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Biomedical subjects

Ighovwerha Ofotokun

Publications and source records attributed to Ighovwerha Ofotokun.

6 recordsLinked to original sources
PubMed2005

Results of an antimicrobial control program at a university hospital.

PURPOSE: The results of the first five years of an ongoing antimicrobial control program are reported. METHODS: In 1998, a multidisciplinary antimicrobial subcommittee of the pharmacy and therapeutics committee of a university hospital was formed and charged with making formulary interventions in an effort to reduce rising antimicrobial resistance rates and drug expenditures. In 1999, a number of measures were implemented for controlling antimicrobial use. Selected antimicrobials with the potential for inappropriate use or whose inappropriate use had been documented were placed in the control of physicians in the infectious diseases (ID) division. Prior approval by an ID physician was required before the pharmacy could dispense these agents. Other key interventions included removal of ceftazidime and cefotaxime from the formulary, restriction of vancomycin and carbapenem use, and replacement of ciprofloxacin with levofloxacin as the sole fluoroquinolone on the formulary. Data regarding antimicrobial use and expenditures between 1998 and 2002 were compared and analyzed. RESULTS: Antimicrobial use was reduced by 80% for third-generation cephalosporins and 15% for vancomycin following the implementation of the new antimicrobial policies. Antimicrobial-resistance patterns for many important gram-negative pathogens, including Pseudomonas aeruginosa, demonstrated a reversal of previous increases. In addition, the rate of methicillin-resistant Staphylococcus aureus decreased by an average of 3% each year from 1999 to 2002. Pharmacy expenditures for all antimicrobials, including antiviral, antifungal, and antibacterial agents, decreased 24.7%, with a cumulative cost saving of 1,401,126 US dollars, without inflation assumptions. CONCLUSION: The implementation of an antimicrobial control program decreased the use of selected antimicrobial agents and resulted in substantial reduction of expenditures for antimicrobials.

Anti-Infective Agents↗
PubMed2003

Late-onset drug fever associated with minocycline: case report and review of the literature.

A 15-year-old Caucasian boy experienced severe fever, fatigue, and a 40-lb weight loss after 2 years of minocycline therapy. A workup for infectious causes was negative. One week after minocycline discontinuation, the patient reported that his fever had resolved. Two months later, he reported full resolution of symptoms, weight gain, and a return to normal activity. An objective causality assessment indicated that his illness probably was caused by minocycline, which is considered a safe drug; however, it has been associated with rare serious adverse effects. This patient's presentation of fever was noteworthy not only because minocycline is a rare cause of drug fever, but also because of the delayed onset. Clinicians should be aware that minocycline may cause severe fever and illness even after an extended period of drug exposure.

Acne Vulgaris↗
PubMed2002

Treatment of azole-resistant oropharyngeal candidiasis with topical amphotericin B.

OBJECTIVE: To report a case of successful treatment of azole-refractory oropharyngeal candidiasis with topical amphotericin B. CASE SUMMARY: A 30-year-old white woman presented with recurrent oral thrush. The patient had been exposed to azole antifungals for >20 years, and in vitro susceptibility tests revealed class resistance. The patient started taking amphotericin B 100 mg oral suspension swish-and-spit 4 times daily. After 4 weeks of topical amphotericin B treatment, the patient reported significant symptomatic improvement. The oral candidiasis worsened following a course of oral antibiotics, but improved once the antibiotic was discontinued and after receiving amphotericin B swish-and-swallow for 4 additional weeks. DISCUSSION: Current Infectious Diseases Society of America guidelines include topical amphotericin B as a potentially effective option for the treatment of oropharyngeal candidiasis. There is limited evidence to support this recommendation. Besides lack of data, an appropriate dosing regimen and consistent means of product formulation need to be determined. CONCLUSIONS: This report demonstrates the potential role for topical amphotericin B in the treatment of azole-refractory oral candidiasis. Double-blind, randomized, controlled trials are needed to define dosing, efficacy, administration, and long-term safety of oral amphotericin B.

Administration, Topical↗
PubMedDate not supplied

Sex differences in adverse reactions to antiretroviral drugs.

There have been recent increases in the number of female participants in HIV clinical trials and the number of studies addressing the influence of sex on HIV infection. The findings of some studies indicate a potential sex differences in the frequency and severity of adverse reactions to antiretroviral drugs. This article reviews the available data on the incidence and characteristics of potential sex differences in adverse reactions to certain nucleoside and nonnucleoside reverse transcriptase inhibitors and protease inhibitors. Adverse effects for which a sex difference has been reported include lactic acidosis, rash, elevation in liver enzymes, dyslipidemia, and insulin resistance. The reasons for these sex differences in adverse drug events are unclear but may include differences between men and women in body mass index and fat composition, hormonal effects on drug metabolism, or the effects of genomic constitutional differences on the levels of various enzymes. These differences warrant further study.

Anti-HIV Agents↗
PubMedDate not supplied

Sex differences in the pharmacologic effects of antiretroviral drugs: potential roles of drug transporters and phase 1 and 2 metabolizing enzymes.

Sex differences in the pharmacologic effects of antiretroviral drugs are increasingly being reported. Emerging evidence suggests that women may be at increased risk of developing adverse effects of antiretroviral drugs. Several mechanisms have been proposed to explain sex differences in drug effects, including physiologic differences between men and women and the influence of sex hormones on drug metabolism. This article reviews sex-related variations in the levels of expression and activities of drug transporters and metabolizing enzymes involved in the disposition of the antiretroviral drugs, and postulates that these variations may partly explain sex differences in the responses to these drugs. Studies that explore relationships between levels of expression and activities of relevant enzymes and drug transporters and observed sex-related differences in treatment responses to antiretroviral drugs will help clarify the extent to which molecules involved in drug disposition affect sex differences in treatment response.

ATP Binding Cassette Transporter, Subfamily B, Mem↗