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21. <i>In Vitro</i> Activity of Bedaquiline and Delamanid Against Nontuberculous Mycobacteria Including Macrolide-Resistant Clinical Isolates. Full Text available with Trip Pro

In Vitro Activity of Bedaquiline and Delamanid Against Nontuberculous Mycobacteria Including Macrolide-Resistant Clinical Isolates. We evaluated the in vitro activities of the antimicrobial drugs bedaquiline and delamanid against the major pathogenic nontuberculous mycobacteria (NTM). Delamanid showed high MIC values for all NTM except Mycobacterium kansasii However, bedaquiline showed low MIC values for the major pathogenic NTM, including M. avium complex, M. abscessus, M. massiliense (...) , and M. kansasii Bedaquiline also had low MIC values with macrolide-resistant NTM and warrants further investigation as a potential antibiotic for NTM treatment.Copyright © 2019 American Society for Microbiology.

2019 Antimicrobial Agents and Chemotherapy

22. Macrolide-Resistant Mycoplasma genitalium in Southeastern Region of the Netherlands, 2014-2017. Full Text available with Trip Pro

Macrolide-Resistant Mycoplasma genitalium in Southeastern Region of the Netherlands, 2014-2017. Mycoplasma genitalium infections of the urogenital tract are usually treated with azithromycin; however, for the past several years, rates of azithromycin treatment failure have increased. To document the occurrence and frequency of macrolide resistance-mediating mutations (MRMMs) in M. genitalium infections, we collected 894 M. genitalium-positive samples during April 2014-December 2017

2019 Emerging Infectious Diseases

23. Impact of Previous Exposure to Macrolide Antibiotics on Helicobacter pylori Infection Treatment Outcomes. (Abstract)

Impact of Previous Exposure to Macrolide Antibiotics on Helicobacter pylori Infection Treatment Outcomes. Helicobacter pylori (H. pylori) guidelines, including the recent ACG clinical guideline, recommend avoiding clarithromycin-based triple therapy (TT-C) among patients with past macrolide exposure. Data to support this recommendation are scarce, and the impact of macrolide exposure on quadruple therapies is unclear. We aimed to determine the impact of macrolide exposure on the efficacy of H (...) . pylori treatment in our region.We searched the Clalit Health Services database to identify subjects aged 25-60 years who underwent the first-ever C-urea breath test between 2010 and 2015. Patients who underwent a previous H. pylori stool antigen test or gastroscopy were excluded. Pharmacy dispensation data were retrieved.We identified 7,842 subjects (36.1% male individuals, age: 40.3 ± 10.5 years), including 3,062 (39.0%) with previous macrolide exposure. The efficacy of TT-C was 74.3% and 82.4

2019 American Journal of Gastroenterology

24. Risk of mortality and cardiovascular events following macrolide prescription in chronic rhinosinusitis patients: a cohort study using linked primary care electronic health records. Full Text available with Trip Pro

Risk of mortality and cardiovascular events following macrolide prescription in chronic rhinosinusitis patients: a cohort study using linked primary care electronic health records. Macrolide antibiotics have demonstrated important anti-inflammatory and immunomodulatory properties in chronic rhinosinusitis (CRS) patients. However, reports of increased risks of cardiovascular events have led to safety concerns. We investigated the risk of all-cause and cardiac death, and cardiovascular outcomes (...) , associated with macrolide use.Observational cohort (1997-2016) using linked data from the Clinical Practice Research Datalink, Hospital Episodes Statistics, and the Office for National Statistics. Patients aged 16-80 years with CRS prescribed a macrolide antibiotic or penicillin were included, comparing prescriptions for macrolide antibiotics to penicillin. Outcomes were all-cause mortality, cardiac death, myocardial infarction, stroke, diagnosis of peripheral vascular disease, and cardiac

2019 Rhinology

25. Long-term low rate of macrolide resistant <i>Mycoplasma pneumoniae</i> strains in Germany. Full Text available with Trip Pro

Long-term low rate of macrolide resistant Mycoplasma pneumoniae strains in Germany. Mycoplasma pneumoniae is a frequent cause of infections of the lower and upper respiratory tract of humans.….Copyright © 2019 American Society for Microbiology.

2019 Antimicrobial Agents and Chemotherapy

26. Allele-specific real-time PCR testing for minor macrolide-resistant Mycoplasma Pneumoniae. Full Text available with Trip Pro

Allele-specific real-time PCR testing for minor macrolide-resistant Mycoplasma Pneumoniae. The point mutations in 23S rRNA gene of Mycoplasma pneumoniae (M. pneumoniae) can lead to high-level resistance to macrolides. This study aimed to evaluate allele-specific real-time PCR (ASPCR) to detect the resistance-related mutations located at positions A2063G and A2064G of 23S rRNA gene.We detected 178 pharyngeal swab specimens and calculated the proportions of resistant and sensitive quasispecies (...) using ASPCR assays. ASPCR assays can detect down to 10 copies of 23S rRNA gene and achieved sensitivities of < 0.1% for A2063G and A2064G. We also compared the findings of ASPCR with the results of nested PCR with sequencing.Of 178 samples, 164 were found to have M. pneumoniae including 90.85% (149/164) samples with macrolide-resistant M. pneumoniae (MRMP) quasispecies by ASPCR, while 153 were found to be M. pneumoniae-positive including 71.90% (110/153) samples with MRMP quasispecies by nested PCR

2019 BMC Infectious Diseases

27. Computed tomographic findings of macrolide-resistant Mycobacterium massiliense pulmonary disease and changes after antibiotic treatment. Full Text available with Trip Pro

Computed tomographic findings of macrolide-resistant Mycobacterium massiliense pulmonary disease and changes after antibiotic treatment. The purpose of this study was to present the computed tomographic (CT) findings of lung abnormalities in macrolide-resistant Mycobacterium massiliense pulmonary disease and its changes in follow-up CT after antibiotic treatment.Chest CT scans of patients with macrolide-resistant M massiliense pulmonary disease (n = 19) were retrospectively reviewed. Patients (...) were treated with multidrug therapy, and sputum examinations were performed. Follow-up CT scans obtained during antibiotic treatment after detection of macrolide resistance were also reviewed, if available (n = 13). The CT scores at detection of macrolide resistance and at the last follow-up periods were also compared.Of all patients with macrolide-resistant M massiliense pulmonary disease, 2 (11%) patients achieved sputum culture conversion during the follow-up period. The most common CT findings

2019 Medicine

28. Macrolide combination therapy for hospitalised CAP patients? An individualised approach supported by machine learning. (Abstract)

Macrolide combination therapy for hospitalised CAP patients? An individualised approach supported by machine learning. The role of macrolide/beta-lactam combination therapy in community-acquired pneumonia (CAP) of moderate severity is a matter of debate. Macrolides expand the coverage to atypical pathogens and attenuate pulmonary inflammation, but have been associated with cardiovascular toxicity and drug interactions. We developed a decision tree based on etiological and clinical parameters (...) , which are available ex ante to support a personalised decision pro or con macrolides for the best clinical outcome of the individual patient.We employed machine learning in a cross-validation scheme based on a well balanced selection of 4898 patients after propensity score matching to data available on admission of 6440 hospitalised patients with moderate severity (non-ICU patients) from the observational, prospective, multinational CAPNETZ study. We aimed to improve the primary outcome of 180 days

2019 European Respiratory Journal

29. Macrolide Resistance in MORDOR I - A Cluster-Randomized Trial in Niger. Full Text available with Trip Pro

Macrolide Resistance in MORDOR I - A Cluster-Randomized Trial in Niger. 31167060 2019 06 18 2019 06 18 1533-4406 380 23 2019 06 06 The New England journal of medicine N. Engl. J. Med. Macrolide Resistance in MORDOR I - A Cluster-Randomized Trial in Niger. 2271-2273 10.1056/NEJMc1901535 Doan Thuy T Francis I. Proctor Foundation, San Francisco, CA thuy.doan@ucsf.edu. Arzika Ahmed M AM Carter Center, Niamey, Niger. Hinterwirth Armin A Francis I. Proctor Foundation, San Francisco, CA. Maliki (...) , CA. MORDOR Study Group eng ClinicalTrials.gov NCT02047981 United States N Engl J Med 0255562 0028-4793 0 Anti-Bacterial Agents 0 Macrolides 83905-01-5 Azithromycin AIM IM N Engl J Med. 2019 Jun 6;380(23):2264-2265 31167057 N Engl J Med. 2019 Nov 28;381(22):2184 31774978 Administration, Oral Anti-Bacterial Agents pharmacology therapeutic use Azithromycin therapeutic use Child, Preschool Drug Resistance, Bacterial Humans Infant Macrolides pharmacology therapeutic use Niger Pneumococcal Infections

2019 The New England journal of medicine Controlled trial quality: uncertain

30. Staphylococcus aureus with an erm-mediated constitutive macrolide-lincosamide-streptogramin B resistance phenotype has reduced susceptibility to the new ketolide, solithromycin. Full Text available with Trip Pro

Staphylococcus aureus with an erm-mediated constitutive macrolide-lincosamide-streptogramin B resistance phenotype has reduced susceptibility to the new ketolide, solithromycin. Solithromycin, the fourth generation of ketolides, has been demonstrated potent antibacterial effect against commonly-isolated gram-positive strains. However, Staphylococcus aureus (S. aureus) strains with a higher solithromycin MIC have already been emerged, the mechanism of which is unknown.Antimicrobial (...) of the erm gene between the constitutive macrolide-lincosamide-streptogramin B (cMLSB)- and inducible MLSB (iMLSB)-phenotypes.In the erm-positive S. aureus strains, the minimum inhibitory concentration (MIC)50/90 of solithromycin (2/> 16 mg/L) was significantly higher than that in the erm-negative strains (0.125/0.25 mg/L). Of note, the MIC50 value of the strains with iMLSB (0.25 mg/L) was significantly lower than that of the strains with cMLSB (4 mg/L). A comparison among strains demonstrated

2019 BMC Infectious Diseases

31. A review of non-cystic fibrosis bronchiectasis in children with a focus on the role of long-term treatment with macrolides. (Abstract)

A review of non-cystic fibrosis bronchiectasis in children with a focus on the role of long-term treatment with macrolides. Bronchiectasis is a rare chronic airway disease arising from several respiratory and systemic diseases. The grade of evidence for specific treatment of childhood bronchiectasis unrelated to cystic fibrosis (CF) is low with very few randomized controlled trials. Treatment has been based mainly on evidence from studies in adults with non-cystic fibrosis bronchiectasis (...) and patients with cystic fibrosis. Recently, long-term treatment with macrolides has been proposed. These molecules offer the advantage of anti-inflammatory and immunomodulatory properties in addition to their antibacterial properties. A total of three randomized double-blind placebo-controlled trials conducted in adults showed that macrolides taken for 6-12 months led to a significant reduction in exacerbation rates. Only one long-term, randomized double-blind placebo-controlled trial was conducted

2019 Pediatric pulmonology Controlled trial quality: predicted high

32. Species Distribution and Macrolide Susceptibility of <i>Mycobacterium fortuitum</i> Complex Clinical Isolates. Full Text available with Trip Pro

Species Distribution and Macrolide Susceptibility of Mycobacterium fortuitum Complex Clinical Isolates. The understanding of species distribution and inducible macrolide resistance in the Mycobacterium fortuitum complex (MFC) is limited. Of 90 mostly respiratory MFC clinical isolates, half were M. fortuitum, followed by M. peregrinum, M. porcinum, M. septicum, and M. conceptionense Most M. fortuitum, M. porcinum, and M. septicum isolates were inducibly resistant to clarithromycin

2019 Antimicrobial Agents and Chemotherapy

33. Idiopathic chronic productive cough and response to open-label macrolide therapy: An observational study. Full Text available with Trip Pro

Idiopathic chronic productive cough and response to open-label macrolide therapy: An observational study. Adult patients with chronic productive cough of unknown cause are commonly seen in respiratory clinics. We have previously described a subgroup of these patients who have a short-lived response to standard antibiotic treatment but a prolonged response to 3 months of low-dose azithromycin therapy.This observational study describes the physiological, radiological and pathological features

2019 Respirology

34. Cardiac events after macrolides or fluoroquinolones in patients hospitalized for community-acquired pneumonia: post-hoc analysis of a cluster-randomized trial. Full Text available with Trip Pro

Cardiac events after macrolides or fluoroquinolones in patients hospitalized for community-acquired pneumonia: post-hoc analysis of a cluster-randomized trial. Guidelines recommend macrolides and fluoroquinolones in patients hospitalized with community-acquired pneumonia (CAP), but their use has been associated with cardiac events. We quantified associations between macrolide and fluoroquinolone use and cardiac events in patients hospitalized with CAP in non-ICU wards.This was a post-hoc (...) analysis of a cluster-randomized trial as a cohort study; including patients with a working diagnosis of CAP admitted to non-ICU wards without a cardiac event on admission. We calculated cause-specific hazard ratio's (HR's) for effects of time-dependent macrolide and fluoroquinolone exposure as compared to beta-lactam monotherapy on cardiac events, defined as new or worsening heart failure, arrhythmia, or myocardial ischemia during hospitalization.Cardiac events occurred in 146 (6.9%) of 2107 patients

2019 BMC Infectious Diseases Controlled trial quality: uncertain

35. Impact of Macrolide Antibiotics on Hospital Readmissions and other Clinically Important Outcomes in Critically Ill Patients with Acute Exacerbations of Chronic Obstructive Pulmonary Disease: A Propensity Score-Matched Cohort Study. Full Text available with Trip Pro

Impact of Macrolide Antibiotics on Hospital Readmissions and other Clinically Important Outcomes in Critically Ill Patients with Acute Exacerbations of Chronic Obstructive Pulmonary Disease: A Propensity Score-Matched Cohort Study. To assess whether a macrolide-based antibiotic treatment strategy reduces in-hospital mortality, decreases hospital readmissions, or improves other clinically important outcomes compared with a non-macrolide antibiotic treatment strategy in critically ill patients (...) with acute exacerbations of chronic obstructive pulmonary disease (AECOPD).Propensity score-matched pharmacoepidemiologic cohort study.Premier's Perspective Hospital Database.A total of 28,700 adults aged 40 years or older who were admitted to one of 566 United States intensive care units and had the primary diagnosis of AECOPD between January 2010 and December 2014, and received antibiotic treatment within 2 days of hospital admission were included. Patients were divided into macrolide (11,602 patients

2019 Pharmacotherapy

36. Evaluation of severity score-guided approaches to macrolide use in community-acquired pneumonia Full Text available with Trip Pro

Evaluation of severity score-guided approaches to macrolide use in community-acquired pneumonia International guidelines including those in the UK, Japan, Australia and South Africa recommend the avoidance of macrolides in patients with low-severity community-acquired pneumonia (CAP). We hypothesised that severity scores are poor predictors of atypical pneumonia and response to macrolide therapy, and thus, inadequate tools for guiding antibiotic prescriptions.Secondary analysis of four (...) independent prospective CAP datasets was conducted. The predictive values of the CURB-65 and pneumonia severity index (PSI) for clinically important groups of causative pathogens were evaluated. The effect of macrolide use according to risk class was assessed by multivariable analysis. Patients (3297) were evaluated, and the predictive values of CURB-65 and PSI for atypical pathogens were poor (AUC values of 0.37 and 0.42, respectively). No significant differences were noted among the effects of macrolide

2017 EvidenceUpdates

37. Macrolides inhibit capsule formation of highly virulent <i>Cryptococcal gattii</i> and promotes innate immune susceptibility. Full Text available with Trip Pro

Macrolides inhibit capsule formation of highly virulent Cryptococcal gattii and promotes innate immune susceptibility. Cryptococcus gattii is a fungal pathogen, endemic in tropical and subtropical regions, the west coast of Canada and the United States, causes a potentially fatal infection in otherwise healthy individuals. Because the cryptococcal polysaccharide capsule is a leading virulence factor due to its resistance against innate immunity, the inhibition of capsule formation may (...) be a promising new therapeutic strategy for Cgattii Macrolides have numerous non-antibiotic effects including immunomodulation of mammalian cells and suppression of bacterial (but not fungal) pathogenicity. Thus, we hypothesized that a macrolide would inhibit cryptococcal capsule formation and improve the host immune response. Co-incubation with clarithromycin and azithromycin significantly reduced the capsule thickness and the amount of capsular polysaccharide of both Cgattii and C. neoformas CAM-treated C

2019 Antimicrobial Agents and Chemotherapy

38. Structure of dirithromycin bound to the bacterial ribosome suggests new ways for rational improvement of macrolides. Full Text available with Trip Pro

Structure of dirithromycin bound to the bacterial ribosome suggests new ways for rational improvement of macrolides. Although macrolides are known as excellent antibacterials, their medical use has been significantly limited due to the spread of bacterial drug resistance. Therefore, it is necessary to develop new potent macrolides to combat the emergence of drug-resistant pathogens. One of the key steps in rational drug design is the identification of chemical groups that mediate drug binding (...) to its target and their subsequent derivatization to strengthen drug-target interactions. In the case of macrolides, a few groups are known to be important for drug binding to the ribosome, such as desosamine. Search for the new chemical moieties improving the interactions of a macrolide with the 70S ribosome might be of crucial importance for the invention of new macrolides. For this purpose, here we studied a "classic" macrolide dirithromycin, which has extended (2-methoxyethoxy)-methyl side chain

2019 Antimicrobial Agents and Chemotherapy

39. Bordetella pertussis Infection in Infants and Young Children in Shanghai, China, 2016-2017: Clinical Features, Genotype Variations of Antigenic Genes and Macrolides Resistance. (Abstract)

Bordetella pertussis Infection in Infants and Young Children in Shanghai, China, 2016-2017: Clinical Features, Genotype Variations of Antigenic Genes and Macrolides Resistance. The global resurgence of pertussis in countries with high vaccination coverage has been a concern of public health.Nasopharyngeal swabs were collected for Bordetella pertussis culture from children with suspected pertussis. Clinical and vaccination information were reviewed through electronic medical chart (...) (17.7%) had completed at least 3 doses of DTaP and 75 (53.2%) had a clear exposure to household members with persistent cough. Fully vaccinated cases manifested milder disease than unvaccinated and not-fully vaccinated cases. All strains were MLST2. High-virulent strains characteristic of ptxP3/prn2/ptxC2 constituted 41.1% (58/141) and were all susceptible to macrolides while low-virulent strains characteristic of ptxP1/prn1/ptxC1 constituted 58.9% (83/141) and 97.6% (81/83), respectively, were

2019 Pediatric Infectious Dsease Journal

40. Mycoplasma genitalium in symptomatic male urethritis: macrolide use is associated with increased resistance. (Abstract)

Mycoplasma genitalium in symptomatic male urethritis: macrolide use is associated with increased resistance. Mycoplasma genitalium (Mg) causes symptomatic urethritis in men, and can infect alone or together with other STI agents.The prevalence of Mg and other STIs were determined in 1816 men with symptomatic urethritis. Resistance of Mg to macrolides and fluoroquinolones was determined by sequencing; the impact of recent antimicrobial usage on the distribution of Mg single or mixed infections (...) was determined.Overall, prevalence of Mg infection was 19.7% (358/1816). 54.1% (166/307) of Mg infections occurred alone in the absence of other STI agents. Men with single Mg infection self-administered or were prescribed antibiotics more often in the 30 days prior to enrollment than subjects with urethritis caused by Mg coinfection (P<0.0001). Higher rates (96.7%) of infection with macrolide resistance in Mg were identified in men who had taken macrolides prior to enrollment (P< 0.03). Overall, 88.9% (303/341

2019 Clinical Infectious Diseases

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