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41. Empirical prescribing of penicillin G/V reduces risk of readmission of hospitalized patients with community-acquired pneumonia in Norway: a retrospective observational study. Full Text available with Trip Pro

Empirical prescribing of penicillin G/V reduces risk of readmission of hospitalized patients with community-acquired pneumonia in Norway: a retrospective observational study. Norwegian guideline recommendations on first-line empirical antibiotic prescribing in hospitalised patients with community-acquired pneumonia (CAP) are penicillin G/V in monotherapy, or penicillin G in combination with gentamicin (or cefotaxime) in severely ill patients. The aim of this study was to explore how different (...) duration and clinical outcomes from electronic patient records and the hospital administrative system. We used directed acyclic graphs for statistical model selection, and analysed data with mulitvariable logistic and linear regression.We included 651 patients. Median age was 77 years [IQR; 64-84] and 46.5% were female. Median LOS was 4 days [IQR; 3-6], 30-day readmission rate was 14.4% and 30-day mortality rate was 6.9%. Penicillin G/V were empirically prescribed in monotherapy in 51.5% of patients

2020 BMC pulmonary medicine

42. The association of penicillin allergy with outcomes after open ventral hernia repair. (Abstract)

The association of penicillin allergy with outcomes after open ventral hernia repair. Up to 11% of patients report a penicillin allergy (PA), with 1-2% demonstrating a true IgE mediated allergy upon testing. PA patients often receive non-beta-lactam antibiotic surgical prophylaxis (non-BLP). This study evaluates the relationship of PA to outcomes after open ventral hernia repair (OVHR).A prospective institutional database was queried for patients undergoing OVHR. Demographics, operative

2020 Surgical endoscopy

43. Prenatal low-dose penicillin results in long-term sex-specific changes to murine behaviour, immune regulation, and gut microbiota. (Abstract)

Prenatal low-dose penicillin results in long-term sex-specific changes to murine behaviour, immune regulation, and gut microbiota. Growing evidence suggests that environmental disruptors of maternal microbes may have significant detrimental consequences for the developing fetus. Antibiotic exposure during early life can have long-term effects on neurodevelopment in mice and humans. Here we explore whether exposure to low-dose penicillin during only the last week of gestation in mice has long (...) -term effects on offspring behaviour, brain, immune function, and gut microbiota. We found that this treatment had sex-specific effects in the adult mouse offspring. Female, but not male, mice demonstrated decreased anxiety-like behaviours, while male, but not female, mice had abnormal social behaviours which correlated with altered brain expression of AVPR1A, AVPR1B, and OXTR, and decreases in the balance of splenic FOXP3+ regulatory T cells. Prenatal penicillin exposure also led to distinct

2020 Brain, behavior, and immunity

44. Accuracy of Penicillin Allergy Diagnostic Tests: A Systematic Review and Meta-analysis. Full Text available with Trip Pro

Accuracy of Penicillin Allergy Diagnostic Tests: A Systematic Review and Meta-analysis. Having a penicillin allergy label associates with higher risk for antibiotic resistance and increased healthcare use.To assess the accuracy of skin tests and specific IgE quantification in the diagnostic evaluation of patients reporting a penicillin/β-lactam allergy.We performed a systematic review and diagnostic accuracy meta-analysis, searching on MEDLINE, Scopus and Web of Science. We included studies (...) conducted in patients reporting a penicillin allergy and in whom skin tests and/or specific IgE quantification were performed and compared with drug challenge results. We quantitatively assessed the accuracy of diagnostic tests with bivariate random-effects meta-analyses. Meta-regression and subgroup analyses were performed to explore causes of heterogeneity. Studies' quality was evaluated using QUADAS-2 criteria.We included 105 primary studies, assessing 31,761 participants. Twenty-seven studies were

2020 Journal of Allergy and Clinical Immunology

45. Proactive management of penicillin and other antibiotic allergies. (Abstract)

Proactive management of penicillin and other antibiotic allergies. Background: Antibiotic allergies, especially penicillin, are the most frequent drug allergy listed in the medical record. Proactive evaluations of antibiotic allergies, particularly penicillin allergies, have been recommended by various specialty societies. Objective: To review the history of the discovery of penicillin, implications of the penicillin allergy label, various delabeling strategies as well as a brief overview (...) of the approach to cephalosporin, fluoroquinolone, and macrolide allergy. Methods: Recent studies on penicillin allergy delabeling and on cephalosporin and fluoroquinolone allergies were reviewed. Results: Although Alexander Fleming is often solely credited with the discovery of penicillin, other scientists were critical to the development of penicillin as a life-saving antibiotic. The vast majority of patients with a penicillin allergy label are not allergic; however, this label results in increased

2020 Allergy and Asthma Proceedings

46. The complexity of T cell-mediated penicillin hypersensitivity reactions. Full Text available with Trip Pro

The complexity of T cell-mediated penicillin hypersensitivity reactions. Penicillin refers to a group of beta-lactam antibiotics that are the first-line treatment for a range of infections. However, they also possess the ability to form novel antigens, or neoantigens, through haptenation of proteins and can stimulate a range of immune-mediated adverse reactions - collectively known as drug hypersensitivity reactions (DHRs). IgE-mediated reactions towards these neoantigens are well studied (...) , discussing the nature of the lesional T cells, the characterisation of drug-responsive T cells isolated from patient blood, and the potential mechanisms by which penicillins enter the antigen processing and presentation pathway to stimulate these deleterious responses. Thus, we highlight the need for a more comprehensive understanding of the underlying genetic and molecular basis of penicillin-induced DHRs.This article is protected by copyright. All rights reserved.

2020 Allergy

47. Preoperative Allergy Testing for Patients Reporting Penicillin and Cephalosporin Allergies is Cost-Effective in Preventing Infection after Total Knee and Hip Arthroplasty. (Abstract)

Preoperative Allergy Testing for Patients Reporting Penicillin and Cephalosporin Allergies is Cost-Effective in Preventing Infection after Total Knee and Hip Arthroplasty. Routine preoperative allergy testing in patients reporting penicillin and cephalosporin allergies increases the number able to receive cefazolin, which should reduce the risk of infection after total knee and hip arthroplasty (TKA/THA), but it remains unclear whether this practice is cost-effective. Using a break-even (...) analysis, we calculated the cost-effectiveness of routine preoperative allergy testing for infection prevention in total joint arthroplasty patients reporting penicillin and cephalosporin allergies.The cost of a penicillin allergy evaluation, the cost of revision arthroplasty for prosthetic joint infection (PJI), and baseline rates of PJI in patients receiving a noncefazolin antibiotic in the perioperative period were derived from existing literature. A break-even economic model using these variables

2020 Journal of Arthroplasty

48. Plasmid mediated penicillin and tetracycline resistance among Neisseria gonorrhoeae isolates from Kenya. Full Text available with Trip Pro

Plasmid mediated penicillin and tetracycline resistance among Neisseria gonorrhoeae isolates from Kenya. Treatment of gonorrhea is complicated by the development of antimicrobial resistance in Neisseria gonorrhoeae (GC) to the antibiotics recommended for treatment. Knowledge on types of plasmids and the antibiotic resistance genes they harbor is useful in monitoring the emergence and spread of bacterial antibiotic resistance. In Kenya, studies on gonococcal antimicrobial resistance are few (...) antimicrobial resistance determinants were done using Bioedit sequence alignment editor.Twenty-four (66.7%) isolates had both β-lactamase (TEM) and TetM encoding plasmids. 8.3% of the isolates lacked both TEM and TetM plasmids and had intermediate to susceptible penicillin and tetracycline MICs. Twenty-six (72%) isolates harbored TEM encoding plasmids. 25 of the TEM plasmids were of African type while one was an Asian type. Of the 36 isolates, 31 (86.1%) had TetM encoding plasmids, 30 of which harbored

2020 BMC Infectious Diseases

49. Penicillin skin testing in methicillin-sensitive staphylococcus aureus bacteremia: A cost-effectiveness analysis. Full Text available with Trip Pro

Penicillin skin testing in methicillin-sensitive staphylococcus aureus bacteremia: A cost-effectiveness analysis. Beta-lactams are the mainstay for treating methicillin-susceptible Staphylococcus aureus (MSSA) infections complicated by bacteremia due to superior outcomes compared with vancomycin. With approximately 11% of inpatients reporting a penicillin (PCN) allergy, many patients receive suboptimal treatment for MSSA bacteremia.Evaluate the cost-effectiveness of penicillin skin testing (PST

2019 PLoS ONE

50. Risk of meticillin resistant <i>Staphylococcus aureus</i> and <i>Clostridium difficile</i> in patients with a documented penicillin allergy: population based matched cohort study. Full Text available with Trip Pro

Risk of meticillin resistant Staphylococcus aureus and Clostridium difficile in patients with a documented penicillin allergy: population based matched cohort study. To evaluate the relation between penicillin allergy and development of meticillin resistant Staphylococcus aureus (MRSA) and C difficile.Population based matched cohort study.United Kingdom general practice (1995-2015).301 399 adults without previous MRSA or C difficile enrolled in the Health Improvement Network (...) database: 64 141 had a penicillin allergy and 237 258 comparators matched on age, sex, and study entry time.The primary outcome was risk of incident MRSA and C difficile. Secondary outcomes were use of β lactam antibiotics and β lactam alternative antibiotics.Among 64 141 adults with penicillin allergy and 237 258 matched comparators, 1365 developed MRSA (442 participants with penicillin allergy and 923 comparators) and 1688 developed C difficile (442 participants with penicillin allergy and 1246

2018 BMJ

51. ASCIA Penicillin Allergy Guide for health professionals

ASCIA Penicillin Allergy Guide for health professionals • In severe penicillin allergy (e.g. anaphylaxis, bronchospasm, urticaria, angioedema), avoid ALL penicillins, cephalosporins and other beta-lactam antibiotics • In non-severe penicillin allergy (e.g. mild rash) use cephalosporins and carbapenems with caution • Some reactions (e.g. nausea) are not considered allergies and do not warrant prohibiting penicillin use Contraindicated At all times where reasonable evidence of penicillin allergy (...) exists Caution Avoid if severe penicillin allergy (e.g. anaphylaxis) Use with caution if non-severe allergy (e.g. minor rash) Seek specialist advice Considered Safe In the absence of other contraindications Cefaclor Cefepime Cefotaxime Cefoxitin Ceftazidime Ceftriaxone Cefuroxime Cephalexin Cephazolin Doripenem, ertapenem, imipenem, meropenem Aztreonam Azithromycin, erythromycin, roxithromycin, clarithromycin Ciprofloxacin, norfloxacin, moxifloxacin Clindamycin, lincomycin Doxycycline, minocycline

2016 Australasian Society of Clinical Immunology and Allergy

52. Impacts of Penicillin Binding Protein 2 Inactivation on β-Lactamase Expression and Muropeptide Profile in Stenotrophomonas maltophilia Full Text available with Trip Pro

Impacts of Penicillin Binding Protein 2 Inactivation on β-Lactamase Expression and Muropeptide Profile in Stenotrophomonas maltophilia Penicillin binding proteins (PBPs) are involved in peptidoglycan synthesis, and their inactivation is linked to β-lactamase expression in ampR-β-lactamase module-harboring Gram-negative bacteria. There are seven annotated PBP genes, namely, mrcA, mrcB, pbpC, mrdA, ftsI, dacB, and dacC, in the Stenotrophomonas maltophilia genome, and these genes encode PBP1a

2017 mSystems

53. The incidence of penicillin allergy among ED patients with acute cellulitis treated with penicillin antibiotics

The incidence of penicillin allergy among ED patients with acute cellulitis treated with penicillin antibiotics Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. CRD bears no responsibility or liability for the content of this registration record, any associated files or external websites. Email salutation (e.g. "Dr Smith" or "Joanne") for correspondence

2018 PROSPERO

54. Short-term oral antibiotics may be as effective as the standard course of penicillin for children with acute streptococcal pharyngitis

Short-term oral antibiotics may be as effective as the standard course of penicillin for children with acute streptococcal pharyngitis Short-term oral antibiotics may be as effective as the standard course of penicillin for children with acute streptococcal pharyngitis ADA Websites Access news, member benefits and ADA policy Attend ADA's premier event Access cutting-edge continuing education courses Find evidence to support your clinical decisions Access member-only practice content Investing (...) boards Evidence Education * Associated Topics Short-term oral antibiotics may be as effective as the standard course of penicillin for children with acute streptococcal pharyngitis Shukan Kanuga, DDS, MSD . Overview Systematic Review Conclusion Three to 6 days of short-term late-generation antibiotics have comparable treatment efficacy as a 10-day course of oral penicillin in children with acute group A β-hemolytic streptococcus (GABHS) pharyngitis. Critical Summary Assessment On the basis of good

2015 ADA Center for Evidence-Based Dentistry

55. Short-term oral antibiotics may be as effective as the standard course of penicillin for children with acute streptococcal pharyngitis

Short-term oral antibiotics may be as effective as the standard course of penicillin for children with acute streptococcal pharyngitis Short-term oral antibiotics may be as effective as the standard course of penicillin for children with acute streptococcal pharyngitis ADA Websites Access news, member benefits and ADA policy Attend ADA's premier event Access cutting-edge continuing education courses Find evidence to support your clinical decisions Access member-only practice content Investing (...) boards Evidence Education * Associated Topics Short-term oral antibiotics may be as effective as the standard course of penicillin for children with acute streptococcal pharyngitis Shukan Kanuga, DDS, MSD . Overview Systematic Review Conclusion Three to 6 days of short-term late-generation antibiotics have comparable treatment efficacy as a 10-day course of oral penicillin in children with acute group A β-hemolytic streptococcus (GABHS) pharyngitis. Critical Summary Assessment On the basis of good

2015 ADA Center for Evidence-Based Dentistry

56. Short-term oral antibiotics may be as effective as the standard course of penicillin for children with acute streptococcal pharyngitis

Short-term oral antibiotics may be as effective as the standard course of penicillin for children with acute streptococcal pharyngitis Short-term oral antibiotics may be as effective as the standard course of penicillin for children with acute streptococcal pharyngitis ADA Websites Access news, member benefits and ADA policy Attend ADA's premier event Access cutting-edge continuing education courses Find evidence to support your clinical decisions Access member-only practice content Investing (...) boards Evidence Education * Associated Topics Short-term oral antibiotics may be as effective as the standard course of penicillin for children with acute streptococcal pharyngitis Shukan Kanuga, DDS, MSD . Overview Systematic Review Conclusion Three to 6 days of short-term late-generation antibiotics have comparable treatment efficacy as a 10-day course of oral penicillin in children with acute group A β-hemolytic streptococcus (GABHS) pharyngitis. Critical Summary Assessment On the basis of good

2015 ADA Center for Evidence-Based Dentistry

57. Systematic review: Penicillin is the drug of choice to treat all stages of syphilis despite a paucity of clinical trials data for the treatment of some stages, pregnant women and HIV-infected people

Systematic review: Penicillin is the drug of choice to treat all stages of syphilis despite a paucity of clinical trials data for the treatment of some stages, pregnant women and HIV-infected people Penicillin is the drug of choice to treat all stages of syphilis despite a paucity of clinical trials data for the treatment of some stages, pregnant women and HIV-infected people | BMJ Evidence-Based Medicine We use cookies to improve our service and to tailor our content and advertising to you (...) Penicillin is the drug of choice to treat all stages of syphilis despite a paucity of clinical trials data for the treatment of some stages, pregnant women and HIV-infected people Article Text Therapeutics/Prevention Systematic review Penicillin is the drug of choice to treat all stages of syphilis despite a paucity of clinical trials data for the treatment of some stages, pregnant women and HIV-infected people Susan Tuddenham , Khalil G Ghanem Statistics from Altmetric.com Commentary on : Clement ME

2015 Evidence-Based Medicine

58. Low-dose penicillin for recurrent cellulitis?

Low-dose penicillin for recurrent cellulitis? Low-dose penicillin for recurrent cellulitis? Toggle navigation Shared more. Cited more. Safe forever. Toggle navigation View Item JavaScript is disabled for your browser. Some features of this site may not work without it. Search MOspace This Collection Browse Statistics Low-dose penicillin for recurrent cellulitis? View/ Open Date 2014-01 Format Metadata Abstract Practice changer: Prescribe low-dose penicillin to patients with recurrent leg

2014 PURLS

59. Cefuroxime, levofloxacin, esomeprazole, and bismuth as first-line therapy for eradicating Helicobacter pylori in patients allergic to penicillin. Full Text available with Trip Pro

Cefuroxime, levofloxacin, esomeprazole, and bismuth as first-line therapy for eradicating Helicobacter pylori in patients allergic to penicillin. Eradicating Helicobacter pylori infection is clinically challenging, notably in cases with penicillin allergy. Cephalosporin could be used in lieu of amoxicillin to eradicate Helicobacter pylori. The current work aimed to assess therapeutic efficacy and safety of a cefuroxime-based quadruple regimen in treatment-naïve individuals with penicillin (...) allergy, as well as patient compliance.In the present prospective single-center cohort study, 152 Helicobacter pylori infected individuals with penicillin allergy received eradication therapy with cefuroxime (500 mg twice/day), levofloxacin (500 mg once/day), esomeprazole (20 mg twice/day) and bismuth potassium citrate (220 mg twice/day; 14 days). Safety and compliance were evaluated 1 to 3 days upon eradication. The urea breath test was carried out 8 to 12 weeks upon eradication for efficacy

2019 BMC Gastroenterology

60. Four-Weekly Benzathine Penicillin G Provides Inadequate Protection against Acute Rheumatic Fever in Some Children. Full Text available with Trip Pro

Four-Weekly Benzathine Penicillin G Provides Inadequate Protection against Acute Rheumatic Fever in Some Children. This study aimed to identify recurrent acute rheumatic fever (ARF) episodes which occurred despite adherence to prophylactic benzathine penicillin G (BPG). Data from Australia's Northern Territory were analyzed; ARF recurrences between 2012 and 2017 diagnosed while the person was prescribed BPG were identified. Days at risk (DAR)-median and interquartile range-preceding ARF onset

2019 American Journal of Tropical Medicine & Hygiene

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