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Clinical Outcome of Febrile Neutropenia and Associated Factors Among Adult Patients with Cancer Treated at Ethiopian Oncology Centers: A Retrospective Observational Study.

IntroductionFebrile neutropenia (FN) is a major cause of dose-limiting complications in cancer treatment that predisposes patients to serious infections. Despite advancements in therapies, including empirical and definitive antibiotics, FN remains a major morbidity and mortality issue among patients with cancer undergoing cancer treatment. Little is known about the 30-day all-cause mortality rates from FN in Ethiopia, particularly in the Northwest Ethiopia oncology centers.MethodsThis retrospective cross-sectional study was conducted via chart review without direct patient contact at two North

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… The extended-spectrum cephalosporins (cefepime or ceftazidime), carbapenems (imipenem or meropenem), and the antipseudomonal penicillin (piperacillin–tazobactam or ticarcillin–clavulanate) are the mainstay of empiric monotherapy or combination therapy among patients with FN [ 7 ]. …

Infectious Complications of Cancer Therapy

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… Bacteremia due to Klebsiella pneumoniae isolates producing the TEM-52 extended-spectrum beta-lactamase: treatment outcome of patients receiving imipenem or ciprofloxacin. Clin Infect Dis. 2004;38:243–251. doi: 10.1086/380645. 25. Schimpff S., Satterlee W., Young V.M., Serpick A. …

Infections in Hospitalized Cancer Patients.

Cancer patients are at an increased risk of developing infections that are primarily treatment-driven but may also be malignancy-driven. While cancer treatments such as chemotherapy, radiotherapy, and surgery have been known to improve malignancy morbidity and mortality, they also have the potential to weaken immune defenses and induce periods of severe cytopenia. These adverse effects pave the way for opportunistic infections to complicate a hospitalized cancer patient's clinical course. Understanding the risk each patient inherently has for developing a bacterial, fungal, or viral infection

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… E. coli strains that produce extended-spectrum beta-lactamase (ESBL) should be preferentially treated with carbapenems including meropenem or imipenem [ 49 ]. …

Clinical and Genomic Epidemiology of Carbapenem-Nonsusceptible Citrobacter spp. at a Tertiary Health Care Center over 2 Decades.

Carbapenem-nonsusceptible Citrobacter spp. (CNSC) are increasingly recognized as health care-associated pathogens. Information regarding their clinical epidemiology, genetic diversity, and mechanisms of carbapenem resistance is lacking. We examined microbiology records of adult patients at the University of Pittsburgh Medical Center (UMPC) Presbyterian Hospital (PUH) from 2000 to 2018 for CNSC, as defined by ertapenem nonsusceptibility. Over this time frame, the proportion of CNSC increased from 4% to 10% (P = 0.03), as did daily defined carbapenem doses/1,000 patient days (6.52 to 34.5; R2 =

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… Carbapenem (ertapenem, doripenem, meropenem, and imipenem) DDDs were measured per year at UPMC-PUH ( 22 ). …

Gut microbiota shapes cancer immunotherapy responses.

The gut microbiota significantly influences cancer immunotherapy efficacy by modulating immune responses, remodeling the tumor microenvironment (TME), and producing key metabolites. Strategies such as FMT, probiotics, and dietary interventions show promise in enhancing responses to ICIs and ACTs while reducing immune-related adverse events (irAEs). This review summarizes clinical and preclinical findings and discusses microbiota-based interventions and future directions for precision immunotherapy.

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… In 2022, Lauren et al. found that patients treated with piperacillin/tazobactam, meropenem, or imipenem/cilastatin (P-I-M) antibiotics within four weeks before CD19-targeted CAR-T therapy had lower survival rates and higher neurotoxicity risks. … combination treatment 215 Melanoma 568 Cephalosporins; penicillins; fluoroquinolone αPD-1 mAb; αCTLA-4 mAb; combined 216 Lung cancer; etc. 767 Antibiotics αPD-1/αPD-L1 mAb; 217 NSCLC 256 Antibiotics αPD-1/PD-L1 mAb, αCTLA-4 mAb 218 B cell lymphoma; leukemia 228 Piperacillin/tazobactam, meropenem and imipenem …

Emerging insights into the gut microbiota as a key regulator of immunity and response to immunotherapy in hepatocellular carcinoma.

The gut microbiota, a complex microbial ecosystem closely connected to the liver via the portal vein, has emerged as a critical regulator of liver health and disease. Numerous studies have underscored its role in the onset and progression of liver disorders, including alcoholic liver disease, metabolic dysfunction-associated steatotic liver disease (MASLD), metabolic dysfunction-associated steatohepatitis (MASH), liver fibrosis, cirrhosis, and hepatocellular carcinoma (HCC). This review provides a comprehensive overview of current insights into the influence of the gut microbiota on HCC progre

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… Another group utilized a transgenic mouse model of MYC to induce spontaneous HCC and administered an antibiotic mixture containing vancomycin, neomycin, and imipenem + cilastatin in drinking water. …

Management of chimeric antigen receptor T (CAR-T) cell-associated toxicities.

The use of chimeric antigen receptor T (CAR-T) cells is a significant therapeutic improvement increasing the prognosis for patients with a variety of hematological malignancies. However, this therapy has also sometimes life-threatening, complications. Therefore, knowledge of the treatment and management of these complications, especially in treatment centers and intensive care units, respectively, is of outstanding importance. This review provides recommendations for the diagnosis, management, and treatment of CAR-T cell-associated complications such as cytokine release syndrome, immune effect

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… If the focus is unclear, a Pseudomonas-effective antibiotic (piperacillin/tazobactam, imipenem, meropenem, cefepime, or ceftazidime) must be initiated within one hour [ 21 ]. …

Understanding and Managing Sepsis in Patients With Cancer in the Era of Antimicrobial Resistance.

Sepsis is a frequent complication in immunosuppressed cancer patients and hematopoietic stem cell transplant recipients that is associated with high morbidity and mortality rates. The worldwide emergence of antimicrobial resistance is of special concern in this population because any delay in starting adequate empirical antibiotic therapy can lead to poor outcomes. In this review, we aim to address: (1) the mechanisms involved in the development of sepsis and septic shock in these patients; (2) the risk factors associated with a worse prognosis; (3) the impact of adequate initial empirical ant

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… Other novel antibiotics displaying activity against MDR-GNB are currently under clinical evaluation (e.g., imipenem/relabactam, plazomicin, cefiderocol, meropenem/vaborbactam, and eravacycline), and given time, these may improve the antibiotic armamentarium. …

[Guidelines for off-label use of anti-tuberculosis drugs].

Tuberculosis (TB) remains a major global public health problem. According to the World Health Organization (WHO) Global Tuberculosis Report … isk or prolonged treatment, to support individualized dosing (1, B).Recommendation 25: Meropenem or imipenem/cilastatin, each combined with clavulanate, may be considered as a Group C option for MDR/RR-TB when Group A and B drugs cannot form an effective regimen (2, D). In drug-resistant, severe, or refractory TBM, individualized use may be considered only …

Dietary fungi in cancer immunotherapy: From the perspective of gut microbiota.

Immunotherapies are recently emerged as a new strategy in treating various kinds of cancers which are insensitive to standard therapies, while the clinical application of immunotherapy is largely compromised by the low efficiency and serious side effects. Gut microbiota has been shown critical for the development of different cancer types, and the potential of gut microbiota manipulation through direct implantation or antibiotic-based depletion in regulating the overall efficacy of cancer immunotherapies has also been evaluated. However, the role of dietary supplementations, especially fungal

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… anti-CD19 CAR T cell therapy in B cell malignancy patients, as revealed by distinct bacterial taxa and metabolic pathways in patients treated with/without antibiotics, as well as worse survival and increased neurotoxicity seen in patients exposed to antibiotics (piperacillin/tazobactam, meropenem and imipenem …

P941 – P1197

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Drug Repurposing of Selected Antibiotics: An Emerging Approach in Cancer Drug Discovery.

Drug repurposing is a method of investigating new therapeutic applications for previously approved medications. This repurposing approach to "old" medications is now highly efficient, simple to arrange, and cost-effective and poses little risk of failure in treating a variety of disorders, including cancer. Drug repurposing for cancer therapy is currently a key topic of study. It is a way of exploring recent therapeutic applications for already-existing drugs. Theoretically, the repurposing strategy has various advantages over the recognized challenges of creating new molecular entities, inclu

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… . | ( 33 ) (b) Ertapenem (c) Imipenem (d) Meropenem 12. | Cephalosporins | (a) Cefadroxil | Bacteria synthesize a cell wall that is strengthened by cross-linking peptidoglycan units via penicillin-binding proteins (PBPs, peptidoglycan transpeptidase). | ( 34 ) (b) Cefazolin (c) Cephalexin (d) Cefaclor …

A year in pharmacology: new drugs approved by the US Food and Drug Administration in 2023.

With 54 new drugs and seven cellular and gene therapy products, the approvals by the US Food and Drug Administration (FDA) recovered 2023 from the 2022 dent back to the levels of 2020-2021. As in previous years of this annual review, we assign these new drugs to one of three levels of innovation: first drug against a condition ("first-in-indication"), first drug using a novel molecular mechanism ("first-in-class"), and "next-in-class," i.e., a drug using an already exploited molecular mechanism. We identify four (7%) "first-in-indication," 22 (36%) "first-in-class," and 35 (57%) "next-in-class

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… Sulbactam and durlobactam were non-inferior to colistin, each given as an add-on to imipenem with cilastatin. Sulbactam and durlobactam have demonstrated good tolerability and a lower risk of nephrotoxicity compared to colistin (Kaye et al. 2023 ; Watkins et al. 2023 ). …

Cancer cachexia--pathophysiology and management.

About half of all cancer patients show a syndrome of cachexia, characterized by anorexia and loss of adipose tissue and skeletal muscle mass. Cachexia can have a profound impact on quality of life, symptom burden, and a patient's sense of dignity. It is a very serious complication, as weight loss during cancer treatment is associated with more chemotherapy-related side effects, fewer completed cycles of chemotherapy, and decreased survival rates. Numerous cytokines have been postulated to play a role in the etiology of cancer cachexia. Cytokines can elicit effects that mimic leptin signaling a

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… Commonly used empiric intravenous antibiotic monotherapies include carbapenems (e.g., imipenem/cilastatin, meropenem), and extended-spectrum antipseudomonal cephalosporins (e.g., ceftazidime, cefepime). …

Drug repurposing in oncology: Compounds, pathways, phenotypes and computational approaches for colorectal cancer.

The strategy of using existing drugs originally developed for one disease to treat other indications has found success across medical fields. Such drug repurposing promises faster access of drugs to patients while reducing costs in the long and difficult process of drug development. However, the number of existing drugs and diseases, together with the heterogeneity of patients and diseases, notably including cancers, can make repurposing time consuming and inefficient. The key question we address is how to efficiently repurpose an existing drug to treat a given indication. As drug efficacy rem

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… 84 , 85 ] Treatment (based on computational/integrated approaches) Phenoxybenzamine (Dibenzyline TM ) | Alfa blocker | Hypertension | + | | | | | | | [ 86 ] GW-8510 | Cyclin kinase 2 inhibitor | RRM2 (human ribonucleotide reductase 2) inhibitor | + | | | | | + | | [ 86 , 87 ] Primaxin (Imipenem … written by Peter Selinger 2001-2019 </metadata><g transform="translate(1.000000,15.000000) scale(0.019444,-0.019444)" fill="currentColor" stroke="none"><path d="M0 440 l0 -40 480 0 480 0 0 40 0 40 -480 0 -480 0 0 -40z M0 280 l0 -40 480 0 480 0 0 40 0 40 -480 0 -480 0 0 -40z"/></g></svg> NO1)F Primaxin (Imipenem …

Гут Микробиота Нарушение гематологовой терапии рака: Молекулярное понимание и последствия для эффективности лечения.

Гематологическая магнелезность (ГМ), включая лейкемию, лимфому и множественные миеломы, связана с бесконтрольным распространением аномальных кровеносных клеток, что создает серьезные клинические проблемы из-за их неоднородности и различных методов лечения. Несмотря на недавние достижения в области лечения, благодаря которым повысились показатели выживаемости, особенно в случае хронической лимфоцитической лейкемии и острой лимфоболической лейкемии, такие методы лечения, как химиотерапия и трансплантация стволовых клеток, часто нарушают микробиоту, что может негативно сказаться на результатах ле

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… . | Increase Enterococcus faecalis | Increase Allogeneic stem cell transplantation | 209 patients | ALL AML MDS | Family | Lachnospiraceae | Decrease | Carbapenems (imipenem or meropenem) and amikacin were administered as first-line antibiotics for patients developing fever during neutropenia. | This …

Evolving strategies for addressing CAR T-cell toxicities.

The field of chimeric antigen receptor (CAR) T-cell therapy has grown from a fully experimental concept to now boasting a multitude of treatments including six FDA-approved products targeting various hematologic malignancies. Yet, along with their efficacy, these therapies come with side effects requiring timely and thoughtful interventions. In this review, we discuss the most common toxicities associated with CAR T-cells to date, highlighting risk factors, prognostication, implications for critical care management, patient experience optimization, and ongoing work in the field of toxicity mit

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… exam, EEG, brain MRI Neurology involvement for patients with neuro comorbidities Preventative medications (e.g., levetiracetam) Initial interventions : neuro monitoring (exams, ICE score) days 0–30 or longer if delayed/prolonged toxicity, steroids, reduce neuroexcitotoxic medications (e.g., cefepime, imipenem … exam, EEG, brain MRI Neurology involvement for patients with neuro comorbidities Preventative medications (e.g., levetiracetam) Initial interventions : neuro monitoring (exams, ICE score) days 0–30 or longer if delayed/prolonged toxicity, steroids, reduce neuroexcitotoxic medications (e.g., cefepime, imipenem …

Infections in Recipients of Hematopoietic Stem Cell Transplants

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… after 3 weeks of appropriate antimicrobial therapy, which suggests that prolonged antibiotic treatment is indicated for HSCT recipients with legionellosis. 138 Medical therapies for nocardiosis often consist of administration of sulfonamide in combination with a synergistic agent such as ceftazidime or imipenem-cilastatin …

Gut microbiota and microbial metabolites for osteoporosis.

Osteoporosis is an age-related bone metabolic disease. As an essential endocrine organ, the skeletal system is intricately connected with extraosseous organs. The crosstalk between bones and other organs supports this view. In recent years, the link between the gut microecology and bone metabolism has become an important research topic, both in preclinical studies and in clinical trials. Many studies have shown that skeletal changes are accompanied by changes in the composition and structure of the gut microbiota (GM). At the same time, natural or artificial interventions targeting the GM can

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… . | Antibiotic cocktail with ampicillin (180 mg/kg/d), vancomycin (72 mg/kg/d), metronidazole (90 mg/kg/d) and imipenem (90 mg/kg/d), twice daily (12 h interval) for three consecutive days. | 25 10 | Brain lipid metabolism | C57Bl/6JRj mice (4 weeks) | Germ-free C3H/HeN mice (8 weeks) | The intestinal …

Proceedings of Reanimation 2021, the French Intensive Care Society International Congress.

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