The Experts below are selected from a list of 12756 Experts worldwide ranked by ideXlab platform
Christopher M Parry - One of the best experts on this subject based on the ideXlab platform.
-
suitable disk antimicrobial susceptibility breakpoints defining salmonella enterica serovar typhi isolates with reduced susceptibility to fluoroquinolones
Antimicrobial Agents and Chemotherapy, 2010Co-Authors: Christopher M Parry, Chau Tran Thuy, Sabina Dongol, Abhilasha Karkey, Ha Vinh, Nguyen Tran Chinh, Pham Thanh Duy, Tran Vu Thieu Nga, James Campbell, Nguyen Van Minh HoangAbstract:Infections with Salmonella enterica serovar Typhi isolates that have reduced susceptibility to Ofloxacin (MIC ≥ 0.25 μg/ml) or ciprOfloxacin (MIC ≥ 0.125 μg/ml) have been associated with a delayed response or clinical failure following treatment with these antimicrobials. These isolates are not detected as resistant using current disk susceptibility breakpoints. We examined 816 isolates of S. Typhi from seven Asian countries. Screening for nalidixic acid resistance (MIC ≥ 16 μg/ml) identified isolates with an Ofloxacin MIC of ≥0.25 μg/ml with a sensitivity of 97.3% (253/260) and specificity of 99.3% (552/556). For isolates with a ciprOfloxacin MIC of ≥0.125 μg/ml, the sensitivity was 92.9% (248/267) and specificity was 98.4% (540/549). A zone of inhibition of ≤28 mm around a 5-μg Ofloxacin disc detected strains with an Ofloxacin MIC of ≥0.25 μg/ml with a sensitivity of 94.6% (246/260) and specificity of 94.2% (524/556). A zone of inhibition of ≤30 mm detected isolates with a ciprOfloxacin MIC of ≥0.125 μg/ml with a sensitivity of 94.0% (251/267) and specificity of 94.2% (517/549). An Ofloxacin MIC of ≥0.25 μg/ml and a ciprOfloxacin MIC of ≥0.125 μg/ml detected 74.5% (341/460) of isolates with an identified quinolone resistance-inducing mutation and 81.5% (331/406) of the most common mutant (carrying a serine-to-phenylalanine mutation at codon 83 in the gyrA gene). Screening for nalidixic acid resistance or ciprOfloxacin and Ofloxacin disk inhibition zone are suitable for detecting S. Typhi isolates with reduced fluoroquinolone susceptibility.
-
randomized controlled comparison of Ofloxacin azithromycin and an Ofloxacin azithromycin combination for treatment of multidrug resistant and nalidixic acid resistant typhoid fever
Antimicrobial Agents and Chemotherapy, 2007Co-Authors: Christopher M Parry, Vo Anh Ho, Le Thi Phuong, Mai Ngoc Lanh, Le Thanh Tung, Nguyen Thi Hong Tham, John Wain, Tran Tinh HienAbstract:Isolates of Salmonella enterica serovar Typhi that are multidrug resistant (MDR, resistant to chloramphenicol, ampicillin, and trimethoprim-sulfamethoxazole) and have reduced susceptibility to fluoroquinolones (nalidixic acid resistant, Nar) are common in Asia. The optimum treatment for infections caused by such isolates is not established. This study compared different antimicrobial regimens for the treatment of MDR/Nar typhoid fever. Vietnamese children and adults with uncomplicated typhoid fever were entered into an open randomized controlled trial. Ofloxacin (20 mg/kg of body weight/day for 7 days), azithromycin (10 mg/kg/day for 7 days), and Ofloxacin (15 mg/kg/day for 7 days) combined with azithromycin (10 mg/kg/day for the first 3 days) were compared. Of the 241 enrolled patients, 187 were eligible for analysis (186 S. enterica serovar Typhi, 1 Salmonella enterica serovar Paratyphi A). Eighty-seven percent (163/187) of the patients were children; of the S. enterica serovar Typhi isolates, 88% (165/187) were MDR and 93% (173/187) were Nar. The clinical cure rate was 64% (40/63) with Ofloxacin, 76% (47/62) with Ofloxacin-azithromycin, and 82% (51/62) with azithromycin (P = 0.053). The mean (95% confidence interval [CI]) fever clearance time for patients treated with azithromycin (5.8 days [5.1 to 6.5 days]) was shorter than that for patients treated with Ofloxacin-azithromycin (7.1 days [6.2 to 8.1 days]) and Ofloxacin (8.2 days [7.2 to 9.2 days]) (P < 0.001). Positive fecal carriage immediately posttreatment was detected in 19.4% (12/62) of patients treated with Ofloxacin, 6.5% (4/62) of those treated with the combination, and 1.6% (1/62) of those treated with azithromycin (P = 0.006). Both antibiotics were well tolerated. Uncomplicated typhoid fever due to isolates of MDR S. enterica serovar Typhi with reduced susceptibility to fluoroquinolones (Nar) can be successfully treated with a 7-day course of azithromycin.
-
the treatment of multidrug resistant and nalidixic acid resistant typhoid fever in viet nam
Transactions of The Royal Society of Tropical Medicine and Hygiene, 2004Co-Authors: Christopher M ParryAbstract:Abstract Multidrug-resistant (MDR) Salmonella Typhi (resistant to chloramphenicol, ampicillin, and trimethoprim–sulphamethoxazole) and isolates with reduced susceptibility to fluoroquinolones (indicated by resistance to nalidixic acid, NaR) have caused epidemics and become endemic in southern Viet Nam during the 1990s. Short courses of Ofloxacin have proved acceptable for treating MDR/NaS isolates of S. Typhi (Ofloxacin MIC90=0.06 mg/l) causing uncomplicated disease. Ofloxacin (10–15 mg/kg/d) given for 2, 3, or 5 d cured >90% of patients with an average fever clearance time (FCT) of 4 d. Less than 3% of patients relapsed or had a positive post-treatment stool culture. In contrast, the response of NaR isolates (Ofloxacin MIC90=0.5 mg/l) to such regimens is poor. For example, Ofloxacin (20 mg/kg/d) given for 7 d cured only 75% of patients, with an FCT of 7 d, and 19% of patients had positive post-treatment faecal cultures. Currently available alternatives for NaR infections include ceftriaxone, cefixime, and azithromycin. These antimicrobials are reasonably effective but expensive. New, effective, and affordable regimens are needed to treat these NaR infections. Short courses of the new generation fluoroquinolones or combinations of the available antimicrobials are possible options.
Tran Tinh Hien - One of the best experts on this subject based on the ideXlab platform.
-
randomized controlled comparison of Ofloxacin azithromycin and an Ofloxacin azithromycin combination for treatment of multidrug resistant and nalidixic acid resistant typhoid fever
Antimicrobial Agents and Chemotherapy, 2007Co-Authors: Christopher M Parry, Vo Anh Ho, Le Thi Phuong, Mai Ngoc Lanh, Le Thanh Tung, Nguyen Thi Hong Tham, John Wain, Tran Tinh HienAbstract:Isolates of Salmonella enterica serovar Typhi that are multidrug resistant (MDR, resistant to chloramphenicol, ampicillin, and trimethoprim-sulfamethoxazole) and have reduced susceptibility to fluoroquinolones (nalidixic acid resistant, Nar) are common in Asia. The optimum treatment for infections caused by such isolates is not established. This study compared different antimicrobial regimens for the treatment of MDR/Nar typhoid fever. Vietnamese children and adults with uncomplicated typhoid fever were entered into an open randomized controlled trial. Ofloxacin (20 mg/kg of body weight/day for 7 days), azithromycin (10 mg/kg/day for 7 days), and Ofloxacin (15 mg/kg/day for 7 days) combined with azithromycin (10 mg/kg/day for the first 3 days) were compared. Of the 241 enrolled patients, 187 were eligible for analysis (186 S. enterica serovar Typhi, 1 Salmonella enterica serovar Paratyphi A). Eighty-seven percent (163/187) of the patients were children; of the S. enterica serovar Typhi isolates, 88% (165/187) were MDR and 93% (173/187) were Nar. The clinical cure rate was 64% (40/63) with Ofloxacin, 76% (47/62) with Ofloxacin-azithromycin, and 82% (51/62) with azithromycin (P = 0.053). The mean (95% confidence interval [CI]) fever clearance time for patients treated with azithromycin (5.8 days [5.1 to 6.5 days]) was shorter than that for patients treated with Ofloxacin-azithromycin (7.1 days [6.2 to 8.1 days]) and Ofloxacin (8.2 days [7.2 to 9.2 days]) (P < 0.001). Positive fecal carriage immediately posttreatment was detected in 19.4% (12/62) of patients treated with Ofloxacin, 6.5% (4/62) of those treated with the combination, and 1.6% (1/62) of those treated with azithromycin (P = 0.006). Both antibiotics were well tolerated. Uncomplicated typhoid fever due to isolates of MDR S. enterica serovar Typhi with reduced susceptibility to fluoroquinolones (Nar) can be successfully treated with a 7-day course of azithromycin.
John Wain - One of the best experts on this subject based on the ideXlab platform.
-
randomized controlled comparison of Ofloxacin azithromycin and an Ofloxacin azithromycin combination for treatment of multidrug resistant and nalidixic acid resistant typhoid fever
Antimicrobial Agents and Chemotherapy, 2007Co-Authors: Christopher M Parry, Vo Anh Ho, Le Thi Phuong, Mai Ngoc Lanh, Le Thanh Tung, Nguyen Thi Hong Tham, John Wain, Tran Tinh HienAbstract:Isolates of Salmonella enterica serovar Typhi that are multidrug resistant (MDR, resistant to chloramphenicol, ampicillin, and trimethoprim-sulfamethoxazole) and have reduced susceptibility to fluoroquinolones (nalidixic acid resistant, Nar) are common in Asia. The optimum treatment for infections caused by such isolates is not established. This study compared different antimicrobial regimens for the treatment of MDR/Nar typhoid fever. Vietnamese children and adults with uncomplicated typhoid fever were entered into an open randomized controlled trial. Ofloxacin (20 mg/kg of body weight/day for 7 days), azithromycin (10 mg/kg/day for 7 days), and Ofloxacin (15 mg/kg/day for 7 days) combined with azithromycin (10 mg/kg/day for the first 3 days) were compared. Of the 241 enrolled patients, 187 were eligible for analysis (186 S. enterica serovar Typhi, 1 Salmonella enterica serovar Paratyphi A). Eighty-seven percent (163/187) of the patients were children; of the S. enterica serovar Typhi isolates, 88% (165/187) were MDR and 93% (173/187) were Nar. The clinical cure rate was 64% (40/63) with Ofloxacin, 76% (47/62) with Ofloxacin-azithromycin, and 82% (51/62) with azithromycin (P = 0.053). The mean (95% confidence interval [CI]) fever clearance time for patients treated with azithromycin (5.8 days [5.1 to 6.5 days]) was shorter than that for patients treated with Ofloxacin-azithromycin (7.1 days [6.2 to 8.1 days]) and Ofloxacin (8.2 days [7.2 to 9.2 days]) (P < 0.001). Positive fecal carriage immediately posttreatment was detected in 19.4% (12/62) of patients treated with Ofloxacin, 6.5% (4/62) of those treated with the combination, and 1.6% (1/62) of those treated with azithromycin (P = 0.006). Both antibiotics were well tolerated. Uncomplicated typhoid fever due to isolates of MDR S. enterica serovar Typhi with reduced susceptibility to fluoroquinolones (Nar) can be successfully treated with a 7-day course of azithromycin.
Nguyen Van Minh Hoang - One of the best experts on this subject based on the ideXlab platform.
-
suitable disk antimicrobial susceptibility breakpoints defining salmonella enterica serovar typhi isolates with reduced susceptibility to fluoroquinolones
Antimicrobial Agents and Chemotherapy, 2010Co-Authors: Christopher M Parry, Chau Tran Thuy, Sabina Dongol, Abhilasha Karkey, Ha Vinh, Nguyen Tran Chinh, Pham Thanh Duy, Tran Vu Thieu Nga, James Campbell, Nguyen Van Minh HoangAbstract:Infections with Salmonella enterica serovar Typhi isolates that have reduced susceptibility to Ofloxacin (MIC ≥ 0.25 μg/ml) or ciprOfloxacin (MIC ≥ 0.125 μg/ml) have been associated with a delayed response or clinical failure following treatment with these antimicrobials. These isolates are not detected as resistant using current disk susceptibility breakpoints. We examined 816 isolates of S. Typhi from seven Asian countries. Screening for nalidixic acid resistance (MIC ≥ 16 μg/ml) identified isolates with an Ofloxacin MIC of ≥0.25 μg/ml with a sensitivity of 97.3% (253/260) and specificity of 99.3% (552/556). For isolates with a ciprOfloxacin MIC of ≥0.125 μg/ml, the sensitivity was 92.9% (248/267) and specificity was 98.4% (540/549). A zone of inhibition of ≤28 mm around a 5-μg Ofloxacin disc detected strains with an Ofloxacin MIC of ≥0.25 μg/ml with a sensitivity of 94.6% (246/260) and specificity of 94.2% (524/556). A zone of inhibition of ≤30 mm detected isolates with a ciprOfloxacin MIC of ≥0.125 μg/ml with a sensitivity of 94.0% (251/267) and specificity of 94.2% (517/549). An Ofloxacin MIC of ≥0.25 μg/ml and a ciprOfloxacin MIC of ≥0.125 μg/ml detected 74.5% (341/460) of isolates with an identified quinolone resistance-inducing mutation and 81.5% (331/406) of the most common mutant (carrying a serine-to-phenylalanine mutation at codon 83 in the gyrA gene). Screening for nalidixic acid resistance or ciprOfloxacin and Ofloxacin disk inhibition zone are suitable for detecting S. Typhi isolates with reduced fluoroquinolone susceptibility.
Vo Anh Ho - One of the best experts on this subject based on the ideXlab platform.
-
randomized controlled comparison of Ofloxacin azithromycin and an Ofloxacin azithromycin combination for treatment of multidrug resistant and nalidixic acid resistant typhoid fever
Antimicrobial Agents and Chemotherapy, 2007Co-Authors: Christopher M Parry, Vo Anh Ho, Le Thi Phuong, Mai Ngoc Lanh, Le Thanh Tung, Nguyen Thi Hong Tham, John Wain, Tran Tinh HienAbstract:Isolates of Salmonella enterica serovar Typhi that are multidrug resistant (MDR, resistant to chloramphenicol, ampicillin, and trimethoprim-sulfamethoxazole) and have reduced susceptibility to fluoroquinolones (nalidixic acid resistant, Nar) are common in Asia. The optimum treatment for infections caused by such isolates is not established. This study compared different antimicrobial regimens for the treatment of MDR/Nar typhoid fever. Vietnamese children and adults with uncomplicated typhoid fever were entered into an open randomized controlled trial. Ofloxacin (20 mg/kg of body weight/day for 7 days), azithromycin (10 mg/kg/day for 7 days), and Ofloxacin (15 mg/kg/day for 7 days) combined with azithromycin (10 mg/kg/day for the first 3 days) were compared. Of the 241 enrolled patients, 187 were eligible for analysis (186 S. enterica serovar Typhi, 1 Salmonella enterica serovar Paratyphi A). Eighty-seven percent (163/187) of the patients were children; of the S. enterica serovar Typhi isolates, 88% (165/187) were MDR and 93% (173/187) were Nar. The clinical cure rate was 64% (40/63) with Ofloxacin, 76% (47/62) with Ofloxacin-azithromycin, and 82% (51/62) with azithromycin (P = 0.053). The mean (95% confidence interval [CI]) fever clearance time for patients treated with azithromycin (5.8 days [5.1 to 6.5 days]) was shorter than that for patients treated with Ofloxacin-azithromycin (7.1 days [6.2 to 8.1 days]) and Ofloxacin (8.2 days [7.2 to 9.2 days]) (P < 0.001). Positive fecal carriage immediately posttreatment was detected in 19.4% (12/62) of patients treated with Ofloxacin, 6.5% (4/62) of those treated with the combination, and 1.6% (1/62) of those treated with azithromycin (P = 0.006). Both antibiotics were well tolerated. Uncomplicated typhoid fever due to isolates of MDR S. enterica serovar Typhi with reduced susceptibility to fluoroquinolones (Nar) can be successfully treated with a 7-day course of azithromycin.
