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fluoroquinolones

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81. Attributable mortality due to fluoroquinolone and extended-spectrum cephalosporin resistance in hospital-onset Escherichia coli and Klebsiella spp bacteremia: A matched cohort study in 129 Veterans Health Administration medical centers. (Abstract)

Attributable mortality due to fluoroquinolone and extended-spectrum cephalosporin resistance in hospital-onset Escherichia coli and Klebsiella spp bacteremia: A matched cohort study in 129 Veterans Health Administration medical centers. In this cohort of Escherichia coli and Klebsiella spp hospital-onset bacteremia, isolated fluoroquinolone resistance had a larger relative impact on mortality than other phenotypic resistance patterns. This finding may support stewardship efforts targeting (...) unnecessary fluoroquinolone use and increased attention from infection prevention and control departments.

2019 Infection control and hospital epidemiology

82. TB Preventive Therapy for individuals exposed to drug-resistant tuberculosis: feasibility and safety of a community-based delivery of fluoroquinolone-containing preventive regimen. (Abstract)

TB Preventive Therapy for individuals exposed to drug-resistant tuberculosis: feasibility and safety of a community-based delivery of fluoroquinolone-containing preventive regimen. Observational studies have demonstrated the effectiveness of a fluoroquinolone-based regimen to treat individuals exposed to or presumed to be infected with drug-resistant (DR)-TB. We sought to assess the feasibility of this approach in an urban setting in South Asia.From February 2016 until March 2017, all household

2019 Clinical Infectious Diseases

83. Fluoroquinolones in drug-resistant tuberculosis: culture conversion and pharmacokinetic/pharmacodynamic target attainment to guide dose selection. (Full text)

Fluoroquinolones in drug-resistant tuberculosis: culture conversion and pharmacokinetic/pharmacodynamic target attainment to guide dose selection. Fluoroquinolones are group A drugs in tuberculosis guidelines. We aim to compare the culture conversion between new- (levofloxacin and moxifloxacin) and old-generation (ciprofloxacin and ofloxacin) fluoroquinolones, develop pharmacokinetic models, and calculate target attainment for levofloxacin and moxifloxacin. We included three U.S. tuberculosis (...) centers. Patients admitted between 1984 and 2015, infected with drug-resistant tuberculosis, and received fluoroquinolones for ≥28 days were included. Demographics, sputum cultures and susceptibility, treatment regimens, and serum concentrations were collected. A time-to-event analysis was conducted, and Cox proportional hazards model was used to compare the time to culture conversion. Using additional data from ongoing studies, pharmacokinetic modelling and Monte Carlo simulations were performed

2019 Antimicrobial Agents and Chemotherapy PubMed abstract

84. Profile of a Novel Anionic Fluoroquinolone-Delafloxacin. (Full text)

Profile of a Novel Anionic Fluoroquinolone-Delafloxacin. Fluoroquinolones have been in clinical use for over 50 years with significant efficacy. However, increasing resistance and emergence of some marked adverse events have limited their usage. The most recently approved class member, delafloxacin, is the only available anionic (non-zwitterionic) fluoroquinolone. Its unique molecular structure provides improved in vitro activity against most Gram-positive pathogens, including quinolone

2019 Clinical Infectious Diseases PubMed abstract

85. Invasive paediatric Elizabethkingia meningoseptica infections are best treated with a combination of piperacillin/tazobactam and trimethoprim/sulfamethoxazole or fluoroquinolone. (Full text)

Invasive paediatric Elizabethkingia meningoseptica infections are best treated with a combination of piperacillin/tazobactam and trimethoprim/sulfamethoxazole or fluoroquinolone. Elizabethkingia meningoseptica is a multi-drug-resistant organism that is associated with high mortality and morbidity in newborn and immunocompromised patients. This study aimed to identify the best antimicrobial therapy for treating this infection.A retrospective descriptive study was conducted from 2010 to 2017 (...) in a tertiary paediatric hospital in Singapore. Paediatric patients aged 0 to 18 years old with a positive culture for E. meningoseptica from any sterile site were identified from the hospital laboratory database. The data collected included clinical characteristics, antimicrobial susceptibility and treatment, and clinical outcomes.Thirteen cases were identified in this study. Combination therapy with piperacillin/tazobactam and trimethoprim/sulfamethoxazole or a fluoroquinolone resulted in a cure rate

2019 Journal of Medical Microbiology PubMed abstract

86. Reactive Oxygen Species Production is a Major Factor Directing the Post-antibiotic Effect of Fluoroquinolones in <i>Streptococcus pneumoniae</i>. (Full text)

Reactive Oxygen Species Production is a Major Factor Directing the Post-antibiotic Effect of Fluoroquinolones in Streptococcus pneumoniae. We studied the molecular mechanisms involved in the post-antibiotic effect of the fluoroquinolones levofloxacin and moxifloxacin in Streptococcus pneumoniae Wild-type strain R6 had post-antibiotic effects of 2.05±0.10 h (mean±SD) and 3.23±0.45 h at 2.5× and 10× MIC of levofloxacin, respectively. Moxifloxacin exhibited a lower effect, of 0.87±0.1 (...) and 2.41±0.29 h at 2.5× and 10× MIC, respectively. Fluoroquinolone-induced chromosome fragmentation was measured at equivalent post-antibiotic effects for levofloxacin (2.5 × MIC) and moxifloxacin (10 × MIC). After 2 h of drug removal, reductions were of about 7-fold for levofloxacin and 3-fold for moxifloxacin, without further decrease at later times. Variations in reactive oxygen species production were detected afterwards, after 4-6 h of drug withdrawals, with decreases ≥400-fold for levofloxacin

2019 Antimicrobial Agents and Chemotherapy PubMed abstract

87. Using Mycobacterium tuberculosis Single-Nucleotide Polymorphisms To Predict Fluoroquinolone Treatment Response. (Full text)

Using Mycobacterium tuberculosis Single-Nucleotide Polymorphisms To Predict Fluoroquinolone Treatment Response. Clinical phenotypic fluoroquinolone susceptibility testing of Mycobacterium tuberculosis is currently based on M. tuberculosis growth at a single critical concentration, which provides limited information for a nuanced clinical response. We propose using specific resistance-conferring M. tuberculosis mutations in gyrA together with population pharmacokinetic and pharmacodynamic (...) modeling as a novel tool to better inform fluoroquinolone treatment decisions. We sequenced the gyrA resistance-determining region of 138 clinical M. tuberculosis isolates collected from India, Moldova, Philippines, and South Africa and then determined each strain's MIC against ofloxacin, moxifloxacin, levofloxacin, and gatifloxacin. Strains with specific gyrA single-nucleotide polymorphisms (SNPs) were grouped into high or low drug-specific resistance categories based on their empirically measured

2019 Antimicrobial Agents and Chemotherapy PubMed abstract

88. N-acetylcysteine blocks SOS induction and mutagenesis produced by fluoroquinolones in Escherichia coli. (Abstract)

N-acetylcysteine blocks SOS induction and mutagenesis produced by fluoroquinolones in Escherichia coli. Fluoroquinolones such as ciprofloxacin induce the mutagenic SOS response and increase the levels of intracellular reactive oxygen species (ROS). Both the SOS response and ROS increase bacterial mutagenesis, fuelling the emergence of resistant mutants during antibiotic treatment. Recently, there has been growing interest in developing new drugs able to diminish the mutagenic effect

2019 Journal of Antimicrobial Chemotherapy

89. Fluoroquinolone resistance in carbapenem-resistant Elizabethkingia anophelis: phenotypic and genotypic characteristics of clinical isolates with topoisomerase mutations and comparative genomic analysis. (Full text)

Fluoroquinolone resistance in carbapenem-resistant Elizabethkingia anophelis: phenotypic and genotypic characteristics of clinical isolates with topoisomerase mutations and comparative genomic analysis. MDR Elizabethkingia anophelis strains are implicated in an increasing number of healthcare-associated infections worldwide, including a recent cluster of E. anophelis infections in the Midwestern USA associated with significant morbidity and mortality. However, there is minimal information (...) on the antimicrobial susceptibilities of E. anophelis strains or their antimicrobial resistance to carbapenems and fluoroquinolones.Our aim was to examine the susceptibilities and genetic profiles of clinical isolates of E. anophelis from our hospital, characterize their carbapenemase genes and production of MBLs, and determine the mechanism of fluoroquinolone resistance.A total of 115 non-duplicated isolates of E. anophelis were examined. MICs of antimicrobial agents were determined using the Sensititre 96-well

2019 Journal of Antimicrobial Chemotherapy PubMed abstract

90. Fluoroquinolone efficacy against tuberculosis is driven by penetration into lesions and activity against resident bacterial populations. (Full text)

Fluoroquinolone efficacy against tuberculosis is driven by penetration into lesions and activity against resident bacterial populations. Fluoroquinolones are the pillar of multi-drug resistant tuberculosis (MDR-TB) treatment, with either moxifloxacin, levofloxacin or gatifloxacin being prescribed to MDR-TB patients. Recently, several clinical trials of 'universal' drug regimens, aiming to treat drug susceptible and resistant TB, have included a fluoroquinolone. In the absence of clinical data (...) comparing their side-by-side efficacy in controlled MDR-TB trials, a pharmacological rationale is needed to guide the selection of the most efficacious fluoroquinolone. The present studies were designed to test the hypothesis that fluoroquinolone concentrations (pharmacokinetics) and activity (pharmacodynamics) at the site of infection are better predictors of efficacy than plasma concentrations and potency measured in standard growth inhibition assays, and to determine whether one

2019 Antimicrobial Agents and Chemotherapy PubMed abstract

91. Assessing Fluoroquinolone-associated Aortic Aneurysm and Dissection: Data Mining of the Public Version of the FDA Adverse Event Reporting System. (Abstract)

Assessing Fluoroquinolone-associated Aortic Aneurysm and Dissection: Data Mining of the Public Version of the FDA Adverse Event Reporting System. A recent large epidemiological study found fluoroquinolone use is associated with an increased risk of aortic aneurysm or dissection. We aimed to examine fluoroquinolone (ciprofloxacin, levofloxacin, moxifloxacin) associated aortic aneurysm or dissection through data mining of the US Food and Drug Administration Adverse Event Reporting System (FAERS (...) reports, all three fluoroquinolones are associated with aortic aneurysm, and levofloxacin is associated with aortic dissection. Risk of aortic aneurysm is higher than aortic dissection. Oral administration of fluoroquinolones is more likely to produce these adverse events.The results obtained herein are consistent with clinical observations, suggesting the necessity for further clinical research on aortic aneurysm and dissection associated with fluoroquinolones. This article is protected by copyright

2019 International journal of clinical practice

92. Differences in clinical manifestations, antimicrobial susceptibility patterns and mutations of fluoroquinolone target genes between <i>Chryseobacterium gleum</i> and <i>Chryseobacterium indologenes</i>. (Full text)

Differences in clinical manifestations, antimicrobial susceptibility patterns and mutations of fluoroquinolone target genes between Chryseobacterium gleum and Chryseobacterium indologenes. Chryseobacterium infections are uncommon, and previous studies have revealed that C. gleum is frequently misidentified as C. indologenes We aimed to explore the differences in clinical manifestations and antimicrobial susceptibility patterns between C. gleum and C. indologenes The database (...) of susceptibility to piperacillin, piperacillin-tazobactam, ceftazidime, tigecycline, and levofloxacin. Alterations in DNA gyrase subunit A were identified to be associated with fluoroquinolone resistance in C. indologenes No non-synonymous substitutions were observed in the QRDRs of C. gleum Differences in epidemiology, clinical manifestations, and antimicrobial susceptibility patterns exist between C. gleum and C. indologenes Additional investigations are needed to explore the significance

2019 Antimicrobial Agents and Chemotherapy PubMed abstract

93. Electrocardiographic Effects of a Supratherapeutic Dose of WCK 2349, a Benzoquinolizine Fluoroquinolone. (Full text)

Electrocardiographic Effects of a Supratherapeutic Dose of WCK 2349, a Benzoquinolizine Fluoroquinolone. The purpose of this study was to measure the electrocardiographic (ECG) effects of WCK 2349 (the L-alanine ester prodrug of levonadifloxacin) at a supratherapeutic oral dose of 2,600 mg. A total of 48 healthy volunteers were randomized to treatment with placebo, WCK 2349, or oral moxifloxacin, 400 mg, in a crossover-designed thorough QT study. A supratherapeutic mean maximum levonadifloxacin

2019 Clinical and translational science Controlled trial quality: uncertain PubMed abstract

94. Delamanid, linezolid, levofloxacin, and pyrazinamide for the treatment of patients with fluoroquinolone-sensitive multidrug-resistant tuberculosis (Treatment Shortening of MDR-TB Using Existing and New Drugs, MDR-END): study protocol for a phase II/III, m (Full text)

Delamanid, linezolid, levofloxacin, and pyrazinamide for the treatment of patients with fluoroquinolone-sensitive multidrug-resistant tuberculosis (Treatment Shortening of MDR-TB Using Existing and New Drugs, MDR-END): study protocol for a phase II/III, m Treatment success rates of multidrug-resistant tuberculosis (MDR-TB) remain unsatisfactory, and long-term use of second-line anti-TB drugs is accompanied by the frequent occurrence of adverse events, low treatment compliance, and high costs (...) . The development of new efficient regimens with shorter treatment durations for MDR-TB will solve these issues and improve treatment outcomes.This study is a phase II/III, multicenter, randomized, open-label clinical trial of non-inferiority design comparing a new regimen to the World Health Organization-endorsed conventional regimen for fluoroquinolone-sensitive MDR-TB. The control arm uses a conventional treatment regimen with second-line drugs including injectables for 20-24 months. The investigational arm

2019 Trials PubMed abstract

95. Correction: Predictors of fluoroquinolone-resistant bacteria in the rectal vault of men undergoing prostate biopsy. (Full text)

Correction: Predictors of fluoroquinolone-resistant bacteria in the rectal vault of men undergoing prostate biopsy. The original version of this article contained an error in the name of author Alfredo Mena Lora. This has now been corrected.

2019 Prostate cancer and prostatic diseases PubMed abstract

96. The Association of Antibiotic Stewardship With Fluoroquinolone Prescribing in Michigan Hospitals: A Multi-hospital Cohort Study. (Full text)

The Association of Antibiotic Stewardship With Fluoroquinolone Prescribing in Michigan Hospitals: A Multi-hospital Cohort Study. Fluoroquinolones increase the risk of Clostridioides difficile infection and antibiotic resistance. Hospitals often use pre-prescription approval or prospective audit and feedback to target fluoroquinolone prescribing. Whether these strategies impact aggregate fluoroquinolone use is unknown.This study is a 48-hospital, retrospective cohort of general-care, medical (...) patients hospitalized with pneumonia or positive urine culture between December 2015-September 2017. Hospitals were surveyed on their use of pre-prescription approval and/or prospective audit and feedback to target fluoroquinolone prescribing during hospitalization (fluoroquinolone stewardship). After controlling for hospital clustering and patient factors, aggregate (inpatient and post-discharge) fluoroquinolone (ciprofloxacin, levofloxacin, moxifloxacin) exposure was compared between hospitals

2019 Clinical Infectious Diseases PubMed abstract

97. Macrolide and fluoroquinolone resistance-associated mutations in Mycoplasma genitalium in Johannesburg, South Africa, 2007-2014. (Full text)

Macrolide and fluoroquinolone resistance-associated mutations in Mycoplasma genitalium in Johannesburg, South Africa, 2007-2014. Antimicrobial resistance in Mycoplasma genitalium is rising globally with resultant clinical treatment failure. We investigated the prevalence of mutations in the macrolide and fluoroquinolone resistance-determining regions of M. genitalium in Johannesburg, South Africa, and ascertained their association with HIV serostatus.Stored M. genitalium positive specimens (...) were detected in any of the specimens analysed. QRDR mutations with known M. genitalium-associated fluoroquinolone resistance were not detected in gyrA, however, one specimen (0.4%) contained a D87Y amino acid alteration in parC, which has been linked to fluoroquinolone treatment failure. The most common parC amino acid change detected, of unknown clinical significance, was P62S (18.8%). We found no significant association between QRDR mutations in M. genitalium and HIV-infection.Ongoing

2019 BMC Infectious Diseases PubMed abstract

98. Oral Fluoroquinolone or Trimethoprim-sulfamethoxazole vs. ß-lactams as Step-Down Therapy for Enterobacteriaceae Bacteremia: Systematic Review and Meta-analysis. (Full text)

Oral Fluoroquinolone or Trimethoprim-sulfamethoxazole vs. ß-lactams as Step-Down Therapy for Enterobacteriaceae Bacteremia: Systematic Review and Meta-analysis. Using published data, we sought to compare outcomes in patients transitioned to either oral fluoroquinolones (FQ) or trimethoprim-sulfamethoxazole (TMP-SMX) versus ß-lactams (BL's) after an initial intravenous (IV) course for gram-negative rod (GNR) bacteremia.We conducted a systematic review of PubMed and EMBASE and published IDWeek

2019 Open forum infectious diseases PubMed abstract

99. Fluoroquinolone use and serious arrhythmias: A Nationwide Case-Crossover Study. (Abstract)

Fluoroquinolone use and serious arrhythmias: A Nationwide Case-Crossover Study. Fluoroquinolones have been associated with life-threatening ventricular arrhythmias and even sudden cardiac death. We aimed to assess the temporal relationship of fluoroquinolone use and serious arrhythmias via a case-crossover analysis of a large cohort of serious arrhythmias patients.In a national administrative database, we compare the distributions of fluoroquinolone exposure for the same patient across a 30-day (...) period before the serious arrhythmia event and 5 randomly selected 30-day periods before the serious arrhythmia event. Odds ratios (ORs) and 95% Confidence Intervals (CIs) were estimated using conditional logistic regression analysis.From a total of 2 million participants, 7657 patients with serious arrhythmias were identified. Use of fluoroquinolones within the 30-day period before the event was significantly associated with increased risk for serious arrhythmia (OR: 3.03, 95% CI: 2.48, 3.71

2019 Resuscitation

100. Association between urinary community-acquired fluoroquinolone-resistant Escherichia coli and neighbourhood antibiotic consumption: a population-based case-control study. (Abstract)

Association between urinary community-acquired fluoroquinolone-resistant Escherichia coli and neighbourhood antibiotic consumption: a population-based case-control study. It is unknown whether increased use of antibiotics in a community increases the risk of acquiring antibiotic resistance by individuals living in that community, regardless of prior individual antibiotic consumption and other risk factors for antibiotic resistance.We used a hierarchical multivariate logistic regression approach (...) to evaluate the association between neighbourhood fluoroquinolone consumption and individual risk of colonisation or infection of the urinary tract with fluoroquinolone-resistant Escherichia coli. We did a population-based case-control study of adults (aged ≥22 years) living in 1733 predefined geographical statistical areas (neighbourhoods) in Israel. A multilevel study design was used to analyse data derived from electronic medical records of patients enrolled in the Clalit state-mandated health service

2019 Lancet infectious diseases

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