scholarly journals Time for Precision: A World Without Susceptibility Breakpoints

2018 ◽  
Vol 5 (12) ◽  
Author(s):  
Justin C Bader ◽  
Elizabeth A Lakota ◽  
David R Andes ◽  
Christopher M Rubino ◽  
Paul G Ambrose ◽  
...  
Keyword(s):  
Treatment Success ◽  
Professional Organizations ◽  
Patient Specific ◽  
Specific Information ◽  
Patient Centered ◽  
In Vitro Susceptibility ◽  
Centered Care ◽  
In Vitro Susceptibility Testing ◽  
Selection Of

Abstract Interpretive criteria for in vitro susceptibility testing criteria, “susceptibility breakpoints,” underpin the evaluation and selection of antimicrobial regimens. However, despite their strengths, susceptibility breakpoints are a relatively blunt instrument employed to address an extremely complex question—what is the likelihood of treatment success for individual patients? With regard to evaluating patients on a case-by-case basis, breakpoints merely allow us to account for pathogen susceptibility. This approach precludes consideration of drug exposures achieved in patients, thus overlooking half of the equation for predicting treatment success. Herein, we propose the framework for considering both pathogen- and patient-specific information to provide clinicians a means of evaluating antimicrobial regimens for individual patients through tools automating pharmacokinetic-pharmacodynamic target attainment analyses. Implementing these tools along with their acceptance by professional organizations will allow for a shift in the paradigm for how antimicrobials are selected and dosed—toward patient-centered care through precision medicine.

scholarly journals Methodologies and Cell Lines Used for Antimicrobial Susceptibility Testing of Chlamydia spp

2003 ◽  
Vol 47 (2) ◽  
pp. 636-642 ◽  
Author(s):  
R. J. Suchland ◽  
W. M. Geisler ◽  
Walter E. Stamm
Keyword(s):  
Cell Line ◽  
Chlamydia Pneumoniae ◽  
Susceptibility Testing ◽  
Chlamydia Psittaci ◽  
In Vitro Susceptibility ◽  
Persistent Infections ◽  
In Vitro Susceptibility Testing ◽  
Cell Culture Passage ◽  
Selection Of

ABSTRACT In vitro susceptibility testing was performed on strains of Chlamydia trachomatis, Chlamydia pneumoniae, and Chlamydia psittaci under various conditions, including the cell line utilized, the time between infection and the addition of an antimicrobial, the concentration of inoculum, and the effect of multiple passage on the minimal chlamydicidal concentrations for the antibiotics doxycycline, azithromycin, erythromycin, ofloxacin, and tetracycline. With macrolides, the MIC varied depending upon the cell line utilized. With all antimicrobials, the MIC was related to the time at which the antimicrobial was added after infection. By an optimized cell culture passage method, all strains of chlamydia tested demonstrated survival after exposure to high levels (>100 times the MIC) of antimicrobials. Furthermore, upon retest, these surviving organisms did not demonstrate increased MICs. Thus, this phenomenon does not reflect selection of antimicrobial-resistant mutants but rather survival of some organisms in high antimicrobial concentrations (heterotypic survival). An additional 44 clinical isolates of C. trachomatis from patients with single-incident infections were tested against those from patients with recurrent or persistent infections, and heterotypic survival was seen in all isolates tested; hence, in vitro resistance did not correlate with the patient's apparent clinical outcome.

scholarly journals How Sensor, Signal, and Imaging Informatics May Impact Patient Centered Care and Care Coordination

2015 ◽  
Vol 24 (01) ◽  
pp. 102-105
Author(s):  
A. Moreau-Gaudry ◽  
S. Voros ◽  
Keyword(s):  
Care Coordination ◽  
Review Process ◽  
Patient Centered Care ◽  
Imaging Informatics ◽  
Patient Specific ◽  
Specific Information ◽  
Sensor Signal ◽  
Patient Centered ◽  
Excellent Research ◽  
Centered Care

Summary Objective: This synopsis presents a selection for the IMIA (International Medical Informatics Association) Yearbook 2015 of excellent research in the broad field of Sensor, Signal, and Imaging Informatics published in the year 2014, with a focus on patient centered care coordination. Methods: The two section editors performed a systematic initial selection and a double blind peer review process to select a list of candidate best papers in the domain published in 2014, from the PubMed and Web of Science databases. A set of MeSH keywords provided by experts was used. This selection was peer-reviewed by external reviewers. Results: The review process highlighted articles illustrating two current trends related to care coordination and patient centered care: the enhanced capacity to predict the evolution of a disease based on patient-specific information can impact care coordination; similarly, better perception of the patient and his treatment could lead to enhanced personalized care with a potential impact on care coordination. Conclusions: This review shows the multiplicity of angles from which the question of patient-centered care can be addressed, with consequences on care coordination that will need to be confirmed and demonstrated in the future.

scholarly journals Depression patient-derived cortical neurons reveal potential biomarkers for antidepressant response

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yishai Avior ◽  
Shiri Ron ◽  
Dana Kroitorou ◽  
Claudia Albeldas ◽  
Vitaly Lerner ◽  
...  
Keyword(s):  
Cortical Neurons ◽  
Antidepressant Treatment ◽  
Patient Specific ◽  
Specific Gene ◽  
Specific Information ◽  
Patient Response ◽  
Patient Will ◽  
Gene Expression Alterations ◽  
Treatment Alternatives

AbstractMajor depressive disorder is highly prevalent worldwide and has been affecting an increasing number of people each year. Current first line antidepressants show merely 37% remission, and physicians are forced to use a trial-and-error approach when choosing a single antidepressant out of dozens of available medications. We sought to identify a method of testing that would provide patient-specific information on whether a patient will respond to a medication using in vitro modeling. Patient-derived lymphoblastoid cell lines from the Sequenced Treatment Alternatives to Relieve Depression study were used to rapidly generate cortical neurons and screen them for bupropion effects, for which the donor patients showed remission or non-remission. We provide evidence for biomarkers specific for bupropion response, including synaptic connectivity and morphology changes as well as specific gene expression alterations. These biomarkers support the concept of personalized antidepressant treatment based on in vitro platforms and could be utilized as predictors to patient response in the clinic.

scholarly journals Reframing the Medication Experience in Pharmacy Using Seminal Concepts of Patient-Centered Care—Implications for Practice

Pharmacy ◽  
2021 ◽  
Vol 9 (1) ◽  
pp. 9
Author(s):  
Brian Isetts ◽  
Anthony Olson ◽  
Jon Schommer
Keyword(s):  
Therapeutic Relationship ◽  
Secondary Analysis ◽  
Patient Centered Care ◽  
National Sample ◽  
Patient Specific ◽  
Structured Interviews ◽  
Patient Centeredness ◽  
Patient Centered ◽  
Centered Care ◽  
Medication Experience

Team-based, Patient-Centered Care is essential to chronic disease prevention and management but there are differing ideas about the concept’s meaning across healthcare populations, settings and professions. This commentary’s objective is to empirically evaluate the theoretical relationships of the [a] Medication Experience, [b] Patient-Centeredness and other relevant component concepts from pharmaceutical care (i.e., [c] Therapeutic Relationship, [d] Patient-specific preferences for achieving goals of therapy and resolving drug therapy problems) so as to provide practice-based insights. This is achieved using a secondary analysis of 213 excerpts generated from in-depth semi-structured interviews with a national sample of pharmacists and patients about Patient-Centeredness in pharmacist practice. The four component concepts (i.e., a–d) related to the objective were examined and interpreted using a novel 3-archetype heuristic (i.e., Partner, Client and Customer) revealing common practice-based themes related to care preferences and expectations in collaborative goal setting, enduring relationships, value co-creation and evolving patient expectations during challenging medical circumstances. Most practice-based insights were generated within the Partner archetype, likely reflecting high congruence with pharmacist and patient responses related to the Medication Experience and Therapeutic Relationship. The practice-based insights may be especially useful for new practitioners and students accelerating their advancement in providing effective and efficient Patient-Centered Care.

scholarly journals Atypical clinical and laboratory features of fish-tank granuloma: A case report

2018 ◽  
Vol 6 ◽  
pp. 2050313X1880407 ◽  
Author(s):  
Michael Sander ◽  
Judith L Isaac-Renton ◽  
Megan A Sander
Keyword(s):  
Case Report ◽  
Susceptibility Testing ◽  
Mycobacterium Marinum ◽  
In Vitro Susceptibility ◽  
Laboratory Features ◽  
In Vitro Susceptibility Testing ◽  
Fish Tank ◽  
Fish Tank Granuloma

We report a case of cutaneous Mycobacterium marinum infection with the unusual reported features of pruritus and paresthesia. In addition, we report a lack of in-vivo response to antibiotics based on in-vitro susceptibility testing.

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