The resistance to current antimicrobial agents, including fluoroquinolones, has continued to grow among various pathogens indicating a need for new antimicrobials to combat multi-drug resistant (MDR) organisms. In June 2017, delafloxacin received approval by the US Food and Drug Administration for the treatment of acute bacterial skin and skin-structure infections (ABSSSIs) in adults caused by designated susceptible bacteria. Areas covered: This review describes the pharmacology, pharmacodynamics, pharmacokinetics, product information, efficacy, and safety of delafloxacin. Expert commentary: Delafloxacin is a novel oral and intravenous fluoroquinolone with activity against methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa, offering a new option for the treatment of ABSSSI and potentially for complicated urinary tract infections and severe community-acquired bacterial pneumonia.
Ceftazidime-avibactam (CAZ-AVI) is a novel cephalosporin beta lactamase inhibitor combination that has shown activity against carbapenem-resistant Enterobactericeae. Data are limited on its utilization in the treatment of carbapenem-resistant Klebsiella pneumoniae osteomyelitis in solid organ transplant patients. We describe a case report on the use of CAZ-AVI in the treatment of vertebral osteomyelitis in a renal transplant recipient.
Currently available data on immunologic and virologic responses to antiretroviral therapy (ART) in elderly patients are conflicting. The primary objective of this study was to assess immunologic and virologic responses to ART in treatment-naïve, HIV-infected elderly patients compared to younger patients. This was a single center, retrospective, descriptive study including treatment-naïve, HIV-infected adults initiated on ART between 1 January 2005 and 30 April 2015. Immunologic and virologic responses were compared between the ages ≥50 and < 50 years old. A total of 158 patients were included. By 14 months of ART, 85.9% (n = 67/78) of the patients ≥50 years old and 92.5% (n = 74/80) of those < 50 years old achieved immunologic response (p = 0.02). By 24 weeks of ART, 64.1% (n = 50/78) of the patients ≥50 years old and 65% (n = 52/80) of those < 50 years old achieved virologic response (p = 1). The amount of time it took the elderly patients to achieve virologic suppression was not significantly different compared to the younger patients (p = 0.459). Treatment-naïve, HIV-infected elderly patients achieved virologic response to ART that was comparable to younger patients although their immunologic response to ART was significantly lower.
Migraine headaches are widespread, debilitating and considered a main cause of disability worldwide. Symptoms of migraines include unilateral, pulsating pain that can last for hours to days, frequently associated with photophobia and phonophobia, nausea, or vomiting, and often aggravated by physical activity. The Canadian Headache Society and American Headache Society guidelines suggest strong evidence of the efficacy of triptans, acetaminophen, aspirin, diclofenac sodium, naproxen and ibuprofen for the acute treatment of migraines. The use of calcitonin gene-related peptide (CGRP) antagonists for the treatment and prevention of migraines has been gaining utilization since the approval of the first agent in this class in 2018. There are increasing available options for the acute treatment of migraines. The purpose of this article is to provide a narrative review of the pharmacological and clinical characteristics of ubrogepant and rimegepant and to discuss their implications for use.
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