scholarly journals A European Perspective on Topical Ophthalmic Antibiotics: Current and Evolving Options

2011 ◽  
Vol 3 ◽  
pp. OED.S4866 ◽  
Author(s):  
D. Bremond-Gignac ◽  
F. Chiambaretta ◽  
S. Milazzo
Keyword(s):  
Bacterial Infections ◽  
Treatment Options ◽  
Anterior Segment ◽  
Eye Drops ◽  
Short Treatment ◽  
Eye Infections ◽  
Perioperative Prophylaxis ◽  
Treatment And Prevention ◽  
Ocular Infections ◽  
Comprehensive Search

Background Eye infections can be vision-threatening and must be treated effectively by appropriate and safe use of topical ophthalmic anti-infectives. This review will essentially consider the current and evolving treatment options for the various types of bacterial eye infections. Ocular surface bacterial infections affect subjects of all ages with a high frequency in newborns and children. Methods This article presents a review of the peer-reviewed published scientific literature in order to define the well-established uses of anti-infective eye drops in the field of ocular infections. A comprehensive search of the recent published literature including topical ophthalmic anti-infectives effective in bacterial ocular infections was performed. Clinical studies provide relevant data concerning the characteristics and clinical efficacy of antibacterial eye drops in ocular anterior segment infections or for perioperative prophylaxis. Publications were included to cover the current options of antibacterial eye drops available in Europe. Results Several recent publications identified effective topical ocular antibacterials requiring a reduced dose regimen and a short treatment course. Additional literature reviewed included data on novel perioperative prophylaxis, indications for topical fortified antibiotics and innovative research including the risk of resistance. Conclusions Safe and effective topical antibiotic eye drops for the treatment and prevention of ocular infections must be adapted to the type of bacteria suspected. Usual topical antimicrobials should be replaced by more recent and more effective treatments. The use of highly effective fluoroquinolones should be reserved for the most severe cases to avoid resistance. Short treatment courses, such as azithromycin, can be easily used in children, thereby improving quality of life.

scholarly journals Monitoring the antimicrobial activity of antiseptic eye drops

2019 ◽  
Vol 12 (3) ◽  
pp. 67-74 ◽  
Author(s):  
Igor N. Okolov
Keyword(s):  
Antimicrobial Activity ◽  
Inflammatory Diseases ◽  
Eye Drops ◽  
Bacterial Conjunctivitis ◽  
Gram Positive ◽  
Important Place ◽  
Treatment And Prevention ◽  
Ocular Infections ◽  
Clinically Significant ◽  
Gram Positive Cocci

Introduction. Antiseptic drugs currently occupy an important place in the treatment and prevention of ocular infectious and inflammatory diseases. Often microorganisms are characterized not only by resistance to a single antibiotic, but also by the presence of multiple resistances, which limits the choice of an effective drug. This problem requires a detailed study and monitoring of the sensitivity of the main pathogens of ocular infections, not only to antibiotics but also to antiseptics. The aim was to study the species composition of conjunctival microflora in patients with ocular surface infection and to evaluate the antimicrobial activity of antiseptic eye drops. Materials and methods. Investigation was carried out in 20122018 in 4237 bacterial conjunctivitis patients. The sensitivity to antiseptic preparations of pathogens isolated from patients with conjunctivitis was detected. Results. 1068 strains of microorganisms isolated from the conjunctival cavity of patients were tested. Gram-positive cocci dominated among clinically significant pathogens 47.4%. Antimicrobial activity of Vitabact eye drops against gram-positive cocci was higher than that of antiseptic Okomistin. Summary. Antimicrobial activity of the studied antiseptics against gram-positive and gram-negative pathogens was different. It is necessary to conduct further research on the antimicrobial activity of antiseptic eye drops.

scholarly journals TOPICAL DRUG DELIVERY FOR EFFECTIVE TREATMENT OF BACTERIAL INFECTIONS OF THE ANTERIOR SEGMENT OF THE EYE

2018 ◽  
Vol 11 (5) ◽  
pp. 13
Author(s):  
Ahmed Abd El-bary ◽  
Howida Kamal Ibrahim ◽  
Balqees Saeed Hazaa
Keyword(s):  
Drug Delivery ◽  
Bacterial Infections ◽  
Bacterial Species ◽  
Anterior Segment ◽  
Complex Nature ◽  
Eye Infections ◽  
Therapeutic Measures ◽  
Appropriate Therapy ◽  
The Right ◽  
Ocular Therapy

Anterior parts of the eye are susceptible to infections caused by different bacterial species. The use of suitable therapeutic measures in case of ocular infections can be sight saving. The appropriate therapy depends on selecting the right antibacterial as well as an efficient drug delivery system. Despite their accessibility, topical delivery of the selected antibiotic into the anterior ocular parts is still a challenging issue due to the complex nature of the eye. Ocular therapy would be significantly improved by modifying the physicochemical properties of the drug and by prolonging its pre-corneal residence time. This review will help pharmaceutical formulators to identify different parts of the eye and the corresponding bacterial infections, ocular barriers to drug delivery, and general consideration when formulating ocular drug delivery systems for the treatment of eye infections.

scholarly journals Bloodstream infection with Acinetobacter baumanii in a Plasmodium falciparum positive infant: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Charity Wiafe Akenten ◽  
Kennedy Gyau Boahen ◽  
Kwadwo Sarfo Marfo ◽  
Nimako Sarpong ◽  
Denise Dekker ◽  
...  
Keyword(s):  
Case Report ◽  
Bacterial Infections ◽  
Treatment Options ◽  
Female Child ◽  
Correct Choice ◽  
Blood Cultures ◽  
Microbial Culture ◽  
Acinetobacter Baumanii ◽  
Inappropriate Use ◽  
History Of

Abstract Background The increasing incidence of multi-antibiotic-resistant bacterial infections, coupled with the risk of co-infections in malaria-endemic regions, complicates accurate diagnosis and prolongs hospitalization, thereby increasing the total cost of illness. Further, there are challenges in making the correct choice of antibiotic treatment and duration, precipitated by a lack of access to microbial culture facilities in many hospitals in Ghana. The aim of this case report is to highlight the need for blood cultures or alternative rapid tests to be performed routinely in malaria patients, to diagnose co-infections with bacteria, especially when symptoms persist after antimalarial treatment. Case presentation A 6-month old black female child presented to the Agogo Presbyterian Hospital with fever, diarrhea, and a 3-day history of cough. A rapid diagnostic test for malaria and Malaria microscopy was positive for P. falciparum with a parasitemia of 224 parasites/μl. The patient was treated with Intravenous Artesunate, parental antibiotics (cefuroxime and gentamicin) and oral dispersible zinc tablets in addition to intravenous fluids. Blood culture yielded Acinetobacter baumanii, which was resistant to all of the third-generation antibiotics included in the susceptibility test conducted, but sensitive to ciprofloxacin and gentamicin. After augmenting treatment with intravenous ciprofloxacin, all symptoms resolved. Conclusion Even though this study cannot confirm whether the bacterial infection was nosocomial or otherwise, the case highlights the necessity to test malaria patients for possible co-infections, especially when fever persists after parasites have been cleared from the bloodstream. Bacterial blood cultures and antimicrobial susceptibility testing should be routinely performed to guide treatment options for febril illnesses in Ghana in order to reduce inappropriate use of broad-spectrum antibiotics and limit the development of antimicrobial resistance.

scholarly journals In Pursuit of an Effective Treatment: the Past, Present and Future of Clinical Trials in Inclusion Body Myositis

2021 ◽  
Author(s):  
A. M. Snedden ◽  
J. B. Lilleker ◽  
H. Chinoy
Keyword(s):  
Clinical Practice ◽  
Effective Treatment ◽  
Inclusion Body ◽  
Therapeutic Effect ◽  
Outcome Measures ◽  
Inclusion Body Myositis ◽  
Cytotoxic T Cells ◽  
Treatment Options ◽  
Trial Methodology ◽  
Short Treatment

Abstract Purpose of review No clinical trial in sporadic inclusion body myositis (IBM) thus far has shown a clear and sustained therapeutic effect. We review previous trial methodology, explore why results have not translated into clinical practice, and suggest improvements for future IBM trials. Recent findings Early trials primarily assessed immunosuppressive medications, with no significant clinical responses observed. Many of these studies had methodological issues, including small participant numbers, nonspecific diagnostic criteria, short treatment and/or assessment periods and insensitive outcome measures. Most recent IBM trials have instead focused on nonimmunosuppressive therapies, but there is mounting evidence supporting a primary autoimmune aetiology, including the discovery of immunosuppression-resistant clones of cytotoxic T cells and anti-CN-1A autoantibodies which could potentially be used to stratify patients into different cohorts. The latest trials have had mixed results. For example, bimagrumab, a myostatin blocker, did not affect the 6-min timed walk distance, whereas sirolimus, a promotor of autophagy, did. Larger studies are planned to evaluate the efficacy of sirolimus and arimoclomol. Summary Thus far, no treatment for IBM has demonstrated a definite therapeutic effect, and effective treatment options in clinical practice are lacking. Trial design and ineffective therapies are likely to have contributed to these failures. Identification of potential therapeutic targets should be followed by future studies using a stratified approach and sensitive and relevant outcome measures.

scholarly journals INFECTIONS AND FOLLICULAR LYMPHOMA: IS THERE A LINK?

2017 ◽  
Vol 9 (1) ◽  
pp. e2017035
Author(s):  
Francesco Zallio ◽  
Giulia Limberti ◽  
Marco Ladetto
Keyword(s):  
Follicular Lymphoma ◽  
B Cell ◽  
Bacterial Infections ◽  
Classical Model ◽  
Infectious Agent ◽  
Epidemiological Studies ◽  
Gastric Malt Lymphoma ◽  
Infectious Agents ◽  
Non Hodgkin Lymphoma ◽  
Treatment And Prevention

Several infectious agents appear to provide a proliferative signal -- “antigen-drive” – that  could be implicated in the pathogenesis of various type of Non-Hodgkin Lymphoma (NHL). A classical model of infection-driven lymphoprolipherative disorder is Helicobacter pylori-induced gastric MALT lymphoma, where antibiotic therapy allows eradication of both the infectious agent and the clonal B-cell expansion;  following the footsteps of these example, several retrospective studies have found a correlation with other pathogens and B-cell Lymphomas, adding new important informations about pathogenesis and laying the groundwork for chemotherapy-free treatments.Although no clear association with infectious agents has yet been identified for Follicular Lymphoma (FL), a growing number of biological and clinical observations suggests that interaction with physiological and pathological microbial populations might play a role also in this subtype of lymphoma: in the last years epidemiological studies investigating the association of known risk factors and FL found a potential correlation with viral or bacterial infections; moreover recent findings about the stimulation of FL clones support the importance of microbial exposure to lymphomagenesis and disease progression.In the following review we make an attempt to find tangible evidences in favor of a role of either physiological and pathological exogenous microbial species in the pathogenesis of FL, and try to integrate the findings coming from epidemiological, biological and interventional studies to define future  novel treatment and prevention strategies for FL.

scholarly journals Bacteriocins of Non-aureus Staphylococci Isolated from Bovine Milk

2017 ◽  
Vol 83 (17) ◽  
Author(s):  
Domonique A. Carson ◽  
Herman W. Barkema ◽  
Sohail Naushad ◽  
Jeroen De Buck
Keyword(s):  
Staphylococcus Aureus ◽  
Bacterial Infections ◽  
Genome Mining ◽  
Bovine Milk ◽  
Gene Clusters ◽  
Antibiotic Use ◽  
Content Type ◽  
Treatment And Prevention ◽  
Whole Genomes

ABSTRACT Non-aureus staphylococci (NAS), the bacteria most commonly isolated from the bovine udder, potentially protect the udder against infection by major mastitis pathogens due to bacteriocin production. In this study, we determined the inhibitory capability of 441 bovine NAS isolates (comprising 26 species) against bovine Staphylococcus aureus. Furthermore, inhibiting isolates were tested against a human methicillin-resistant S. aureus (MRSA) isolate using a cross-streaking method. We determined the presence of bacteriocin clusters in NAS whole genomes using genome mining tools, BLAST, and comparison of genomes of closely related inhibiting and noninhibiting isolates and determined the genetic organization of any identified bacteriocin biosynthetic gene clusters. Forty isolates from 9 species (S. capitis, S. chromogenes, S. epidermidis, S. pasteuri, S. saprophyticus, S. sciuri, S. simulans, S. warneri, and S. xylosus) inhibited growth of S. aureus in vitro, 23 isolates of which, from S. capitis, S. chromogenes, S. epidermidis, S. pasteuri, S. simulans, and S. xylosus, also inhibited MRSA. One hundred five putative bacteriocin gene clusters encompassing 6 different classes (lanthipeptides, sactipeptides, lasso peptides, class IIa, class IIc, and class IId) in 95 whole genomes from 16 species were identified. A total of 25 novel bacteriocin precursors were described. In conclusion, NAS from bovine mammary glands are a source of potential bacteriocins, with >21% being possible producers, representing potential for future characterization and prospective clinical applications. IMPORTANCE Mastitis (particularly infections caused by Staphylococcus aureus) costs Canadian dairy producers $400 million/year and is the leading cause of antibiotic use on dairy farms. With increasing antibiotic resistance and regulations regarding use, there is impetus to explore bacteriocins (bacterially produced antimicrobial peptides) for treatment and prevention of bacterial infections. We examined the ability of 441 NAS bacteria from Canadian bovine milk samples to inhibit growth of S. aureus in the laboratory. Overall, 9% inhibited growth of S. aureus and 58% of those also inhibited MRSA. In NAS whole-genome sequences, we identified >21% of NAS as having bacteriocin genes. Our study represents a foundation to further explore NAS bacteriocins for clinical use.

A Comparative Study Between Preoperative Subconjunctival Bevacizumab Injection And Postoperative Topical Application In Prevention Of Recurrence After Excision Of Primary Pterygium In Egyptian Patients

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Basma Helal Mohamed ◽  
Othman Ali Othman Ziko ◽  
Hisham M Khairy Abd El Dayem ◽  
Nancy Ezzelregal Khamis Ahmed
Keyword(s):  
Corneal Thickness ◽  
Anterior Segment ◽  
P Value ◽  
Eye Drops ◽  
Subconjunctival Injection ◽  
Fibrovascular Tissue ◽  
Significant Difference ◽  
Group 2 ◽  
Group 1 ◽  
Primary Pterygium

Abstract Purpose to compare between recurrence incidence after primary pterygium excision when using preoperative subconjunctival injection of Bevacizumab (Avastin) and using it as a postoperative eye drops. Methods thirty two eyes of thirty patients (two patients had bilateral pterygium) with primary pterygia were clinically examined, classified into 3 groups and operated by simple excision with bare sclera technique. Group 1 included 10 patients received Bevacizumab (Avastin) in the form of eye drops (10 mg/ml) 3 times daily for 6 days postoperative. Group 2 included 10 patients received preoperative Bevacizumab in the form of subconjunctival injection (1.25 mg/0.05ml) single dose 1 week preoperative. Group 3 included 10 patients (12 eyes) 2 patients with bilateral Pterygium didn’t receive any form of Bevacizumab. Postoperative follow up was done clinically and by serial photography at 1 week, 1 month, 3 months and 6 months searching for signs of recurrence and/or complications. Results The results showed different grades of recurrence in 18 eyes of 32.True recurrence was seen in 7 patients of 18 (1 patient in group 1, 2 in group 2 and 4 in group3).Recurrence grades in group 1and 2 who used the Bevacizumab (20%grade II, 50% grade III, and 30% grade IV). Recurrence could be predicted by 100% depending on fibrovascular tissue appearing in the surgical bed at 3 months postoperative (P value 0.038).Preoperative fleshy pterygium has high statistical significance in realation to recurrence(P value = 0.006).Patient’s sex, residence and occupation had no statistically significant value in the process of recurrence (P value > 0.05). Patients with recurrent Pterygia (in group 1&2) had statistically significant changes in the corneal K- readings at 3 months and 6 months.No significant difference in the limbal or central corneal thickness in the operated eye and the other eye (Pvalue > 0.05). Conclusion Bevacizumab (Avastin) is a well tolerated drug with multiple drug delivery methods.The eye drops give better results than the subconjunctival injection.Appearance of fibrovascular tissue in the surgical bed at 3 months predict the recurrence by 100%. Preoperative fleshy pterygia will mostly recur again whatever Bevacizumab form was used .The corneal thickness by anterior segment OCT has no role in prediction or detection of early pterygium recurrence.

scholarly journals Protection againstStaphylococcus aureusColonization and Infection by B- and T-Cell-Mediated Mechanisms

mBio ◽  
2018 ◽  
Vol 9 (5) ◽  
Author(s):  
Fan Zhang ◽  
Olivia Ledue ◽  
Maria Jun ◽  
Cibelly Goulart ◽  
Richard Malley ◽  
...  
Keyword(s):  
T Cell ◽  
Soft Tissue ◽  
Bacterial Infections ◽  
Vaccine Development ◽  
Pathological Condition ◽  
Treatment Options ◽  
Immune Defense ◽  
Invasive Infection ◽  
Content Type ◽  
Increased Risk

ABSTRACTStaphylococcus aureusis a major cause of morbidity and mortality worldwide.S. aureuscolonizes 20 to 80% of humans at any one time and causes a variety of illnesses. Strains that are resistant to common antibiotics further complicate management.S. aureusvaccine development has been unsuccessful so far, largely due to the incomplete understanding of the mechanisms of protection against this pathogen. Here, we studied the role of different aspects of adaptive immunity induced by anS. aureusvaccine in protection againstS. aureusbacteremia, dermonecrosis, skin abscess, and gastrointestinal (GI) colonization. We show that, depending on the challenge model, the contributions of vaccine-inducedS. aureus-specific antibody and Th1 and Th17 responses to protection are different: antibodies play a major role in reducing mortality duringS. aureusbacteremia, whereas Th1 or Th17 responses are essential for prevention ofS. aureusskin abscesses and the clearance of bacteria from the GI tract. Both antibody- and T-cell-mediated mechanisms contribute to prevention ofS. aureusdermonecrosis. Engagement of all three immune pathways results in the most robust protection under each pathological condition. Therefore, our results suggest that eliciting multipronged humoral and cellular responses toS. aureusantigens may be critical to achieve effective and comprehensive immune defense against this pathogen.IMPORTANCES. aureusis a leading cause of healthcare- and community-associated bacterial infections.S. aureuscauses various illnesses, including bacteremia, meningitis, endocarditis, pneumonia, osteomyelitis, sepsis, and skin and soft tissue infections.S. aureuscolonizes between 20 and 80% of humans; carriers are at increased risk for infection and transmission to others. The spread of multidrug-resistant strains limits antibiotic treatment options. Vaccine development againstS. aureushas been unsuccessful to date, likely due to an inadequate understanding about the mechanisms of immune defense against this pathogen. The significance of our work is in illustrating the necessity of generating multipronged B-cell, Th1-, and Th17-mediated responses toS. aureusantigens in conferring enhanced and broad protection againstS. aureusinvasive infection, skin and soft tissue infection, and mucosal colonization. Our work thus, provides important insights for future vaccine development against this pathogen.

Clinical, Microbial, and Biochemical Aspects of the Exfoliative Toxins Causing Staphylococcal Scalded-Skin Syndrome

1999 ◽  
Vol 12 (2) ◽  
pp. 224-242 ◽  
Author(s):  
Shamez Ladhani ◽  
Christopher L. Joannou ◽  
Denise P. Lochrie ◽  
Robert W. Evans ◽  
Susan M. Poston
Keyword(s):  
Clinical Features ◽  
Treatment Options ◽  
Entire Body ◽  
Secondary Complications ◽  
Staphylococcal Scalded Skin Syndrome ◽  
Treatment And Prevention ◽  
Causative Agents ◽  
Underlying Diseases ◽  
Disease Understanding ◽  
Significant Mortality

SUMMARY The exfoliative (epidermolytic) toxins of Staphylococcus aureus are the causative agents of the staphylococcal scalded-skin syndrome (SSSS), a blistering skin disorder that predominantly affects children. Clinical features of SSSS vary along a spectrum, ranging from a few localized blisters to generalized exfoliation covering almost the entire body. The toxins act specifically at the zona granulosa of the epidermis to produce the characteristic exfoliation, although the mechanism by which this is achieved is still poorly understood. Despite the availability of antibiotics, SSSS carries a significant mortality rate, particularly among neonates with secondary complications of epidermal loss and among adults with underlying diseases. The aim of this article is to provide a comprehensive review of the literature spanning more than a century and to cover all aspects of the disease. The epidemiology, clinical features, potential complications, risk factors, susceptibility, diagnosis, differential diagnoses, investigations currently available, treatment options, and preventive measures are all discussed in detail. Recent crystallographic data on the toxins has provided us with a clearer and more defined approach to studying the disease. Understanding their mode of action has important implications in future treatment and prevention of SSSS and other diseases, and knowledge of their specific site of action may provide a useful tool for physiologists, dermatologists, and pharmacologists.

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