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41. 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

42. 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

43. 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

44. 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

45. Safety of direct drug provocation testing in adults with penicillin allergy and association with health and economic benefits. (Abstract)

Safety of direct drug provocation testing in adults with penicillin allergy and association with health and economic benefits. Nonprescription of penicillin-containing antibiotics in patients diagnosed with penicillin allergy is associated with morbidity and mortality. Adverse reactions to penicillins comprise type A and B reactions.To assess the feasibility of penicillin allergy evaluation without penicillin skin testing (PST) for adult patients with type B reactions and the health (...) and economic benefits of this process.Inpatients at an Australian tertiary hospital between April 1, 2017, and April 30, 2018, with a diagnosis of type B penicillin allergy, requiring a penicillin-containing antibiotic for treatment, were included. All patients underwent clinical history review, PST, and drug provocation testing (DPT).Seventy-one patients were enrolled. Sixty-three reported a history of type B or unknown adverse reactions. No patients had a history of anaphylaxis requiring intubation

2019 Asthma & Immunology

46. Four-Weekly Benzathine Penicillin G Provides Inadequate Protection against Acute Rheumatic Fever in Some Children. (Abstract)

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

47. Endocarditis Caused by Highly Penicillin-Resistant Viridans Group Streptococci: Still Room for Vancomycin-Based Regimens. Full Text available with Trip Pro

Endocarditis Caused by Highly Penicillin-Resistant Viridans Group Streptococci: Still Room for Vancomycin-Based Regimens. Introduction: Optimal treatment options remain unknown for infective endocarditis (IE) caused by penicillin (PEN)-resistant viridans group streptococcal (VGS) strains. The aims of this study were to report two cases of highly-PEN-resistant-VGS-IE, perform a literature review, and to evaluate various antibiotic combinations in vitro and in vivoMaterials and Methods

2019 Antimicrobial Agents and Chemotherapy

48. Penicillin-binding protein typing, antibiotic resistance gene identification and molecular phylogenetic analysis of meropenem-resistant <i>Streptococcus pneumoniae</i> serotype 19A-CC3111 strains in Japan. Full Text available with Trip Pro

Penicillin-binding protein typing, antibiotic resistance gene identification and molecular phylogenetic analysis of meropenem-resistant Streptococcus pneumoniae serotype 19A-CC3111 strains in Japan. Since the introduction of pneumococcal conjugate vaccines, the prevalence of non-meropenem-susceptible pneumococci has been increasing in Japan. In an earlier study, we demonstrated that the multidrug-resistant serotype 15A-ST63 in Japan has a specific pbp1a sequence (pbp1a--13) that could (...) acquisition of pbp1a-13 seemed to cause only penicillin resistance and not multidrug resistance; a combination of PBP recombination in the pbp2b and/or pbp2x region(s) with acquisition of pbp1a-13 caused multidrug resistance. Conserved amino acid motif analysis suggested that the pbp1a 370SXXK, pbp2b 448SXN and pbp2x 337SXXN motifs were the candidates for amino acid substitutions increasing the MICs of meropenem, cefotaxime and penicillin. We identified a specific clone that was correlated with multidrug

2019 Antimicrobial Agents and Chemotherapy

49. Is direct oral amoxicillin challenge a viable approach for 'low-risk' patients labelled with penicillin allergy? Full Text available with Trip Pro

Is direct oral amoxicillin challenge a viable approach for 'low-risk' patients labelled with penicillin allergy? Spurious penicillin allergy (PenA) is a major public health problem. Up to 10% of the population and 20% of inpatients are labelled with PenA, but only <5%-10% have a proven allergy following comprehensive investigations. PenA tests are labour intensive and require specialist input, which may not be readily available due to limited allergy services. Therefore, patients with PenA

2019 Journal of Antimicrobial Chemotherapy

50. Evaluation of a pharmacist-led penicillin allergy de-labelling ward round: a novel antimicrobial stewardship intervention. (Abstract)

Evaluation of a pharmacist-led penicillin allergy de-labelling ward round: a novel antimicrobial stewardship intervention. Antibiotic allergy labels (AALs), reported by up to 25% of hospitalized patients, are a significant barrier to appropriate prescribing and a focus of antimicrobial stewardship (AMS) programmes.A prospective audit of a pharmacist-led AMS penicillin allergy de-labelling ward round at Austin Health (Melbourne, Australia) was evaluated. Eligible inpatients with a documented (...) penicillin allergy receiving an antibiotic were identified via an electronic medical report and then reviewed by a pharmacist-led AMS team. The audit outcomes evaluated were: (i) AMS post-prescription review recommendations; (ii) direct de-labelling; (iii) inpatient oral rechallenge referral; (iv) skin prick testing/intradermal testing referral; and (v) outpatient antibiotic allergy clinic assessment.Across a 5 month period, 106 patients were identified from a real-time electronic prescribing antibiotic

2019 Journal of Antimicrobial Chemotherapy

51. 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

52. Clinical and Economic Outcomes of Penicillin Skin Testing as an Antimicrobial Stewardship Initiative in a Community Health System. Full Text available with Trip Pro

Clinical and Economic Outcomes of Penicillin Skin Testing as an Antimicrobial Stewardship Initiative in a Community Health System. Penicillin skin testing (PST) is a novel way to reduce the use of broad-spectrum agents in penicillin-allergic patients. This study evaluated the outcomes of patients with antimicrobials prescribed with and without PST in a community health system.We performed a quasi-experimental study that compared an intervention group of 100 patients who completed PST over (...) an open enrollment period beginning January 2016 with a matched control group of 100 patients who were penicillin allergic. Patients in the control group were matched to infection diagnosis codes of members of the PST group and randomly selected and matched on a 1:1 basis. The primary outcome was noncarbapenem beta-lactam days of therapy (DOT). The secondary outcome assessed the average cost of antimicrobial therapy for the intervention group before and after PST.Seventy of the 98 patients (71%) who

2019 Open forum infectious diseases Controlled trial quality: uncertain

53. Determining the impact of Benzathine penicillin G prophylaxis in children with latent rheumatic heart disease (GOAL trial): Study protocol for a randomized controlled trial. (Abstract)

Determining the impact of Benzathine penicillin G prophylaxis in children with latent rheumatic heart disease (GOAL trial): Study protocol for a randomized controlled trial. Rheumatic heart disease (RHD) remains a high prevalence condition in low- and middle-income countries. Most individuals with RHD present late, missing the opportunity to benefit from secondary antibiotic prophylaxis. Echocardiographic screening can detect latent RHD, but the impact of secondary prophylaxis in screen (...) -detected individuals is not known.This trial aims to determine if secondary prophylaxis with every-4-week injectable Benzathine penicillin G (BPG) improves outcomes for children diagnosed with latent RHD. This is a randomized controlled trial in consenting children, aged 5 to 17 years in Northern Uganda, confirmed to have borderline RHD or mild definite RHD on echocardiography, according to the 2012 World Heart Federation criteria. Qualifying children will be randomized to every-4-week injectable

2019 American Heart Journal Controlled trial quality: predicted high

54. Efficacy of high doses of penicillin versus amoxicillin in the treatment of uncomplicated community acquired pneumonia in adults. A non-inferiority controlled clinical trial. Full Text available with Trip Pro

Efficacy of high doses of penicillin versus amoxicillin in the treatment of uncomplicated community acquired pneumonia in adults. A non-inferiority controlled clinical trial. Community-acquired pneumonia (CAP) is treated with penicillin in some northern European countries.To evaluate whether high-dose penicillin V is as effective as high-dose amoxicillin for the treatment of non-severe CAP.Multicentre, parallel, double-blind, controlled, randomized clinical trial.31 primary care centers (...) in Spain.Patients from 18 to 75 years of age with no significant associated comorbidity and with symptoms of lower respiratory tract infection and radiological confirmation of CAP were randomized to receive either penicillin V 1.6 million units, or amoxicillin 1000mg three times per day for 10 days.The main outcome was clinical cure at 14 days, and the primary hypothesis was that penicillin V would be non-inferior to amoxicillin with regard to this outcome, with a margin of 15% for the difference in proportions

2019 Atencion Primaria Controlled trial quality: predicted high

55. Relatively high rates of cefotaxime- and ceftriaxone-non-susceptible isolates among group B streptococci with reduced penicillin susceptibility (PRGBS) in Japan. (Abstract)

Relatively high rates of cefotaxime- and ceftriaxone-non-susceptible isolates among group B streptococci with reduced penicillin susceptibility (PRGBS) in Japan. We have previously identified group B Streptococcus (GBS) clinical isolates with reduced penicillin susceptibility (PRGBS) that were non-susceptible to cefotaxime; however, the rates of cefotaxime and ceftriaxone non-susceptibility among PRGBS isolates have never been reported. Therefore, we first determined the MICs of 22 (...) antibacterial drugs/compounds for 74 PRGBS isolates and then determined the rates of cefotaxime and ceftriaxone non-susceptibility among these isolates.We used 74 clinical PRGBS isolates, previously collected in Japan and confirmed to harbour relevant amino acid substitutions in PBP2X. We also used 80 penicillin-susceptible GBS (PSGBS) clinical isolates as controls. The MICs of 22 antibacterial drugs/compounds for all 154 GBS isolates were determined via microdilution and/or agar dilution methods

2019 Journal of Antimicrobial Chemotherapy

56. Direct oral amoxicillin challenge without preliminary skin testing in adult patients with allergy and at low risk with reported penicillin allergy. (Abstract)

Direct oral amoxicillin challenge without preliminary skin testing in adult patients with allergy and at low risk with reported penicillin allergy. Introduction: Ten percent of hospitalized patients report penicillin allergy; however, recent studies indicate that ∼98% of these patients are not acutely hypersensitive. Unconfirmed penicillin allergy poses public health risks, and an evaluation of penicillin allergy labels is recommended to improve antibiotic stewardship. Although the most widely (...) accepted protocol is penicillin skin testing, followed by oral amoxicillin challenge, time constraints and resources may preclude this. Recent literature supports the safety and efficacy of direct oral amoxicillin challenge in individuals at low risk. Methods: We retrospectively evaluated direct oral challenge acceptance and outcomes in eligible adult outpatients with allergy and with a penicillin allergy label over a 6-month period. Direct oral amoxicillin challenge was recommended in patients

2019 Allergy and Asthma Proceedings

57. 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

58. The Effect of Non-penicillin Antibiotic Regimens on Neonatal Outcomes in Preterm Premature Rupture of Membranes. Full Text available with Trip Pro

The Effect of Non-penicillin Antibiotic Regimens on Neonatal Outcomes in Preterm Premature Rupture of Membranes. Objective  A 7-day course of a penicillin (PCN) and macrolide is standard of care (SAR) in preterm premature rupture of membranes (PPROM). Data regarding alternative antibiotic regimens are limited. We sought to assess the impact of non-PCN regimens on neonatal outcomes. Study Design  Secondary analysis of randomized controlled trial of antenatal magnesium sulfate. Singleton

2019 AJP Reports Controlled trial quality: predicted high

59. Management of a surgical patient with a label of penicillin allergy: narrative review and consensus recommendations. Full Text available with Trip Pro

Management of a surgical patient with a label of penicillin allergy: narrative review and consensus recommendations. Unsubstantiated penicillin-allergy labels are common in surgical patients, and can lead to significant harm through avoidance of best first-line prophylaxis of surgical site infections and increased infection with resistant bacterial strains. Up to 98% of penicillin-allergy labels are incorrect when tested. Because of the scarcity of trained allergists in all healthcare systems

2019 British Journal of Anaesthesia

60. Kinetic Profile and Molecular Dynamic Studies Show that Y229W Substitution in an NDM-1/L209F Variant Restores the Hydrolytic Activity of the Enzyme toward Penicillins, Cephalosporins, and Carbapenems. Full Text available with Trip Pro

Kinetic Profile and Molecular Dynamic Studies Show that Y229W Substitution in an NDM-1/L209F Variant Restores the Hydrolytic Activity of the Enzyme toward Penicillins, Cephalosporins, and Carbapenems. The New Delhi metallo-β-lactamase-1 (NDM-1) enzyme is the most common metallo-β-lactamase identified in many Gram-negative bacteria causing severe nosocomial infections. The aim of this study was to focus the attention on non-active-site residues L209 and Y229 of NDM-1 and to investigate

2019 Antimicrobial Agents and Chemotherapy

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