scholarly journals High chloroquine treatment failure rates and predominance of mutant genotypes associated with chloroquine and antifolate resistance among falciparum malaria patients from the island of Car Nicobar, India

2010 ◽  
Vol 65 (6) ◽  
pp. 1258-1261 ◽  
Author(s):  
M. K. Das ◽  
V. Lumb ◽  
P. Mittra ◽  
S. S. Singh ◽  
A. P. Dash ◽  
...  
Keyword(s):  
Treatment Failure ◽  
Falciparum Malaria ◽  
Failure Rates ◽  
Chloroquine Treatment ◽  
Antifolate Resistance

Predictors of chloroquine treatment failure in children and adults with falciparum malaria in Kampala, Uganda.

2000 ◽  
Vol 62 (6) ◽  
pp. 686-692 ◽  
Author(s):  
G Dorsey ◽  
C R Phares ◽  
J N Babirye ◽  
G Ndeezi ◽  
M R Kamya ◽  
...  
Keyword(s):  
Treatment Failure ◽  
Falciparum Malaria ◽  
Chloroquine Treatment

scholarly journals Predictors of treatment failures of plasmodium falciparum malaria in Vietnam: a 4-year single‐centre retrospective study

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Minh Cuong Duong ◽  
Oanh Kieu Nguyet Pham ◽  
Phong Thanh Nguyen ◽  
Van Vinh Chau Nguyen ◽  
Phu Hoan Nguyen
Keyword(s):  
Plasmodium Falciparum ◽  
Treatment Failure ◽  
Severe Malaria ◽  
Falciparum Malaria ◽  
Control Strategies ◽  
Artemisinin Resistance ◽  
Plasmodium Falciparum Malaria ◽  
Molecular Technique ◽  
Drug Resistant ◽  
Public Health Burden

Abstract Background Drug-resistant falciparum malaria is an increasing public health burden. This study examined the magnitude of Plasmodium falciparum infection and the patterns and predictors of treatment failure in Vietnam. Methods Medical records of all 443 patients with malaria infection admitted to the Hospital for Tropical Diseases between January 2015 and December 2018 were used to extract information on demographics, risk factors, symptoms, laboratory tests, treatment, and outcome. Results More than half (59.8%, 265/443, CI 55.1–64.4%) of patients acquired Plasmodium falciparum infection of whom 21.9% (58/265, CI 17.1–27.4%) had severe malaria, while 7.2% (19/265, CI 4.6–10.9%) and 19.2% (51/265, CI 14.7–24.5%) developed early treatment failure (ETF) and late treatment failure (LTF) respectively. Among 58 patients with severe malaria, 14 (24.1%) acquired infection in regions where artemisinin resistance has been documented including Binh Phuoc (11 patients), Dak Nong (2 patients) and Gia Lai (1 patient). Under treatment with intravenous artesunate, the median (IQR) parasite half-life of 11 patients coming from Binh Phuoc was 3 h (2.3 to 8.3 h), two patients coming from Dak Nong was 2.8 and 5.7 h, and a patient coming from Gia Lai was 6.5 h. Most patients (98.5%, 261/265) recovered completely. Four patients with severe malaria died. Severe malaria was statistically associated with receiving treatment at previous hospitals (P < 0.001), hepatomegaly (P < 0.001) and number of inpatient days (P < 0.001). Having severe malaria was a predictor of ETF (AOR 6.96, CI 2.55–19.02, P < 0.001). No predictor of LTF was identified. Conclusions Plasmodium falciparum remains the prevalent malaria parasite. Despite low mortality rate, severe malaria is not rare and is a significant predictor of ETF. To reduce the risk for ETF, studies are needed to examine the effectiveness of combination therapy including parenteral artesunate and a parenteral partner drug for severe malaria. The study alerts the possibility of drug-resistant malaria in Africa and other areas in Vietnam, which are known as non-endemic areas of anti-malarial drug resistance. A more comprehensive study using molecular technique in these regions is required to completely understand the magnitude of drug-resistant malaria and to design appropriate control strategies.

scholarly journals Adiponectin, Insulin Sensitivity, β-Cell Function, and Racial/Ethnic Disparity in Treatment Failure Rates in TODAY

Diabetes Care ◽  
2016 ◽  
Vol 40 (1) ◽  
pp. 85-93 ◽  
Author(s):  
Silva Arslanian ◽  
Laure El ghormli ◽  
Fida Bacha ◽  
Sonia Caprio ◽  
Robin Goland ◽  
...  
Keyword(s):  
Insulin Sensitivity ◽  
Treatment Failure ◽  
Cell Function ◽  
Ethnic Disparity ◽  
Failure Rates ◽  
Β Cell ◽  
Β Cell Function ◽  
Racial Ethnic

scholarly journals 1342. Clinical failure rates of amoxicillin for the treatment of acute otitis media in young children

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S682-S683
Author(s):  
Holly M Frost ◽  
Samuel Dominguez ◽  
Sarah Parker ◽  
Andrew Byars ◽  
Sara Michelson ◽  
...  
Keyword(s):  
Treatment Failure ◽  
Otitis Media ◽  
Failure Rate ◽  
Acute Otitis Media ◽  
Relative Reduction ◽  
Failure Rates ◽  
Beta Lactamase ◽  
Clinical Failure ◽  
Recurrence Rates ◽  
Antibiotic Failure

Abstract Background Acute otitis media(AOM) is the most common indication for antibiotics in children. The primary pathogens that cause AOM have changed since the introduction of the pneumococcal conjugate vaccine(PCV). The clinical failure rate of amoxicillin for treatment of AOM post-PCV is unknown.We aimed to determine the clinical failure rate of amoxicillin for the treatment of uncomplicated AOM in children. Organisms identified on culture and amoxicillin treatment failure from nasopharyngeal specimens of children age 6-35 months with uncomplicated acute otitis media at Denver Health, Denver, CO from April 2019-March 2020. Methods Children age 6-35 months seen at Denver Health, Denver, CO with uncomplicated AOM and prescribed amoxicillin were prospectively enrolled. An interim analysis of patients enrolled from April 2019-March 2020 was completed. Patients completed surveys that included the AOM-SOS©(UPMC, Pittsburgh, PA) at enrollment, days 5, 14, and 30 and had chart abstraction completed. Treatment failure was defined as: (1) requiring a new antibiotic within 14 days; (2) AOM-SOS© score on day 5 or 14 not improved by a relative reduction of ≥ 55% from baseline. Recurrence was defined as requiring a new antibiotic within 15-30 days. Nasopharyngeal swabs were obtained and bacterial culture was completed. Results In total,110 patients were enrolled. Rates of treatment failure defined by AOM-SOS© were 28.4%(37; 95%CI:25.5-33.6%) at 5 days and 15.5%(27; 95%CI:17.5-24.5%) at 14 days. However, only 4.5%(5; 95%CI:2.0-4.5%) required a new antibiotic. Recurrence occurred in 5.5% (6, 95%CI:2.5-5.5%) of patients. Of patients who had not received antibiotics before enrollment(82), culture yielded no organism in 17.0%, one organism in 42.7%, and multiple organisms in 40.0% (Table). M.catarrhalis was the most frequently identified organism (53.7% of children). Of H.influenzae isolates 52.9% (9/17) produced beta-lactamase, resulting in no treatment failures or recurrences requiring a new antibiotic. Failure rates were similar between organisms. Conclusion Despite the change in otopathogen prevalence post-PCV, preliminary data suggest that while early subjective treatment failure was common, the 14 day treatment failure and 30 day recurrence rates was low when measured by need for a new antibiotic. Failure was low even among patients with organisms that would not be expected to be treated successfully with amoxicillin, such as those with beta-lactamase producing H.influenzae and M.catarrhalis. Disclosures Samuel Dominguez, MD, PhD, BioFire (Consultant, Research Grant or Support)

scholarly journals Bayesian Network Meta-Analysis of the Effectiveness of Various Interventions for Nontraumatic Osteonecrosis of the Femoral Head

2018 ◽  
Vol 2018 ◽  
pp. 1-11 ◽  
Author(s):  
Ji Wang ◽  
Jing Wang ◽  
Kai Zhang ◽  
Yanfang Wang ◽  
Xuanwen Bao
Keyword(s):  
Femoral Head ◽  
Treatment Failure ◽  
Bayesian Network ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Failure Rates ◽  
Randomized Controlled ◽  
Harris Score ◽  
Fibular Grafting

Objective. To assess the effectiveness of various therapeutic hip preservation strategies on patients with nontraumatic osteonecrosis of the femoral head (ONFH). Design. This is a systematic review of previous literature and in-depth Bayesian network meta-analysis of randomized controlled trials (RCTs) to compare the clinical effect of various operation methods and one physical intervention (extracorporeal shockwave). Data Sources. Electronic literature, for studies published up to December 2017, was collected from PubMed, Medline, and the Cochrane Library. Study Selection. We selected RCTs on patients with ONFH. Treatment methods included extracorporeal shockwave (ESW), core decompression (CD), multiple drilling decompression (DD), vascularized fibular grafting (VFG), free-vascularized fibular grafting (FVFG), inverted femoral head grafting (IFHG), vascular iliac pedicle bone grafting (VIPBG), osteotomy, and tantalum implantation (TI). Outcome. The primary outcome was Harris score; the secondary outcome was Harris hip score (HHS), including total hip arthroplasty requirement (THA) and progression to collapse. Results. A total of 14 randomized controlled trials were investigated. ESW had the highest improvement on Harris score (probability best 52%), followed by VFG (probability was 38%). In the meanwhile, VFG also proved to be superior in reducing the failure rates of treatment (probability lowest 59%), followed by ESW (probability lowest 24%). In femoral necrosis stage-II, VFG achieved the highest probability in preventing treatment failures (52%) and showed better performance in reducing treatment failure rates than CD. Conclusion. ESW therapy (ESWT) is the most effective intervention to improve HHS, and VFG shows superior effect on reducing treatment failure rates.

Comparison of Ceftriaxone and Antipseudomonal β-Lactam Antibiotics Utilized for Potential AmpC β-Lactamase-Producing Organisms

2020 ◽  
pp. 001857872093146
Author(s):  
David M. Peters ◽  
Jessica B. Winter ◽  
Christopher A. Droege ◽  
Neil E. Ernst ◽  
Siyun Liao
Keyword(s):  
Treatment Failure ◽  
Therapeutic Option ◽  
Primary Objective ◽  
Definitive Treatment ◽  
Failure Rates ◽  
Production Methods ◽  
Optimal Dosing ◽  
Definitive Therapy ◽  
Enterobacteriaceae Infections ◽  
Tract Infections

Background: Induction of antibiotic resistance is associated with increased morbidity and mortality in AmpC β-lactamase producing Enterobacteriaceae. The use of ceftriaxone is controversial for treatment of these organisms due to concerns for inducible resistance. This study was designed to compare treatment failure rates between ceftriaxone and antipseudomonal β-lactam antibiotics when used as definitive therapy for organisms most commonly associated with chromosomal AmpC β-lactamase production. Methods: A retrospective, single-center cohort study was performed enrolling patients hospitalized with monomicrobial Enterobacter, Citrobacter, or Serratia spp. infections. The primary objective compared proportion of treatment failure between groups. All patients received either ceftriaxone or an antipseudomonal β-lactam alone within 24 hours of culture finalization, and with a duration of at least 72 hours for definitive treatment. Treatment failure was defined as either clinical failure (abnormal white blood cell count or temperature on day 7 or 14 post-antibiotics) or microbiologic failure (regrowth of the same organism at same site within 14 or 21 days). Results: Of 192 total patients, treatment failure was observed in 24/71 patients (34%) receiving ceftriaxone and in 42/121 patients (35%) receiving antipseudomonal β-lactam ( P = .98). No difference was observed between clinical or microbiologic failure rates between groups. The ceftriaxone group had significantly more patients undergoing treatment for urinary tract infections (51% vs 17%, P < .001), but treatment failure rates remained similar between groups when comparing infections of all other sources. Conclusion: Ceftriaxone has comparable treatment failure rates to antipseudomonal β-lactams for susceptible Enterobacteriaceae infections and may be considered as a therapeutic option. Further, prospective research is needed to validate optimal dosing and application in all sites of infection.

scholarly journals Chlorproguanil-dapsone: effective treatment for uncomplicated falciparum malaria.

1997 ◽  
Vol 41 (10) ◽  
pp. 2261-2264 ◽  
Author(s):  
E Amukoye ◽  
P A Winstanley ◽  
W M Watkins ◽  
R W Snow ◽  
J Hatcher ◽  
...  
Keyword(s):  
Single Dose ◽  
Falciparum Malaria ◽  
Salvage Therapy ◽  
Uncomplicated Falciparum Malaria ◽  
Double Blind ◽  
Treatment Groups ◽  
First Choice ◽  
Rate Of Emergence ◽  
Antifolate Resistance ◽  
Triple Dose

Pyrimethamine-sulfadoxine, the first choice for uncomplicated falciparum malaria in Africa, exerts strong selection pressure for resistance because of its slow elimination. It is likely that resistance will emerge rapidly, and there is no widely affordable replacement. Chlorproguanil-dapsone is cheap, rapidly eliminated, more potent than pyrimethamine-sulfadoxine, and could be introduced in the near future to delay the onset of antifolate resistance and as "salvage therapy" for pyrimethamine-sulfadoxine failure. A total of 448 children were randomly allocated (double blind) to either a single dose of pyrimethamine-sulfadoxine or to one of two chlorproguanil-dapsone regimens: a single dose or three doses at 24-h intervals. Reinfections are clinically indistinguishable from recrudescence and are more likely after treatment with rapidly eliminated drugs; we measured the incidence of parasitemia in 205 initially aparasitemic children to allow comparison with the three treatment groups. The patients and a community surveillance group were followed up for 28 days. At the study end point, 31.2% (95% confidence interval, 24.9-38.0) of the community surveillance group subjects were parasitemic, compared with subjects in the treatment groups, whose rates of parasitemia were 40.8% (32.9-49.0; relative risk [RR], 1.31 [0.99-1.73]) after triple-dose chlorproguanil-dapsone, 19.7% (13.5-27.2; RR, 0.63 [0.43-0.93]) after pyrimethamine-sulfadoxine, and 65.6% (57.5-73.0; RR, 2.10 [1.66-2.65]) after single-dose chlorproguanil-dapsone. Pyrimethamine-sulfadoxine and triple-dose chlorproguanil-dapsone were effective treatments. Pyrimethamine-sulfadoxine provided chemoprophylaxis during follow-up because of its slow elimination. Triple-dose chlorproguanil-dapsone should now be developed in an attempt to reduce the rate of emergence of antifolate resistance in Africa and for affordable salvage therapy in cases of pyrimethamine-sulfadoxine failure.

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