Tag Archives: Antibiotic

The use of anti-malaria drugs for COVID-19 is associated with an increased risk of cardiac arrhythmias | Instant News

Since the World Health Organization declared COVID-19 as a Public Health Concern for Global Interests on January 30, more than one million tested positive for illness in the United States, and more than 62,000 have died. In the absence of FDA-approved treatments to date, the anti-malaria drug, hydroxychloroquine, has emerged as a potential therapy for pneumonia associated with COVID-19, with or without the antibiotic azithromycin.

In a short report published today at JAMA Cardiology, a team of pharmacists and doctors at Beth Israel Deaconess Medical Center (BIDMC), part of Beth Israel Lahey Health, found evidence that showed patients who received hydroxychloroquine for COVID-19 were at an increased risk of electrical changes in the heart and cardiac arrhythmias. The combination of hydroxychloroquine with azithromycin is associated with greater changes compared to hydroxychloroquine alone.

While hydroxychloroquine and azithromycin are generally well-tolerated drugs, increased use in the context of COVID-19 is likely to increase the frequency of adverse drug events (ADE). This is particularly concerning given that patients with underlying cardiac comorbidities appear to be disproportionately affected by COVID-19 and that the virus itself can damage the heart. “

Nicholas J. Mercuro, PharmD, first co-author, pharmaceutical specialist in infectious diseases at BIDMC

Hydroxychloroquine and azithromycin can respectively cause electrical disturbances in the heart known as QTc extension, shown by a longer distance between certain peaks on the electrocardiogram. The extension of QTc indicates that the heart muscle takes milliseconds longer than usual to refill between beats. Delay can cause cardiac arrhythmia, which in turn increases the chance of a heart attack, stroke, or death.

In this observational, retrospective, single center study, Mercuro and colleagues evaluated 90 adults with COVID-19 who were hospitalized at BIDMC between March 1 and April 7, 2020, and received at least one day of hydroxychloroquine. More than half of these patients also have high blood pressure, and more than 30 percent have diabetes.

Seven patients (19 percent) who received hydroxychloroquine alone developed QTc lasting 500 milliseconds or more, and three patients experienced changes in QTc of 60 milliseconds or more. Of the 53 patients who also received azithromycin, 21 percent had QTc that lasted 500 milliseconds or more, and 13 percent experienced a change in QTc of 60 milliseconds or more.

In our study, patients who were hospitalized and received hydroxychloroquine for COVID-19 often experienced extended QTc and adverse drug events. One participant who used a combination of drugs experienced a potentially lethal tachycardia called torsades de pointes, which to our knowledge has not been reported elsewhere in the COVID-19 literature reviewed by peers. “

Christina F. Yen, MD, first co-author, BIDMC Medical Department

In 2003, preliminary data showed that hydroxychloroquine might be effective against SARS-CoV-1, a fatal but difficult-to-transmit respiratory virus associated with coronavirus that causes COVID-19. Recently, a small study of patients with COVID-19 appears to benefit from anti-malaria drugs. However, subsequent studies failed to confirm both of these findings. Regarding their data, Gold and his colleagues urge caution and careful consideration before giving hydroxychloroquine as a treatment for COVID-19.

“When considering the use of hydroxychloroquine, specifically combined with azithromycin, doctors must carefully weigh the risks and benefits, and monitor QTc – especially considering the patient’s co-morbidity and concurrent drug use,” said senior author Howard S. Gold, MD, a specialist infectious disease at BIDMC and assistant professor of medicine at Harvard Medical School. “Based on our current knowledge, hydroxychloroquine for the treatment of COVID-19 may have to be limited to clinical trials.”


Journal reference:

Mercuro, N.J., et al. (2020) The risk of prolongation of the QT interval associated with the use of hydroxychloroquine with or without concurrent azithromycin among inpatients who tested positive for Coronavirus 2019 (COVID-19). JAMA Cardiology. doi.org/10.1001/jamacardio.2020.1834.


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Lasers turn metal surfaces into bacterial killers | Instant News

Purdue University researchers have found laser treatments for metal textures that have the potential to change almost any metal surface to quickly eliminate bacteria that come in contact with it. This study, published in the journal Advanced Material Interface in April 2020, it could help break the chain of general superbug transmission and reduce the number of infections caused by indirect spread through the surface.

Purdue University engineers have created a laser treatment method that has the potential to turn any metal surface into a fast bacterial killer – just by giving the metal surface a different texture.

Why is surface disinfection important?

Bacteria are responsible for many diseases that make our lives difficult – salmonella, boils, and syphilis are just a few of the many types of damage that bacteria can cause to our bodies. One of the disturbing things about bacteria is that most of them can survive on metal surfaces for a long time. Add to this the fact that most of the things we touch most – door handles, bathroom fixtures, car keys – are made of metal, and you have a number of potential pathogens waiting to rise to your skin.

The new process might change all that, transmitting metal from a friendly hangout zone to kill fields for bacteria. It works by using a laser to change the texture of metal surfaces. Copper, for example, is often used as a natural antimicrobial ingredient; However, it takes hours to kill most of the bacteria on its surface. But with Purdue University’s treatment, the number of bacteria that touch and die instantly accelerates dramatically, making it clinically useful.

A laser prepares for the surface texture of copper, increasing its antimicrobial properties. (Photo of Purdue University / Kayla Wiles)

A laser prepares for the surface texture of copper, increasing its antimicrobial properties. (Photo of Purdue University / Kayla Wiles)

Copper usually has a smooth surface. This limits the area of ​​contact with bacteria, which means how many bacteria die. Previously, efforts had been made to use nanostructures to increase the surface area of ​​metals, but this came very easily and was often toxic.

How laser etching works to kill more bacteria

With a new approach, the technology works with the metal itself. They use lasers to etch nano paths into metals, increase their surface area and improve their antibiotic properties. Working with native metals makes this far more powerful than existing technology – it does not damage or damage the environment.

“The nice thing about our process is that it’s not something we add to the surface,” said Rahim Rahimi from Purdue University’s material engineering division, “so no additional ingredients are needed. No antibiotics, no spray coating. It’s just modifying the original surface of the material … “we have created a powerful process that selectively produces micron and nanoscale patterns directly to the targeted surface without changing most of the material.” Research is ongoing in using this procedure on alloys that have antimicrobial properties already there before.

The treated surface has been shown to improve germ killing properties – even with aggressive pathogens that have developed resistance to conventional antibiotics such as MRSA. However, the material has not yet been developed to the point where it can eliminate viruses such as those responsible for the COVID-19 pandemic, because these viruses are much smaller than bacteria. The etching surface has been shown to be effective in Gram-negative and Gram-positive bacteria.

Can this make medical implants safer?

This technology works far beyond making the door handles more sanitary. However: Rahimi and his team are working to adapt it for use with orthopedic implants and wearable wound patches. Implants are a vulnerable place in the immune system because they are intrinsically foreign. This means additional measures must be taken to protect areas that are prone to infection. Usually, antibiotics are used to prevent the formation of bacterial biofilms, but this can cause antibiotic resistance in bacteria.

Purdue University’s laser etching technique can prevent this because of the great impulse it gives to the antimicrobial properties of the surface of the implant, without the use of antibiotics or anti-adherence coatings that can slow the implant’s integration into the body.

Etching a metal surface with a nanoscopic pattern has another benefit: making the material more hydrophilic. Several studies have been carried out on the hydrophilic surface and how they help cure: they have been shown to control inflammation, help bone cells to stick back stronger, increase implant integration with the body, and contribute to faster osteogenesis, or bone regeneration. Rahimi and his team have observed this behavior in fibroblast cells. Also, when used in the field of wounds, the hydrophilic surface helps the blood to thicken more efficiently while reducing the potential for infection.

Is laser etching commercially viable?

With simplicity and scalability, the etching laser process pioneered by Purdue University is easy to integrate into manufacturing practices that already operate for medical devices. Bacteria have ranged from harassment to life-threatening killings, and a large amount of medical team work is aimed at preventing them. Laser etching can provide a useful way to significantly reduce this burden.


Now metal surfaces can be instant bacterial killers, thanks to new laser treatment techniques

Journal reference:

Selvamani, V., Zareei, A., Elkashif, A., Maruthamuthu, MK, Chittiboyina, S., Delisi, D., Li, Z., Cai, L., Pol, VG, Seleem, MN, Rahimi, R ., Micro / Mesoporous Copper Hierarchy Structure with Enhanced Antimicrobial Properties through Laser Surface Textures. Adv. Mater. Interface 2020, 1901890. https://onlinelibrary.wiley.com/doi/abs/10.1002/admi.201901890?_ga=2.35057185.1008137069.1586741252-712945497.1586489343


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