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Could the next "disease X" be a pandemic of virus-induced encephalitis? What should our first medical response be? 下一个 "X 病 "会是由病毒引起的脑炎大流行吗?我们的第一医疗反应应该是什么?
IF 4.2 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2024-11-19 DOI: 10.1080/14787210.2024.2432277
Mina T Kelleni
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引用次数: 0
Is the UK set to be hepatitis C free? 英国将成为无丙型肝炎国家吗?
IF 4.2 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2024-08-01 Epub Date: 2023-09-11 DOI: 10.1080/14787210.2023.2255751
Maria Fernanda Guerra-Veloz, Riham Soliman, Kosh Agarwal
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引用次数: 0
Effects of supplementation with low-dose group B vitamins on clinical and biochemical parameters in critically ill patients with COVID-19: a randomized clinical trial. 补充小剂量 B 族维生素对 COVID-19 重症患者临床和生化指标的影响:随机临床试验。
IF 4.2 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2024-07-01 Epub Date: 2022-09-28 DOI: 10.1080/14787210.2022.2125867
Nazanin Majidi, Effat Bahadori, Soheila Shekari, Maryam Gholamalizadeh, Shirin Tajadod, Marjan Ajami, Somayeh Gholami, Mahdi Shadnoush, Mina Ahmadzadeh, Anoush Dehnadi Moghadam, Naeemeh Hassanpour Ardekanizadeh, Hanieh Shafaei Kachaei, Fatemeh Shafie, Alireza Moslem, Saeid Doaei, Mark O Goodarzi

Background: : This study aimed to check the effect of supplementation with low-dose group B vitamins on clinical and biochemical parameters on patients with coronavirus disease 2019 (COVID-19).

Research design and method: : This double-blind, randomized clinical trial was carried out on 85 critically ill patients with COVID-19. All patients received high protein prescriptions of 30 kcal/kg/d by enteral nutrition. The intervention group (n = 40) received vitamin B complex, including thiamine (10 mg), riboflavin (4 mg), nicotinamide (40 mg), and dexpanthenol (6 mg). The control group received similar nutritional supports, except for group B vitamins. Assessments were carried out at baseline and after 2 weeks of intervention.

Results: : Vitamin B supplementation had no effects on the biochemical and pathological parameters including kidney function, arterial blood gas parameters, Glasgow coma scale, cell blood count, and serum electrolytes of the intervention group compared with the control group. The 30-day mortality was insignificantly lower in the intervention group than in the control group (83.3% against 96.1%, P = 0.07).

Conclusions: The mortality rate of patients with COVID-19 might be improved by low-dose vitamin B supplementation.

研究背景: :本研究旨在检测补充低剂量B族维生素对2019年冠状病毒病(COVID-19)患者临床和生化指标的影响:这项双盲随机临床试验针对 85 名 COVID-19 重症患者展开。所有患者均通过肠内营养接受 30 千卡/千克/天的高蛋白处方。干预组(n = 40)接受复合维生素 B,包括硫胺素(10 毫克)、核黄素(4 毫克)、烟酰胺(40 毫克)和脱泛醇(6 毫克)。对照组接受类似的营养支持,但 B 组维生素除外。评估在基线和干预 2 周后进行:与对照组相比,补充维生素 B 对干预组的生化和病理参数(包括肾功能、动脉血气参数、格拉斯哥昏迷量表、细胞血细胞计数和血清电解质)没有影响。干预组的 30 天死亡率显著低于对照组(83.3% 对 96.1%,P = 0.07):结论:通过补充小剂量维生素 B,COVID-19 患者的死亡率可能会有所改善。
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引用次数: 0
Evaluation of Tamarix nilotica Fractions in Combating Candida albicans Infections. 评估柽柳提取物在抗白色念珠菌感染中的作用。
IF 5.7 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2024-04-01 Epub Date: 2023-07-04 DOI: 10.1080/14787210.2023.2232112
Ehssan Moglad, Engy Elekhnawy, Walaa A Negm, Fatma A Mokhtar, Reem Binsuwaidan, Nashwah G M Attallah, Eman Ahmed, Sameh Magdeldin, Omnia Momtaz Al-Fakhrany

Objectives: Evaluation of the antifungal properties of Tamarix nilotica fractions against Candida albicans clinical isolates.

Methods: The in vitro antifungal potential was evaluated by agar well diffusion and broth microdilution methods. The antibiofilm potential was assessed by crystal violet, scanning electron microscopy (SEM), and qRT-PCR. The in vivo antifungal activity was evaluated by determining the burden in the lung tissues of infected mice, histopathological, immunohistochemical studies, and ELISA.

Results: Both the dichloromethane (DCM) and ethyl acetate (EtOAc) fractions had minimum inhibitory concentration (MIC) values of 64-256 and 128-1024 μg/mL, respectively. SEM examination showed that the DCM fraction decreased the biofilm formation capacity of the treated isolates. A significant decline in biofilm gene expression was observed in 33.33% of the DCM-treated isolates. A considerable decline in the CFU/g lung count in infected mice was observed, and histopathological examinations revealed that the DCM fraction maintained the lung tissue architecture. Immunohistochemical investigations indicated that the DCM fraction significantly (p < 0.05) decreased the expression of pro-inflammatory and inflammatory cytokines (TNF-α, NF-kB, COX-2, IL-6, and IL-1β) in the immunostained lung sections. The phytochemical profiling of DCM and EtOAc fractions was performed using Liquid chromatography-mass spectrometry (LC-ESI-MS/MS).

Conclusion: T. nilotica DCM fraction could be a significant source of natural products with antifungal activity against C. albicans infections.

目的方法:采用琼脂井扩散法和肉汤微稀释法评估玉竹馏分对白色念珠菌临床分离株的抗真菌特性:方法:采用琼脂井扩散法和肉汤微稀释法评估体外抗真菌潜力。抗生物膜的潜力通过水晶紫、扫描电子显微镜(SEM)和 qRT-PCR 进行评估。通过测定感染小鼠肺组织中的负担、组织病理学、免疫组织化学研究和酶联免疫吸附试验评估了体内抗真菌活性:结果:二氯甲烷(DCM)和乙酸乙酯(EtOAc)馏分的最低抑菌浓度(MIC)值分别为 64-256 μg/mL 和 128-1024 μg/mL。扫描电镜检查显示,DCM馏分降低了经处理的分离物的生物膜形成能力。在 33.33% 经 DCM 处理的分离物中观察到生物膜基因表达明显下降。受感染小鼠肺部的 CFU/g 数显著下降,组织病理学检查显示,DCM 部分保持了肺组织结构。免疫组化检查表明,DCM 部分显著(p 结论:DCM 部分对小鼠肺部组织结构的影响较小:黑木耳 DCM 部分可能是具有抗白僵菌感染活性的天然产品的重要来源。
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引用次数: 0
Interaction of zincite, alpha-terpineol, geranyl acetate, linalool, myrcenol, terpinolene, and thymol with virulence factors of Escherichia coli, Mycobacterium tuberculosis, Pseudomonas aeruginosa, and Staphylococcus aureus. 锌石、α-松油醇、乙酸香叶酯、芳樟醇、月桂烯醇、萜品醇和百里酚与大肠杆菌、结核分枝杆菌、绿脓杆菌和金黄色葡萄球菌毒力因子的相互作用。
IF 5.7 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2024-04-01 Epub Date: 2023-07-23 DOI: 10.1080/14787210.2023.2238123
Mehran Alavi, Morahem Ashengroph

Background: Based on gas chromatography - mass spectrometry (GC-MS) results of a previous study, six metabolites including alpha-terpineol, geranyl acetate, linalool, myrcenol, terpinolene, and thymol showed significantly higher amounts relative to other metabolites.

Methods: A continuation of the previous study, the interaction of these metabolites with the main virulence factors of P. aeruginosa (pseudomonas elastase and exotoxin A), Staphylococcus aureus (alpha-hemolysin and protein 2a), Mycobacterium tuberculosis (ESX-secreted protein B and the serine/threonine protein kinase), and Escherichia coli (heat-labile enterotoxin and Shiga toxin) were evaluated by molecular docking study and molecular simulation.

Results: In the case of Shiga toxin, higher and lower binding affinities were related to alpha-terpinolene and zincite with values of -5.8 and -2.6 kcal/mol, respectively. For alpha-hemolysin, terpinolene and alpha-terpinolene demonstrated higher binding affinities with similar energies of -5.9 kcal/mol. Thymol and geranyl acetate showed lower binding energy of -5.7 kcal/mol toward protein 2a. Furthermore, thymol had a higher binding affinity toward heat-labile enterotoxin and ESX-secreted protein B with values of -5.9 and -6.1 kcal/mol, respectively.

Conclusions: It is concluded that the availability of secondary metabolites of A. haussknechtii surrounding zinc oxide (ZnO) NPs can hinder P. aeruginosa by inactivating Pseudomonas elastase and exotoxin.

背景:根据之前研究的气相色谱-质谱(GC-MS)结果,α-松油醇、乙酸香叶酯、芳樟醇、香叶醇、萜品醇和百里酚等六种代谢物的含量明显高于其他代谢物:方法:继续先前的研究,研究这些代谢物与铜绿假单胞菌(P. aeruginosa)主要毒力因子的相互作用。方法:继续先前的研究,通过分子对接研究和分子模拟评估了这些代谢物与铜绿假单胞菌(弹性蛋白酶和外毒素 A)、金黄色葡萄球菌(α-溶血素和蛋白 2a)、结核分枝杆菌(ESX 分泌蛋白 B 和丝氨酸/苏氨酸蛋白激酶)和大肠杆菌(热嗜酸性肠毒素和志贺毒素)的主要致病因子之间的相互作用:就志贺毒素而言,α-萜品烯和锌矿的结合亲和力较高和较低,分别为-5.8和-2.6 kcal/mol。对于α-溶血素,萜品油烯和α-萜品油烯的结合亲和力较高,能量相似,均为-5.9 kcal/mol。百里酚和乙酸香叶酯与蛋白质 2a 的结合能较低,为-5.7 kcal/mol。此外,百里酚与热嗜性肠毒素和 ESX 分泌蛋白 B 的结合亲和力较高,分别为 -5.9 和 -6.1 kcal/mol:结论:氧化锌(ZnO)氮氧化物周围的A. haussknechtii次生代谢物可以通过灭活假单胞菌弹性蛋白酶和外毒素来抑制铜绿假单胞菌。
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引用次数: 0
Hospital-acquired bacterial pneumonia (HABP) and ventilator-associated bacterial pneumonia (VABP) in Canada: treatment update and the role of new IV antimicrobials. 加拿大的医院获得性细菌性肺炎(HABP)和呼吸机相关细菌性肺炎:治疗更新和新型静脉抗菌药物的作用。
IF 5.7 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2023-10-09 DOI: 10.1080/14787210.2023.2268287
Coleman Rotstein, Joseph P Lynch, George G Zhanel

Introduction: Hospital-acquired bacterial pneumonia (HABP) and ventilator-associated bacterial pneumonia (VABP) continue to be common infections causing significant morbidity and mortality worldwide. The timely initiation of empiric antimicrobial therapy is essential. In this paper, we provide a focused expert opinion on the current and potential empiric antimicrobial treatment options in HABP and VABP in Canada influenced by antimicrobial resistance impacting the use of older agents as well as available new intravenous (IV) antimicrobials.

Areas covered: The authors discuss treatment options for HABP and VABP in Canada. In addition, we focus on the potential role of new IV antimicrobials recently introduced to Canada. A literature search of HABP and VABP treatments was performed via PubMed (up to March 2023), using the following key words: monotherapy, combination therapy, aminoglycosides, carbapenems, cephalosporins, fluoroquinolones, penicillins as well as amoxicillin/clavulanate, ceftobiprole, ceftolozane/tazobactam, dalbavancin, and fosfomycin.

Expert opinion: Empiric antimicrobial treatment for HABP and VABP in Canada continues to focus on both the severity of illness and the presence/absence of patient risk factors for antimicrobial resistance. The role of new IV antimicrobials in the empiric treatment for HABP and VABP depends on their antimicrobial activity and published data on efficacy and safety and influenced by Health Canada-approved indications.

引言:医院获得性细菌性肺炎(HABP)和呼吸机相关细菌性肺炎仍然是常见的感染,在全球范围内造成显著的发病率和死亡率。及时开始经验性抗菌治疗至关重要。在这篇论文中,我们就加拿大HABP和VABP目前和潜在的经验性抗菌治疗方案提供了一个集中的专家意见,这些方案受到抗菌耐药性的影响,影响了旧药物的使用,以及可用的新型静脉(IV)抗菌剂。涵盖领域:作者讨论了加拿大HABP和VABP的治疗方案。此外,我们还关注最近引入加拿大的新型静脉注射抗菌药物的潜在作用。通过PubMed(截至2023年3月)检索了HABP和VABP治疗的文献,关键词为:单药治疗、联合治疗、氨基糖苷类、碳青霉烯类、头孢菌素类、氟喹诺酮类、青霉素类以及阿莫西林/克拉维酸、头孢托比唑、头孢托洛唑/他唑巴坦、达尔巴万星和磷霉素。专家意见:加拿大HABP和VABP的经验性抗菌治疗继续关注疾病的严重程度和患者是否存在抗微生物耐药性的风险因素。新型静脉注射抗菌药物在HABP和VABP经验性治疗中的作用取决于其抗菌活性、已发表的疗效和安全性数据以及加拿大卫生部批准的适应症的影响。
{"title":"Hospital-acquired bacterial pneumonia (HABP) and ventilator-associated bacterial pneumonia (VABP) in Canada: treatment update and the role of new IV antimicrobials.","authors":"Coleman Rotstein,&nbsp;Joseph P Lynch,&nbsp;George G Zhanel","doi":"10.1080/14787210.2023.2268287","DOIUrl":"10.1080/14787210.2023.2268287","url":null,"abstract":"<p><strong>Introduction: </strong>Hospital-acquired bacterial pneumonia (HABP) and ventilator-associated bacterial pneumonia (VABP) continue to be common infections causing significant morbidity and mortality worldwide. The timely initiation of empiric antimicrobial therapy is essential. In this paper, we provide a focused expert opinion on the current and potential empiric antimicrobial treatment options in HABP and VABP in Canada influenced by antimicrobial resistance impacting the use of older agents as well as available new intravenous (IV) antimicrobials.</p><p><strong>Areas covered: </strong>The authors discuss treatment options for HABP and VABP in Canada. In addition, we focus on the potential role of new IV antimicrobials recently introduced to Canada. A literature search of HABP and VABP treatments was performed via PubMed (up to March 2023), using the following key words: monotherapy, combination therapy, aminoglycosides, carbapenems, cephalosporins, fluoroquinolones, penicillins as well as amoxicillin/clavulanate, ceftobiprole, ceftolozane/tazobactam, dalbavancin, and fosfomycin.</p><p><strong>Expert opinion: </strong>Empiric antimicrobial treatment for HABP and VABP in Canada continues to focus on both the severity of illness and the presence/absence of patient risk factors for antimicrobial resistance. The role of new IV antimicrobials in the empiric treatment for HABP and VABP depends on their antimicrobial activity and published data on efficacy and safety and influenced by Health Canada-approved indications.</p>","PeriodicalId":12213,"journal":{"name":"Expert Review of Anti-infective Therapy","volume":" ","pages":"1-13"},"PeriodicalIF":5.7,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41125075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Point prevalence probing of antimicrobial prescription patterns from a developing country. 发展中国家抗菌药物处方模式的点流行率调查。
IF 5.7 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2023-09-15 DOI: 10.1080/14787210.2023.2259098
Nazia Khursheed, Qadeer Ahsan, Salima Rattani, Madeeha Fatima, Ali Raza, Saba Tariq, Tauqeer Mustafa, Kamran Ahmed, Sadia Iqbal, Sibgha Zulfiqar, Syed Masroor Ahmed, Ghulam Fatima, Shehzad Akbar Khan, Farman Ullah, Rana Altaf Ahmed, Saba Jamal

Background: Irrational use of antibiotics intensifies resistance and jeopardizes advances made in modern medicine. We aimed to conduct a baseline gap analysis survey on antibiotic prescription practices across Pakistan.

Research design and methods: This multi-centered cross-sectional survey was conducted at six public sector tertiary care hospitals from February 2021 to March 2021. Data related to various variables including hospital infrastructure, policies and practices, monitoring and feedback, and epidemiological, clinical, and antibiotic prescription for surveyed patients was collected using World Health Organization (WHO) Point Prevalence Survey (PPS) methodology.

Results: In a survey of 837 inpatients, 78.5% were prescribed antibiotics. Most commonly prescribed antimicrobial was ceftriaxone (21.7%), followed by metronidazole (17.3%), cefoperazone-sulbactam (8.4%), amoxicillin-clavulanate (6.3%), and piperacillin/tazobactam (5.9%). Surgical prophylaxis (36.7%) and community-acquired infections (24.7%) were the main reasons for antibiotic prescriptions. Single antibiotics were given to 46.7% of patients, 39.9% received a combination of two antibiotics, and 12.5% were prescribed three or more antibiotics. Among six hospitals surveyed, two had drug and therapeutic committees, three had infection prevention and control committees, and one had an antibiotic formulary.

Conclusion: Findings demonstrate high consumption of broad-spectrum antimicrobials and emphasize the importance of expanding antimicrobial stewardship programs among hospitals. Mentoring clinical teams could help rationalize antimicrobial use.

背景:抗生素的不合理使用加剧了耐药性,危及现代医学的进步。我们旨在对巴基斯坦各地的抗生素处方做法进行基线差距分析调查。研究设计和方法:这项多中心的横断面调查于2021年2月至2021年3月在六家公立三级护理医院进行。使用世界卫生组织(世界卫生组织)点流行率调查(PPS)方法收集与各种变量相关的数据,包括医院基础设施、政策和实践、监测和反馈,以及受访患者的流行病学、临床和抗生素处方。结果:在对837名住院患者的调查中,78.5%的患者服用了抗生素。最常用的抗菌药物是头孢曲松(21.7%),其次是甲硝唑(17.3%)、头孢哌酮-舒巴坦(8.4%)、阿莫西林-克拉维酸盐(6.3%)和哌拉西林/他唑巴坦(5.9%)。手术预防(36.7%)和社区获得性感染(24.7%)是开具抗菌药物处方的主要原因。46.7%的患者服用单一抗生素,39.9%的患者服用两种抗生素的组合,12.5%的患者服用三种或三种以上抗生素。在接受调查的六家医院中,两家有药物和治疗委员会,三家有感染预防和控制委员会,一家有抗生素处方。结论:研究结果表明,广谱抗菌药物的消费量很高,并强调了在医院中扩大抗菌药物管理计划的重要性。指导临床团队可以帮助合理使用抗菌药物。
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引用次数: 0
Impact of some antiviral drugs on health care utilization for patients with COVID-19: a systematic review and meta-analysis. 部分抗病毒药物对COVID-19患者医疗保健利用的影响:系统综述和荟萃分析
IF 5.7 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2023-09-05 DOI: 10.1080/14787210.2023.2254491
Bincai Wei, Ruhao Zhang, Huatang Zeng, Liqun Wu, Rongxin He, Junyao Zheng, Hao Xue, Jinlin Liu, Fengchao Liang, Bin Zhu

Background: We aimed to assess the impact of antiviral drugs (fluvoxamine,remdesivir, lopinavir/ritonavir (LPV/r), molnupiravir, andnirmatrelvir/ritonavir (NRV/r)) on health care utilization (HCU) inCOVID-19 patients. We summarized findings from randomized controlledtrials (RCTs) and observational studies.

Methods: We systematically searched four medical databases (PubMed, Web of Science, Embase, Cochrane Library) for COVID-19 studies up to February 15, 2023. A comprehensive review, meta-analysis, sensitivity analysis, and subgroup analysis were conducted. Pooled effects with 95% confidence intervals (CIs) were calculated for antiviral drugs' impact on hospitalization, mechanical ventilation (MV), and intensive care unit (ICU) outcomes.

Results: Our analysis included 34 studies (584,978 patients). Meta-analysisindicated potential benefits: remdesivir and molnupiravir potentiallyreduced MV risk, and NRV/r correlated with lower hospitalizationrates. However, LPV/r did not notably curb HCU. Remdesivir waspreferable for high-risk COVID-19 patients, while molnupiravir andNRV/r were recommended for those aged 60 and above.

Conclusion: Remdesivir, molnupiravir, and NRV/r may reduce HCU during the COVID-19 pandemic. However, due to limited study details and significant heterogeneity in effect estimates, further precise evidence is crucial, especially concerning emerging variants.

背景:我们旨在评估抗病毒药物(氟伏沙明、瑞德西韦、洛匹那韦/利托那韦(LPV/r)、莫努匹拉韦和尼马特利韦/利托那韦(NRV/r))对covid -19患者医疗保健利用(HCU)的影响。我们总结了随机对照试验(rct)和观察性研究的结果。方法:系统检索截至2023年2月15日的4个医学数据库(PubMed、Web of Science、Embase、Cochrane Library),检索COVID-19研究。进行综合评价、荟萃分析、敏感性分析和亚组分析。以95%置信区间(ci)计算抗病毒药物对住院、机械通气(MV)和重症监护病房(ICU)结局的综合效应。结果:我们的分析包括34项研究(584,978例患者)。荟萃分析显示了潜在的益处:remdesivir和molnupiravir可能降低MV风险,NRV/r与较低的住院率相关。然而,LPV/r并没有显著抑制HCU。高危COVID-19患者优先使用Remdesivir, 60岁及以上患者推荐使用molnupiravir和nrv /r。结论:Remdesivir、molnupiravir和NRV/r可降低COVID-19大流行期间的HCU。然而,由于有限的研究细节和效果估计的显著异质性,进一步的精确证据是至关重要的,特别是关于新出现的变异。
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引用次数: 0
Nirmatrelvir and ritonavir combination: an antiviral therapy for COVID-19. Nirmatrevir和利托那韦联合用药:新冠肺炎的抗病毒治疗。
IF 5.7 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2023-07-01 Epub Date: 2023-08-01 DOI: 10.1080/14787210.2023.2241638
Gangireddy Navitha Reddy, Akanksha Jogvanshi, Sana Naikwadi, Rajesh Sonti

Introduction: The emergence of the Omicron SARS-CoV-2 variant of concern in late November 2021 presaged yet another stage of the COVID-19 pandemic. Paxlovid, a co-packaged dosage form of two antiviral drugs (nirmatrelvir and ritonavir) developed by Pfizer, received its first FDA Emergency Use Authorization (EUA) and conditional marketing by European Medical Agency in patients at high risk of developing severe COVID-19.

Areas covered: We reviewed the timeline of the drug nirmatrelvir from its discovery to authorization by FDA. After 1 year of its authorization, numerous studies and reports on paxlovid's use and post-use consequences are available. This review summarizes the complete journey of paxlovid from its development, preclinical studies, clinical trials, regulatory approvals, ongoing clinical trials, and safety measures, followed by discussions on recent updates on drug-drug interactions, adverse effects, and relapse of COVID-19.

Expert opinion: Paxlovid, a new oral antiviral therapy for COVID-19, has shown promising results in clinical trials and has the potential to be effective against the pandemic, particularly for individuals at high risk of severe illness. Comorbidity usage and pharmacovigilance will play a significant stake in the future of paxlovid development. Second-generation Mpro inhibitors play an important role in the upcoming problems associated with COVID-19.

简介:2021年11月下旬令人担忧的奥密克戎SARS-CoV-2变种的出现预示着新冠肺炎大流行的又一阶段。奈玛特韦片/利托那韦片组合包装是辉瑞公司开发的两种抗病毒药物(尼马特雷韦和利托那韦)的联合包装剂型,获得了美国食品药品监督管理局的首次紧急使用授权(EUA),并由欧洲医疗机构有条件地在患有严重COVID-19的高风险患者中上市。涉及的领域:我们回顾了尼马特雷维尔药物从发现到获得美国食品药品管理局授权的时间表。在获得授权1年后,可获得关于奈玛特韦片/利托那韦片组合包装的使用和使用后后果的大量研究和报告。这篇综述总结了奈玛特韦片/利托那韦片组合包装从开发、临床前研究、临床试验、监管批准、正在进行的临床试验和安全性措施的完整历程,随后讨论了药物相互作用、不良反应和新冠肺炎复发的最新进展,在临床试验中显示出了有希望的结果,并有可能对新冠肺炎有效,特别是对重症高危人群。合并症的使用和药物警戒将在奈玛特韦片/利托那韦片组合包装的未来发展中发挥重要作用。二代Mpro抑制剂在即将到来的新冠肺炎相关问题中发挥着重要作用。
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引用次数: 1
Overcoming clinical challenges in the management of invasive fungal infections in low- and middle-income countries (LMIC). 克服低收入和中等收入国家侵袭性真菌感染管理方面的临床挑战。
IF 5.7 2区 医学 Q1 INFECTIOUS DISEASES Pub Date : 2023-07-01 Epub Date: 2023-09-12 DOI: 10.1080/14787210.2023.2257895
Arunaloke Chakrabarti, Atul K Patel, Rajeev Soman, Subhash Todi

Introduction: The management of invasive fungal infections (IFIs) in low- and middle-income countries (LMIC) is a serious challenge due to limited epidemiology studies, sub-optimal laboratory facilities, gap in antifungal management training and resources. Limited studies highlighted distinctive epidemiology of IFIs in those countries, and difficulty in distinguishing from closely related infections. To overcome the gaps for appropriate management of IFIs, innovative approaches are required.

Areas covered: Extensive literature search and discussion with experts have helped us to summarize the epidemiology, diagnostic and management difficulties in managing IFIs in LMIC, and recommend certain solutions to overcome the challenges.

Expert opinion: The strategies to overcome the challenges in diagnosis may include local epidemiology study, training of healthcare workers, association of fungal infections with already existing budgeted national programs, development and incorporation of point-of-care test (POCT) for prompt diagnosis, simplifying clinical diagnostic criteria suitable for LMIC, judicious use of available expertise, and diagnostic stewardship. For management strategies judicious use of antifungal, partnering with industry for inexpensive antifungal agents, development of LMIC specific guidelines for cost-effective management of IFIs and fungal outbreaks, improvement of infection control practices, advocacy for implementation of WHO recommended antifungal use, and integration of IFIs with public health.

引言:由于流行病学研究有限、实验室设施不理想、抗真菌管理培训和资源不足,低收入和中等收入国家的侵袭性真菌感染(IFI)管理是一项严峻的挑战。有限的研究强调了这些国家IFI的独特流行病学,以及难以区分密切相关的感染。为了克服国际单项体育联合会适当管理方面的差距,需要采取创新办法。涵盖领域:广泛的文献检索和与专家的讨论帮助我们总结了LMIC中管理IFI的流行病学、诊断和管理困难,并提出了克服这些挑战的某些解决方案。专家意见:克服诊断挑战的策略可能包括当地流行病学研究、医护人员培训、真菌感染与现有预算国家计划的关联、开发和纳入即时诊断的护理点测试(POCT)、简化适用于LMIC的临床诊断标准,明智地使用现有的专业知识和诊断管理。对于管理策略,明智地使用抗真菌药物,与廉价抗真菌药物行业合作,制定LMIC特定指南,对IFI和真菌疫情进行成本效益管理,改进感染控制实践,倡导实施世界卫生组织推荐的抗真菌药物使用,并将IFI与公共卫生相结合。
{"title":"Overcoming clinical challenges in the management of invasive fungal infections in low- and middle-income countries (LMIC).","authors":"Arunaloke Chakrabarti,&nbsp;Atul K Patel,&nbsp;Rajeev Soman,&nbsp;Subhash Todi","doi":"10.1080/14787210.2023.2257895","DOIUrl":"10.1080/14787210.2023.2257895","url":null,"abstract":"<p><strong>Introduction: </strong>The management of invasive fungal infections (IFIs) in low- and middle-income countries (LMIC) is a serious challenge due to limited epidemiology studies, sub-optimal laboratory facilities, gap in antifungal management training and resources. Limited studies highlighted distinctive epidemiology of IFIs in those countries, and difficulty in distinguishing from closely related infections. To overcome the gaps for appropriate management of IFIs, innovative approaches are required.</p><p><strong>Areas covered: </strong>Extensive literature search and discussion with experts have helped us to summarize the epidemiology, diagnostic and management difficulties in managing IFIs in LMIC, and recommend certain solutions to overcome the challenges.</p><p><strong>Expert opinion: </strong>The strategies to overcome the challenges in diagnosis may include local epidemiology study, training of healthcare workers, association of fungal infections with already existing budgeted national programs, development and incorporation of point-of-care test (POCT) for prompt diagnosis, simplifying clinical diagnostic criteria suitable for LMIC, judicious use of available expertise, and diagnostic stewardship. For management strategies judicious use of antifungal, partnering with industry for inexpensive antifungal agents, development of LMIC specific guidelines for cost-effective management of IFIs and fungal outbreaks, improvement of infection control practices, advocacy for implementation of WHO recommended antifungal use, and integration of IFIs with public health.</p>","PeriodicalId":12213,"journal":{"name":"Expert Review of Anti-infective Therapy","volume":" ","pages":"1057-1070"},"PeriodicalIF":5.7,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10204744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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Expert Review of Anti-infective Therapy
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