摘要:

Bacterial genomes sequenced to date almost invariably contain genes apparently coding for multidrug efflux pumps, and the yeast genome contains more than 30 putative multidrug efflux genes. Thus it is not surprising that multidrug efflux is a major cause of intrinsic drug resistance in many microorganisms, and plays an even more prominent role in organisms with a low-permeability cell wall, such as Gram negative bacteria in general andPseudomonas aeruginosain particular, as well asMycobacteriumspecies. Furthermore, overproduction of intrinsic pumps, or acquisition of pump genes from external sources, often results in high levels of resistance. This review discusses the classification of efflux proteins, their mechanism of action, the regulation of their expression, and the clinical significance of efflux pumps.

ISSN:0951-7375    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Major differences in the epidemiology of vanA carrying enterococci exist between Europe and the USA, where these organisms have been well investigated. These differences are probably related to the differences in antibiotic use in humans and animals in both continents, but more research is needed before firm conclusions can be drawn.

ISSN:0951-7375    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Chronic obstructive pulmonary disease is a disease state characterized by the presence of airflow obstruction due to chronic bronchitis and/or emphysema. The airflow obstruction is generally progressive. In the past asthma was often confused with chronic obstructive pulmonary disease but as the cellular inflammatory mechanisms are quite different to chronic bronchitis and emphysema it is prudent to separate this condition of airway hyper-responsiveness.Exacerbation of chronic obstructive pulmonary disease is a considerable burden on health service resources in terms of morbidity and mortality. Approximately one half of exacerbations can be attributed to bacterial pathogens, the major pathogens beingHaemophilus influenzae,Streptococcus pnemoniaeandMoraxella catarrhalis. Resistance to common first-line treatment antibiotics such as the β-lactams can be variable. Newer fluoroquinolones such as grepafloxacin, levofloxacin, sparfloxacin, clinafloxacin, moxifloxacin, gatifloxacin and gemifloxacin are characterized by improved activity against Gram positive bacteria as well as their Gram negative properties. However, more randomized controlled trials need to be accomplished before the true role of quinolones in exacerbation of chronic obstructive pulmonary disease is clearly ascertained.

ISSN:0951-7375    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Despite the widespread prophylactic use of antifungal agents in neutropenic patients, invasive fungal infections continue to emerge as major causes of morbidity and mortality. With the exception of fluconazole prophylaxis in allogeneic marrow transplant recipients, no firm conclusions can be drawn due to the lack of reliable, randomized trials. At the present time, it seems that antifungal chemoprophylaxis is more a matter of faith rather than science. Earlier diagnosis based on noninvasive diagnostic techniques and pre-emptive strategies may offer more promise than a liberal prophylactic approach.

ISSN:0951-7375    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:0951-7375    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Visceral leishmaniasis is a widespread and deadly disease. First-line drugs are antimonials, but amphotericin B and its lipid formulations B is used for treating visceral leishmaniasis that is unresponsive to antimony. New therapeutic approaches are being actively developed, including the following: use of drug carriers targeted specifically to the parasite location, thus reduce adverse effects of drug; use of immunomodulating drugs; evaluation of natural products; phamacokinetic studies; and drug combinations. Recent clinical trials with paromomycin and miltefosine were successful and these drugs appear to be promising for the future therapy of visceral leishmaniasis. Furthermore, identification and therapeutic evaluation of specific targets in theLeishmaniaorganism could lead to new compounds, such as antileishmanial drugs and reversal agents of drug resistance.

ISSN:0951-7375    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

There is a growing momentum for the global control and elimination of the major human filariases as public health problems worldwide. The renewed optimism for undertaking this objective reflects the development of simple and potentially cost-effective strategies for mass drug delivery in onchocerciasis and the availability of new extremely effective drug combinations to treat infection, and new methods of morbidity control in lymphatic filariasis. It also reflects the development and current availability of very effective diagnostic, surveillance and control modeling tools for both parasites. Control programming will also be aided by our greater understanding of the biology of transmission, host immunity and disease pathogenesis.

ISSN:0951-7375    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

The launch of the Roll Back Malaria initiative by the World Health Organization in the period under review confirms malaria's place as one of the great public health priorities worldwide. The period 1998-1999 has seen some advances and some disappointments in the treatment of malaria, against a backdrop of spreading drug resistance. Most encouraging is the clear demonstration that intermittent prospective treatment of asymptomatic pregnant women in endemic areas reduces morbidity. The greatest disappointment has been the result of trials with the artemether-benflumetol fixed-dose combination therapy. Questions have been raised about several widely accepted practices, including measurement of quinine levels, exchange transfusion, and the prophylactic use of anticonvulsants in children with cerebral malaria.

ISSN:0951-7375    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:0951-7375    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

The monitoring of the pharmacokinetics of antiretroviral drugs is sometimes thought to be the next routine test in the management of HIV. This overview will provide some background information on the subject, and discusses whether there is a need for therapeutic drug monitoring for antiretroviral drugs.

ISSN:0951-7375    

出版商:OVID    

年代:1999

数据来源: OVID