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161. Diversity of mosaic <i>pbp2x</i> families of penicillin-resistant <i>Streptococcus pneumoniae</i> from Iran and Romania. Full Text available with Trip Pro

Diversity of mosaic pbp2x families of penicillin-resistant Streptococcus pneumoniae from Iran and Romania. Penicillin-resistant Streptococcus pneumoniae strains are found at high rates in Romania and Iran. The mosaic structure of PBP2x was investigated in 9 strains from Iran and in 15 strains from Romania to understand their evolutionary history. Mutations potentially important for β-lactam resistance were identified by comparison of the PBP2x sequences with the sequence (...) of the related PBP2x of reference penicillin-sensitive S. mitis strains. Two main PBP2x mosaic gene families were recognized. Eight Iranian strains expressed PBP2x variants in group 1, which had a mosaic block highly related to PBP2x of the Spain23F-1 clone, which is widespread among international penicillin-resistant S. pneumoniae clones. A second unique PBP2x group was observed in Romanian strains; furthermore, three PBP2x single mosaic variants were found. Sequence blocks of penicillin-sensitive strain S

2017 Antimicrobial Agents and Chemotherapy

162. A Multicenter Study Evaluating Ceftriaxone and Benzathine Penicillin G as Treatment Agents for Early Syphilis in Jiangsu, China. Full Text available with Trip Pro

A Multicenter Study Evaluating Ceftriaxone and Benzathine Penicillin G as Treatment Agents for Early Syphilis in Jiangsu, China. The aim of this study was to assess the efficacy of ceftriaxone and benzathine penicillin G (BPG) in nonpregnant, immunocompetent adults with early syphilis because there is a lack of clinical evidence supporting ceftriaxone as an alternative treatment for early syphilis without an human immunodeficiency virus coinfection.A randomized, open-label controlled study

2017 Clinical Infectious Diseases Controlled trial quality: uncertain

163. Enhancing antibiotic stewardship by tackling 'spurious' penicillin allergy. (Abstract)

Enhancing antibiotic stewardship by tackling 'spurious' penicillin allergy. Approximately 90-99% of patients with a label of penicillin allergy (PenA) are not allergic when comprehensively investigated. An inaccurate label of PenA has major public health implications-longer hospital stay, more frequent hospital admissions, greater use of fluoroquinolones, glycopeptides, cephalosporins and other expensive antibiotics resulting in significantly higher costs to the health service and predisposing

2017 Clinical and Experimental Allergy

164. A survey of inpatient practitioner knowledge of penicillin allergy at 2 community teaching hospitals. Full Text available with Trip Pro

A survey of inpatient practitioner knowledge of penicillin allergy at 2 community teaching hospitals. The negative effect of the penicillin allergy label on antibiotic use and patient outcomes has brought to light the need for thorough penicillin allergy assessments and heightened practitioner education.To evaluate practitioner knowledge of penicillin allergy and the clinical approach to the patients with penicillin allergy.An electronic survey was distributed to attending physicians, residents (...) , pharmacists, nurse practitioners, and physician assistants practicing adult inpatient medicine at 2 community-based teaching hospitals from February to April 2016.A total of 276 (39%) of 716 practitioners completed surveys were analyzed. Most respondents were attending physicians (45%) with more than 10 years of experience (53%). Approximately half of the respondents indicated that they were unfamiliar with the rate of cross-reactivity between penicillin and cephalosporin (46%), carbapenem (42

2017 Asthma & Immunology

165. Benzathine Penicillin G once-every-3-week prophylaxis for recurrent erysipelas a retrospective study of 132 patients. (Abstract)

Benzathine Penicillin G once-every-3-week prophylaxis for recurrent erysipelas a retrospective study of 132 patients. To evaluate effectivity, safety and patients' adherence to benzathine penicillin G (BPG) 1,200,000 units (1.2 MU) once-every-3-week intramuscularly prophylaxis for recurrent erysipelas.Patients with documented two or more erysipelas episodes in last two years who received at least one of 10 planned doses of BPG 1.2 MU intramuscularly between January 2009 and December 2015 were (...) ; 95% CI: 0.05-0.34; p < .01). In univariate analysis recurrence was significantly associated only with presence of any local risk factor concurrently with obesity (OR 3.40; 95% CI: 1.10-10.50; p < .05).Benzathine penicillin G 1.2 MU once every 3 weeks is an effective and well-tolerated prophylaxis of recurrent erysipelas with good patient adherence to the treatment. Further studies to determine the appropriate duration of prophylaxis are necessary.

2017 Journal of Dermatological Treatment

166. Cefazolin versus anti-staphylococcal penicillins for treatment of methicillin-susceptible Staphylococcus aureus bacteremia: a narrative review. Full Text available with Trip Pro

Cefazolin versus anti-staphylococcal penicillins for treatment of methicillin-susceptible Staphylococcus aureus bacteremia: a narrative review. Anti-staphylococcal penicillins (ASPs) are recommended as first-line agents in methicillin-susceptible Staphylococcus aureus (MSSA) bacteraemia. Concerns about their safety profile have contributed to the increased use of cefazolin. The comparative clinical effectiveness and safety profile of cefazolin versus ASPs for such infections remain unclear

2017 Clinical Microbiology and Infection

167. Amoxicillin and Ceftriaxone as Treatment Alternatives to Penicillin for Maternal Syphilis. Full Text available with Trip Pro

Amoxicillin and Ceftriaxone as Treatment Alternatives to Penicillin for Maternal Syphilis. There is no proven alternative to penicillin for treatment of maternal syphilis. We report 2 case-patients with maternal syphilis who were successfully treated without penicillin. We used amoxicillin and probenecid for the first case-patient and amoxicillin, probenecid, and ceftriaxone for the second case-patient.

2017 Emerging Infectious Diseases

168. Penicillin treatment for patients with Community-Acquired Pneumonia in Denmark: a retrospective cohort study. Full Text available with Trip Pro

Penicillin treatment for patients with Community-Acquired Pneumonia in Denmark: a retrospective cohort study. Community-acquired pneumonia (CAP) is a severe infection, with high mortality. Antibiotic strategies for CAP differ across Europe. The objective of the study was to describe the epidemiology of CAP in Denmark and evaluate the prognosis of patients empirically treated with penicillin-G/V monotherapy.Retrospective cohort study including hospitalized patients with x-ray confirmed CAP. We (...) calculated the population-based incidence, reviewed types of empiric antibiotics and duration of antibiotic treatment. We evaluated the association between mortality and treatment with empiric penicillin-G/V using logistic regression analysis.We included 1320 patients. The incidence of hospitalized CAP was 3.1/1000 inhabitants. Median age was 71 years (IQR; 58-81) and in-hospital mortality was 8%. Median duration of antibiotic treatment was 10 days (IQR; 8-12). In total 45% were treated with penicillin-G

2017 BMC pulmonary medicine

169. Single Dose Versus 3 Doses of Intramuscular Benzathine Penicillin for Early Syphilis in HIV: A Randomized Clinical Trial. Full Text available with Trip Pro

Single Dose Versus 3 Doses of Intramuscular Benzathine Penicillin for Early Syphilis in HIV: A Randomized Clinical Trial. Patients coinfected with syphilis and human immunodeficiency virus (HIV) may have a slower decrease in rapid plasma reagin (RPR) titers. Currently a single dose of 2.4 million units of intramuscular benzathine penicillin G (BPG) is recommended for the treatment of early syphilis. Some observational studies have suggested that this regimen may lead to high failure rates

2017 Clinical Infectious Diseases Controlled trial quality: predicted high

170. Mutations in Genes Encoding Penicillin-Binding Proteins and Efflux Pumps Play a Role in β-Lactam Resistance in <i>Helicobacter cinaedi</i>. Full Text available with Trip Pro

Mutations in Genes Encoding Penicillin-Binding Proteins and Efflux Pumps Play a Role in β-Lactam Resistance in Helicobacter cinaedi. β-Lactams are often used to treat Helicobacter cinaedi infections; however, the mechanism underlying β-lactam resistance is unknown. In this study, we investigated β-lactam resistance in an H. cinaedi strain, MRY12-0051 (MICs of amoxicillin [AMX] and ceftriaxone [CRO], 32 and 128 μg/ml; obtained from human feces). Based on a comparative whole-genome (...) analysis of MRY12-0051 and the CRO-susceptible H. cinaedi strain MRY08-1234 (MICs of AMX and CRO, 1 and 4 μg/ml; obtained from human blood), we identified five mutations in genes encoding penicillin-binding proteins (PBPs), including two in pbpA, one in pbp2, and two in ftsI Transformation and penicillin binding assays indicated that CRO resistance was mainly associated with mutations in pbpA; mutations in ftsI also led to increased resistance to AMX. Knocking out cmeB and cmeD, which encode resistance

2017 Antimicrobial Agents and Chemotherapy

171. Impact of Penicillin Allergy on Empirical Carbapenem Use in Gram-Negative Bloodstream Infections: An Antimicrobial Stewardship Opportunity. (Abstract)

Impact of Penicillin Allergy on Empirical Carbapenem Use in Gram-Negative Bloodstream Infections: An Antimicrobial Stewardship Opportunity. Retrospective matched-cohort study evaluating association between penicillin allergy and empirical carbapenem use in gram-negative bloodstream infections (BSIs) and utility of antimicrobial stewardship interventions in reducing carbapenem utilization.Hospitalized adults with community-onset gram-negative BSI from January 1, 2010, to June 30, 2015, at two (...) large community hospitals in Columbia, SC, were identified. Antimicrobial stewardship interventions targeting penicillin allergy and carbapenem utilization were fully implemented January 1, 2014. Multivariate logistic regression was used to examine impact of penicillin allergy and antimicrobial stewardship interventions on empirical carbapenem use. Kaplan-Meier analysis was used to evaluate time to carbapenem deescalation in patients with penicillin allergy before and after interventions.Patients

2017 Pharmacotherapy

172. Development of a novel multi-penicillin assay and assessment of the impact of analyte degradation: lessons for scavenged sampling in antimicrobial pharmacokinetic study design. Full Text available with Trip Pro

Development of a novel multi-penicillin assay and assessment of the impact of analyte degradation: lessons for scavenged sampling in antimicrobial pharmacokinetic study design. Penicillins are widely used to treat infections in children; however, the evidence is continuing to evolve in defining the optimal dosing. Modern pediatric pharmacokinetic study protocols frequently favor opportunistic, "scavenged" sampling. This study aimed to develop a small-volume single assay for five major (...) penicillins and to assess the influence of sample degradation on inferences made using pharmacokinetic modeling, to investigate the suitability of scavenged sampling strategies. Using a rapid ultrahigh-performance liquid chromatographic-tandem mass spectrometric method, an assay for five penicillins (amoxicillin, ampicillin, benzylpenicillin, piperacillin, and flucloxacillin) in blood plasma was developed and validated. Penicillin stabilities were evaluated under different conditions. Using these data

2017 Antimicrobial Agents and Chemotherapy

173. Shortages of benzathine penicillin for prevention of mother-to-child transmission of syphilis: An evaluation from multi-country surveys and stakeholder interviews. Full Text available with Trip Pro

Shortages of benzathine penicillin for prevention of mother-to-child transmission of syphilis: An evaluation from multi-country surveys and stakeholder interviews. Benzathine penicillin G (BPG) is the only recommended treatment to prevent mother-to-child transmission of syphilis. Due to recent reports of country-level shortages of BPG, an evaluation was undertaken to quantify countries that have experienced shortages in the past 2 years and to describe factors contributing

2017 PLoS medicine

174. Allergy Testing in Children With Low-Risk Penicillin Allergy Symptoms. Full Text available with Trip Pro

Allergy Testing in Children With Low-Risk Penicillin Allergy Symptoms. Penicillin allergy is commonly reported in the pediatric emergency department (ED). True penicillin allergy is rare, yet the diagnosis results from the denial of first-line antibiotics. We hypothesize that all children presenting to the pediatric ED with symptoms deemed to be low-risk for immunoglobulin E-mediated hypersensitivity will return negative results for true penicillin allergy.Parents of children aged 4 to 18 years (...) old presenting to the pediatric ED with a history of parent-reported penicillin allergy completed an allergy questionnaire. A prespecified 100 children categorized as low-risk on the basis of reported symptoms completed penicillin allergy testing by using a standard 3-tier testing process. The percent of children with negative allergy testing results was calculated with a 95% confidence interval.Five hundred ninety-seven parents completed the questionnaire describing their child's reported allergy

2017 Pediatrics

175. Meningococcal B Vaccine Failure With a Penicillin-Resistant Strain in a Young Adult on Long-Term Eculizumab. Full Text available with Trip Pro

Meningococcal B Vaccine Failure With a Penicillin-Resistant Strain in a Young Adult on Long-Term Eculizumab. We describe a case of invasive meningococcal disease due to a vaccine-preventable and penicillin-resistant strain in a fully immunized young adult on long-term complement inhibitor therapy and daily penicillin chemoprophylaxis. Eculizumab is a humanized monoclonal antibody that binds human complement C5 protein and inhibits the terminal complement pathway. It is currently recommended (...) for the treatment of complement-mediated thrombotic microangiopathies. An unwanted complication of inhibiting complement, however, is an increased risk of invasive meningococcal disease. Here, we report the first case of meningococcal group B vaccine failure in a young adult receiving eculizumab for atypical hemolytic uremic syndrome. She developed invasive meningococcal disease due to a vaccine-preventable and penicillin-resistant meningococcal group B strain 4 months after receiving 2 doses of meningococcal

2017 Pediatrics

176. Influence of the duration of penicillin prescriptions on outcomes for acute sore throat in adults: the DESCARTE prospective cohort study in UK general practice. Full Text available with Trip Pro

Influence of the duration of penicillin prescriptions on outcomes for acute sore throat in adults: the DESCARTE prospective cohort study in UK general practice. Guidelines recommend 10-day treatment courses for acute sore throat, but shorter courses may be used in practice.To determine whether antibiotic duration predicts adverse outcome of acute sore throat in adults in routine care.A secondary analysis of the DESCARTE (Decision rule for the Symptoms and Complications of Acute Red Throat (...) -days RR 0.86 [95% CI = 0.59 to 1.23]) but these differences did not reach statistical significance.In adults prescribed antibiotics for sore throat, the authors cannot rule out a small advantage in terms of reduced re-consultation for a 10-day course of penicillin, but the effect is likely to be small.© British Journal of General Practice 2017.

2017 British Journal of General Practice

177. A clinical decision-making algorithm for penicillin allergy. (Abstract)

A clinical decision-making algorithm for penicillin allergy. About 10% of subjects report suspected penicillin allergy, but 85-90% of these patients are not truly allergic and could safely receive beta-lactam antibiotics Objective: To design and validate a clinical decision-making algorithm, based on anamnesis (chronology, severity, and duration of the suspected allergic reactions) and reaching a 100% sensitivity and negative predictive value, to assess allergy risk related to a penicillin (...) prescription in general practise.All patients were included prospectively and explorated based on ENDA/EAACI recommendations. Results of penicillin allergy work-up (gold standard) were compared with results of the algorithm.Allergological work-up diagnosed penicillin hypersensitivity in 41/259 patients (15.8%) [95% CI: 11.5-20.3]. Three of these patients were diagnosed as having immediate-type hypersensitivity to penicillin, but had been misdiagnosed as low risk patients using the clinical algorithm. Thus

2017 Annals of Medicine

178. Surveillance reports: epidemiological/serological evaluation of tropical yaws following mass penicillin campaings (Thailand, Philippines, Nigeria)

Surveillance reports: epidemiological/serological evaluation of tropical yaws following mass penicillin campaings (Thailand, Philippines, Nigeria) Surveillance reports: epidemiological/serological evaluation of tropical yaws following mass penicillin campaings (‎Thailand, Philippines, Nigeria)‎ JavaScript is disabled for your browser. Some features of this site may not work without it. Toggle navigation Toggle navigation Search Browse Statistics Related Links Surveillance reports (...) : epidemiological/serological evaluation of tropical yaws following mass penicillin campaings (‎Thailand, Philippines, Nigeria)‎ View/ Open View Statistics Altmetrics Share Citation Guthe, T. & de Vries, J. L. (‎1966)‎. Surveillance reports: epidemiological/serological evaluation of tropical yaws following mass penicillin campaings (‎Thailand, Philippines, Nigeria)‎. World Health Organization. Description 20 p. Gov't Doc # GES/SR/66.2 WHO/VDT/66.336 Collections Language English Metadata Related items Showing

1966 WHO

179. Utility of minor determinants for skin testing in inpatient penicillin allergy evaluation. (Abstract)

Utility of minor determinants for skin testing in inpatient penicillin allergy evaluation. Most patients with a history of penicillin allergy can tolerate penicillin. Skin testing can identify tolerant patients, but not all known allergenic determinants are commercially available. Protocols exist that use only available reagents, but the sensitivity and safety of these protocols, particularly for hospitalized patients, are controversial.To determine the number of hospitalized patients referred (...) for penicillin skin testing who showed unique positivity to the minor determinants penicilloate and penilloate.A retrospective chart review was conducted of all inpatients who underwent penicillin skin testing at 1 institution. Patients were referred by their treating physician. All patients underwent skin prick testing to benzylpenicilloyl polylysine (major determinant), penicillin G, penicilloate, penilloate (minor determinants), amoxicillin, and positive and negative controls. If the result was negative

2017 Asthma & Immunology

180. Genome Evolution to Penicillin Resistance in Serotype 3 <i>Streptococcus pneumoniae</i> by Capsular Switching. Full Text available with Trip Pro

Genome Evolution to Penicillin Resistance in Serotype 3 Streptococcus pneumoniae by Capsular Switching. Streptococcus pneumoniae isolates of serotype 3 were collected from cases of invasive pneumococcal disease (n = 124) throughout Japan between April 2010 and March 2013. A penicillin-resistant S. pneumoniae (PRSP) isolate from an adult patient, strain KK0981 of serotype 3, was identified among these strains. Whole-genome analysis characterized this PRSP as a recombinant strain derived (...) from PRSP of serotype 23F with the cps locus (20.3 kb) replaced by that of a penicillin-susceptible strain of serotype 3.Copyright © 2017 American Society for Microbiology.

2017 Antimicrobial Agents and Chemotherapy

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