Antibiotic Sensitivity Patterns of Aerobic Bacterial Agents in Post-Surgical Orofacial Infections

Background: There is no data on the bacteriology of postsurgical orofacial infections at our institutions. Uncontrolled use of antibiotics may lead to development of resistance with the resultant increase in morbidity and cost of treatment. We aimed to determine the aerobic bacterial agents and antibiotic sensitivity of post-surgical infections in the orofacial region. Methodology: Patients were evaluated for post-surgical wound infection from the 5th to 30th post-operative day. In cases where a surgical implantwas placed the period of review was extended for up twelve months. The specimens were collected using sterile swabs and transported to the  microbiology laboratory within two hours of collection. The specimens were then analyzed for bacteriology according to the standard bacteriological  techniques. A wide range of antibiotics including those commonly used to treat orofacial infections were tested for sensitivity against the isolates obtained using the disk diffusion test (Kirby-Bauer procedure, using CLSI protocols). Results: Staphylococcus aureus accounted for 40% of the isolates followedby Klebsiella species (23%) and the Pseudomonas species (19%).  Amoxycillin/clavulinic acid, the 2nd and 3rd generation cephalosporins were effective against most of the bacterial infections from the orofacial region. Conclusion: Staphylococcus aureus, Klebsiella, and Pseudomonas species arethe commonest isolates from the oral facial region. Antibiotics which showed adequate efficacy against them were the augmented Penicillins and newer generations Cephalosporins.Key Words: Oro-facial infection, Post-surgical, Antibiotic

Seasons of Risk: Anticipated Behavior on Vacation and Interest in Episodic Antiretroviral Pre-exposure Prophylaxis (PrEP) Among a Large National Sample of U.S. Men Who have Sex with Men (MSM)

The current analysis evaluates interest in and acceptability of daily PrEP during short episodes of anticipated increased risk (i.e. Epi-PrEP). In 2013, U.S. members of an Internet-based MSM sexual networking site were invited to complete a survey about HIV prevention practices in the context of vacationing. 7,305 MSM responded to the survey. Of respondents who had vacationed in the past year, 25.6% reported condomless anal sex (CAS) with new male sex partners while vacationing. Most (92.6%) respondents agreed that having to use PrEP every day was a barrier to PrEP use and 74.3% indicated they would take PrEP if they knew it would be helpful for short periods of anticipated increased risk. MSM who reported increased CAS while on vacation in the past year were more likely to indicate that they would take PrEP if it were helpful when used for short periods than respondents who did not (aOR=2.02, 95% CI 1.59–2.56, p <0.001). Studies designed to evaluate uptake, adherence, and protective benefit of short PrEP courses are warranted

Clinical Treatment Options Infectious Diseases: Update on PrEP Implementation, Adherence, and Advances in Delivery

Pre-exposure prophylaxis (PrEP) is an effective and evidence-based HIV-prevention option and is recommended for individuals with substantial risk for HIV infection [1]. Randomized controlled trials have demonstrated that daily oral PrEP dramatically reduces the risk of HIV infection when it is taken as directed. Concerns regarding widespread emergence of antiretroviral resistance attributable to PrEP and behavioral disinhibition have to date not been observed in clinical trials and open-label demonstration projects. PrEP has great potential as part of an HIV risk reduction strategy and barriers to wider implementation including community education, prescriber availability, and elimination of financial barriers should be aggressively pursued. Adherence is critical to PrEP efficacy and has varied across study populations; developing and refining ways of measuring and supporting adherence is essential to the success of PrEP. Evaluation of long-acting medications and alternative formulations for PrEP is underway and may lead to the wider implementation and impact of PrEP