Why people susceptible to colds, asthma, and sinusitis must be careful while having ash gourd or petha

University Of Florida Researchers Secured $11.8 Million Grant To Combat Antibiotic-Resistant Bacteria

University of Florida Health scientists exploring how combinations of antibiotics can fight resistant bacteria have been awarded an $11.8 million grant for work that could help save the tens of thousands of lives lost yearly to infections that are increasingly plaguing humanity.

The National Institutes of Health, or NIH, grant to the UF College of Medicine and the UF College of Pharmacy will support scientists working to uncover the mechanics of how bacteria and antibiotics interact, down to the molecular level.

That mechanistic knowledge has become crucial as bacteria become ever-more resistant to antibiotics. Few pharmaceutical companies are developing new antibiotics, leaving scientists to find novel methods to make older drugs more effective when used in combination.

Accordingly, the National Institute of Allergy and Infectious Diseases, under the NIH, solicited competitive proposals in a "call to arms" to address the crisis, UF Health researchers said.

"It's very clear on these serious infections with antibiotic-resistant bacteria that monotherapy cannot work," said Jürgen Bulitta, Ph.D., a co-principal investigator on the project at the UF Research and Academic Center at Lake Nona, Orlando. "Using one antibiotic at a time, you cannot win. You must tag-team with more than one drug to have any chance against serious infections."

The hope is to "dial in" these antibiotics using newfound insight from the laboratory. It's like understanding an enemy's weaknesses to form a battle plan that takes advantage of those chinks in the armor. What receptors on bacteria are best targeted by antibiotics? What precise dosages in a drug cocktail will kill a bacterial population without resistant stragglers surviving to multiply?

Bulitta and UF Health researcher and co-principal investigator George L. Drusano, M.D., a professor and director of the UF College of Medicine's Institute of Therapeutic Innovation, will examine two of the deadliest resistant bacteria, Acinetobacter baumannii and Klebsiella pneumoniae.

The bacteria, sometimes called "superbugs," are often found in hospitals, usually infecting patients with weakened immune systems. They are adept at finding genetic adaptations to elude the drugs hunting them.

"These bacteria are not only multi-resistant to antibiotics, they're also hypervirulent," said Drusano. "They have turned into really nasty, nasty bugs that wreak havoc on patients' bodies and too often kill them. We have some great antibiotics. But we need to optimize them and find new approaches that will cure people and get them out of the hospital."

The researchers are using advanced computer modeling techniques and in vitro (outside-the-body) testing, such as a relatively new method called the hollow fiber infection model.

This technique uses a collection of hollow fibers 200 microns in diameter — roughly twice the thickness of a human hair — to culture cells and bacteria. The method reproduces what happens in the human body and helps scientists measure how bacteria respond to drugs and develop resistance.

These bacteria reproduce and evolve in rapid cycles of life and death as short as 20 to 30 minutes, and generations of reproduction are achieved in days. A severe infection might generate billions of bacteria in the lungs, making it highly probable that a beneficial bacterial adaptation will get a toehold, defanging an antibiotic.

Even with a patient's natural immune defense and antibiotics, Bulitta said, bacteria are reproducing so rapidly, "it's a near certainty you will still have 100 to 1,000 resistant bacteria remaining in severe lung infections."

Multidrug therapy seeks to reduce the population of that bacteria with one antibiotic regimen, then hitting it with a second or third using different drugs. This can reduce bacterial numbers before the superbugs can again adapt new protections.

"It's a game of cat and mouse," said Bulitta, a professor and The Perry E. Foote Eminent Scholar Chair in the UF College of Pharmacy's Department of Pharmacotherapy and Translational Research.

UF Health is leading this multicenter investigation. Other participants include researchers at Case Western Reserve University in Cleveland; the Children's Hospital of Los Angeles, Monash University in Australia; St. Jude's Children's Research Hospital in Memphis; Northern Arizona University in Flagstaff, Arizona; and the University of Central Florida in Orlando.

Penicillin Allergy Delabeling In Syphilis Patients Assists In Furthering Treatment

BOSTON (Oct. 24, 2024) – About 10% of Americans believe they are allergic to penicillin, and approximately 90% of those patients are not actually allergic. As a result, those with the penicillin allergy label are often prescribed more toxic, dangerous and expensive antibiotics that might not be necessary or effective. A new study being presented at this year's American College of Allergy, Asthma and Immunology (ACAAI) Annual Scientific Meeting in Boston showed that syphilis patients labeled as penicillin allergic who are low risk should be delabeled to avoid treatment failure and other negative health consequences.

"The number of people with untreated syphilis in the United States is at its highest since the 1950s, and penicillin is the preferred, most effective antibiotic for syphilis." says allergist Cosby Stone, MD, MPH, senior author of the study and ACAAI member. "With the goal of delabeling patients with syphilis who believed themselves to be allergic to penicillin, we collected data on demographics, syphilis stage, results of penicillin allergy testing, use of second-line treatment, healthcare utilization and use of penicillin after delabeling, and clearance of syphilis. Importantly, among those who came to us for penicillin allergy testing, we noticed a pattern in which more than half had failed other treatments, doxycycline in particular, before penicillin allergy testing was even considered."

Of the 12 patients identified, 12 out of 12 were ultimately delabeled of their penicillin allergy. Nine of 12 had documented subsequent penicillin treatment, while 3 of 12 had incomplete histories or lost follow up. Of the 9 who received penicillin, 5 had clearance, 3 had failed clearance (2  for reinfection, 1 for unknown reasons), and 1 had unknown clearance outcome.

The authors conclude that most patients labeled as penicillin allergic should have their allergies evaluated as quickly as possible after a syphilis diagnosis and should be aggressively delabeled to avoid treatment failure, increased healthcare utilization, and negative public health consequences.

Abstract Title: A CALL TO ACTION FOR PENICILLIN ALLERGY DELABELING IN PATIENTS WITH SYPHILIS (Full abstract below)

Presenter: Aiwei Yan, MD

For more information about drug allergies, or to find an allergist in your area, visit AllergyandAsthmaRelief.Org. The ACAAI Annual Scientific Meeting is Nov. 9-13. For more news and research from the ACAAI Scientific Meeting, go to our newsroom and follow the conversation on X/Twitter #ACAAI24.

About ACAAI

The American College of Allergy, Asthma & Immunology (ACAAI) is a professional medical organization of more than 6,000 allergists-immunologists and allied health professionals, headquartered in Arlington Heights, Ill. Founded in 1942, the College fosters a culture of collaboration and congeniality in which its members work together and with others toward the common goals of patient care, education, advocacy, and research. ACAAI allergists are board-certified physicians trained to diagnose allergies and asthma, administer immunotherapy, and provide patients with the best treatment outcomes. For more information and to find relief, visit AllergyandAsthmaRelief.Org. Join us on Facebook, Pinterest, Instagram and X/Twitter.

R002A CALL TO ACTION FOR PENICILLIN ALLERGY DELABELING IN PATIENTS WITH SYPHILIS

A. Yan*1, G. Koo1, C. Allocco1, E. Phillips2, C. Stone1, 1. Nashville, TN; 2. Franklin, TN.

Introduction: The number of people with untreated syphilis in the United States is at its highest since the 1950s. Penicillin, the first-line treatment for syphilis, may be avoided in those labeled as penicillin allergic, thus fueling the public health crisis, risk of congenital syphilis, individual morbidity, and excessive healthcare utilization.

Methods: We retrospectively reviewed penicillin allergy labeled patients with confirmed syphilis referred to our drug allergy clinic for assessment and delabeling from January 2014 to January 2024. We collected data on demographics, syphilis stage, results of penicillin allergy testing, use of second-line treatment, healthcare utilization and use of penicillin after delabeling, and clearance of syphilis.

Results: Of 12 patients identified, 83.3% were male and the median age was 39. Prior to our evaluation, 9 patients were treated with doxycycline, some multiple times (5 successful and 7 failed treatments total). One ceftriaxone-treated patient failed treatment. Three patients were desensitized to penicillin in the ICU. One female patient treated with penicillin desensitization had a pregnancy complicated by congenital syphilis. 12/12 patients were ultimately delabeled of their penicillin allergy. 9/12 had documented subsequent penicillin treatment, while 3/12 had incomplete/lost follow up in our EHR. Of the 9 who received penicillin, 5 had clearance, 3 had failed clearance (2 reinfection, 1 unknown reasons), and 1 had unknown clearance outcome.

Conclusion: Syphilis is an individual and public health emergency. We have shown that most patients labeled as penicillin allergic that are low risk should be aggressively delabeled to avoid treatment failure, increased healthcare utilization, and negative public health consequences.

 

Journal

Annals of Allergy Asthma & Immunology

Method of Research

Observational study

Subject of Research

People

Article Title

Penicillin Allergy Delabeling in Syphilis Patients Assists in Furthering Treatment

Article Publication Date

24-Oct-2024

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Find Out What Happens To The Body When You Don't Complete An Antibiotics Course

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