Real-World Evidence of Efficacy and Safety of Levonadifloxacin (Oral and IV) in the Management of Acute Bacterial Skin and Skin Structure Infections (ABSSSI): Findings of a Retrospective, Multi-Center Study.

Background Antimicrobial resistance by bacteria poses a substantial threat to the success in the treatment of acute bacterial skin and skin structure infections (ABSSSI). Levonadifloxacin is a novel benzoquinolizine subclass of quinolone which has a broad spectrum of activity, available in both oral and intravenous formulations for the treatment of skin structure infections caused by Gram-positive pathogens including methicillin-resistant Staphylococcus aureus (MRSA). Patients and methods This prescription event monitoring study captured data of 227 patients receiving levonadifloxacin (oral and/or IV) in a real-world setting to assess the safety and efficacy in the treatment of ABSSSI. Study outcomes were a clinical and microbial success at the end of therapy and safety was assessed based on adverse events reported. Results One hundred and forty patients received IV levonadifloxacin therapy, 76 patients received oral alalevonadifloxacin, and 11 received IV followed by oral therapy. The mean duration of therapy was 7.3 days. Out of 227 patients, MRSA isolates were identified in 79 patients. Clinical success rates with oral, IV, and IV followed by oral levonadifloxacin therapy were 97.3%, 97.8%, and 100% respectively. The overall microbial success rate was 99.2% and only two patients reported two adverse events. Conclusions The excellent safety and efficacy profile of levonadifloxacin on oral and/or intravenous therapy, makes it a desirable treatment modality for management of ABSSSI. Unique features of levonadifloxacin such as availability of both IV and oral form, minimal drug-drug interactions, exemption from dosage adjustment in renal and hepatic impaired patients and a broad spectrum of coverage, makes it a suitable agent meeting several unmet clinical needs in contemporary patients.

Recombinant anti-D for prevention of maternal-foetal Rh(D) alloimmunization: a randomized multi-centre clinical trial.

OBJECTIVE: To compare the efficacy and safety of recombinant anti-D (R-anti-D) with conventional polyclonal anti-D (Poly anti-D) in preventing maternal-fetal rhesus D (RhD) alloimmunization and to investigate the immunogenicity of R-anti-D. METHODS: This was a randomized, open-label, multi-center clinical trial conducted in RhD-negative pregnant women who did not receive antenatal anti-D who delivered RhD-positive babies and showed negative indirect Coombs tests (ICTs) at baseline. The women were randomized in a 2:1 ratio to R-anti-D or Poly anti-D groups and were administered 300 mcg (IM) of the corresponding drug within 72 hours of delivery. ICT was performed 72 hours, 90 days, and 180 days after anti-D injection. Serum samples were collected to check for the development of antibodies against R-anti-D at days 90 and 180, using bridging enzyme-linked immunosorbent assay. The proportion of subjects who had positive ICT results at days 90 and 180 were compared between the groups using Fisher's exact test. RESULTS: A total of 144 women were randomized to the R-anti-D group and 71 to the Poly anti-D group. Three women in the R-anti-D and none in the Poly anti-D group had a positive ICT result at day 90. No woman in either group had positive ICT result at day 180. Both drugs were well tolerated with only 4 reports of adverse events in each group-all were mild, non-serious, and resolved without sequelae. No subject developed antibodies against R-anti-D. CONCLUSION: The studied R-anti-D is comparable in efficacy to conventional Poly anti-D and is safe and non-immunogenic.Trial Registration: Clinical Trials Registry of India Identifier: Trial Registration: Clinical Trials Registry of India Identifier: CTRI/2017/03/008101.

A Rare Presentation of Fulminant Viral Myocarditis Associated with H1N1: A Series of Four Cases.

The viral infection during influenza includes several complications like primary pneumonitis, ARDS, bacterial pneumonia, otitis media along with severe increase in the ongoing chronic conditions. Fulminant myocarditis as a primary manifestation of H1N1 is rare. We are reporting four cases that developed fulminant viral myocarditis caused by the H1N1 strain of influenza. These four cases were reported between October 2018 and November 2018, during the post-flood time in Kerala. HOW TO CITE THIS ARTICLE: Thomas TP, Kumar S, Anand A, Kiran R, Sabu V, Gaffoor A. A Rare Presentation of Fulminant Viral Myocarditis Associated with H1N1: A Series of Four Cases. IJCCM 2019;23(11): 538-541.

Efficacy of pine leaves as an alternative bedding material for broiler chicks during summer season.

AIM: The aim was to assess the efficacy of pine leaves as an alternative bedding material on the performance of broiler chicks. MATERIALS AND METHODS: The present study was conducted in summer. Total 120, day old Vencobb straight run chicks were procured, and after 5 days of brooding, chicks were randomly distributed into four treatment groups viz. paddy husk (Group I), paddy straw (Group II), pine leaves (Group III), and combination of paddy straw and pine leaves (Group IV), each having 30 chicks with 3 replicates of 10 chicks each. Chicks were reared under intensive conditions in houses that have a semi-controlled environment, with optimum temperature and adequate ventilation. Food and water were provided as per NRC (1994) requirement. RESULTS: The average body weight after 6 weeks of the experiment was 2018.83±31.11, 1983.80±33.27, 2007.36±35.73, and 1938.43±36.35 g. The bedding type had no significant effect on the carcass characteristics viz. evisceration rate and proportion of cut-up parts of the carcass except giblet yield. The experiment suggested that performance of broiler chicks reared on paddy straw and pine leaves as litter material, had improved body weight and feed conversion ratio as compared to rearing on paddy husk as bedding material. Bacterial count, parasitic load and the N, P, K value of manure of different bedding material shows no significant difference. CONCLUSION: Pine leaves have a potential to be used as an alternative source of litter material to economize poultry production in a sustainable way, so as to make poultry farming as a profitable entrepreneur.