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1.
Dan Med J ; 66(2)2019 Feb.
Article in English | MEDLINE | ID: mdl-30722825

ABSTRACT

INTRODUCTION: We aimed to investigate doctors' ad-herence to the local antibiotic guidelines for treatment of patients admitted with acute pharyngeal infections and to identify patient-related risk factors for non-adherence. METHODS: All patients with acute tonsillitis, peritonsillar abscess (PTA), and parapharyngeal abscess admitted to the Ear-Nose-Throat Department, Aarhus University Hospital, in the 2001-2014 period were included in the study. RESULTS: In total, 2,567 patients were hospitalised with acute pharyngeal infection. In non-allergic patients, penicillin was prescribed to 81%, either alone (48%) or in combination with metronidazole (33%). Macrolides (54%) and cefuroxime (44%) were the drugs of choice in 85 (98%) patients who were allergic to penicillin. Patients were prescribed antibiotics according to guidelines in 63% of cases. The addition of metronidazole to penicillin was the main (75% of cases) reason for non-adherence. Increasing patient age and male gender were independent risk factors for non-adherence. PTA patients treated according to the guidelines had a significantly shorter hospital stay than patients treated with additional metronidazole or broad-spectrum antibiotics. CONCLUSIONS: A significant (37%) proportion of patients with acute pharyngeal infections were treated non-adherently to antibiotic guidelines, mainly because of (inappropriate) addition of metronidazole to penicillin. FUNDING: This work was supported by the Lundbeck Foundation (Grant number R185-2014-2482). TRIAL REGISTRATION: The study was approved by the Danish Data Protection Agency.


Subject(s)
Anti-Bacterial Agents/therapeutic use , Drug Prescriptions/statistics & numerical data , Guideline Adherence/statistics & numerical data , Penicillins/therapeutic use , Pharyngeal Diseases/drug therapy , Acute Disease , Adult , Anti-Bacterial Agents/standards , Denmark , Drug Prescriptions/standards , Female , Humans , Male , Metronidazole/standards , Metronidazole/therapeutic use , Middle Aged , Penicillins/standards , Peritonsillar Abscess/drug therapy , Peritonsillar Abscess/microbiology , Pharyngeal Diseases/microbiology , Tonsillitis/drug therapy
2.
Dynamis (Granada) ; 37(1): 159-186, 2017. tab
Article in Portuguese | IBECS | ID: ibc-160917

ABSTRACT

Portugal foi um dos primeiros países do mundo, não participantes na II Guerra Mundial, a obter penicilina para uso civil. Em 1944 o medicamento começou a ser importado dos Estados Unidos da América pela Cruz Vermelha Portuguesa, mas como as quantidades eram escassas a sua distribuição foi confiada a uma comissão controladora constituída pela instituição. Em 1945, com o aumento da produção mundial, a penicilina foi integrada no circuito comercial de venda de medicamentos. A Comissão Reguladora dos Produtos Químicos e Farmacêuticos, fundada em 1940, enquadrada na política normalizadora do Estado Novo, com a finalidade de tutelar a atividade farmacêutica e o comércio dos medicamentos, exerceu um importante papel na regulação da venda do antibiótico. Entre 1945 e 1947 a penicilina foi importada como medicamento. A partir de 1947 a penicilina começou a ser importada como matéria-prima e em 1948 foram lançadas no mercado as primeiras especialidades farmacêuticas com penicilina preparadas em Portugal. Para garantir a qualidade dos medicamentos e minimizar a existência de produtos sem eficácia terapêutica comprovada a Comissão Reguladora dos Produtos Químicos e Farmacêuticos estabeleceu, em 1942, um laboratório para proceder à verificação analítica de medicamentos e produtos medicinais. Somente a partir de 1948, após o início da produção nacional de medicamentos com penicilina, é que o antibiótico começou a ser verificado analiticamente. A produção industrial de penicilina em Portugal surgiu em 1966. No presente artigo pretendemos demonstrar o papel da Comissão Reguladora dos Produtos Químicos e Farmacêuticos na regulamentação e no controlo da penicilina em Portugal no contexto dos outros medicamentos, bem como dar a conhecer o modo de regulação, circulação e distribuição da penicilina em Portugal nos anos 40 e 50 do século XX (AU)


Portugal did not participate in World War II but was one of the first countries in the world to receive penicillin for civilian use. The Portuguese Red Cross began to import the antibiotic from the United States of America in 1944 and appointed a controlling committee to oversee its distribution, due to the small amount available. In 1945, as world production increased, penicillin began to be distributed through the normal channels. An important role in its regulation was played by the official department responsible for controlling pharmaceutical and chemical products in Portugal, the Comissão Reguladora dos Produtos Químicos e Farmacêuticos (Regulatory Committee for Chemical and Pharmaceutical Products). Penicillin was imported as a raw material from 1947 and the first medicaments containing penicillin, prepared in Portugal, were released into the commercial circuit in 1948. A laboratory had been established in 1942 by the Comissão Reguladora for the analytical verification of medicaments and medicinal products with the aim of certifying their quality and minimizing the number of products with no attested therapeutic efficacy. The number of medicaments analysed by this laboratory increased substantially from 72 in the year of its foundation (1942) to 2478 in 1954, including, after 1948, medicaments containing penicillin. The aim of the present paper was to elucidate the role of the Comissão Reguladora dos Produtos Químicos e Farmacêuticos in regulating and controlling the distribution of penicillin in Portugal during the 1940s and 1950s


Subject(s)
Humans , Male , Female , History, 20th Century , Penicillins/administration & dosage , Penicillins/analysis , Penicillins/pharmacokinetics , Drug and Narcotic Control/history , Drug and Narcotic Control/methods , Medication Systems/organization & administration , Medication Systems/standards , Red Cross/history , Red Cross/organization & administration , Penicillins/standards , Penicillins/therapeutic use , Portugal/epidemiology , Penicillins/history , Drug Industry/history , Drug Industry/standards , Pharmacy and Therapeutics Committee/history , Pharmacy and Therapeutics Committee/standards
3.
Yakushigaku Zasshi ; 51(1): 18-28, 2016.
Article in English | MEDLINE | ID: mdl-30183144

ABSTRACT

In order to investigate the roles of quality requirements for antibiotic products in Japan, from historical and hygienic aspects, we examined and analyzed how technology and knowledge in the production and quality control of penicillin were introduced from the United States of America, applied, and further developed. Owing to the strong support of Colonel Crawford Sams, the chief of the Public Health and Welfare Section of the Supreme Commander for Allied Power/General Headquarters, via the Ministry of Welfare in Japan, the technology and knowledge were acquired from an experienced leader, Dr. Jackson W. Foster, and as a result, domestic production of penicillin was successfully achieved in amounts required to meet national demands sufficiently within three years in a devastated post-war-torn Japan. Based on the consensus that penicillin should be dealt with as "biological products" similar to vaccines and antisera, the quality standards for penicillin were enacted as the "Minimum Requirements for Penicillin (MRP)" on the 1st of May 1947. Due to the development of penicillin production technology, the quality standards of penicillin provided by the MRP were revised often to higher levels ; content of the active element from no less than 60 units/mg (purity 3.8%) to no less than 1,430 units/mg (purity 89.7%). Regarding the penicillin preparations, the content of the active ingredient per vial was changed from 30,000 units at the beginning, to 100,000 units in January 1948, to 3,000,000 units in December 1950, and two preparations containing 200,000 units and 1,000,000 units per vial are currently available, according to clinical convenience.


Subject(s)
Anti-Bacterial Agents/history , Penicillins/history , Animals , Anti-Bacterial Agents/standards , History, 20th Century , Japan , Penicillin G , Penicillins/standards , Quality Control , United States
4.
Yakushigaku Zasshi ; 50(2): 131-42, 2015.
Article in Japanese | MEDLINE | ID: mdl-27149779

ABSTRACT

Domestic production of penicillin was initiated in 1946 and that of streptomycin in 1950. In the early days, however, the quality of products was considerably lower and the capacity of production small. Surprisingly, there was a sufficient amount of penicillin preparations, with a purity of 85% or more, satisfying domestic demand within three years (1949). In the case of streptomycin, within three years (1953), preparations with a purity two-fold higher than initially available were produced in amounts sufficient to meet both domestic demand and create a surplus availability for exporting purposes. Such increases in quality and production were considered to be made possible by strict quality control of penicillin and streptomycin preparations, based on "Minimum Requirements for Penicillin" established in May 1947 and "Minimum Requirements for Streptomycin" established in December 1949. These requirements were also amended over time in order to provide even higher quality standards in response to the evolving improvements in production processes. Life-threatening diseases such as septicemia and pneumonia were controlled by the sufficient supply of high-quality penicillin preparations and the mortality rate of tuberculosis, regarded as a national disease at the time, markedly decreased by that of streptomycin preparations. Achievements of domestic production of penicillin and streptomycin were considered important factors that contributed greatly to the maintenance of public health in Japan.


Subject(s)
Anti-Bacterial Agents/standards , Penicillins/standards , Streptomycin/standards , Hygiene , Japan , Quality Control
5.
Antimicrob Agents Chemother ; 56(9): 4650-5, 2012 Sep.
Article in English | MEDLINE | ID: mdl-22687517

ABSTRACT

To investigate the impact of penicillin nonsusceptibility on clinical outcomes of patients with nonmeningeal Streptococcus pneumoniae bacteremia (SPB), a retrospective cohort study was performed. The characteristics of 39 patients with penicillin-nonsusceptible SPB (PNSPB) were compared to those of a group of age- and sex-matched patients (n = 78) with penicillin-susceptible SPB (PSSPB). Susceptibility to penicillin was redetermined by using the revised Clinical and Laboratory Standards Institute (CLSI) penicillin breakpoints in CLSI document M100-S18. Although the PNSPB group tended to have more serious initial manifestations than the PSSPB group, the two groups did not differ significantly in terms of their 30-day mortality rates (30.8% versus 23.1%; P = 0.37) or the duration of hospital stay (median number of days, 14 versus 12; P = 0.89). Broad-spectrum antimicrobial agents, such as extended-spectrum cephalosporins, vancomycin, and carbapenem, were frequently used in both the PNSPB and PSSPB groups. Multivariate analysis revealed that ceftriaxone nonsusceptibility (adjusted odds ratio [aOR] = 4.88; 95% confidence interval [CI] = 1.07 to 22.27; P = 0.041) was one of the independent risk factors for 30-day mortality. Thus, when the 2008 CLSI penicillin breakpoints are applied and the current clinical practice of using wide-spectrum empirical antimicrobial agents is pursued, fatal outcomes in patients with nonmeningeal SPB that can be attributed to penicillin nonsusceptibility are likely to be rare. Further studies that examine the clinical impact of ceftriaxone nonsusceptibility in nonmningeal SPB may be warranted.


Subject(s)
Anti-Bacterial Agents/pharmacology , Ceftriaxone/pharmacology , Penicillins/pharmacology , Pneumococcal Infections/drug therapy , Adolescent , Adult , Aged , Aged, 80 and over , Carbapenems/pharmacology , Child , Child, Preschool , Female , Humans , Infant , Length of Stay , Male , Middle Aged , Penicillin Resistance , Penicillins/standards , Pneumococcal Infections/microbiology , Pneumococcal Infections/mortality , Retrospective Studies , Streptococcus pneumoniae/drug effects , Streptococcus pneumoniae/growth & development , Survival Rate , Treatment Outcome , Vancomycin/pharmacology
6.
Bol. Asoc. Argent. Odontol. Niños ; 35(1): 22-25, mar. 2006. ilus
Article in Spanish | BINACIS | ID: bin-348

ABSTRACT

Hoy se sabe que se debe atender a una paciente embarazada en forma multi e interdisciplinaria si se quiere bajar la tasa de morbimortalidad infantil. Esto se debe a que dentro de sus multicausalidades se encuentra el mal estado bucodental. Así es que se debe encarar la atención odontológica en la gestante y la lactante desde el uso correcto de la medicación con las diferentes patologías que se puedan presentar. Se tendrá en cuenta la farmacodinamia en la paciente, la transferencia placentaria y la farmacocinética fetal, ya que se sabe que todas las drogas pueden ser tóxicas para el bebé si se abusa de ellas. La medicación analgésica será el paracetamol y como medicación antibiótica se utilizarán penicilinas, sus derivados y asociaciones, macrólidos y cefalosporinas. No debe ser atendida una paciente que presente signos de hpertensión arterial, diabetes gestacional no compensada o que su obstetra no se lo permita por algún motivo. A una urgencia odontológica se la tratará igual que una paciente no grávida, teniendo en cuenta la medicación permitida. Se tendrá en cuenta que se logrará un bebé saludable con una mamá saludable, eso significa que no sólo se cuidará la salud del bebé, sino que se controlará probables infecciones en la mamá (AU)


Subject(s)
Humans , Pregnancy , Analgesics/pharmacokinetics , Analgesics/standards , Drug Interactions , Cephalosporins/standards , Anti-Bacterial Agents/standards , Penicillins/standards , Fetus , Emergencies , Dental Care for Chronically Ill/standards , Acetaminophen/standards
7.
Bol. Asoc. Argent. Odontol. Niños ; 35(1): 22-25, mar. 2006. ilus
Article in Spanish | BINACIS | ID: bin-119973

ABSTRACT

Hoy se sabe que se debe atender a una paciente embarazada en forma multi e interdisciplinaria si se quiere bajar la tasa de morbimortalidad infantil. Esto se debe a que dentro de sus multicausalidades se encuentra el mal estado bucodental. Así es que se debe encarar la atención odontológica en la gestante y la lactante desde el uso correcto de la medicación con las diferentes patologías que se puedan presentar. Se tendrá en cuenta la farmacodinamia en la paciente, la transferencia placentaria y la farmacocinética fetal, ya que se sabe que todas las drogas pueden ser tóxicas para el bebé si se abusa de ellas. La medicación analgésica será el paracetamol y como medicación antibiótica se utilizarán penicilinas, sus derivados y asociaciones, macrólidos y cefalosporinas. No debe ser atendida una paciente que presente signos de hpertensión arterial, diabetes gestacional no compensada o que su obstetra no se lo permita por algún motivo. A una urgencia odontológica se la tratará igual que una paciente no grávida, teniendo en cuenta la medicación permitida. Se tendrá en cuenta que se logrará un bebé saludable con una mamá saludable, eso significa que no sólo se cuidará la salud del bebé, sino que se controlará probables infecciones en la mamá (AU)


Subject(s)
Humans , Pregnancy , Analgesics/pharmacokinetics , Analgesics/standards , Drug Interactions , Cephalosporins/standards , Anti-Bacterial Agents/standards , Penicillins/standards , Fetus , Emergencies , Dental Care for Chronically Ill/standards , Acetaminophen/standards
8.
Afr J Med Med Sci ; 30(1-2): 47-51, 2001.
Article in English | MEDLINE | ID: mdl-14510150

ABSTRACT

Five samples of ampicillin capsules with a label claim of 250 mg were purchased from different dispensing points in a small town in Nigeria. The pharmaceutical quality of the products and a sample from a batch produced by a local manufacturer was evaluated and five of the capsule samples were employed in an in vivo bioavailability study. Three of the five capsule samples from dispensing points were found to be of lower quality than the officially prescribed standards of pharmaceutical quality. The quality lapses observed were sufficient to bring about determinable differences in biological availability. The results demonstrate that ampicillin capsules of sub-standard chemical quality are being dispensed within the study sources from authorised and unauthorised sources and that this may have biological, clinical and epidemiological consequences.


Subject(s)
Ampicillin/pharmacokinetics , Biological Availability , Capsules/pharmacokinetics , Community Pharmacy Services/standards , Penicillins/pharmacokinetics , Quality of Health Care/standards , Suburban Health Services/standards , Ampicillin/standards , Capsules/standards , Drug Compounding/standards , Humans , Nigeria , Penicillins/standards , Quality Control , Therapeutic Equivalency
9.
Prev Vet Med ; 31(1-2): 133-46, 1997 Jul.
Article in English | MEDLINE | ID: mdl-9234432

ABSTRACT

Data from the United States National Swine Survey collected by the National Animal Health Monitoring System were used to describe the use of feed additives in swine feeds. Data were collected from 710 farms. The concentration of feed additives expressed in grams per ton of complete feed was described by stage of production, and the use of feed additives above the labeled treatment levels (i.e. off-label) was identified. Of the 3328 feeds, about 79% contained feed additives used in the labeled manner. For all classes of pigs, the prevalence of labeled feed additive use was greater than 75%. Penicillin was used according to its label most often, followed by apramycin, bacitracin, tetracyclines, lincomycin, and tylosin. Carbadox had the highest prevalence of off-label use. Of the 699 feeds that included feed additives in an off-label manner, about 57% included additives at greater than the recommended concentrations or were fed to an incorrect class of pig. About 56% of the feeds had off-label combinations of additives. Small farms were more likely to use rations with no feed additives than intermediate or large farms (P < 0.001). Of those farms using feed additives, the odds of a small farm using all feed additives in the labeled manner was 7.7 times that of an intermediate or large farm (P < 0.0001). After controlling for herd size, producers who used a veterinary consultant were 2.1 times more likely to use feeds with feed additives (P < 0.0001).


Subject(s)
Animal Feed/standards , Animal Husbandry/statistics & numerical data , Consultants , Food Additives/standards , Swine/physiology , Veterinarians , Aging/physiology , Animal Husbandry/methods , Animal Husbandry/standards , Animals , Anti-Bacterial Agents/standards , Anti-Bacterial Agents/therapeutic use , Anti-Infective Agents/standards , Anti-Infective Agents/therapeutic use , Carbadox/standards , Carbadox/therapeutic use , Dose-Response Relationship, Drug , Female , Food Labeling/standards , Health Status , Male , Penicillins/standards , Penicillins/therapeutic use , Statistics as Topic , Swine/growth & development , Swine Diseases/drug therapy , Swine Diseases/epidemiology , Swine Diseases/prevention & control , United States/epidemiology
11.
Odontol. mod ; 19(2): 23-8, mar.-abr. 1992.
Article in Portuguese | BBO - Dentistry | ID: biblio-852590

ABSTRACT

Os autores apresentam uma reprodução da última revisão (1990) sobre prevenção de endocardite bacteriana, publicada no Journal American Dental Association, 122(2):87-91, 1991, preconizada pela American Heart Association (AHA) e aprovada pelo Council on Dental Therapeutics no que diz respeito às seções que se relacionam à Odontologia. Fazem comentários sobre drogas empregadas na quimioprofilaxias das endocardites bacterianas face à situação brasileira, e, também, pela introdução da amoxicilina, penicilina de largo espectro, já utilizada pelos ingleses com a mesma finalidade, desde 1978, nos atuais esquemas de prevenção


Subject(s)
Child , Adult , Dental Clinics/standards , Drug Utilization/standards , Endocarditis, Bacterial , Dental Prophylaxis/standards , Penicillins/standards , Penicillins/therapeutic use
12.
APMIS ; 99(8): 711-20, 1991 Aug.
Article in English | MEDLINE | ID: mdl-1859644

ABSTRACT

The relationship between susceptibility testing by an agar dilution test and a tablet diffusion test was studied for 60 anaerobic bacteria (20 B. fragilis, 20 anaerobic cocci, 20 Clostridium species). For cefoxitin, no prediffusion and prediffusion times of one h, three h, 12 h, 24 h and 48 h were examined. For metronidazole, erythromycin, clindamycin, penicillin and imipenem, only 24 h prediffusion and no prediffusion were studied. Measurements were made after incubation for 24 h and 48 h. Prediffusion improved the correlation for all antibiotics tested, and 24 h prediffusion gave the best results. The slope of the regression line increased and the influence of the individual growth parameters on zone size was reduced. Prediction of susceptibility based on three zone breakpoints to estimate MIC was also better with 24 h prediffusion. However, the variation about the regression line for many of the antibiotics was still extremely high. Measurements after 24 h and 48 h incubation times showed almost identical regression equations, except for erythromycin, where the regression lines differed.


Subject(s)
Anti-Bacterial Agents/pharmacology , Bacteria, Anaerobic/drug effects , Microbial Sensitivity Tests , Anti-Bacterial Agents/standards , Bacteria, Anaerobic/growth & development , Bacteria, Anaerobic/physiology , Cefoxitin/pharmacology , Cefoxitin/standards , Clindamycin/pharmacology , Clindamycin/standards , Colony Count, Microbial , Erythromycin/pharmacology , Erythromycin/standards , Imipenem/pharmacology , Imipenem/standards , Metronidazole/pharmacology , Metronidazole/standards , Penicillins/pharmacology , Penicillins/standards , Regression Analysis , Time Factors
14.
Cent Afr J Med ; 33(6): 141-4, 1987 Jun.
Article in English | MEDLINE | ID: mdl-3450404
17.
Int Arch Allergy Appl Immunol ; 63(3): 344-6, 1980.
Article in English | MEDLINE | ID: mdl-7419295

ABSTRACT

Using a radioimmunoassay, RIA, small amounts of high molecular weight antigens have been reproducibly identified in both biosynthetic and semisynthetic brands of penicillin. These impurities were found to be eliminated by simple chemical means. Measures to avoid this type of contaminants in penicillin preparations should be undertaken because of the immunogenic nature of the contaminants resulting in increased risk of sensitization of patients to penicillin.


Subject(s)
Antigens/analysis , Penicillins/analysis , Molecular Weight , Penicillins/immunology , Penicillins/standards , Radioimmunoassay
18.
Infection ; 7 Suppl 5: S499-502, 1979.
Article in English | MEDLINE | ID: mdl-511363

ABSTRACT

The results revealed the presence of high molecular weight impurities in commercially available penicillins, measured with a radioimmuno assay. The impurities had penicilloyl specificity and induced antibody formation in mice when the contaminated penicillin was administered in 50 mg/kg body weight daily for ten day periods with a 20 to 30 day interval. Penicillin of high purity similarly administered produced very few antibodies. Furthermore, experimentally contaminated penicillin given according to the same schedule caused IgE antibody formation against the penicilloyl moiety, while pure penicillin did not. These findings were explained by the weak immunogenicity of isologous penicilloylated serum albumin in rabbits both regarding the IgE and the IgG/IgM antibody formation compared to the immunogenicity of heterologous bovine serum albumin similarly penicilloylated.


Subject(s)
Drug Hypersensitivity/etiology , Penicillins/adverse effects , Animals , Antibodies/analysis , Antibody Formation , Female , Immunoglobulin E/analysis , Immunoglobulin G/analysis , Immunoglobulin M/analysis , Male , Mice , Mice, Inbred CBA , Mice, Inbred Strains , Penicillins/immunology , Penicillins/standards , Rabbits , Serum Albumin/immunology
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