University of Pittsburgh Medical Center
Publishes on Antibiotics Pharmacokinetics and Efficacy, Antibiotic Resistance in Bacteria, Meta-analysis and systematic reviews. 3 papers and 231 citations.
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The presence of spontaneous mutational antibiotic resistance among 18 bacteremic isolates of Enterobacter spp. to cefotaxime, ceftazidime, gentamicin, amikacin, ciprofloxacin, and trimethoprim-sulfamethoxazole was determined quantitatively in vitro using a spiral plater. Each drug was delivered using the device and the agar plates were inoculated in radial streaks. The degree of resistance was estimated by dividing the antimicrobial concentration required to inhibit 90% of the colonies growing in the area beyond the MIC by the MIC itself. The degree of resistance to third-generation cephalosporins and aztreonam was statistically significantly greater than that to co-trimoxazole, imipenem, and ciprofloxacin (P < 0.01); the latter three antibiotics showed virtually no mutational resistance. An intermediate level of resistance was induced by aminoglycosides, and mutational resistance to piperacillin varied between this and the higher levels observed for the cephalosporins. By providing a simple and efficient means of detecting spontaneous mutational resistance, the spiral plater may prove useful in identifying those antimicrobial agents which induce few or no mutants and therefore may be more likely to be successful in treating infections due to Enterobacter spp.
Evidence is increasingly showing that open-label placebos (OLPs) can serve as an effective and safe approach for managing a variety of chronic health conditions. Because patients are fully informed that they are taking a placebo, OLPs are typically viewed as an ethically sound alternative to traditional placebo treatments, which rely on deception. Yet, despite their safety and potential therapeutic benefits, the counterintuitive nature of OLPs can make clinicians hesitant to offer them in practi