Search Results (288)

The systemic delivery of oxytetracycline (OTC) by trunk injection has emerged as a viable strategy to manage huanglongbing (HLB, also known as citrus greening), a bacterial disease devastating citrus production around the world. This study examines the efficacy of delivering OTC systemically into the trunk of young, HLB-affected citrus trees using a drill-based or a drill-free system to improve tree health and productivity. Two field trials were conducted in two commercial production sites in Florida. Trees were four years old at the start of the study and composed of ‘Valencia’ or ‘OLL-8’ sweet orange (Citrus sinensis) scion grafted on X-639 (C. reticulata × Poncirus trifoliata) rootstock. Injections were performed in spring or late summer/early fall in 2022 and 2023. Using the drill-based system, 0.79 g of OTC was administered into each tree, whereas 0.15 g or 0.3 g was administered using the drill-free system. Delivering a higher dose of OTC by drill-based injection increased fruit yield and improved juice quality more than delivering lower doses by drill-free injection, though responses varied between cultivars. Injections in late summer/early fall increased the juice total soluble solids content considerably more than injections in spring. However, fall injections resulted in OTC fruit residues exceeding the maximum allowed level. Trunk injury was more extensive when OTC was applied with the drill-free system than when it was applied with the drill-based system. Full article

Background/Objectives: Infectious endophthalmitis is a vision-threatening complication of intraocular surgery and intravitreal injections. Standard treatment involves intravitreal antibiotics; however, concerns regarding multidrug resistance and vancomycin-associated hemorrhagic occlusive retinal vasculitis (HORV) highlight the need for alternative antimicrobial strategies. This study aimed to evaluate the clinical efficacy and safety of a protocol combining intravitreal injection of 1.25% povidone-iodine (PI) with intraoperative irrigation using low concentrations of vancomycin and ceftazidime. Methods: We retrospectively analyzed 11 eyes from patients diagnosed with postoperative or injection-related endophthalmitis. Six of the eleven cases received an initial intravitreal injection of 1.25% PI, followed by pars plana vitrectomy with irrigation using balanced salt solution PLUS containing vancomycin (20 μg/mL) and ceftazidime (40 μg/mL). A second intravitreal PI injection was administered at the end of surgery in all cases. Additional PI injections were administered postoperatively based on clinical response. Clinical outcomes included best-corrected visual acuity (BCVA), microbial culture results, corneal endothelial cell density, and visual field testing. Results: All eyes achieved complete infection resolution without recurrence. The mean BCVA improved significantly from 2.18 logMAR at baseline to 0.296 logMAR at final follow-up (p < 0.001). No adverse events were observed on specular microscopy or visual field assessment. The protocol was well tolerated, and repeated PI injections showed no signs of ocular toxicity. Conclusions: This combination protocol provides a safe and effective treatment strategy for infectious endophthalmitis. It enables rapid and complete infection resolution while minimizing the risks associated with intravitreal antibiotics. These findings support further investigation of this protocol as a practical and globally accessible alternative to standard intravitreal antimicrobial therapy. Full article

Background/Objectives: In Japan, task shifting reduces the working hours of pediatricians, who face excessive workloads. The status of task shifting under the Ministry of Health, Labor, and Welfare’s reforms remains unclear. This study aimed to evaluate the current status and barriers of task shifting in pediatric care in Japan. Methods: A questionnaire survey was conducted among pediatricians working in hospitals in Japan. The results were compared with those from 2020. Results: Questionnaires were sent to 835 hospitals, and valid responses were received from 815 pediatricians in 316 hospitals (response rate: 37.8%). The largest group (31.0%) was 40–49 years, and 34.4% of the participants were women. Among the items surveyed, most pediatricians indicated “shifted” in “Patient transfer (transporting between hospitals using an ambulance)” and “Intravenous injection of antibiotics.” Most physicians believed task shifting improved care quality; 10.3% felt it worsened. The most common estimate for daily working hour reduction due to task shifting was “1 to <2 h” (44.9%). Precisely 15.8% of pediatricians believed that task shifting had “not progressed at all,” with rural areas and non-university hospitals showing lower task-shifting implementation. National university hospitals had a higher likelihood of task shifting than public hospitals. No significant associations were observed for the total hospital bed count or the number of full-time pediatricians. Conclusions: Task shifting in pediatric care remains underdeveloped. While many pediatricians support the concept and report modest reductions in working hours, actual implementation remains limited. Future efforts must address systemic, institutional, and regulatory challenges to facilitate meaningful task redistribution and improve healthcare delivery. Full article

The anti-inflammatory effect of trypsin in animals and humans is the basis for the development of new veterinary and medical drugs and alternatives to antibiotics. The current experiment analyzed the effect of pig pancreatic tissue lyophilizate and crystalline trypsin on the hemodynamic and morpho-biochemical parameters of rabbit blood. The experiments were carried out on 20 rabbits of the Soviet chinchilla breed of 6–8 months of age. Animals were intramuscularly injected with sterile solution of 0.9% NaCl in 0.5 mL (group 1, n = 5), sterile solution of crystalline trypsin in 0.9% NaCl at a concentration of 0.25 mg/kg body weight (group 2, n = 5), sterile solution of crystalline trypsin in 0, 9% NaCl at a concentration of 0.5 mg/kg body weight (group 3, n = 5), or sterile suspension of pig pancreas lyophilizate at a concentration of 1 mg/kg body weight (group 4, n = 5). Animals were injected once daily for five consecutive days. Significant changes in arterial blood pressure, serum enzymes activity, and the count of various blood cellular components were induced by the administration of different trypsin preparations. All data obtained indicate the presence of a biologically active substance in the lyophilizate, the effect of which requires further animal studies to create a prototype for the development of new drugs for human and animal use. Full article

Background: Community-acquired pneumonia (CAP) is the leading cause of death in infants aged 1–59 months. Concurrent with this, there is a need to prescribe antibiotics wisely in Vietnam due to concerns with rising antimicrobial resistance (AMR). Consequently, an urgent need has arisen to treat patients according to agreed guidelines. The aim of this study was to investigate the current management of infants under five years old with CAP in Vietnam as well as identify possible obstacles to adhering to national guidelines. Methods: A mixed-method approach was used incorporating both quantitative and qualitative data analysis in a leading hospital in Vietnam, which influences others. Data from 108 pediatric patient records were collected and analyzed. Subsequently, in-depth interviews were conducted with pediatric doctors treating these patients to ascertain possible reasons for non-adherence to guidelines. Results: The mean age of children diagnosed with CAP was 27.94 ± 12.99 months, with 82.4% having non-severe CAP, and 41.7% of children had previously used antibiotics before hospitalization. The median length of hospital stay was 7 days. All children were prescribed antibiotics, 91.4% of children received these initially intravenously, with third-generation cephalosporins being the most (91.7%) commonly prescribed. Cefoperazone/sulbactam was the most frequently prescribed (48.2%) antibiotic. However, on 96.1% of occasions cefoperazone/sulbactam was given at higher doses than the label instructions. Overall, 73.3% of antibiotics prescribed were “Watch” antibiotics. In addition, the proportion of initial antibiotic regimens that were consistent with current national guidelines was only 4.63%. Conclusions: There were considerable concerns with low adherence rates to current guidelines alongside high rates of prescribing of injectable third-generation cephalosporins due to various internal and external barriers. Antimicrobial stewardship programs with updated national guidelines are urgently needed in Vietnamese hospitals to treat CAP in children as part of ongoing measures to reduce increasing AMR rates. Such activities should also help improve antibiotic use in the community following improved education of trainee ambulatory care physicians regarding appropriate management of children with CAP. Full article

Antimicrobial resistance (AMR) is a growing global concern, influenced by antibiotic use in both human and veterinary medicine, especially in companion animals. In low- and middle-income countries, regulatory oversight on veterinary prescriptions is often limited, creating gaps that can accelerate AMR. This study aimed to characterize the use of antibiotics approved for human use that are prescribed by veterinarians for companion animals in Brazil, a country representative of broader regulatory challenges. We conducted a retrospective analysis of five years (2017–2021) of national sales data recorded by the National System for the Management of Controlled Products (SNGPC), maintained by the Brazilian Health Regulatory Agency (ANVISA). A total of 789,893 veterinary antibiotic prescriptions were analyzed over the five-year period, providing a comprehensive overview of prescribing patterns. The dataset included all oral and injectable antibiotics purchased in human pharmacies with veterinary prescriptions. Data wrangling and cleaning procedures were applied to extract information on volume, antibiotic classes, seasonal variation, and regional distribution. The results revealed a predominance of penicillins, first- and second-generation cephalosporins, and a marked increase in macrolide use, especially azithromycin. Notable regional disparities were observed, with the southeastern region leading in prescription volume. The findings, particularly the disproportionate use of azithromycin and the marked regional disparities, highlight the need for targeted monitoring policies and a stricter regulation of off-label antibiotic use in veterinary medicine. They also offer insights applicable to other countries facing similar AMR threats due to limited surveillance and regulatory frameworks. Full article

Background/Objectives: Gentamicin is one of the most effective and widely used antibiotics to treat serious infections. In addition to its bactericidal properties, gentamicin has a nephrotoxic effect that results in acute kidney injury (AKI). AKI may be intensified by hypovitaminosis D. This study evaluated the effect of hypovitaminosis D in the progression of gentamicin-induced renal injury. Methods: Male Wistar Hannover rats received a standard (SD) or a vitamin D-free diet (VitD^—) before gentamicin treatment. After that, we divided the animals into four groups: Ctrl VitD, SD diet, and saline injection; Ctrl VitD^—, VitD^— diet, and saline injection; Genta VitD, SD diet, and gentamicin injection (40 mg/kg; IM); Genta VitD^—, VitD^— diet, and gentamicin injection (40 mg/kg; IM). After the end of gentamicin treatment, we followed the animals for 5 days (protocol 1) and 30 days (protocol 2). Results: The Genta VitD group (protocol 1) presented impaired renal function. Regarding morphological analyses, the Genta VitD group presented necrotic tubules (protocol 1) and atrophied tubules (protocol 2). In the inflammatory scenario, the Genta VitD group presented an increase in the number of CD68+ cells, as well as in the levels of interleukin 1β (protocols 1 and 2). In addition, gentamicin-treated animals (protocols 1 and 2) presented an increased renal expression of vimentin and fibronectin. Despite the notable changes in functional, inflammatory, and structural parameters induced by gentamicin, hypovitaminosis D did not aggravate the renal injury in this experimental model. Conclusion: Hypovitaminosis D did not aggravate the progression of gentamicin-induced renal injury in rats. Full article

The health benefits associated with microbial species inhabiting aquatic animals have garnered increasing attention, as it is expected that the colonization and efficacy of native probiotic bacteria adapted to the internal environment of the target species will be more active than non-native bacteria. In this study, six isolates were obtained from the intestinal tract of largemouth bass. Three of these isolates demonstrated higher growth ability compared to the others and were further characterized using in vitro assays. Lactococcus lactis LBM15 was found to exhibit antibacterial activity against common pathogens affecting largemouth bass; the adhesion inhibition capabilities of the isolates were systematically evaluated through competitive, repulsive, and substitutive adhesion assays. The strain inhibited adhesion to all six tested pathogen strains, with competitive adhesion inhibition rates ranging from 42% to 54%, the highest of which was observed against V. anguillarum. Repulsive adhesion inhibition rates ranged from 27% to 55%, with the highest rate noted for Edwardsiella tarda. Additionally, substitutive adhesion inhibition rates were found to range from 48% to 76%, with the highest inhibition observed against Aeromonas hydrophila. Furthermore, LBM15 exhibited favorable antimicrobial susceptibility profiles, showing sensitivity to 21 antibiotics tested. Notably, safety assessment trials were performed exposing fish to LBM15 at a concentration of 1 × 10⁹ CFU/mL by injection and at a concentration of 1 × 10⁸ CFU/mL by feed administration. No clinical abnormalities, behavioral alterations, or mortality were documented in either exposure group, confirming the safety of LBM15 for application in aquaculture. The results suggested that LBM15 isolates from largemouth bass have potential for further investigation and possible application as probiotic candidates. Full article

Thermal manipulation (TM) during embryogenesis is a promising non-pharmacological strategy to enhance physiological resilience in broiler chickens. This study evaluated the impact of thermal conditioning of fertile eggs on growth performance, inflammatory responses, and molecular stress markers following a post-hatch lipopolysaccharide (LPS) challenge. Fertilized eggs (average weight 62 ± 3 g) were obtained from 35-week-old Indian River broiler breeder hens. A total of 720 eggs were randomly assigned to either the control group (n = 360) or the TM group (n = 360), with each group consisting of two replicates of 180 eggs. Control eggs were maintained under standard incubation conditions (37.8 °C, 56% RH), while TM eggs were subjected to elevated temperature (38.8 °C, 65% RH) for 18 h daily from embryonic day 10 to 18. On post-hatch day 15, control and TM groups were administered either saline or LPS via intraperitoneal (IP) injection. Body weight and temperature, internal organ weights, and splenic mRNA expression levels of inflammatory cytokines, toll-like receptors, transcription factors, and heat shock proteins were assessed. TM did not alter hatchability (p = 0.633), but significantly shortened hatch time (p < 0.05) and improved feed efficiency (p < 0.05). While LPS induced marked inflammatory responses in all birds, those subjected to TM exhibited attenuated proinflammatory cytokine expression, enhanced anti-inflammatory signaling, and differential regulation of stress-associated genes, including nuclear factor kappa B (NF-κB), heat shock protein 70 (HSP70), and heat shock factors (HSFs). These findings suggest that TM during incubation promotes a more regulated immune response and improved stress adaptation post-hatch. This approach offers a potential antibiotic-free intervention to enhance broiler health, performance, and resilience under immunological stress. Full article

Background: Endophthalmitis, associated with intraocular procedures, is an infection of the eye that can rapidly result in substantial irreversible loss of vision and may even lead to removal of the eye. Prevention strategies vary globally and often include antibiotic use—often consisting of a broad-spectrum mono-therapeutic agent. The purpose of this study is to test the efficacy and value of combinations of cefuroxime (cefu), cefazolin (cefa), azithromycin (azith), and/or tobramycin (tob) as alternatives to the use of moxifloxacin. We looked for synergism since these antimicrobials used different mechanisms of inhibition. Methods: Initially, we examined individual antimicrobials to determine the minimal bactericidal concentrations (MBC) of each individual treatment against Klebsiella pneumonia, Pseudomonas aeruginosa, Staphylococcus aureus, two clinical isolates of MRSA, and Staphylococcus epidermidis, by both the Zone of Inhibition (ZOI) and the Colony Forming Unit (CFU) assays. We then used these data in a combinatorial study. Results: We found combinations that were synergistic against all the bacteria tested, resulting in total eradication [8 logs] of all bacteria. We found that the ZOI assay provided less consistent results than the CFU assays. Conclusions: We have found combinations of these antimicrobials that were synergistic in the total eradication (8 logs) of all bacteria tested. These three combinations were: cefuroxime/azithromycin; azithromycin/tobramycin; and cefuroxime/tobramycin. Moxifloxacin (Vigamox) did not completely eradicate Staphylococcus epidermidis. These combinations can then be used as eye drops to serve as a prophylactic for endophthalmitis after eye injections and eye surgery. Full article

Background and Clinical Significance: Local anesthetic injections, routine in dental practice, ensure pain control during procedures like root canal treatments. Though generally safe, they can occasionally cause hematomas, localized blood accumulations in tissue planes. Rapidly expanding hematomas in the head and neck are exceptionally rare but dangerous due to anatomical complexity, potentially threatening the airway. This case report emphasizes the critical need for the prompt recognition and management of such complications to prevent life-threatening outcomes, highlighting vigilance in routine dental procedures. Case Presentation: A 63-year-old male presented with rapidly enlarging right buccal swelling four hours post-local anesthetic injection for a root canal on a right maxillary molar. Examination showed warm, erythematous edema and buccal ecchymosis; a CT scan confirmed a 3.8 cm × 8.4 cm × 5.5 cm buccal space hematoma. His medical history revealed controlled type 2 diabetes and hyperlipidemia, and his coagulation was normal. Conservative management failed as the hematoma progressed, limiting mouth and eye opening. Urgent surgical decompression under general anesthesia evacuated clots and ligated facial and angular arteries. ICU monitoring ensured airway stability, with discharge on day three with antibiotics and follow-up. Conclusions: This case highlights the rare potential for dental anesthetic injections to cause rapidly progressive hematomas, requiring urgent surgical intervention and multidisciplinary care to prevent airway compromise. Early recognition, imaging, and decisive management are vital in achieving favorable outcomes in such serious complications. Full article

The presence of substandard and falsified (SF) medicines poses a significant challenge in resource-limited countries. Low-quality antibiotics are commonly reported in low-income countries. The present study aimed to develop and validate a liquid chromatography method with ultraviolet detection (LC-UV) for the identity screening and assay of 13 different injectable antibiotics, i.e., cefepime, amoxicillin, cefazolin, ampicillin, chloramphenicol, ceftazidime, ceftriaxone, cefotaxime, vancomycin, flucloxacillin, cloxacillin, benzylpenicillin, and meropenem in pharmaceutical formulations. Separation was performed using an XBridge C18 column and gradient elution. Mixtures of acetonitrile and 20 mM phosphate buffer (pH 8.0) were used as the mobile phases. The screening method was validated in terms of specificity and robustness, while linearity, precision, accuracy, and sensitivity were checked for the quantification method. The determination coefficients (R²) following linear regression were all greater than 0.999. The method showed good precision, with relative standard deviation values below 1%. The percentage recovery values were close to 100%. The method was applied to analyze 17 injectable antibiotics collected from the Ethiopian market. All commercial samples analyzed contained the correct API and met USP content specifications. Full article

Long-acting injectable (LAI) formulations have revolutionized veterinary pharmaceuticals by improving patient compliance, minimizing dosage frequency, and improving therapeutic efficacy. These formulations utilize advanced drug delivery technologies, including microspheres, liposomes, oil solutions/suspensions, in situ-forming gels, and implants to achieve extended drug release. Biodegradable polymers such as poly(lactic-co-glycolic acid) (PLGA), and polycaprolactone (PCL) have been approved by the USFDA and are widely employed in the development of various LAIs, offering controlled drug release and minimizing the side effects. Various classes of veterinary medicines, including non-steroidal anti-inflammatory drugs (NSAIDs), antibiotics, and reproductive hormones, have been successfully formulated as LAIs. Some remarkable LAI products, such as ProHeart^® (moxidectin), Excede^® (ceftiofur), and POSILACTM (recombinant bovine somatotropin), show clinical relevance and commercial success. This review provides comprehensive information on the formulation strategies currently being used and the emerging technologies in LAIs for veterinary purposes. Additionally, challenges in characterization, in vitro testing, in vitro in vivo correlation (IVIVC), and safety concerns regarding biocompatibility are discussed, along with the prospects for next-generation LAIs. Continued advancement in the field of LAI in veterinary medicine is essential for improving animal health. Full article

Background/Objectives: Exudative age-related macular degeneration (AMD) is a disease of choroidal neovascularization that causes blindness. Current treatments to preserve vision in this prevalent and blinding condition are repeat intraocular injections of anti-vascular endothelial growth factor medicines for a patient’s lifetime to preserve and prevent vision loss leading to blindness. Rifampicin, a small-molecule antibiotic, has previously been reported to exhibit anti-angiogenic properties and a topical safety profile that is well-tolerated. Based on this evidence, we investigated the feasibility of formulating rifamycin as an ophthalmic drop capable of delivering therapeutic concentrations to the posterior segment of the eye. Methods: Inhibition of neovascularization by administration of rifampicin was analyzed in the rat oxygen-induced retinopathy (OIR) and mouse laser-induced choroidal neovascularization (CNV) models. Pharmacokinetic (PK) studies were conducted in mice, rats, and rabbits by dosing various formulations containing rifampicin, and the compound was quantified by LC/MS analysis. Results: Results from dose escalation studies in the mouse laser-induced CNV model suggested the minimum effective dose of rifampicin required for inhibiting neovascularization in subretinal tissues to be 0.7 mg/kg, which is substantially lower than the 20 mg/kg dosage approved for infectious disease treatments. The previous studies did not report the minimum effective dose in the anti-angiogenesis effects. The effective area under the concentration-time curve (AUC) in the sub-retina was evaluated as 0.27 h·ng/mg. In rabbits, rifampicin was delivered to the sub-retina by a single topical application of various formulations in a dose-dependent manner. The topical application of the formulations containing 1% rifampicin, which was well-tolerated in clinical trials previously reported for ocular trachoma, achieved subretinal delivery approximately 2–32 times greater than the effective AUC. Plasma exposure of the compound by the topical application was evaluated to range approximately 0.5–10 ng/mL. Conclusions: Rifampicin was delivered to the sub-retina in rabbits with an efficiency greater than the effective dose required for inhibiting neovascularization. Limited amounts of plasma exposure by the topical application were detected. These results suggested the therapeutic potential of the rifampicin formulations for the topical treatment of exudative macular degeneration. Full article

Case summary: A 2-year-old male neutered domestic shorthair cat was presented with a progressive history of tetraparesis, ataxia, and inappetence over 4 days. A physical exam revealed mucopurulent nasal discharge and stertor. A neurologic exam revealed a multifocal neurolocalization. The cat was non-ambulatory tetraparetic and developed seizures while in hospital. Hematologic assessment revealed anemia, hypoalbuminemia and hyperglobulinemia. Magnetic resonance imaging (MRI) of the brain revealed multifocal meningeal contrast enhancement in the brainstem and cervical spine, as well as mandibular and retropharyngeal lymphadenopathy. Cerebrospinal fluid revealed marked neutrophilic pleocytosis; no infectious organisms were seen. Toxoplasma IgG/IgM and Cryptococcus antigen latex agglutination were negative. Mandibular and abdominal lymph nodes were aspirated, and cytology revealed mixed inflammation. The cat was suspected to have feline infectious peritonitis, and to aid in clinical diagnosis he was enrolled in research study—with targeted Nanopore-based sequencing specifically identifying and characterizing FCoV-1 RNA in spinal fluid and anal swab, but not in urine. The cat was treated with anticonvulsants (phenobarbital and levetiracetam), an antibiotic (ampicillin/clavulanic acid), and GS-441524. Neurologic signs did not improve on an antibiotic alone but improved significantly after two subcutaneous injections of GS-441524. The cat received an 84-day course of GS-441524 and, at the time of manuscript preparation (over 12 months after diagnosis), remains ambulatory and seizure-free without recurrence of neurologic signs and no detectable viral shedding in feces. Full article