RESUMO
OBJECTIVES: To determine antibiotic susceptibility of Streptococcus pneumoniae and Haemophilus influenzae isolates from community-acquired respiratory tract infections (CA-RTIs) collected in 2015-17 from Argentina, Chile and Costa Rica. METHODS: MICs were determined by CLSI broth microdilution and susceptibility was assessed using CLSI, EUCAST (dose-specific) and pharmacokinetic/pharmacodynamic (PK/PD) breakpoints. RESULTS: A total of 170 S. pneumoniae and 218 H. influenzae isolates were collected at five centres in Argentina, Chile and Costa Rica in 2015-17. Small S. pneumoniae isolate numbers from Costa Rica (n = 2) meant that these could only be included in the penicillin susceptibility analysis; they were excluded from further country analyses. Around one-third of pneumococcal isolates from Argentina and two-thirds from Chile were non-susceptible to penicillin by CLSI oral or EUCAST low-dose IV breakpoints, but most (≥89%) were susceptible by CLSI IV or EUCAST high-dose breakpoints. Amongst pneumococci from Argentina, about 80% or more were susceptible to most other antibiotics except cefaclor (all breakpoints), cefixime (PK/PD breakpoints), cefuroxime (EUCAST breakpoints) and trimethoprim/sulfamethoxazole (CLSI and PK/PD breakpoints). S. pneumoniae isolates from Chile showed significantly lower susceptibility (P < 0.05) using CLSI breakpoints compared with those from Argentina for many of the antibiotics tested. Among isolates of H. influenzae from Latin America, more than 90% were susceptible to amoxicillin/clavulanic acid (high dose), cefixime, cefpodoxime, ceftriaxone and fluoroquinolones, irrespective of the breakpoints used. The application of different EUCAST breakpoints for low and higher doses for some of the antibiotics (amoxicillin, amoxicillin/clavulanic acid, ampicillin, penicillin, ceftriaxone, clarithromycin, erythromycin, levofloxacin and trimethoprim/sulfamethoxazole) allowed, for the first time in a SOAR study, the effect of raising the dosage on susceptibility to be quantified. CONCLUSIONS: Antibiotic susceptibility of H. influenzae isolates was generally high in the Latin American countries studied; however, susceptibility profiles varied for S. pneumoniae by country and depending on the breakpoints used, especially for cefaclor. These factors are important in decision making for empirical therapy of bacterial infections.
Assuntos
Haemophilus influenzae , Infecções Respiratórias , Antibacterianos/farmacologia , Argentina/epidemiologia , Chile/epidemiologia , Costa Rica/epidemiologia , Farmacorresistência Bacteriana , Monitoramento Epidemiológico , Humanos , América Latina/epidemiologia , Testes de Sensibilidade Microbiana , Infecções Respiratórias/epidemiologiaRESUMO
The statistical optimization of sustained-release matrix tablets of lobenzarit disodium salt (LDS) was performed using the central composite experiment design 2(3) for three independent variables: the amount of polymer (Eudragit RS-PO) AP, the total volume of granulation solvent VS, and the amount of filler (microcrystalline cellulose) CE. The t90% was selected as the response variable. The response surfaces were performed from a statistical mathematical model. The optimal formulation was obtained for the variables (AP = 15 mg, VS = 60 microliters, and CE = 0).
Assuntos
Anti-Inflamatórios não Esteroides/administração & dosagem , ortoaminobenzoatos/administração & dosagem , Anti-Inflamatórios não Esteroides/farmacocinética , Celulose/química , Preparações de Ação Retardada , Humanos , Modelos Teóricos , Polímeros , Solventes , Comprimidos , ortoaminobenzoatos/farmacocinéticaRESUMO
El presente documento, es un taller de fortalecimiento integral del sistema de defensa civil, con el objetivo de comparar los sistemas nacionales de prevención y atención de desastres de Bolivia y Colombia y proponer alternativas que permitan mejorar el sistema boliviano