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81. Penicillin Allergy Is Not Necessarily Forever Full Text available with Trip Pro

Penicillin Allergy Is Not Necessarily Forever 28672303 2017 08 22 2018 11 13 1538-3598 318 1 2017 Jul 04 JAMA JAMA Penicillin Allergy Is Not Necessarily Forever. 82-83 10.1001/jama.2017.6510 Trubiano Jason A JA Department of Infectious Diseases, Austin Hospital, Melbourne, Victoria, Australia2Department of Infectious Diseases, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia. Adkinson N Franklin NF John Hopkins Asthma and Allergy Centre, Baltimore, Maryland. Phillips Elizabeth Jane (...) EJ Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee5Institute for Immunology and Infectious Diseases, Murdoch University, Western Australia, Australia. eng P50 GM115305 GM NIGMS NIH HHS United States Journal Article United States JAMA 7501160 0098-7484 0 Penicillins 37341-29-0 Immunoglobulin E AIM IM JAMA. 2017 Nov 7;318(17 ):1714 29114824 Diagnosis, Differential Drug Hypersensitivity diagnosis immunology Exanthema chemically induced Humans Immunoglobulin E

2017 JAMA

82. Are Short-Term Late-Generation Antibiotics Equivalent to Standard Penicillin Therapy in the Resolution of Symptoms in Acute Strep Throat in Children?

Are Short-Term Late-Generation Antibiotics Equivalent to Standard Penicillin Therapy in the Resolution of Symptoms in Acute Strep Throat in Children? Systematic Review Snapshot TAKE-HOME MESSAGE Although antibiotics are not the best agent for symptomatic management of streptococcal pharyngitis, according to limited data, short-course antibiotics appear to reduce the duration of symptoms more effectively than longer-course therapy. Are Short-Term Late-Generation Antibiotics Equivalent (...) to Standard Penicillin Therapy in the Resolution of Symptoms in Acute Strep Throat in Children? EBEM Commentators Anand Swaminathan, MD, MPH New York University School of Medicine/Bellevue Hospital Center Department of Emergency Medicine New York, NY Jeffrey Hom, MD, MPH Stony Brook University School of Medicine Departments of Pediatrics (Emergency) and Emergency Medicine Stony Brook, NY Results Table 1. Short (3 days) versus standard (7 days) antibiotic course. Symptom Number of Subjects Difference

2013 Annals of Emergency Medicine Systematic Review Snapshots

83. Penicillin allergy de-labelling ahead of elective surgery: feasibility and barriers. Full Text available with Trip Pro

Penicillin allergy de-labelling ahead of elective surgery: feasibility and barriers. Around 10-15% of the in-patient population carry unsubstantiated 'penicillin allergy' labels, the majority incorrect when tested. These labels are associated with harm from use of broad-spectrum non-penicillin antibiotics. Current testing guidelines incorporate both skin and challenge tests; this is prohibitively expensive and time-consuming to deliver on a large scale. We aimed to establish the feasibility (...) of a rapid access de-labelling pathway for surgical patients, using direct oral challenge.'Penicillin allergic' patients, recruited from a surgical pre-assessment clinic, were risk-stratified using a screening questionnaire. Patients at low risk of true, immunoglobulin E (IgE)-mediated allergy were offered direct oral challenge using incremental amoxicillin to a total dose of 500 mg. A 3-day course was completed at home. De-labelled patients were followed up to determine antibiotic use in surgery

2018 British Journal of Anaesthesia

84. Effect of Periodontal Therapy With Amoxicillin-Metronidazole on Pharyngeal Carriage of Penicillin- and Erythromycin-Resistant Viridans Streptococci. (Abstract)

Effect of Periodontal Therapy With Amoxicillin-Metronidazole on Pharyngeal Carriage of Penicillin- and Erythromycin-Resistant Viridans Streptococci. Previous studies have focused on antibiotic resistance of Gram-negative bacteria before and after periodontal therapy. The purpose of this analysis is to assess changes in resistance patterns of the commensal Gram-positive microbiota. The viridans group streptococci (VGS) have been suggested to serve as reservoirs of resistance genes for more (...) pathogenic streptococci and may be implicated in some non-oral infections.In this randomized clinical trial, 80 patients with periodontitis are distributed randomly into two groups. In group A, patients received 375 mg amoxicillin and 500 mg metronidazole three times per day for 7 days during the non-surgical treatment phase (T1). In group B, the antibiotics were administered during the surgical phase (T2). Resistance of VGS to penicillin and erythromycin was determined by the epsilometer test.At

2018 Journal of periodontology Controlled trial quality: uncertain

85. Variability of surgical prophylaxis in penicillin-allergic children. Full Text available with Trip Pro

Variability of surgical prophylaxis in penicillin-allergic children. We retrospectively evaluated the effect of penicillin adverse drug reaction (ADR) labeling on surgical antibiotic prophylaxis. Cefazolin was administered in 86% of penicillin ADR-negative (-) and 28% penicillin ADR-positive (+) cases. Broad-spectrum antibiotic use was more common in ADR(+) cases and was more commonly associated with perioperative adverse drug events.

2018 Infection control and hospital epidemiology

86. Is direct oral challenge a safe and effective method of de-labelling in adults with an unverified penicillin allergy?

Is direct oral challenge a safe and effective method of de-labelling in adults with an unverified penicillin allergy? 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. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content of this registration record, any associated

2020 PROSPERO

87. A systematic review of the effect of therapeutic drug monitoring on patient health outcomes during treatment with penicillins and carbapenems

A systematic review of the effect of therapeutic drug monitoring on patient health outcomes during treatment with penicillins and carbapenems 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. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content

2020 PROSPERO

88. An evidence-based approach to penicillin allergy testing and de-labelling: a systematic review

An evidence-based approach to penicillin allergy testing and de-labelling: a systematic review 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. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content of this registration record, any associated files or external

2020 PROSPERO

89. Pharmacokinetics of penicillin G in preterm and term neonates. Full Text available with Trip Pro

Pharmacokinetics of penicillin G in preterm and term neonates. Group B streptococci are common causative agents of early-onset neonatal sepsis (EOS). Pharmacokinetic (PK) data for penicillin G have been described for extremely preterm neonates but have been poorly described for late-preterm and term neonates. Thus, evidence-based dosing recommendations are lacking. We describe the PK of penicillin G in neonates with a gestational age (GA) of ≥32 weeks and a postnatal age of <72 h. Penicillin G (...) for V of the central and peripheral compartments, respectively, and 13.2 liters/h/70 kg for CL. Considering the fraction of unbound penicillin G to be 40%, the PTA of an unbound drug concentration that exceeds the MIC for 40% of the dosing interval was >90% for MICs of ≤2 mg/liter with doses of 25,000 IU/kg q12h. In neonates, regardless of GA, the PK parameters of penicillin G were similar. The dose of 25,000 IU/kg q12h is suggested for treatment of group B streptococcal EOS diagnosed within

2018 Antimicrobial Agents and Chemotherapy

90. Analysis of multidrug resistant group B streptococci with reduced penicillin susceptibility forming small, less hemolytic colonies. Full Text available with Trip Pro

Analysis of multidrug resistant group B streptococci with reduced penicillin susceptibility forming small, less hemolytic colonies. Group B streptococci (GBS; Streptococcus agalactiae) are the leading cause of neonatal invasive diseases and are also important pathogens for elderly adults. Until now, nearly all GBS with reduced penicillin susceptibility (PRGBS) have shown β-hemolytic activity and grow on sheep blood agar. However, we have previously reported three PRGBS clinical isolates

2017 PLoS ONE

91. Diversity and composition of vaginal microbiota of pregnant women at risk for transmitting Group B Streptococcus treated with intrapartum penicillin. Full Text available with Trip Pro

Diversity and composition of vaginal microbiota of pregnant women at risk for transmitting Group B Streptococcus treated with intrapartum penicillin. Administering intravenous antibiotics during labor to women at risk for transmitting Group B Streptococcus (GBS) can prevent infections in newborns. However, the impact of intrapartum antibiotic prophylaxis on mothers' microbial community composition is largely unknown. We compared vaginal microbial composition in pregnant women experiencing (...) preterm birth at ≤ 32 weeks gestation that received intrapartum antibiotic prophylaxis with that in controls.Microbiota in vaginal swabs collected shortly before delivery from GBS positive women that received penicillin intravenously during labor or after premature rupture of membranes was compared to controls. Microbiota was analyzed by 16S rRNA sequencing using the PGM Ion Torrent to determine the effects of penicillin use during hospitalization and GBS status on its composition.Penicillin

2017 PLoS ONE

92. Does macrolide use confer risk of out-of-hospital cardiac arrest compared with penicillin V? A Danish national case-crossover and case-time-control study. Full Text available with Trip Pro

Does macrolide use confer risk of out-of-hospital cardiac arrest compared with penicillin V? A Danish national case-crossover and case-time-control study. Macrolides have been associated with proarrhythmic properties, but the evidence is conflicting. We evaluated the risk of out-of-hospital cardiac arrest (OHCA) associated with specific macrolides in a retrospective study. Associations between specific macrolides and OHCA were examined by conditional logistic regression analyses in case (...) -crossover and case-time-control models, using penicillin-V treatment as the comparative reference. From nationwide registries, we identified all OHCAs in Denmark from 2001 to 2010 and use of antibiotics.The present study was approved by the Danish Data Protection Agency (Danish Data Protection Agency (ref.no. 2007-58-0015, local ref.no. GEH-2014-017, (I-Suite.nr. 02 735)).We identified 29 111 patients with an OHCA. Of these, 514 were in macrolide treatment ≤7 days before OHCA and 1237 in penicillin-V

2018 BMJ open

93. Serological response to therapy following retreatment of serofast early syphilis patients with benzathine penicillin. Full Text available with Trip Pro

Serological response to therapy following retreatment of serofast early syphilis patients with benzathine penicillin. Some syphilitic patients remain in a serologically positive state after the recommended therapy. Although we often retreat patients in clinical practice, the optimal treatment protocol remains uncertain due to the paucity of data regarding serological response to retreatment and long-term outcomes.We examined rapid plasma reagin serological test results of 70 serofast early (...) syphilis cases who were retreated with 2.4 million units of benzathine penicillin weekly for 3 weeks. Serological retreatment success was defined as a minimum 4-fold decrease in baseline rapid plasma reagin test antibody titre within 6 months.Thirty-four (48.6%) of the patients who failed to achieve serological cure at 6 months after initial therapy achieved serological cure at 12 months. Patients who had higher non-treponemal titres at baseline and at 6 months were more likely to exhibit serological

2018 Journal of Antimicrobial Chemotherapy

94. The Impact of a Reported Penicillin Allergy on Surgical Site Infection Risk. Full Text available with Trip Pro

The Impact of a Reported Penicillin Allergy on Surgical Site Infection Risk. A reported penicillin allergy may compromise receipt of recommended antibiotic prophylaxis intended to prevent surgical site infections (SSIs). Most patients with a reported penicillin allergy are not allergic. We determined the impact of a reported penicillin allergy on the development of SSIs.In this retrospective cohort study of Massachusetts General Hospital hip arthroplasty, knee arthroplasty, hysterectomy, colon (...) surgery, and coronary artery bypass grafting patients from 2010 to 2014, we compared patients with and without a reported penicillin allergy. The primary outcome was an SSI, as defined by the Centers for Disease Control and Prevention's National Healthcare Safety Network. The secondary outcome was perioperative antibiotic use.Of 8385 patients who underwent 9004 procedures, 922 (11%) reported a penicillin allergy, and 241 (2.7%) had an SSI. In multivariable logistic regression, patients reporting

2018 Clinical Infectious Diseases

95. Clinical and economic burden of hospitalizations with registration of penicillin allergy. (Abstract)

Clinical and economic burden of hospitalizations with registration of penicillin allergy. Penicillin allergy is commonly reported, but only a minority of claimants has a confirmed diagnosis. Nevertheless, patients labeled as having penicillin allergy are treated with second-line antibiotics, which are more expensive and less effective, possibly increasing the risk of drug-resistant infections.To compare hospitalizations with and without registration of penicillin allergy concerning (...) their morbidity and hospital resource use.We analyzed a national administrative database containing a registration of all Portuguese hospitalizations from 2000 to 2014. All episodes occurring in adults with a penicillin allergy registration were compared with an equal number of hospitalizations without such registration and matched for inpatients' age, sex, and main diagnosis. We compared those episodes concerning their length of stay, hospital price charges, comorbidities, and frequency of drug-resistant

2018 Asthma & Immunology

96. Identification of T-cell epitopes from benzylpenicillin conjugated to human serum albumin and implication in penicillin allergy. Full Text available with Trip Pro

Identification of T-cell epitopes from benzylpenicillin conjugated to human serum albumin and implication in penicillin allergy. There is in vitro evidence that T cells from allergic patients react to benzylpenicillin-human serum albumin (BP-HSA) bioconjugates. Our group has recently shown the existence of naïve CD4+ T cells recognizing BP-HSA in healthy donors. However, BP-haptenated peptides from HSA participating in the immunization of allergic patients have never been identified (...) on lysines 159, 212, and 525. Two of these benzylpenicilloylated peptides (lysines 159 and 525) were also found to induce PBMCs proliferation in patients with allergic reaction to penicillins.This study identifies and characterizes for the first time the BP-haptenated peptides from HSA involved in the immunization of patients to penicillins.© 2018 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.

2018 Allergy

97. Evaluation and Management of Penicillin Allergy. Full Text available with Trip Pro

Evaluation and Management of Penicillin Allergy. Penicillin allergy is the most commonly reported drug allergy in the United States. Although penicillin allergy is widely reported, 80% to 90% of individuals with self-reported penicillin allergy are actually able to tolerate penicillins after undergoing evaluation for penicillin allergy. Because most patients with self-reported penicillin allergy will have subsequent negative allergy testing results and tolerate penicillins, they may (...) be unnecessarily exposed to broader-spectrum antibiotics. Use of such antibiotics leads to increased risks of developing antibiotic-resistant microorganisms and incur higher health care utilization costs. In this article, we provide an overview of penicillin allergy and its clinical manifestations as well as an approach for the evaluation and management of penicillin allergy.Copyright © 2017 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

2018 Mayo Clinic Proceedings

98. Transcriptional Modulation of Penicillin-Binding Protein 1b, Outer Membrane Protein P2 and Efflux Pump (AcrAB-TolC) during Heat Stress Is Correlated to Enhanced Bactericidal Action of Imipenem on Non-typeable Haemophilus influenzae Full Text available with Trip Pro

Transcriptional Modulation of Penicillin-Binding Protein 1b, Outer Membrane Protein P2 and Efflux Pump (AcrAB-TolC) during Heat Stress Is Correlated to Enhanced Bactericidal Action of Imipenem on Non-typeable Haemophilus influenzae Objective: The purpose of the present study was to investigate the penicillin binding proteins (PBPs), drug influx and efflux modulations during heat stress and their effects on the bactericidal action of imipenem on non-typeable Haemophilus influenzae (NTHi

2018 Frontiers in microbiology

99. Single nucleotide polymorphisms in genes encoding penicillin-binding proteins in β-lactamase-negative ampicillin-resistant Haemophilus influenzae in Japan Full Text available with Trip Pro

Single nucleotide polymorphisms in genes encoding penicillin-binding proteins in β-lactamase-negative ampicillin-resistant Haemophilus influenzae in Japan β-Lactamase-negative ampicillin-resistant Haemophilus influenzae is a common opportunistic pathogen of hospital- and community-acquired infections, harboring multiple single nucleotide polymorphisms in the ftsI gene, which codes for penicillin-binding protein-3. The objectives of this study were to perform comprehensive genetic analyses (...) of whole regions of the penicillin-binding proteins in H. influenzae and to identify additional single nucleotide polymorphisms related to antibiotic resistance, especially to ampicillin and other cephalosporins.In this genome analysis of the ftsI gene in 27 strains of H. influenzae, 10 of 23 (43.5%) specimens of group III genotype β-lactamase-negative ampicillin-resistant H. influenzae were paradoxically classified as ampicillin-sensitive phenotypes. Unfortunately, we could not identify any novel

2018 BMC research notes

100. Therapeutic Management of Pseudomonas aeruginosa Bloodstream Infection Non-Susceptible to Carbapenems but Susceptible to “Old” Cephalosporins and/or to Penicillins Full Text available with Trip Pro

Therapeutic Management of Pseudomonas aeruginosa Bloodstream Infection Non-Susceptible to Carbapenems but Susceptible to “Old” Cephalosporins and/or to Penicillins It is unknown as to whether other beta-lactams can be used for bloodstream infections (BSI) resulting from Pseudomonas aeruginosa (PA) which are non-susceptible to one or more carbapenem. We conducted a retrospective cohort study at the Assaf Harofeh Medical Center (AHMC) from January 2010 to August 2014. Adult patients with PA

2018 Microorganisms

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