- |||||||||| Orencia (abatacept) / BMS
Post-Transplant Cyclophosphamide, Abatacept, and Short Course of Tacrolimus Combination (CAST) Is Safe and Seems Highly Effective in Preventing Graft-Versus-Host Disease Following Haploidentical Peripheral Blood Stem Cell Transplantation (GWCC - Hall B5, Level 1) - Nov 5, 2021 - Abstract #ASH2021ASH_5606;
However, a recent registry study showed increased incidence GvHD and inferior outcomes in patients receiving haploidentical SCT with PTCy, tacrolimus and mycophenolate mofetil for GvHD prevention as opposed to matched unrelated donor SCT with PTCy-based GvHD prevention...In early studies, abatacept has shown promising results when added to methotrexate and tacrolimus in matched and mismatched donor SCT...All patients received standard supportive care including levofloxacin until neutrophil engraftment, posaconazole until day +75, acyclovir for 1 year and, if CMV positive by serology, letermovir until day +100...One patient had EBV reactivation and required preemptive therapy with 2 weekly rituximab doses...The study is accruing actively and the results of a larger cohort with longer follow-up will be presented at the meeting. If confirmed, by improving the outcomes of haploidentical SCT, this regimen may further address a health care disparity issue, offering almost every patient in need of allogeneic SCT an alternative donor option with equal outcomes.
- |||||||||| Actemra IV (tocilizumab) / Roche, JW Pharma, Abecma (idecabtagene vicleucel) / BMS, 2seventy bio
Infectious Complications in Patients Treated with Idecabtagene Vicleucel for Relapsed and Refractory Multiple Myeloma (GWCC - Hall B5, Level 1) - Nov 5, 2021 - Abstract #ASH2021ASH_5537;
P1, P2
Of note, these results represent a cross study single institution subgroup analysis that may not reflect the complete trial data. The overall incidence of infection was similar to what has previously been reported in patients receiving CD-19 directed CAR T-cell therapy, even with persistent neutropenia after one month documented in 41% of patients.
- |||||||||| Efficacy and Safety of FLAG-Ida As Frontline Therapy in a Pediatric AML Population: A Single Institution Experience (GWCC - Hall B5, Level 1) - Nov 5, 2021 - Abstract #ASH2021ASH_3965;
The MRC AML15 trial randomized DA/ADE versus fludarabine-cytarabine-idarubicin (FLAG-Ida) and found superior event-free survival (EFS) from FLAG-Ida, with fewer cycles of intensive chemotherapy (4 vs 5), and less than half the cardiotoxic exposure, potentially reducing acute and long-term morbidity...Patients routinely received antimicrobial prophylaxis with sulfamethoxazole-trimethoprim, an azole or echinocandin, and levofloxacin...These data support our continued use of FLAG-Ida in pediatric AML alone or in combination with targeted and/or molecular therapies. Further study of FLAG-Ida as frontline therapy in children with AML is warranted.
- |||||||||| Actemra IV (tocilizumab) / Roche, JW Pharma
Risk of Infections with BCMA-Directed Immunotherapy in Multiple Myeloma (GWCC - Hall B5, Level 1) - Nov 5, 2021 - Abstract #ASH2021ASH_3206;
Standard antimicrobial prophylaxis included herpes zoster prophylaxis for all MM patients with antibacterial (levofloxacin) / antifungal (fluconazole) during periods of neutropenia and IVIG supplementation as per the treating physician’s discretion...Tocilizumab was used in 40.9% (bsAb -30.8% versus CAR-T 55.6%) patients for CRS...Conclusion : BCMA-targeted therapies seem to be associated with clinically significant bacterial and viral infections. Repetitive dosing with bsAb therapies could be the reason for the propensity to serious bacterial infections compared to CAR-T recipients and may need novel prophylaxis strategies.
- |||||||||| Quinsair (levofloxacin inhalational) / Horizon Therapeutics, Chiesi
Journal: Development and Optimization of Inhalable Levofloxacin Nanoparticles for The Treatment of Tuberculosis. (Pubmed Central) - Nov 4, 2021
The optimized formulation showed a mean particle size of 171.5 nm, sustained the drug release up to 24 h in simulated lung fluid, and revealed MMAD of 3.18 μm, which can confirm delivery of the drug to the deep lung region. However, further in vivo studies are required to design a suitable dosage regimen and establish the fate of nanoparticles for safe and efficacious delivery of the drug.
- |||||||||| rifampicin / Generic mfg.
Clinical, Journal: Impact of Antimicrobial Stewardship Bundle on Inpatient Use of Highly Bioavailable Antibacterials. (Pubmed Central) - Oct 31, 2021
Stewardship interventions were associated with decreased overall use and an increased enteral percentage of total use for both clindamycin and fluoroquinolones, although not metronidazole. These data provide an easy-to-collect benchmark for pediatric hospitals to compare IV with enteral use of highly bioavailable antibacterials within the context of overall antibacterial use.
- |||||||||| Journal: Effect of antimicrobials on Stenotrophomonas maltophilia biofilm. (Pubmed Central) - Oct 30, 2021
Gentamicin displayed surprising activity against S. maltophilia biofilms. Chloramphenicol was indicated as a good option against young S. maltophilia biofilms, and trimethoprim-sulfamethoxazole showed limited antibiofilm activity.
- |||||||||| levofloxacin / Generic mfg.
Preclinical, Journal: Protective effects of Re-yan-ning mixture on Streptococcus pneumonia in rats based on network pharmacology. (Pubmed Central) - Oct 30, 2021
Forty male SPF Sprague Dawley rats were divided into four groups of 10 rats: control (normal saline), model (normal saline), levofloxacin-intervened and RYNM-intervened groups...The RYNM exhibited its therapeutic effects on Streptococcus pneumonia mainly via the regulation of cell proliferation and survival through the IL-6/IL-10/IL-17, Bax/Bcl-2, COX-1/COX-2, NF-κB and TNF-α signalling pathways. The present study demonstrated the protective effects of RYNM on Streptococcus pneumonia, providing a potential mechanism for the treatment of bacterial pneumonia with RYNM.
- |||||||||| ampicillin / Generic mfg., clarithromycin / Generic mfg.
Review, Journal: Prevalence and impact of antimicrobial resistance in gastrointestinal infections: A review. (Pubmed Central) - Oct 30, 2021
The microorganisms that demonstrated the highest percentage of resistance were Helicobacter pylori (metronidazole 50%-80%, clarithromycin 20%-40%, and levofloxacin 30%-35%), Clostridioides difficile (clindamycin 8.3%-100%, cephalosporines 51%), Campylobacter jejuni and Campylobacter coli (fluoroquinolones 85%), Escherichia coli (ampicillin 76.5%), Entamoeba histolytica (metronidazole 50%), and bacterial peritonitis (third-generation cephalosporines 40%, methicillin 85%). Antimicrobial resistance is reaching elevated percentages, making it necessary to evaluate the situation of each patient, to successfully treat gastrointestinal infections.
- |||||||||| ceftriaxone / Generic mfg.
Clinical, Journal: Molecular Epidemiology and Characteristics of CTX-M-55 Extended-Spectrum β-Lactamase-Producing Escherichia coli From Guangzhou, China. (Pubmed Central) - Oct 30, 2021
However, the sensitivity rate of piperacillin/tazobactam, amoxicillin/clavulanate, and amikacin exceeded 90%...The most common structure was type II "ISEcp1-bla -ORF477." In conclusion, whether ST1193, which carries bla gene, will be an epidemic clone of this region in the future remains to be concerned. The plasmids IncI1 and IncFII, and mobile elements such as ISEcp1 and IS26 may be the main factors leading to the spread and prevalence of CTX-M-55 genotypes.
- |||||||||| Noxafil (posaconazole) / Merck (MSD)
Journal: A Unique Triad of Invasive Sinusitis, Brain Abscess with Focal Cerebritis, and COVID-19. (Pubmed Central) - Oct 29, 2021
Given these findings, his antibiotics were changed to meropenem and the amphotericin B dose was increased...He was advised to continue Posaconazole and levofloxacin but he could only afford levofloxacin...CONCLUSIONS Our patient had mild COVID-19 infection and presented with secondary infective complications, which are usually associated with an immunocompromised state, despite receiving no immunosuppressives. It is imperative that all clinicians treating COVID-19 be watchful for fungal or bacterial co-infections in patients with active SARS-CoV-2 infection, even if the presenting symptoms are mild, particularly if other risk factors are present.
- |||||||||| clarithromycin / Generic mfg.
Clinical, Journal: Rescue Therapies for Helicobacter pylori Infection in Foreign Patients Treated in Italy. (Pubmed Central) - Oct 28, 2021
To our knowledge, this is the first study assessing H. pylori eradication rates in foreigner patients, who failed at least one therapeutic attempt, managed in Italy. Even by using a culture-based approach, the infection was not cured in a definite number of patients.
- |||||||||| Xolair (omalizumab) / Roche, Novartis
Journal: State of the Art in Cystic Fibrosis Pharmacology Optimization of anti-microbials in the treatment of Cystic Fibrosis Pulmonary Exacerbations: III. Executive Summary. (Pubmed Central) - Oct 28, 2021
aureus) antibiotics include ceftaroline, clindamycin, fluoroquinolone derivatives (ciprofloxacin, levofloxacin), glycopeptide derivatives (telavancin, vancomycin), linezolid, rifampin, sulfamethoxazole/trimethoprim, and tetracycline derivatives (doxycycline, minocycline, tigecycline). Medications used for ABPA include corticosteroids, amphotericin B, azole anti-fungals (isavuconazole, itraconazole, posaconazole, and voriconazole), and a monoclonal antibody, omalizumab.
- |||||||||| daunorubicin / Generic mfg., levofloxacin / Generic mfg., cytarabine / Generic mfg.
[VIRTUAL] MUCORMICOSIS IN THE HEAD AND NECK REGION IN A PATIENT WITH ACUTE MYELOID LEUKEMIA: A CASE REPORT () - Oct 27, 2021 - Abstract #HEMO2021HEMO_1168;
such as sinusitis and periorbital cellulitis, with drainage of secretions by the rhinopharynx and oropharynx. In May 2021, the patient was diagnosed with mucormycosis in the periorbital region, also affecting the nasal cavity and left maxillary sinus. He presented a white blood cell count of 1510 leukocytes, 408 of which were neutrophils in peripheral blood. During the dental evaluation, a small nodule of fibrous consistency, approximately 0.1cm long, yellowish in color, was seen in the inserted gingiva region of the first upper left premolar, when a panoramic radiography and computed tomography of the beam were suggested and performed. conical to define the extent of the lesion. Culture was performed suggesting a diagnosis of fungal infection compatible with mucormycosis. Treatment with Isavuconazole and Levofloxacin was started. The patient died due to severe acute respiratory syndrome-Covid-19. It is concluded that a multidisciplinary approach in the diagnosis of patients with onco-hematological diseases is necessary to establish the correct treatment and monitoring of the diseases.
- |||||||||| [VIRTUAL] CASE REPORT: CEREBELLAR TOXICITY INDUCED BY CYTHARABINE DURING TREATMENT OF ACUTE MYELOID LEUKEMIA (AML) () - Oct 27, 2021 - Abstract #HEMO2021HEMO_395;
Initiated 7+3 protocol and RHZE (Rifampicin, Isoniazid, Pyrazinamide, Ethambutol). Evolution with sepsis, with worsening renal function requiring renal replacement therapy and worsening liver function (BT: 8.1; BD: 7.06; TGO: 182; TGP: 72; GGT: 124; FA: 316) tuberculostatic treatment being modified to amikacin, levofloxacin and ethambutol. With progressive improvement in renal function, hemodialysis was suspended and liver function improved. He underwent the first HIDAC cycle when he presented improving liver function (BT: 2.57 BD: 2.01 FA:81 and transaminases within normal limits) and mild loss of renal function (CKD-EPI: 71 mL/min x 1.73 m2). Two days after the end of this first HIDAC cycle, he developed dysarthria and ataxic gait. He underwent a cranial tomography without alterations, followed by a lumbar puncture with CSF collection and cranial magnetic resonance, both also without alterations. Assessed by the Neurology service, consistent with the hypothesis of neurotoxicity to Cytarabine. Methylprednisolone 1 mg/kg was started for four days, with partial improvement of symptoms. Discussion and Conclusion Cytarabine penetrates the central nervous system, but the pathophysiology of neurotoxicity is poorly understood and there is no effective treatment so far. Reports suggest the possibility of CSF removal and the use of methylprednisolone for patients with symptoms. So far, there is a suggestion that age, cumulative dose, liver and kidney dysfunction are the main risk factors, but without a clear definition of dose adjustment and adequate treatment. As neurotoxicity is a serious complication with a potential to reduce quality of life, the analysis of related factors and risk should be considered.
- |||||||||| clarithromycin / Generic mfg.
Retrospective data, Journal: The exposure of antibiotics on the eradication of bismuth quadruple therapy in H.pylori infection (Pubmed Central) - Oct 27, 2021
In patients newly diagnosed with H.pylori infection, the previous exposure to macrolide or quinolones antibiotics is related to lower eradiation rates of H. pylori. Although the exposure to nitroimidazole also indicates drug resistance to metronidazole, the clinical efficacy of BQT with metronidazole 400 mg four times a day is not affected.
- |||||||||| ciprofloxacin oral / Generic mfg., levofloxacin / Generic mfg.
Journal: Infectious keratitis: trends in microbiological and antibiotic sensitivity patterns. (Pubmed Central) - Oct 27, 2021
We documented an increasing trend in the percentage of gram positive bacteria. Levofloxacin monotherapy might still be a good option in patients with gram negative bacterial keratitis, however owing to increasing resistance of staphylococci to fluoroquinolones, a regimen consisting of a combination of fortified antibiotics may be more effective in staphylococcal keratitis.
- |||||||||| levofloxacin / Generic mfg.
Journal: New promising levofloxacin derivatives: Design, synthesis, cytotoxic activity screening, Topo2β polymerase inhibition assay, cell cycle apoptosis profile analysis. (Pubmed Central) - Oct 27, 2021
In addition, 3c, 3e and 4a showed a significant elevation in active caspase-3 levels (10.01, 8.98 and 10.71 folds, respectively). The effect of the new compounds on normal cells was also investigated including breast (MCF10a), liver (THLE2), and lymphocytic (PCS-800-011) normal cell lines.
- |||||||||| rifampicin / Generic mfg.
Journal: Antibiotic Susceptibility of Environmental Legionella pneumophila Strains Isolated in Northern Italy. (Pubmed Central) - Oct 27, 2021
MICs of azithromycin, erythromycin, ciprofloxacin, levofloxacin, and rifampicin were determined by the microdilution method using buffered yeast extract broth supplemented with α-ketoglutarate (BYEα)...Interestingly, one isolate was tested and found to be PCR-positive for the azithromycin LpeAB active efflux system, further confirmed by the reserpine/resazurin microtiter assay. In conclusion, this study has provided additional susceptibility data for environmental Legionella pneumophila isolates from Northern Italy demonstrating, in general, low MICs values for the tested antimicrobials, although one strain tested was shown to possess the LpeAB resistance determinant, indicating that future surveillance studies are warranted.
- |||||||||| ampicillin / Generic mfg., clarithromycin / Generic mfg.
Journal: Antimicrobial Resistance of Listeria monocytogenes Strains Isolated from Humans, Animals, and Food Products in Russia in 1950-1980, 2000-2005, and 2018-2021. (Pubmed Central) - Oct 25, 2021
Resistance to tylosin, ampicillin, enrofloxacin, linezolid, chloramphenicol, and tetracycline was found in less than 2%...Statistical analysis demonstrated that the temporal evolution of resistance in L. monocytogenes has an antibiotic-specific character. While resistance to some antibiotics such as ampicillin and penicillin G has gradually decreased in the population, resistance to other antibiotics acquired by particular strains in recent years has not been accompanied by changes in resistance of other strains.
- |||||||||| levofloxacin / Generic mfg.
Journal: Genetic and Phenotypic Characterization of the Novel Metallo-β-Lactamase NDM-29 From Escherichia coli. (Pubmed Central) - Oct 22, 2021
The susceptibility testing results showed 19NC225 was resistant to cephalosporins, carbapenems, combinations of β-lactam and β-lactamase inhibitors, and levofloxacin...The sequence results also indicated several important virulence genes. The findings of the novel carbapenemase NDM-29 could pose a threat to the control of antimicrobial resistance and arouse attention about the mutation of bacteria.
- |||||||||| levofloxacin / Generic mfg.
Journal: Effective production of multifunctional magnetic-sensitive biomaterial by an extrusion-based additive manufacturing technique. (Pubmed Central) - Oct 22, 2021
Highly loaded inks comprising iron-doped hydroxyapatite and β-tricalcium phosphate powders suspended in a chitosan-based solution, in the presence of levofloxacin (LEV) as model drug and magnetic nanoparticles (MNP), were developed...The addition of magnetic nanoparticles in the CaP-based inks leads to magnetic response and induction heating enhancements, due to ferro/ferrimagnetic interactions between the iron ions of doped CaP-based powders and the magnetic nanoparticles. Moreover, iron presence in crystalline structure of HA and -TCP enhances significantly human mesenchymal stem cell metabolic activity and proliferation.
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