Classical antibacterial drugs were designed to target specific bacterial properties distinct from host human cells to maximize potency and selectivity. These designs were quite effective as they ...could be easily derivatized to bear next-generation drugs. However, the rapid mutation of bacteria and their associated acquired drug resistance have led to the rise of highly pathogenic superbug bacterial strains for which treatment with first line drugs is no match. More than ever, there is a dire need for antibacterial drug design that goes beyond conventional standards. Taking inspiration by the body’s innate immune response to employ its own supply of labile copper ions in a toxic attack against pathogenic bacteria, which have a very low Cu tolerance, this review article examines the feasibility of Cu-centric strategies for antibacterial preventative and therapeutic applications. Promising results are shown for the use of Cu-containing materials in the hospital setting to minimize patient bacterial infections. Studies directed at disrupting bacterial Cu regulatory pathways elucidate new drug targets that can enable toxic increase of Cu levels and perturb bacterial dependence on iron. Likewise, Cu intracellular chelation/prochelation strategies effectively induce bacterial Cu toxicity. Cu-based small molecules and nanoparticles demonstrate the importance of the Cu ions in their mechanism and display potential synergism with classical drugs.
Drug-Induced Anaphylaxis in Latin American Countries Jares, Edgardo José; Baena-Cagnani, Carlos E; Sánchez-Borges, Mario ...
The journal of allergy and clinical immunology in practice (Cambridge, MA),
09/2015, Letnik:
3, Številka:
5
Journal Article
Recenzirano
Information regarding the clinical features and management of drug-induced anaphylaxis (DIA) in Latin America is lacking.
The objective of this study was to assess implicated medications, ...demographics, and treatments received for DIA in Latin American patients referred to national specialty centers for evaluation.
A database previously used to compile information on drug-induced allergic reactions in 11 Latin American countries was used to identify and characterize patients presenting specifically with a clinical diagnosis of DIA. Information regarding clinical presentation, causative agent(s), diagnostic studies performed, treatment, and contributing factors associated with increased reaction severity was analyzed.
There were 1005 patients evaluated for possible drug hypersensitivity reactions during the study interval, and 264 (26.3%) met criteria for DIA. DIA was more frequent in adults and in elderly females (N = 129 76.6% and N = 30 75%, respectively) compared with children and/or adolescents (N = 21 42.9%, P < .01). Severe DIA was less frequent with underlying asthma (N = 22 vs 35 38.6% vs 61.4%, P < .05) or atopy (N = 62 vs 71 43% vs 59% , P < .01). Nonsteroidal anti-inflammatory drugs (NSAIDs) (N = 178 57.8%), beta-lactam antibiotics (N = 44 14.3%), and other antibiotics (N = 16 5.2%) were the most frequently implicated drug classes. Anaphylaxis was rated as severe in N = 133 (50.4%) and anaphylactic shock (AS) was present in N = 90 (34.1%). Epinephrine was only used in N = 73 (27.6%) overall, but in N = 70 (77.8%) of patients with AS.
In Latin American patients referred for evaluation of DIA, NSAIDs and antibiotics were implicated in approximately 80% of cases. Most of these reactions were treated in the emergency department. Epinephrine was administered in only 27.6% of all cases, although more frequently for anaphylactic shock. Dissemination of anaphylaxis guidelines among emergency department physicians should be encouraged to improve management of DIA.
