nongrowing persister mycobacteria. The standard plasma-based pharmacokinetic-pharmacodynamic profile of ethambutol suggests that the drug may be of limited clinical value. Here, we hypothesized (...) that this apparent contradiction may be explained by favorable penetration of the drug into TB lesions. First, we utilized novel in vitro lesion pharmacokinetic assays and predicted good penetration of the drug into lesions. We then employed mass spectrometry imaging and laser capture microdissection coupled to liquid chromatography and tandem mass spectrometry (LCM and LC/MS-MS, respectively) to show that ethambutol, indeed, accumulates in diseased tissues and penetrates the major human-like lesion types

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2017 Antimicrobial Agents and Chemotherapy

16. Ethambutol optic neuropathy. (PubMed)

Ethambutol optic neuropathy. We provide a summary of the epidemiology, clinical findings, management and outcomes of ethambutol-induced optic neuropathy (EON). Ethambutol-induced optic neuropathy is a well-known, potentially irreversible, blinding but largely preventable disease. Clinicians should be aware of the importance of patient and physician education as well as timely and appropriate screening.Two of the largest epidemiologic studies investigating EON to date showed the prevalence (...) of EON in all patients taking ethambutol to be between 0.7 and 1.29%, a value consistent with previous reports of patients taking the doses recommended by the World Health Organization (WHO). Several studies evaluated the utility of optical coherence tomography (OCT) in screening for EON. These showed decreased retinal nerve fiber layer (RNFL) thickness in patients with clinically significant EON, but mixed results in their ability to detect such changes in patients taking ethambutol without visual

2017 Current Opinion in Ophthalmology

17. Substitution of ethambutol with linezolid during the intensive phase of treatment of pulmonary tuberculosis: study protocol for a prospective, multicenter, randomized, open-label, phase II trial. (PubMed)

Substitution of ethambutol with linezolid during the intensive phase of treatment of pulmonary tuberculosis: study protocol for a prospective, multicenter, randomized, open-label, phase II trial. Linezolid, an oxazolidinone, substantially improves treatment outcomes of multidrug-resistant tuberculosis and extensively drug-resistant tuberculosis. We started a trial to test whether the use of linezolid instead of ethambutol could increase the rate of sputum culture conversion as of 8 weeks (...) of treatment in patients with drug-susceptible tuberculosis.This is a phase II, multicenter, randomized study with three arms. We are enrolling patients with pulmonary tuberculosis without rifampicin resistance screened by the Xpert MTB/RIF® assay. The standard treatment arm uses isoniazid (6 months), rifampicin (6 months), pyrazinamide (2 months), and ethambutol (2 months). Experimental arm 1 uses linezolid (600 mg/day) for 4 weeks instead of ethambutol. Experimental arm 2 uses linezolid (600 mg/day

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2017 Trials

18. ETHAMBUTOL IS CLEARED BY A CONTEMPORARY HIGH-FLUX HEMODIALYZER, AND DRUG MONITORING ENSURES SAFETY AND THERAPEUTICITY. (PubMed)

ETHAMBUTOL IS CLEARED BY A CONTEMPORARY HIGH-FLUX HEMODIALYZER, AND DRUG MONITORING ENSURES SAFETY AND THERAPEUTICITY. It is uncertain, given the lack of recent data and the inconclusive nature of previous data, whether ethambutol is cleared by hemodialysis using contemporary dialyzers. We measured serum ethambutol concentrations before, during, and 1 h after hemodialysis in a 75-year-old Caucasian man receiving ethambutol for disseminated Bacille Calmette-Guérin infection. There was a mean 41 (...) % decrease in serum ethambutol concentration during dialysis, confirming the hemodialyzability of ethambutol and the utility of drug monitoring in ensuring safety.Copyright © 2017 American Society for Microbiology.

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2017 Antimicrobial Agents and Chemotherapy

19. Primary ethambutol resistance among Iranian pulmonary tuberculosis patients: a systematic review. (PubMed)

Primary ethambutol resistance among Iranian pulmonary tuberculosis patients: a systematic review. Ethambutol (EMB) is an anti-mycobacterial agent that is most commonly used in combination with other anti-tuberculosis (TB) drugs in the treatment of TB. Studies have shown that primary resistance rates of Mycobacterium tuberculosis to EMB vary widely, that is, from 1% to as high as 14%. In this study, we aimed to determine the exact prevalence of primary EMB resistance among pulmonary TB

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2017 Therapeutic advances in infectious disease

20. High Resolution Melting Curve Analysis for Rapid Detection of Streptomycin and Ethambutol Resistance in Mycobacterium tuberculosis (PubMed)

High Resolution Melting Curve Analysis for Rapid Detection of Streptomycin and Ethambutol Resistance in Mycobacterium tuberculosis Development of molecular techniques for rapid detection of drug resistant tuberculosis allows for the prompt initiation of appropriate anti-TB treatment. We aimed to assess high-resolution melting (HRM) analysis for the detection of rpsL, rrs and embB mutations to identify streptomycin and ethambutol resistance in Mycobacterium tuberculosis.A total of 76 clinical (...) isolates of M. tuberculosis including 25 SM-R, 21 EB-R and 30 drug susceptible - determined by the proportion method of drug susceptibility testing (DST) - were analyzed by HRM analysis, and the results were confirmed using DNA sequencing.The sensitivity and specificity of the HRMA compared to phenotypic DST were 88% and 100.0%, respectively for the detection of streptomycin resistance (SM-R), and 90.4% and 96.6%, respectively for ethambutol resistance (EB-R). Three SM-R and two EB-R isolates had

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2017 Mædica

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