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Latest & greatest articles for penicillin
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Are Short-Term Late-Generation Antibiotics Equivalent to Standard Penicillin Therapy in the Resolution of Symptoms in Acute Strep Throat in Children? Systematic Review Snapshot TAKE-HOME MESSAGE Although antibiotics are not the best agent for symptomatic management of streptococcal pharyngitis, according to limited data, short-course antibiotics appear to reduce the duration of symptoms more effectively than longer-course therapy. Are Short-Term Late-Generation Antibiotics Equivalent (...) to Standard Penicillin Therapy in the Resolution of Symptoms in Acute Strep Throat in Children? EBEM Commentators Anand Swaminathan, MD, MPH New York University School of Medicine/Bellevue Hospital Center Department of Emergency Medicine New York, NY Jeffrey Hom, MD, MPH Stony Brook University School of Medicine Departments of Pediatrics (Emergency) and Emergency Medicine Stony Brook, NY Results Table 1. Short (3 days) versus standard (7 days) antibiotic course. Symptom Number of Subjects Difference
Use of penicillin and other antibiotics and risk of multiple sclerosis: a population-based case-control study A 2006 study from the United Kingdom found that penicillin use may decrease the risk of multiple sclerosis (MS). To confirm this finding, the authors conducted a nationwide case-control study in Denmark, using the Danish Multiple Sclerosis Registry to identify 3,259 patients with MS onset from 1996 to 2008, and selected 10 population controls per case (n = 32,590), matched on sex (...) and age. Through the National Prescription Database, prescriptions for antibiotics redeemed from 1995 to 2008 and before the date of first MS symptom/index date were identified. Conditional logistic regression analysis was used to compute odds ratios associating antibiotic use with MS occurrence. In total, 1,922 patients (59%) redeemed penicillin prescriptions before the index date and 2,292 (70%) redeemed any type of antibiotic prescription. Penicillin use was associated with an increased risk of MS
Anaphylactic Cross-Reactivity Between Penicillin and Cephalosporin UTCAT848, Found CAT view, CRITICALLY APPRAISED TOPICs University: | | ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM View the CAT / Title Minimal Risk Of Severe Type 1 Hypersensitivity Reaction To Third Generation Cephalosporin In Patients Who Experience Type 1 Hypersensitivity Reaction And Allergy To Penicillin Clinical Question Do patients who experience a severe type 1 hypersensitivity reaction to penicillin and demonstrate (...) an allergy to cephalosporin experience a severe type 1 hypersensitivity reaction to the cephalosporin? Clinical Bottom Line It appears that patients who have a severe type 1 hypersensitivity reaction to penicillin do not have an increased risk of anaphylaxis to cephalosporins. This evidence may be skewed however by adherence to the recommendation not to give cephalosporins to individuals with a history of penicillin anaphylaxis. (See Comments on the CAT below) Best Evidence (you may view more info
Can pneumonia caused by penicillin-resistant Streptococcus pneumoniae be treated with penicillin? BestBets: Can pneumonia caused by penicillin-resistant Streptococcus pneumoniae be treated with penicillin? Can pneumonia caused by penicillin-resistant Streptococcus pneumoniae be treated with penicillin? Report By: V Clifford and M Tebruegge (joint first authors), M Vandeleur and Professor Nigel Curtis - Research Fellows Institution: Infectious Diseases Unit, Department of General Medicine (...) /Paediatrics, University of Melbourne; Murdoch Children's Research Institute. Australia. Date Submitted: 22nd January 2010 Date Completed: 11th February 2010 Last Modified: 12th February 2010 Status: Green (complete) Three Part Question In [ child with pneumonia due to penicillin-resistant Streptococcus pneumoniae] does [treatment with penicillin alone] result in [higher morbidity or mortality]? Clinical Scenario You are looking after a previously healthy 3-year-old girl, who was admitted
Why is Syphilis Still Sensitive to Penicillin? Why is Syphilis Still Sensitive to Penicillin? – Clinical Correlations Search Why is Syphilis Still Sensitive to Penicillin? July 30, 2009 5 min read | | 4 comments on “ Why is Syphilis Still Sensitive to Penicillin? ” Very interesting… Well, this is supposed to be how antibiotics work, by punching a hole in the cell wall of the bacteria. Caprillic acid in coconut oil does the same thing. But why theorized? With the current technology (...) , this supposed action of Treponema destruction should be able to be viewed in real time, If the researchers are only looking for resistance via beta lactamase production, and not the dna alteration into a different gene, they would see exactly what they do see, no resistance. It seems to me that penicillin is a product, being derived from bread mold, that would have been contemporaneous with this human bacteria. In order to claim a cure would not he evidence be a real-time video capture of the bacteria’s
Penicillins vs trimethoprim-based regimens for acute bacterial exacerbations of chronic bronchitis: meta-analysis of randomized controlled trials Penicillins vs trimethoprim-based regimens for acute bacterial exacerbations of chronic bronchitis: meta-analysis of randomized controlled trials Penicillins vs trimethoprim-based regimens for acute bacterial exacerbations of chronic bronchitis: meta-analysis of randomized controlled trials Korbila I P, Manta K G, Siempos I I, Dimopoulos G, Falagas M (...) E CRD summary This review concluded that semisynthetic penicillin and trimethoprim-based regimens seemed to be equivalent for the treatment of acute bacterial exacerbation of chronic bronchitis. The authors' conclusions are reasonable, but they were based on limited evidence and may have limited generalisability to populations with antimicrobial resistance to Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis strains. Authors' objectives To compare the effectiveness
Randomized, comparative efficacy trial of oral penicillin versus cefuroxime for perianal streptococcal dermatitis in children To investigate the efficacy of penicillin compared with cefuroxime for group A beta-hemolytic Streptococcus pyogenes (GABHS) perianal dermatitis.Children 1 to 16 years of age with signs and symptoms of perianal dermatitis and a positive anal swab were randomized to penicillin or cefuroxime treatment and were clinically re-evaluated on day 3 and at the end of treatment (...) (cefuroxime, day 7; penicillin, day 10). An anal swab was obtained to document eradication of GABHS at the end of treatment. Severity of disease was assessed with a clinical score (perianal erythema, 5 points; perianal itch, 3 points; painful defecation, 3 points; constipation, 2 points).Patients were enrolled and randomly assigned to penicillin (n = 18) or cefuroxime (n = 17) treatment. Treatment with penicillin was inferior to cefuroxime, which led to premature study termination after consultation
The first use of penicillin in the United States. The first use of penicillin in the United States occurred in 1942 and saved a moribund patient who had beta-hemolytic streptococcal sepsis. Some of the circumstances involved in obtaining and using the drug are described.
Brief communication: tolerability of meropenem in patients with IgE-mediated hypersensitivity to penicillins. Although clinicians avoid giving meropenem to patients with penicillin allergy because of potential cross-reactivity, the rate of cross-reactivity between penicillins and meropenem has not been prospectively determined.To assess the tolerability of meropenem in patients with documented penicillin allergy.Prospective skin testing and antibiotic challenge.Allergy units of 2 Italian (...) medical centers.104 consecutive participants with immediate hypersensitivity reactions to penicillins and positive skin test results to at least 1 penicillin reagent.Skin tests to meropenem and, if results were negative, challenges with escalating doses of meropenem.One participant (0.9% [95% CI, 0.02% to 5.2%]) had a positive intradermal test result to meropenem. The remaining 103 participants with negative skin test results to meropenem tolerated escalating dose challenges.Challenges were
Drugs - Benzylpenicillin (Penicillin g) Benzylpenicillin (Penicillin G) BPN Drugs October 2006 Page 1 of 2 Drugs PRESENTATION Ampoule containing 600 milligrams of benzylpenicillin as powder. ACTIONS Antibiotic active against a range of bacteria. DOSAGE AND ADMINISTRATION Administer en-route to hospital (unless already administered by GP etc). Administer by slow IV injection. If it is not possible to gain rapid vascular access, the drug should be given by the IM route, as detailed below (...) blisters. May be no rash • pain in joints, muscles and limbs • seizures • level of consciousness: • early in shock – alert/able to speak • as shock advances – babies become limp, ?oppy and drowsy; older children/adults may develop dif?culty in walking/standing, drowsy, confused. Meningococcal septicaemia is commonest in young children and young adults. It may progress rapidly and the sooner benzylpenicillin is administered the better the outcome. CONTRA-INDICATIONS Genuine penicillin allergy. AGE DOSE
Parenteral penicillin for children with meningococcal disease before hospital admission: case-control study. To explore the impact on mortality and morbidity of parenteral penicillin given to children before admission to hospital with suspected meningococcal disease.Retrospective comparison of fatal and non-fatal cases.England, Wales, and Northern Ireland; December 1997 to February 1999.158 children aged 0-16 years (26 died, 132 survived) in whom a general practitioner had made the diagnosis (...) of meningococcal disease before hospital admission.Administration of parenteral penicillin by general practitioners was associated with increased odds ratios for death (7.4, 95% confidence interval 1.5 to 37.7) and complications in survivors (5.0, 1.7 to 15.0). Children who received penicillin had more severe disease on admission (median Glasgow meningococcal septicaemia prognostic score (GMSPS) 6.5 v 4.0, P = 0.002). Severity on admission did not differ significantly with time taken to reach hospital.Children
Benzylpenicillin (Penicillin g) Benzylpenicillin (Penicillin G) BPN Drugs October 2006 Page 1 of 2 Drugs PRESENTATION Ampoule containing 600 milligrams of benzylpenicillin as powder. ACTIONS Antibiotic active against a range of bacteria. DOSAGE AND ADMINISTRATION Administer en-route to hospital (unless already administered by GP etc). Administer by slow IV injection. If it is not possible to gain rapid vascular access, the drug should be given by the IM route, as detailed below, into the antero (...) . May be no rash • pain in joints, muscles and limbs • seizures • level of consciousness: • early in shock – alert/able to speak • as shock advances – babies become limp, ?oppy and drowsy; older children/adults may develop dif?culty in walking/standing, drowsy, confused. Meningococcal septicaemia is commonest in young children and young adults. It may progress rapidly and the sooner benzylpenicillin is administered the better the outcome. CONTRA-INDICATIONS Genuine penicillin allergy. AGE DOSE
Single-dose azithromycin versus penicillin G benzathine for the treatment of early syphilis. Pilot studies suggest that a single, 2-g oral dose of azithromycin may be an alternative to a 2.4-MU intramuscular dose of penicillin G benzathine in the prevention and treatment of syphilis. We evaluated the efficacy of treatment with azithromycin in a developing country.A total of 328 subjects, 25 with primary and 303 with high-titer (a titer of at least 1:8 on a rapid plasmin reagin [RPR] test (...) ) latent syphilis, were recruited through screening of high-risk populations in Mbeya, Tanzania, and randomly assigned to receive 2 g of azithromycin orally (163 subjects) or 2.4 million units of penicillin G benzathine intramuscularly (165 subjects). The primary outcome was treatment efficacy, with cure defined serologically (a decline in the RPR titer of at least two dilutions by nine months after treatment) and, in primary syphilis, by epithelialization of ulcers within one or two weeks.The average
Oral amoxicillin versus injectable penicillin for severe pneumonia in children aged 3 to 59 months: a randomised multicentre equivalency study. Injectable penicillin is the recommended treatment for WHO-defined severe pneumonia (lower chest indrawing). If oral amoxicillin proves equally effective, it could reduce referral, admission, and treatment costs. We aimed to determine whether oral amoxicillin and parenteral penicillin were equivalent in the treatment of severe pneumonia in children aged (...) 3-59 months.This multicentre, randomised, open-label equivalency study was undertaken at tertiary-care centres in eight developing countries in Africa, Asia, and South America. Children aged 3-59 months with severe pneumonia were admitted for 48 h and, if symptoms improved, were discharged with a 5-day course of oral amoxicillin. 1702 children were randomly allocated to receive either oral amoxicillin (n=857) or parenteral penicillin (n=845) for 48 h. Follow-up assessments were done at 5 and 14
2004LancetControlled trial quality: predicted high
Cross-reactivity and tolerability of cephalosporins in patients with immediate hypersensitivity to penicillins. In patients with documented IgE-mediated hypersensitivity to penicillins, data on sensitization to cephalosporins vary. Administering cephalosporins to such patients is often deferred because of the risk for cross-reactivity.To assess the cross-reactivity with cephalosporins and its potential determinants in patients with documented penicillin allergy.Prospective study in patients (...) without clinical indications for cephalosporin treatment.Italy.128 consecutive patients who sustained anaphylactic shock (n = 81) or urticaria (n = 47) and had positive results on skin tests for at least 1 of the penicillin reagents tested.All patients were skin tested with cephalothin, cefamandole, cefuroxime, ceftazidime, ceftriaxone, and cefotaxime. Patients with negative results for the last 4 cephalosporins were challenged with cefuroxime axetil and ceftriaxone.14 patients (10.9% [95% CI, 6.1
Penicillins for the prophylaxis of bacterial endocarditis in dentistry. Many dental procedures cause bacteraemia and it is believed that this may lead to bacterial endocarditis (BE) in a few people. Guidelines in many countries recommend that prior to invasive dental procedures antibiotics are administered to people at high risk of endocarditis. However, it is unclear whether the potential risks of this prophylaxis outweigh the potential benefits.To determine whether prophylactic penicillin (...) to June 2002); EMBASE (1980 to June 2002); SIGLE (to June 2002); and the Meta-register of current controlled trials.Due to the low incidence of BE it was anticipated that few if any trials would be located. For this reason, cohort and case controlled studies were included where suitably matched control or comparison groups had been studied. The intervention was the administration of penicillin compared to no such administration before a dental procedure in people with an increased risk of BE. Cohort
Intramuscular penicillin for the prevention of early onset group B streptococcal infection in newborn infants. Early-onset group B streptococcal disease (EOGBSD) is the most frequent cause of serious infection in the newborn period. Current strategies used to prevent EOGBSD are focused upon maternal antibiotic prophylaxis to reduce transmission of GBS to the infant. Observational studies have suggested that the administration of intramuscular penicillin to the newborn immediately following (...) delivery may be an effective strategy to reduce the incidence of EOGBSD.To determine if the administration of intramuscular penicillin to newborns at birth is a safe and effective method to prevent morbidity and mortality from EOGBSD.The standard search strategy of the Neonatal Review Group was used. This included searches of electronic databases: Oxford Database of Perinatal Trials, Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library Issue 1, 2004), and MEDLINE (1966 - Dec
Penicillin for acute sore throat in children: randomised, double blind trial. To assess the effectiveness of penicillin for three days and treatment for seven days compared with placebo in resolving symptoms in children with sore throat.Randomised, double blind, placebo controlled trial.43 family practices in the Netherlands.156 children aged 4-15 who had a sore throat for less than seven days and at least two of the four Centor criteria (history of fever, absence of cough, swollen tender (...) anterior cervical lymph nodes, and tonsillar exudate). Interventions Patients were randomly assigned to penicillin for seven days, penicillin for three days followed by placebo for four days, or placebo for seven days.Duration of symptoms, mean consumption of analgesics, number of days of absence from school, occurrence of streptococcal sequelae, eradication of the initial pathogen, and recurrences of sore throat after six months.Penicillin treatment was not more beneficial than placebo in resolving
Effect of beta lactam antibiotic use in children on pneumococcal resistance to penicillin: prospective cohort study. To examine the relation between use of antibiotics in a cohort of preschool children and nasal carriage of resistant strains of pneumococcus.Prospective cohort study over two years of 461 children aged under 4 years living in Canberra, Australia.Use of drugs, respiratory symptoms, and visits to doctors were documented in a daily diary by parents of the children during 25 months (...) of observation. Isolates of pneumococci, which were cultured from nasal swabs collected approximately six monthly, were tested for antibiotic resistance.From the four swab collections 631 positive pneumococcal isolates from 461 children were found, of which 13.6% were resistant to penicillin. Presence of penicillin resistant pneumococci was significantly associated with children's use of a beta lactam antibiotic in the two months before each swab collection (odds ratio 2.03 (95% confidence interval 1.15