Podcasts about erythromycin

Welcome to The Nonlinear Library, where we use Text-to-Speech software to convert the best writing from the Rationalist and EA communities into audio. This is: Generative ML in chemistry is bottlenecked by synthesis, published by Abhishaike Mahajan on September 18, 2024 on LessWrong. Introduction Every single time I design a protein - using ML or otherwise - I am confident that it is capable of being manufactured. I simply reach out to Twist Biosciences, have them create a plasmid that encodes for the amino acids that make up my proteins, push that plasmid into a cell, and the cell will pump out the protein I created. Maybe the cell cannot efficiently create the protein. Maybe the protein sucks. Maybe it will fold in weird ways, isn't thermostable, or has some other undesirable characteristic. But the way the protein is created is simple, close-ended, cheap, and almost always possible to do. The same is not true of the rest of chemistry. For now, let's focus purely on small molecules, but this thesis applies even more-so across all of chemistry. Of the 1060 small molecules that are theorized to exist, most are likely extremely challenging to create. Cellular machinery to create arbitrary small molecules doesn't exist like it does for proteins, which are limited by the 20 amino-acid alphabet. While it is fully within the grasp of a team to create millions of de novo proteins, the same is not true for de novo molecules in general (de novo means 'designed from scratch'). Each chemical, for the most part, must go through its custom design process. Because of this gap in 'ability-to-scale' for all of non-protein chemistry, generative models in chemistry are fundamentally bottlenecked by synthesis. This essay will discuss this more in-depth, starting from the ground up of the basics behind small molecules, why synthesis is hard, how the 'hardness' applies to ML, and two potential fixes. As is usually the case in my Argument posts, I'll also offer a steelman to this whole essay. To be clear, this essay will not present a fundamentally new idea. If anything, it's such an obvious point that I'd imagine nothing I'll write here will be new or interesting to people in the field. But I still think it's worth sketching out the argument for those who aren't familiar with it. What is a small molecule anyway? Typically organic compounds with a molecular weight under 900 daltons. While proteins are simply long chains composed of one-of-20 amino acids, small molecules display a higher degree of complexity. Unlike amino acids, which are limited to carbon, hydrogen, nitrogen, and oxygen, small molecules incorporate a much wider range of elements from across the periodic table. Fluorine, phosphorus, bromine, iodine, boron, chlorine, and sulfur have all found their way into FDA-approved drugs. This elemental variety gives small molecules more chemical flexibility but also makes their design and synthesis more complex. Again, while proteins benefit from a universal 'protein synthesizer' in the form of a ribosome, there is no such parallel amongst small molecules! People are certainly trying to make one, but there seems to be little progress. So, how is synthesis done in practice? For now, every atom, bond, and element of a small molecule must be carefully orchestrated through a grossly complicated, trial-and-error reaction process which often has dozens of separate steps. The whole process usually also requires non-chemical parameters, such as adjusting the pH, temperature, and pressure of the surrounding medium in which the intermediate steps are done. And, finally, the process must also be efficient; the synthesis processes must not only achieve the final desired end-product, but must also do so in a way that minimizes cost, time, and required sources. How hard is that to do? Historically, very hard. Consider erythromycin A, a common antibiotic. Erythromycin was isolated in 1949, a natural metabolic byproduct of Streptomyces erythreus, a soil mi...

Administering erythromycin eye ointment to newborns is a standard procedure in the United States to prevent ophthalmia neonatorum. Ophthalmia neonatorum is a newborn eye infection that affects 1-2% of newborns in the United States. This infection can be caused by sexually transmitted infections, viruses, and bacteria. As with any intervention, there are pros and cons to consider. This episode examines the evidence on the efficacy and safety of erythromycin eye ointment so you can make an informed choice for your baby.     Thank you to our sponsors   Zahler goes above and beyond to use high-quality bioavailable ingredients like the active form of folate, bioavailable iron, and omega 3s. The Zahler Prenatal +DHA is my #1 recommendation for a high-quality prenatal vitamin. In April 2024 you can save 20% off the Zahler Prenatal +DHA on Amazon with the code PREPOD20. Plus email your order number and mailing address to vanessa@pregnancypodcast.com to get a free silicone baby bib. You can always see the current promo code for the Zahler prenatal vitamin by clicking here.   For a limited time only, you can get the 8 Sheep Pregnancy Survival Kit at $30 off, with free shipping within the US! Plus, save an additional 10% with the promo code PREGNANCYPODCAST. The Pregnancy Survival Kit includes a set of four handcrafted products that help with common pregnancy pains like pregnancy insomnia, restless legs, lower back and hip pains, leg cramps, swollen and achy legs and feet, and stretch marks. The amazing products from 8 Sheep are made with safe ingredients for you and your baby during pregnancy. Every product from 8 Sheep Organics comes with a 100-Day Happiness Guarantee, so you can try it risk-free.   40% off your first Hungryroot delivery and free veggies for life. Hungryroot is the easiest way to eat healthy. They send you fresh, high-quality groceries and simple recipes. Each order is fully customizable so you can take their suggestions or choose anything you want. They've got fresh produce, high-quality meat & seafood, healthy snacks, smoothies, sweets, ready-to-eat meals, kids' snacks and meals, and much more. Everything from Hungryroot follows a simple standard: it's gotta taste good, be quick to make, and contain whole, trusted ingredients.     Read the full article and resources that accompany this episode.     Join Pregnancy Podcast Premium to access the entire back catalog, listen to all episodes ad-free, get a copy of the Your Birth Plan Book, and more.     Check out the 40 Weeks podcast to learn how your baby grows each week and what is happening in your body. Plus, get a heads up on what to expect at your prenatal appointments and a tip for dads and partners.     For more evidence-based information, visit the Pregnancy Podcast website.

Der Wirkstoff Erythromycin ist ein ganz schönes Sensibelchen. Wird das Makrolid-Antibiotikum nicht im richtigen pH-Bereich verarbeitet, kann es schnell unwirksam werden. Rezepturprofi Sarah Siegler aus dem PTA Beirat erklärt im Podcastgespräch mit Redakteurin Stefanie Fastnacht, was das konkret für die Herstellung bedeutet.

Dr. Nayantara Coelho-Prabhu, Mayo Clinic gastroenterologist specializing in the care of patients with gastrointestinal bleeding and endoscopy, talks through many aspects of acute GI bleeding. She helps to clarify the prioritization of medications, when to incorporate imaging, broadens our differentials for upper and lower GI bleeding, gives mindblowing advice on stool guiac testing and SO much more in this over-stuffed (or should we say constipated) chapter of Always on EM. There is also a special cameo from Dr. Luke Wood going over how to insert a Minnesota tube (esophageal balloon tamponade device)!   CONTACTS X - @AlwaysOnEM; @VenkBellamkonda Instagram – @AlwaysOnEM; @Venk_like_vancomycin; @ASFinch Email - AlwaysOnEM@gmail.com   RECOMMENDATION: Dieulafoy lesion video from New England Journal of Medicine: https://youtu.be/tzJQDen1nug?si=zOmywZ1VN3VvA004    REFERENCES: Drescher MJ, Stapleton S, Britstone Z, Fried J, Smally AJ. A call for reconsideration of the use of fecal occult blood testing in emergency medicine. Journal of Emerg Med. 2020. 58(1)54-58 Mathews BK, Ratcliffe T, Sehgal R, Abraham JM, Monash B. Fecal Occult Blood testing in hospitalized patients with upper gastrointestinal bleeding. Journal of Hospital Medicine. 2017. 12(7)567-569 Harewood GC, McConnell JP, Harrington JJ, Mahoney DW, Ahlquist DA. Detection of occult upper gastrointestinal bleeding: performance in fecal occult blood tests. Mayo Clin Proc. 2002 Jan;77(1):23-28 Blatchford O, et al. A risk score to predict need for treatment for upper gastrointestinal haemorrhage. Lancet 2000. Oct 14;356(9238):1318-21 Blatchford O, Davidson LA, Murray WR, Blatchford M, Pell J. Acute upper gastrointestinal haemorrhage in west of scotland: case ascertainment study. BMJ 1997. Aug 30;315(7107):510-4 Chen IC, Hung MS, Chiu TF, Chen JC, Hsiao CT. Risk scoring systems to predict need for clinical intervention for patients with nonvariceal upper gastrointestinal tract bleeding. Am J Emerg Med. 2007 Sep;25(7):774-9 Laine L, Barkun AN, Saltzman JR, Martel M, Leontiadis GI. ACG Clinical Guideline: Upper Gastrointestinal and Ulcer Bleeding. Am J Gastroenterol. 2021 May 1;116(5):899-917 Roberts I, Shakur-STill H, Afolabi A, et al. Effects of High-dose 24-h infusion of tranexamic acid on death and thromboembolic events in patients with acute gastrointestinal bleeding (HALT-IT): an international randomised, double-blind, placebo-controlled trial. Lancet 2020. 395(10241):1927-1936 Aziz M, Haghbin H, Gangwani MK, Weissman S, Patel AR, Randhawa MK, Samikanu LB, Alyousif ZA, Lee-Smith W, Kamal F, Nawras A, Howden CW. Erythromycin improves the quality of esophagogastroduodenoscopy in upper gastrointestinal bleeding: a network meta-analysis. Dig Dis Sci 2023. Apr;68(4):1435-1446 Abraham NS, Barkun AN, Sauer BG, et al. American College of Gastroenterology-Canadian Association of Gastroenterology Clinical Practice Guideline: Management of anticoagulants and antiplatelets during acute gastrointestinal bleeding and the periendoscopic period. Am J Gastroenterol 2022;00:1-17 Vigano GL, Mannucci PM, Lattuada A, Harris A, Remuzzi G. Subcutaneous desmopressin (DDAVP) shortens the bleeding time in uremia. Am J Hematol 1989. May;31(1):32-5 Chavez-Tapia NC, Barrientos-Gutierrez T, Tellez-Avila FL, Soares-Weiser K, Uribe M. Antibiotic prophylaxis for cirrhotic patients with upper gastrointestinal bleeding. Cochrane Database Syst Rev 2010. Sep 8;2010(9):CD002907 Gao Y, Qian B, Zhang X, Liu H, Han T. Prophylactic antibiotics on patients with cirrhosis and upper gastrointestinal bleeding: A meta-analysis. PLoS One 2022. Dec 22;17(12):e0279496 Steffen R, Knapp J, Hanggi M, Iten M. Use of the REBOA catheter for uncontrollable upper gastrointestinal bleeding with hemorrhagic shock. Anaesthesiologie 2023. May;72(5):332-337 Sato M, Kuriyama A. Countering hemorrhagic shock due to duodenal variceal rupture with resuscitative endovascular balloon occlusion of the aorta. Am J Emerg Med 2023. Feb;64:204.e1-204.e3

Visit: https://nursing.com/140meds to request your free copy of "140 Must Know Meds" Generic Name Erythromycin Trade Name E-Mycin Indication Useful in place of penicillin when patient cannot take penicillin, upper and lower respiratory tract infections, otitis media, skin infections, pertussis, syphilis, rheumatic fever Action Bacteriostatic: suppresses bacterial protein synthesis Therapeutic Class Anti-infective Pharmacologic Class Macrolide Nursing Considerations • Causes QT prolongation, ventricular arrhythmias • Diarrhea • Asses infection • Monitor liver function tests • Instruct patient to finish medication dosage even if they are feeling better • Medication should not be shared

On episode #27 of the Infectious Disease Puscast, Daniel and Sara review the infectious disease literature for the previous two weeks, 4/13 – 4/25/23. Hosts: Daniel Griffin and Sara Dong Click arrow to play Download Puscast 027 (19 MB .mp3, 31 min) Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email Become a patron of Puscast! Links for this episode Prevalence, clinical severity, and seasonality of Adenovirus 40/41, Astrovirus, Sapovirus, and Rotavirus among children with moderate-to severe diarrhea (CID) Antibiotic-prescribing practices for management of childhood diarrhea in 3 sub-Saharan African countries (CID) Drivers of decline in diarrhea mortality (CID) Breastfeeding among people with HIV in North America (CID) Wearable sensor-based detection of Influenza in presymptomatic and asymptomatic individuals (JID) Emergence of erythromycin-resistant invasive group a Streptococcus (EID) Piperacillin-Tazobactam compared With Cefoxitin as antimicrobial prophylaxis for pancreatoduodenectomy (JAMA) VE303 for prevention of recurrent Clostridioides difficile infection (JAMA) Geographic patterns of antimicrobial susceptibilities for Bacteroides species worldwide (IJAA) Intravenous to oral antibiotic switch therapy among patients hospitalized with community-acquired pneumonia (CID) Clinical impact of syndromic molecular point-of-care testing for gastrointestinal pathogens in adults hospitalized with suspected gastroenteritis (The Lancet) Treatment of pulmonary mucormycosis with adjunctive nebulized amphotericin B (Mycoses) Giardia detection and codetection with other enteric pathogens in children in the vaccine impact on diarrhea in Africa (CID) Feasibility of training community health workers to use smartphone-attached microscopy for point-of-care visualization of soil-transmitted helminths (AJTMH) Compassionate use of bacteriophages for failed persistent infections (OFID) Music is by Ronald Jenkees

Erika gave birth to her first child in the hospital and was labeled a "weirdo"  and stamped as "difficult" for her birth plan intentions.  When the hospital staff tried to take her baby away in order to administer the Vitamin K shot and Erythromycin eye ointment, she refused, holding her baby close as the staff tried to pull the baby from Erika's arms. Next came the call to CPS (Child Protective Services), putting Erika on a government watch list as a threat to her child's well-being. As a long-time yoga practitioner and deep spiritualist, Erika shares her perspective on birth as a one-of-a-kind opportunity to embrace discomfort and release the notion of separation from oneness. Erika HalweilDown to Birth is sponsored by:DrinkLMNT -- Purchase LMNT today and receive a free sample kit. Stay salty.Love Majka Products -- Support your milk supply with nourishing protein powder, hydration boosters and lactation bites.Silverette Nursing Cups -- Soothe and heal sore nipples with 925 silver nursing cups.Postpartum Soothe -- Herbs and padsicles to heal and comfort after vaginal birth. **********Connect with us on Patreon for our exclusive content.Email Contact@DownToBirthShow.comInstagram @downtobirthshowCall us at 802-GET-DOWN Work with Cynthia: 203-952-7299 HypnoBirthingCT.com Work with Trisha: 734-649-6294 Please remember we don't provide medical advice. Speak to your licensed medical provider for all your healthcare matters.

Did you know that your newborn is routinely given these 3 medicines moments after birth? Do you know what these medicines are intended for and do you feel you have all the information needed to make an informed decision? The purpose of this episode is to provide parents with information that isn't often talked about. I hope after listening to this podcast, you feel more informed, know your rights, and are able to advocate for your family as you see fit. Follow along with this episode Show Notes/Blog post. If you have any questions, comments, or concerns with motherhood or this episode, please reach out to me! I'm your host, Alisha Foster! Follow me with Learning as They Grow on YouTube // Instagram // Facebook // TikTok // Spotify // Apple Podcast or just check It all out by going here. Make sure to follow or subscribe on your favorite platforms to stay up-to-date on the latest episodes and motherhood tips I share along the way!

Opioidhaltige Schmerzpflaster mit den Wirkstoffen Fentanyl bzw. Buprenorphin sind in der Schmerztherapie weit verbreitet und wegen ihrer recht einfachen Anwendbarkeit und guten schmerzlindernden Effekte etabliert. Apothekerin Dr. Cora Menkens erklärt im Podcast PTA FUNK, welche Pflasterarten es gibt und was PTA bei der Beratung unbedingt beachten sollten. (15:35 Min) https://www.das-pta-magazin.de/news/podcast-pta-funk-opioid-pflaster-richtig-anwenden-3217013.html

Der Bart liegt bei Männern derzeit voll im Trend. Rasiert sich jemand den Vollbart allerdings ab, kann es zur Haarbalgentzündung kommen. Gegen diese Follikulitis hilft eine Erythromycin-Mikrosilber-Creme. Im Podcast PTA FUNK sprechen Redakteurin Stefanie Fastnacht und Rezepturprofi Sarah Siegler über die Herstellung der antibiotischen Creme. (13:57 Min)

Download the cheat: https://bit.ly/50-meds  View the lesson:  https://bit.ly/ErythromycinErythrocinNursingConsiderations    Generic Name Erythromycin Trade Name E-Mycin Indication Useful in place of penicillin when patient cannot take penicillin, upper and lower respiratory tract infections, otitis media, skin infections, pertussis, syphilis, rheumatic fever Action Bacteriostatic: suppresses bacterial protein synthesis Therapeutic Class Anti-infective Pharmacologic Class Macrolide Nursing Considerations • Causes QT prolongation, ventricular arrhythmias • Diarrhea • Asses infection • Monitor liver function tests • Instruct patient to finish medication dosage even if they are feeling better • Medication should not be shared

Lexman Artificial interviews Pieter Abbeel, a physical therapist and assistant professor at the University of Montreal. They discuss Pieter's work with patients who are afflicted with infirmness (e.g. arthritis, fibromyalgia, multiple sclerosis) and the use of erythromycin.

Hey everyone! Starting this month, we have an exciting announcement: Down to Birth Show is now producing longer Q&A episodes. So if you can't get enough Q&A, and you want to enjoy ad-free episodes all the time, be sure to subscribe on Apple Podcasts!This week we're answering questions on: Difficult conversations with your doctor and how to discuss things like aging placentas, eating during labor, breech deliveries, etc.; What Erythromycin eye ointment works for and what it does not;  Are there ways to prevent mastitis? How soon after birth can or should you have a non-hormonal IUD placed?  Does artificial rupturing of membranes make labor more painful? When can I expect some sort of routine with my exclusively-breastfed one-month old baby? Don't forget to check the chapter markers to skip to specific questions or to our quickies section where we talk about elevated prolactin levels, skin-to-skin, doulas & midwives at your birth, "running" from your in-laws, and more! And for Apple subscribers, our ad-free, longer version includes: Our thoughts about one home-birth midwife's advice in telling her client not to take a shower for days after giving birth; how to know whether you're hiring the right doula for you; and we answer a second-time mom's question about her tendency to bleed into her second trimester when pregnant, and whether that's a miscarriage or stillbirth risk. Finally, we give our advice to another second-time mother about how best to prepare her toddler for the imminent new family member, and Trisha answers a breastfeeding question that had us laughing for a bit.Here's the link to the "preparing your dog for baby" episode we referenced: Episode #38: Your Dog And Newborn: Interview with Heather Corum from Canine Company**********This show is sponsored by:Silverette USA*DYPER*NOM Maternity*Vyana Infant Massage*Wildbird.co*Beautiful Births and Beyond*Postpartum Soothe**Use promo code DOWNTOBIRTHConnect with Cynthia and Trisha at:Instagram: @downtobirthshow on InstagramEmail: Contact@DownToBirthShow.comCall: (802) 438-3696 (802-GET-DOWN)Work with Cynthia:Email: Cynthia@HypnoBirthingCT.com Text: 203-952-7299 to RSVP to attend a free information session live on Zoom. Upcoming dates are posted at HypnoBirthingCT.com. You can also sign up for our Fourth Trimester Workshop,  Breastfeeding Workshop or Cynthia's HypnoBirthing classes and weekly postpartum support groups at HypnoBirthing of Connecticut. Work with Trisha at:Email: Trisha.Ludwig@gmail.com for online breastfeeding consulting services or text 734-649-6294 for more info.We serve women and couples coast to coast with our live, online monthly HypnoBirthing classes, support groups and prenatal/postpartum workshops. We are so grateful for your reviews and shares!Please remember we don't provide medical advice, and to speak with your licensed medical provider related to all your healthcare matters. Thanks so much for joining in the conversation, and see you next week!Support the show

In 1997, Mercer et al first published their data on antibiotic use for PPROM latency. With IV Erythromycin shortages, Zmax is a known substitute. New data (EPUB December 2021) now points to Zithromax's validated clinical advantage over Erythromycin in this protocol. In this session, we will review this soon to be released publication in AJOG.

Plausi-Check: Rezeptur-Profi Sarah Siegler aus dem PTA Beirat von DAS PTA MAGAIN und Redakteurin Stefanie Fastnacht nehmen eine Rezeptur mit Tannin und Erythromycin in Basiscreme DAC unter die Lupe. Da diese nicht plausibel ist, zeigen sie Lösungsmöglichkeiten auf und geben Tipps für die Arztrücksprache (14:30 min). https://www.das-pta-magazin.de/serie-rezeptur-tannin-erythromycin-creme-2976238.html

Ophthalmia neonatorum is a newborn eye infection and in the United States occurs in 1-2% of newborns. This infection can be caused by sexually transmitted infections, viruses, and bacteria. Administering erythromycin eye ointment to newborns is standard procedure in the United States to prevent ophthalmia neonatorum. As with any intervention, there are pros and cons to consider. This article examines the evidence on the efficacy and safety of erythromycin eye ointment so you can make an informed choice for your baby.   You can read the full article and resources that accompany this episode by clicking here.   Join Pregnancy Podcast Premium to access the entire back catalog, listen to all episodes ad-free, and more.   For more evidence-based information, visit the Pregnancy Podcast website.

Let's get on to Macrolides, Lincosamides. A little bit of stuff on protein biosynthesis won't hurt to help us understand the pharmacology of these class of drugs, macrolides and Lincosamides. Bacterial protein synthesis involves proteins required for reproduction, and is made possible by ribosomal RNA, mRNA and tRNA. To begin, the double stranded DNA first unwinds in an untwisting motion in the region which codes for the specific protein to be made and only that one strand of the DNA serves as a template for what is known as transcription. RNA polymerase makes a copy of this segment, which now stands as what is called mRNA. Once the strand of mRNA is complete, it detaches from that segment, and in turn become attached to ribosomes. Now it gets interesting. Bacterial ribosomes are made of two subunits, the small 30s and a bigger 50s ribosomal subunits, together makes up 70s ribosomal unit. The numbers don't add up right? Yes 30+50 is not 70. If you want to know why, download the Podroom app and join the discussion, there you can ask me and I'll explain. For now, we move. The ribosomal subunits attach to the mRNA strand like a zipper and begin the synthesis of the polypeptide chain, along that strand. Now the amino acids needed for this synthesis, is bound to tRNA, so tRNA + amino acids bind to the ribosome which is on the mRNA strand and begins to work its way from one end of the strand to the other, making the polypeptide chain in the process, until it hits a stop codon which makes it stop and release the full polypeptide chain it has been making. The 70s ribosome couples itself back and awaits further instruction. It's very easy, see, these are the steps 1.    Bacterial DNA unwinds to reveal a segment to be copied 2.    RNA polymerase makes a copy of this segment, a complete mirror image of the segment, detaches this new copy, which now stands alone as mRNA 3.    This mRNA attaches to 70s ribosome, which clasps the strands above and below with its two subunits 50s and 30s 4.    tRNA which contains amino acids is then bound to the ribosome and this moves along the mRNA strand to synthesize the polypeptide chain. 5.    Macrolides and Lincosamides inhibit this ribosome and do not allow it to move. If it cannot move, polypeptide and hence protein synthesis stops, and bacteria cannot grow, everything becomes static, that is why they say these drugs are bacteriostatic. So now, drugs that affect ribosomes in protein synthesis either affect the 50s or 30s subunits of the 70s ribosome. Don't worry, there is a mnemonic for that. Buy AT 30 and CELL @50 Aminoglycosides and tetracyclines inhibit protein synthesis by inhibiting the 30s ribosomal subunit. Chloramphenicol, Erythromycin (macrolides), Lincosamides and Linezolid all inhibit 50s ribosomal subunit. So macrolides – are a class of antibiotics that contain the following drugs 1.    Erythromycin – the oldest, strep, staph, pertusis, diphtheria, M. pnemonia 2.    Clarithromycin- strongly g +ve, used in eradication of H. pylori, renal toxicity 3.    Azithromycin – strong G -ve, RTI mainly As you go from erythromycin to azithromycin, you go from old to new, and also their half lives increases in that fashion, and hence their frequency of dosing reduces. *MOA* - just like I said, inhibits 50s, along with other counterparts in the mnemonic CELL @50 *Spectrum of activity* – G -ve and +ve, anaerobes (upper airway), atypical bacteria (legionella, chlamydia, mycoplasma etc), others like mycobacterium avium complex, campylobacter, treponema pallidum etc *Absorption* - food decreases it, why enteric coated ones are made. Clarithromycin is well absorbed irrespective of food. *Distribution-* all body fluids and placenta except CSF *and Elimination* - Hepatic: ALL, only clarithromycin is partially excreted by renals, why it needs renal adjustment at times. Cannot dialyze. Erythro t1/2- 1.5hrs, clarithromycin about 6hrs, Azithro – 68hrs *Resistance* - 80% is through the active efflux mechanism in which the mef gene encodes for an efflux pump that actively pumps macrolide out of the cell, away from the ribosome it is supposed to inhibit. Another mechanism is one in which a gene alters the binding site of the macrolide on the ribosome. Lastly, there is cross resistance which occurs between all macrolides. *Adverse Reactions* - M- Motility A: Arrythmias (prolonged qt interval) C: Cholestatic Hepatitis R: Rash 0: eosinophilia *Drug interaction* : it inhibits CYP3A4 enzyme leading to increased effects of carbamazepine, theophylline, warfarin, valproate. Enough of Macrolides. Let's talk about a close relative in mechanism of action. The Lincosamides Briefly! In this class is Clindamycin and Lincomycin They are active against staph, gram +ve and -ve anaerobes. Also against Bacteroides. Mechanism of action – You know this already, yes say it, of course if you Cell@ 50 you will know it binds to 50s ribosome and hence inhibits protein synthesis. It is absorbed well, penetrates well into most tissues including bone, but not CSF Excreted via the liver, bile and Urine. Resistance: mechanisms via drug inactivation, alteration of 50s ribosomal subunit by adenine methylation and mutation of the 50s ribosomal protein. *USES:* 1.    Anaerobic infections 2.    Osteomyelitis, arthritis 3.    AIDS related toxoplasmosis (combined with pyrimethamine) 4.    AIDS related pneumocystis carinii pneumonia. ADVERSE REACTIONS: 1.    Severe diarrhea- pseudomembranous enterocolitis caused by clostridium deficille 2.    High IV dose – neuromuscular blockade 3.    Neutropenia 4.    Impaired liver function 5.    Hypersensitivity And that's all fellas. Next, we talk about Sulphonamides in the next episode. This content is made for medical students, all pharmacology enthusiasts and medical practitioners who want to refresh their memory within the shortest possible time. This is meant to be used in conjunction with detailed pharmacology notes or texts, not sufficient as a standalone.

On today's podcast, we will be talking about the evidence on using erythromycin eye ointment for newborns. As this is a controversial topic, I am excited to talk about the intriguing research evidence and the history of eye ointment regarding how it started and why it was used in the past, as well as why it is still being used today. We have covered this topic before here in our Signature Articles. We will also discuss whether or not it is effective for its designed purpose, along with antibiotic resistance, the benefits and risks of using eye ointment on newborns, and alternatives to use in place of eye ointment.  For more information and news about Evidence Based Birth®, visit www.ebbirth.com. Find us on Facebook (https://www.facebook.com/EvidenceBasedBirth/), Instagram (https://www.instagram.com/ebbirth/), and Pinterest (https://www.pinterest.com/ebbirth/). Ready to get involved? Check out our Professional membership (including scholarship options) (https://evidencebasedbirth.com/become-pro-member/). Find an EBB Instructor here (https://evidencebasedbirth.com/find-an-instructor-parents/), and click here (https://evidencebasedbirth.com/childbirth-class/) to learn more about the Evidence Based Birth® Childbirth Class.

On this episode, I discuss bromocriptine pharmacology. It is a dopamine agonist that can be used for hyperprolactinemia and Parkinson's symptoms. One of the major side effects of bromocriptine is nausea which stems from its dopamine agonist action. Because bromocriptine is a dopamine agonist, it can counteract the action of antipsychotics. Bromocriptine is broken down by CYP3A4, so drug interactions can be common. Erythromycin, some of the azole antifungals, verapamil, grapefruit juice, and diltiazem are all medications that can increase concentrations.

In today's episode, the midwives talk all about newborn eye medication, AKA erythromycin, AKA newborn eye prophylaxis. They cover what it's good for, what it protects against, and how they advise their clients when it comes to decision-making regarding newborn eye medication. --- https://hearthandhomemidwifery.com

Episode 11 Chlamydia with Clau The sun rises over the San Joaquin Valley, California,today is May 8, 2020. On April 28, 2020, the USPSTF released a final recommendation about prevention of tobacco use in children and adolescents. It is recommended that primary care clinicians provide interventions, including education or brief counseling, to prevent initiation of tobacco use among children and adolescents. Note that it doesn’t say prevention of “smoking”, it says prevention of “tobacco use” because we know that vaping is “a thing” among youth nowadays. This is a grade B recommendation, which means there is moderate to substantial benefit for this service. Now, an update about COVID-19. As of May 4, 2020, the CDC reports a total of 1,160,000 cases and 68,000 deaths due to COVID-19 in the USA. It has been a rough year so far for humanity! On May 1st, 2020, the FDA issued an Emergency Use Authorization to remdesivir for the treatment of COVID-19. Remdesivir can be used in hospitalized patients with severe disease. Remdesivir may shorten the time it takes to recover from the infection. It is given intravenously only. The issuance of an Emergency Use Authorization is different than FDA approval. Let’s stay up-to-date as this pandemic continues to evolve.***Welcome to Rio Bravo qWeek, the podcast of the Rio Bravo Family Medicine Residency Program, recorded weekly from Bakersfield, California, the land where growing is happening everywhere.The Rio Bravo Family Medicine Residency Program trains residents and students to prevent illnesses and bring health and hope to our community. Our mission: To Seek, Teach and Serve. Sponsored by Clinica Sierra Vista, Providing compassionate and affordable care to patients throughout Kern and Fresno counties since 1971. [Music continues and fades…] ***"As you would have people do to you, do to them; and what you dislike to be done to you, don't do to them." Taken from Al-Kafi, a Muslim book.In a way or another, the Golden Rule is preached by many major and minor religions, “Do unto others as you would have them do unto you.” I think it’s a wonderful rule. Today we have a very sweet guest who is a very positive person and a hard worker. Welcome Dr Claudia Carranza, thanks for accepting my invitation to talk in front of the microphone… again! As you know, we ask 5 questions in this podcast, and we’ll start with question number 1.Question Number 1: Who are you?My name is Claudia Carranza, I am a second-year family medicine resident in the wonderful Rio Bravo Family Medicine Residency program in Bakersfield, CA. I grew up in Peru then moved to the States for college, attended a couple of community colleges before transferring to UCSD as a Biology major. Then went to Ross University School of Medicine in the Caribbean where I earned my medical degree. I did 1 year of Internal Medicine residency, and then transferred to Family Medicine and I could not be happier!I am also a wife to a very busy IM resident, I am a Dog mom to Chewie. I don’t have lots of time for hobbies but when there’s time I like to do some strength training, dance, go on walks or runs with Chewie, cook healthy meals, bake and hang out with my hubby and friends. My favorite movie is Love Actually, and my favorite sport is swimming.Question number 2: What did you learn this week?This week I learned about the difference between Chlamydia Test of Cure (TOC) and Retesting. At our clinic, we have quite a few obstetrics patients, and they all get tested for Chlamydia as new OB patients, as part of their prenatal lab panel. When they are positive, they get treatment, and after treatment they undergo a Test Of Cure or TOC, no earlier than 3 weeks after completion of therapy. All patients with documented infection should also undergo retesting; this includes pregnant patients. When we have a pregnant patient who is infected we inquire about their partner and encourage the partner's treatment. Those partners, just like anyone with a documented infection, should have retesting done. Example: Let’s say we get a positive C. trachomatis test on one of our pregnant patients. We have to notify the patient of the results and the need for treatment. The recommended regimen for treatment is 1g oral Azithromycin given as a single dose.If you have a patient who CANNOT tolerate Azithromycin then you may treat with either amoxicillin or erythromycin.Recommended doses: Amoxicillin 500mg orally TID for 7 days, Erythromycin base 500mg QID for 7 days or 250mg QID for 14 days, Erythromycin ethylsuccinate 800mg QID for 7 days or 400mg QID for 14 days.Remember after treating the patient and hopefully also their partner, the pregnant patient will need a TOC. Other patients who require a test of cure are any patients that show persistent symptoms or that were treated using a regimen with inferior cure rates, such as erythromycin or amoxicillin.   RetestingRetesting is done to check if a patient has been re-infected. This can be done 3 months after treatment or at their first visit thereafter within 12 months of treatment.Now, think you are at the hospital and you have a pregnant patient that comes to triage in active labor. They brought some of their prenatal records and you know they had a positive C. trachomatis test, and she was treated but she did not have a test of cure, or you don’t have the records to confirm the results. In this case, there is usually not enough time to get a test of cure or retest prior to delivery, so these patients NEED TO BE TREATED upon admission with one of the recommended regimens. Of note, when treating pregnant patients; the antibiotics contraindicated during pregnancy (and lactation) are: Doxycycline, levofloxacin, ofloxacin, and erythromycin estolate.Comment: The pregnancy categories by letters (A, B, C, D, X) were updated on June 30, 2015, by the FDA. Now, all medications are required to include three sections with explanations: Pregnancy, Lactation and Females and Males of Reproductive Potential. Erythromycin should not be used during the first trimester of pregnancy. However, it may be appropriate as an alternative agent for the treatment of chlamydial infections in pregnant women (consult current guidelines)Treatment of the partner(s)There are certain states in which Expedited Partner Therapy (or EPT) is permissible. This means a physician can treat the sex partner of a patient who is being treated for chlamydia; in other words, prescribe their partner medication without having examined them. California is one of the 44 states in which EPT is permissible. Question number 3: Why is that knowledge important for you and your patients? C. trachomatis is the most commonly reported sexually transmitted disease. First of all, the reason why it is important to treat a pregnant patient is to prevent infection transmission during vaginal delivery. If infection is present during delivery the newborn is at risk for developing conjunctivitis or pneumonia. The most effective therapy if the newborn develops either or both is oral erythromycin; Why can we just treat the newborns? It is not that simple. There are studies that have shown an increased risk of hypertrophic pyloric stenosis (IHPS), especially if the infant is treated before 2 weeks of life. How likely is an infant to get IHPS if treated with erythromycin? There is a study by Rosenman and associates that compared the use of erythromycin prophylaxis with watchful waiting in a hypothetic cohort of neonates exposed to C. trachomatis. For every30infants treated with erythromycin, one additional case of pyloric stenosis would occur. This would be quite a few infants if we let chlamydia go untreated and newborns requiring treatment.Pyloric stenosis in a nutshell is a disorder in which the pylorus or gastric outlet can become very narrow or even obstructed which leads to forceful vomiting and requires surgery to fix it.Another caveat to treating an infant is that Erythromycin is effective in up to 90 percent of cases of conjunctivitis and approximately 80 percent of cases of pneumonia caused by C. trachomatis. Therefore, the infant needs close monitoring and at times a second round of treatment. I want the listeners to think for a minute and Just ask your adult self: How fun is it to take antibiotics? The answer is most likely, NOT at all fun; there are always side effects and your GI system is usually the most affected. Now imagine how a tiny little baby must feel.  I would NOT want to put an infant through this treatment unless it is ABSOLUTELY necessary, so if we can prevent it by testing  and treating mothers then let’s do that! Question number 4: How did you get that knowledge? I mostly read UpToDate, AAFP, NEJM, and check the CDC website for updates. If I am not quite sure where I will be able to find a specific topic then sometimes I google what my question is and look through the list to see if any of the sources are reputable or if the articles are from a well known journal then I read the contents.  Question number 5: Where did that knowledge come from? For this topic, I initially had the help of our host Dr Arreaza and then I read different articles in UpToDate, such as “Treatment of Chlamydia Trachomatis infection” and “Chlamydia trachomatis infection of the newborn”. I also read an AAFP article from American Family Physician “Chlamydia trachomatis exposure in newborn”, the CDC “Legal Status of Expedited Partner Therapy”, “Chlamydial infections”, “STDs Clinical Prevention Guidance” and finally Pubmed “Azithromycin in early infancy and pyloric stenosis.”____________________________OTHER SECTIONSSpeaking Medical: Cataplexyby Terrance McGillThe Medical word of the week is Cataplexy. Cataplexy is emotionally-triggered transient muscle weakness. Most episodes are triggered by strong, generally positive emotions such as laughter, joking, or excitement. Episodes may also be triggered by anger or grief in some individuals. Cataplexy develops within three to five years of the onset of sleepiness in 60 percent of people with narcolepsy. Remember the word of the week: Cataplexy, See you next week!____________________________Espanish Por Favor: Agruras by Yodaisy RodriguezThe Spanish word of the week is agruras. Agruras means heartburn (the medical term is pyrosis), and it is typically described as a burning sensation in the retrosternal area, most commonly experienced in the postprandial period, but can be used as well when trying to describe reflux. The scenario will be a patient saying: “Doctor, tengo agrugras”. Agruras is probably a common complaint among our “chili pepper lovers”. Patients with agruras may require additional evaluation if they have red flags, such as weight loss, hematemesis, loss of appetite, vomiting, or more.Now you know the Spanish word of the day, agruras, all you need to do now is asses your patient’s heartburn.____________________________For your Sanityby Fermin Garmendia and Terrance McGill—Doc, Doc—Who’s there?—Disease—Disease who?—Disease the worse disaster I’ve ever seenWhat’s the anesthesiologist’s ABC? Airway, Book, Chair!Conclusion: Now we conclude our episode number 11 “Chlamydia with Clau”. Remember to order a TEST OF CURE for ALL your positive chlamydia patients who are pregnant, and RETEST everyone after 3 months of treatment. Don’t forget to treat sexual partner (or partners) to prevent chlamydia reinfection. It is permissible to send a prescription for the partner, even if you have not seen them. Cataplexy is an interesting symptom in narcolepsy, although it’s uncommon, you need to recognize it when you see it. And, if you have a heartburn after eating your pizza, remember the Spanish word of the day, agruras. _____________________This is the end of Rio Bravo qWeek. We say good bye from Bakersfield, a special place in the beautiful Central Valley of California, United States, a land where growing is happening everywhere.If you have any feedback about this podcast, contact us by email RBresidency@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. This podcast was created with educational purposes only. Visit your primary care physician for additional medical advice. _____________________Our podcast team is Hector Arreaza, Claudia Carranza, Yodaisy Rodriguez, Terrance McGill and Fermin Garmendia. Audio edition: Suraj Amrutia. See you soon! ______________________References “Treatment of Chlamydia trachomatis infection”  by Katherine Hsu, MD, MPH, FAAP, last updated: Mar 02, 2020, UpToDate, https://www.uptodate.com/contents/treatment-of-chlamydia-trachomatis-infection?search=Treatment%20of%20Chlamydia%20Trachomatis%20infection&source=search_result&selectedTitle=1~143&usage_type=default&display_rank=1 “Chlamydia trachomatis infections in the newborn” by Margaret R Hammerschlag, last updated: Nov 15, 2018, UpToDate, https://www.uptodate.com/contents/chlamydia-trachomatis-infections-in-the-newborn?search=2)%09Chlamydia%20trachomatis%20infection%20of%20the%20newborn&source=search_result&selectedTitle=1~143&usage_type=default&display_rank=1 “Chlamydia Trachomatis Infections: Screening, Diagnosis, and Management” by Ranit Mishori, Erica McClaskey and Vince J. Winklerprins, Georgetown University School of Medicine, Washington, District of Columbia, American Family Physician, www.aafp.org/afp, Volume 86, Number 12, December 15, 2012. “Legal Status of Expedited Partner Therapy”, Centers for Disease Control and Prevention, https://www.cdc.gov/std/ept/legal/default.htm , accesed on May 6, 2020. “Chlamydial infections”, Centers For Disease Control and Prevention, https://www.cdc.gov/std/tg2015/chlamydia.htm , accessed on May 6, 2020. “STDs Clinical Prevention Guidance”, Centers for Disease Control and Prevention, https://www.cdc.gov/std/tg2015/clinical.htm , accessex on May 6, 2020. “Azithromycin in early infancy and pyloric stenosis” by Matthew D. Eberly, Matilda B. Eide, Jennifer L. Thompson and Cade M. Nylund, Pediatrics, The Official Journal of the Amercan Academy of Pediatrics, March 2015, https://pediatrics.aappublications.org/content/135/3/483 “Clinical features and diagnosis of narcolepsy in adults” by Thomas E Scammell, last updated: Feb 12, 2020, UpToDate, https://www.uptodate.com/contents/clinical-features-and-diagnosis-of-narcolepsy-in-adults?search=8)%09Clinical%20features%20and%20diagnosis%20of%20narcolepsy%20in%20adults,%20Author:%20Thomas%20E%20Scammell,%20MD&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1#H1

Today we are talking about 2 out of the 3 medications recommended at the birth of your newborn : the Hepatitis B Vaccine and Erythromycin eye ointment. Come back next week when we chat all about the Vitamin K shot! Love ya! --- Support this podcast: https://anchor.fm/what-the-bump/support

Erythromycin uniquely has some potential benefit in the setting of gastroparesis. Azithromycin you will likely not see used for this indication. Erythromycin binds the 50s subunit and ultimately prevents protein synthesis which is necessary for bacteria to grow and replicate. QTc prolongation is a risk with all macrolide antibiotics (erythromycin included). By inhibiting CYP3A4, erythromycin can be responsible for numerous drug interactions.

This week, we leave the US, and travel to the Phillipines, where we are still looking for new antibiotics in the dirt. One Dr. Abelardo Aguilar, working for the company Eli Lilly, eventually discover a new class of antibiotics, known as macrolides, and Robert Woodward Burns our genius chemist makes a re-appearance. Erythromycin StructureWebsite: http://thehistoryofmedicine.buzzsprout.com/E-mail: thehistoryofmedicinepodcast@gmail.comFacebook: https://www.facebook.com/TheHistoryOfMedicine/Transcripts and Sources here!

The post Erythromycin (E-Mycin) Nursing Pharmacology Considerations appeared first on NURSING.com.

Thieme Verlagamrican perinatly0:00Wed, 15 Nov 2

Thieme Verlagamrican perinatly0:00Wed, 15 Nov 2

Vitamin K and erythromycin are involved in two standard procedures that are done to your newborn shortly after birth. All babies are naturally born with low levels of vitamin K. This vitamin is essential to helping your baby's blood clot. The shot of vitamin K is designed to provide your baby with adequate levels of vitamin K to prevent vitamin K deficiency bleeding. Erythromycin eye ointment is an antibacterial medication to prevent eye infections that can cause permanent damage or even blindness in your baby. Find out what the risks are of these complications are and learn more about why vitamin K and erythromycin are administered. Like everything pregnancy and birth related you have choices. This episode gets into what the vitamin K and erythromycin procedures entail, why they are done, all of the risks and benefits, and your options.

TThis podcast covers the JBJS issue for May 2013. Featured are articles covering: Risk Factors Associated with Deep Surgical Site Infections After Primary Total Knee Arthroplasty; Use of Erythromycin and Colistin-Loaded Cement in TKA Does Not Reduce Incidence of Infection; recorded commentary by Dr. Roberts; Adverse Tissue Reactions from Modular Neck Corrosion in THA; The Effect of rhBMP-2 in Single-Level Posterior Lumbar Interbody Arthrodesis; recorded commentary by Dr. Bolesta.

TThis podcast covers the JBJS issue for May 2013. Featured are articles covering: Risk Factors Associated with Deep Surgical Site Infections After Primary Total Knee Arthroplasty; Use of Erythromycin and Colistin-Loaded Cement in TKA Does Not Reduce Incidence of Infection; recorded commentary by Dr. Roberts; Adverse Tissue Reactions from Modular Neck Corrosion in THA; The Effect of rhBMP-2 in Single-Level Posterior Lumbar Interbody Arthrodesis; recorded commentary by Dr. Bolesta.

Buy Erythromycin Without Prescription, A new episode of "A Saudi Life" is up. In this episode I answer a few questions I got, Erythromycin pharmacy. Is Erythromycin safe, This is the last episode I do in the USA, starting with the next episode I will be back recording from Saudi Arabia, discount Erythromycin. Where can […]

ZUSAMMENFASSUNG Die Anwendung antimikrobieller Wirkstoffe in der Human- und Veterinärmedizin hat zu einer Selektion und Anreicherung antibakteriell resistenter Mikroorganismen geführt. Die Bedeutung tierischer Lebensmittel bei der Übertragung von Bakterien auf den Menschen wurde bereits des öfteren beschrieben. In Europa sind die meisten Y. enterocolitica-Stämme, die bei humanen Gastroenteritiden isoliert werden, vom Bioserotyp 4/O:3. Für menschliche Infektionen stellen symptomlos infizierte Schweine das wichtigste Erregerreservoir dar, dabei gilt Schweinefleisch als wichtigste Kontaminationsquelle. In der Literatur wurde bisher nur über eine Empfindlichkeitsbestimmung von Y. enterocolitica 4/O:3 in Deutschland berichtet. Aus diesem Grund befasste sich diese Studie mit dem Resistenzverhalten dieser Bakterien unter Anwendung zweier unterschiedlicher Methoden. Mittels Agardiffusionsverfahren wurden 200 Stämme (60 humane und 140 porcine) auf die antimikrobiellen Wirkstoffe Ampicillin, Amoxicillin/Clavulansäure, Cefotaxim, Aztreonam, Chloramphenicol, Colistin, Erythromycin, Gentamicin, Streptomycin, Nalidixinsäure, Ciprofloxacin, Tetracyclin, Sulphamethoxazol, Sulphamethoxazol/Trimethoprim und Trimethoprim getestet. Im Anschluss wurden 110 der gleichen Stämme (31 humane und 79 porcine) mittels Bouillon-Mikrodilutionsverfahren untersucht. Die im Handel erhältlichen Mikrotiterplatten wurden vom Nationalen Veterinärinstitut Schwedens bezogen und enthielten die antimikrobiellen Wirkstoffe Ampicillin, Cefotaxim, Ceftiofur, Chloramphenicol, Florfenicol, Gentamicin, Kanamycin, Streptomycin, Nalidixinsäure, Ciprofloxacin, Tetracyclin, Sulfamethoxazol und Trimethoprim. Mittels Agardiffusionstest wurden gegen fünf Wirkstoffe Resistenzen ermittelt. 98,0 % der untersuchten Yersinien waren gegen Ampicillin, 92,5 % gegen Erythromycin, 7,0 % gegen Streptomycin, 2,0 % gegen Sulphamethoxazol und nur 1 Stamm (0,5 %) war gegen den Kombinationswirkstoff Sulphamethoxazol/Trimethoprim resistent. Mittels Mikrodilutionsverfahren wurden bei drei von 13 getesteten Wirkstoffen Resistenzen ermittelt. So waren 97,2 % gegen Ampicillin, 15,5 % gegen Streptomycin sowie 1 Stamm (0,9 %), aus einer humanen Stuhlprobe, gegen Sulphamethoxazol resistent. Dieser Stamm war sowohl mittels Agardiffusions- als auch mittels Mikrodilutionsverfahren multiresistent. Es konnte kein wesentlicher Unterschied zwischen den Resistenzergebnissen humaner und porciner Stämme festgestellt werden. Von den 110 Yersinien waren die Ergebnisse von 82 Stämmen, mittels Agardiffusions- und Bouillon-Mikrodilutionsverfahren, übereinstimmend. Bei 28 Y. enterocolitica-Stämmen wurden unterschiedliche Resultate ermitelt. In 6 Fällen handelte es sich um größtmögliche Fehler, 4 mal sind große und 18 mal geringfügige Fehler aufgetreten. Dabei ist bei dem Vergleich der Ergebnisse der MHK-Wert als der verlässlichere anzusehen. Aus diesem zuletzt genannten Grund und da die Mikrodilution im Gegensatz zur Agardiffusion quantitative Ergebnisse liefert, was für eine effektive Therapie von Bedeutung ist, sollten Empfindlichkeitsbestimmungen mittels Mikrodilution durchgeführt werden. Insgesamt betrachtet, zeigen die Ergebnisse dieser Studie, dass Y. enterocolitica- Stämme 4/O:3 gegenüber den meisten antibakteriellen Wirkstoffen empfindlich sind und nur vereinzelt Resistenzen gegen antimikrobielle Wirkstoffe aufweisen. Des Weiteren ist zu sagen, dass bei Y. enterocolitica-Stämmen 4/O:3, die im süddeutschen Raum isoliert wurden, die Resistenzsituation zum derzeitigen Zeitpunkt nicht problematisch ist und mit den Ergebnissen anderer weltweit durchgeführten Untersuchungen übereinstimmt.

Stämme der Spezies Arcanobacterium (A.) pyogenes gelten allgemein als empfindlich gegenüber Penicillinen. Hauptsächlich aus diesem Grund gibt es bisher keine etablierte Methode zur Empfindlichkeitsbestimmung von A. pyogenes. Im Rahmen dieser Arbeit wurde für A. pyogenes eine Methode zur Bestimmung der Minimalen Hemmkonzentration (MHK) mittels Bouillonmikrodilution erarbeitet, die sich an der Vorgehensweise des CLSI (Clinical and Laboratory Standards Institute, USA)-Dokumentes M31-A2 orientiert. Mit Hilfe der erarbeiteten Methode wurden die MHK-Werte zweier Bakterienkollektive mit insgesamt 115 Bakterienstämmen [53 süddeutsche Isolate sowie 62 deutschlandweit im Rahmen eines Monitoringprogramms (Bft-GermVet) gesammelte Stämme] bestimmt. Zusätzlich wurde die genetische Grundlage der dabei häufig zu beobachtenden Tetracyclinresistenz untersucht. Bei Anwendung der vom CLSI-Dokument empfohlenen Verdünnung der Bakteriensuspension im Medium im Verhältnis 1:200 wurde die Inokulumsdichte von A. pyogenes im Vergleich zum vorgeschriebenen Dichtebereich etwa um das Dreifache über-schritten. Daher wurde eine Verdünnung im Verhältnis 1:667 vorgenommen, wodurch valide Inokulumsdichten erreicht wurden. In der vom CLSI-Dokument empfohlenen kationenadjustierten Müller-Hinton-Bouillon (CaMHB) konnte ohne weitere Zusätze kein ausreichendes Bakterienwachstum erreicht werden, unter Zusatz von 2 % fetalem Käl-berserum (FKS; aufgrund des Vorhandenseins von Thymidin nur für die Testung nicht-sulfonamidhaltiger Antibiotika verwendbar) oder 2 % lysiertem Pferdeblut konnte die MHK nach 24 Stunden gut abgelesen werden. Aerob (von der CLSI-Norm empfohlen) und unter Zusatz von 3 Vol% CO2 bebrütete Mikrotiterplatten wiesen nach 24 Stunden keine relevanten Unterschiede in der MHK der untersuchten Wirkstoffe auf. Aufgrund der besseren Ablesbarkeit wurde der Inkubation unter Zusatz von CO2 der Vorzug gegeben. Die aus dem süddeutschen Raum stammenden A. pyogenes-Stämme wurden hinsichtlich ihrer Resistenz gegenüber Tetracyclin, Penicillin G und Erythromycin untersucht. Im Rahmen des BfT-GermVet-Projekts wurden die Isolate auf ihre Empfindlichkeit gegenüber 24 verschiedenen Wirkstoffen geprüft. Eine qualitative Bewertung als „resistent“ oder „sensibel“ konnte anhand der im Dokument M31-A2 vorhandenen Grenzwerte nur für wenige Wirkstoffe (Amoxicillin/Clavulansäure, Cephalothin, Tetracyclin, Chloramphenicol, Sulfa-methoxazol/Trimethoprim, Sulfamethoxazol; Ampicillin und Penicillin unter Vorbehalt) vorgenommen werden. Gegenüber den getesteten β-Lactam-Antibiotika, Aminoglykosiden, Fluorchinolonen und Phenicolen wurden generell niedrige MHK-Werte beobachtet, die - soweit Grenzwerte vorhanden waren - im sensiblen Bereich lagen. Bei der Testung von Sulfonamiden und potenzierten Sulfonamiden kam es zu großen Unterschieden zu früheren Studien, was jedoch eher auf methodische Unterschiede zurückzuführen ist als auf Änderungen der Resistenzraten. Gegenüber Sulfamethoxazol/Trimethoprim waren alle Stämme empfindlich, gegenüber Sulfamethoxazol waren die porcinen Isolate ebenfalls empfindlich, die bovinen Stämme wiesen je nach Indikation eine Resistenzrate von 24 bis 32 % auf. Insgesamt waren 9,5 % der untersuchten Isolate resistenzverdächtig gegenüber Makrolid-Antibiotika. Diese im Vergleich zur Literatur niedrige Zahl ist entweder durch die unterschiedlichen Isolatzahlen bedingt oder tatsächlicher Ausdruck eines Resistenzrückgangs, der mit dem Verbot von Tylosin als Futtermittelzusatzstoff in den 1990er Jahren assoziiert sein könnte. Bei der Untersuchung von Tetracyclin erwiesen sich unabhängig von der Tierart über 60 % der Isolate als resistenzverdächtig, wobei die MHK90 beim Schwein bei 8 µg/ml und beim Rind bei 64 µg/ml lag. Bei der genetischen Untersuchung von 36 tetracyclinresistenten Isolaten aus Süddeutschland auf das Vorkommen von acht verschiedenen tetracyclinresistenzvermittelnden Genen konnte bei 66,7 % der Isolate das für ein ribosomales Schutzprotein kodierende Resistenzgen tet(W) detektiert werden, das in der Literatur als hauptverantwortlich für die Tetracyclinresistenz bei A. pyogenes gilt. Neben diesem konnte auch die strukturelle Einheit eines für ein Effluxprotein kodierenden Gens, tet(33), bei 22,2 % der Isolate nachgewiesen werden. Bei keinem Stamm konnte tet(33) ohne gleichzeitig vorhandenes tet(W) isoliert werden. Die in der Literatur beschriebene Lokalisation von tet(33) auf einem Plasmid konnte für die untersuchten Stämme nicht bestätigt werden. Bei allen tet(W)- und tet(33)-positiven Isolaten handelte es sich um Stämme boviner Herkunft. Der MHK-Wert der tet(W)-positiven Isolate lag zwischen 8 und 64 µg/ml, die Mehrheit der Stämme hatte eine MHK von 16 µg/ml. In Anwesenheit von tet(33) lag die MHK bei sieben von acht Isolaten bei 32 µg/ml, ein Isolat wies eine MHK von 64 µg/ml auf. Bei einem Isolat boviner Herkunft (4371-03), bei dem weder tet(W) noch tet(33) detektiert werden konnte, konnte erstmals für Arcanobakterien die regulatorische Einheit des Gens tet(Z), das bisher nur bei Corynebacterium glutamicum beschrieben wurde, identifiziert werden. Das Strukturgen tetA(Z), das ebenfalls für ein Effluxprotein kodiert, konnte nur partiell nachgewiesen werden. Es ist daher nicht bekannt, ob die bei 4371-03 beobachtete MHK von 8 µg/ml auf das identifizierte tet(Z) zurückzuführen ist. Insgesamt blieben elf Isolate einschließlich aller Stämme porciner Herkunft (N = 8) ohne zugeordnete tet-Determinante.