Hematologic Adverse Effects of Prolonged Piperacillin- Tazobactam Use in Adults

Objective: We aimed to find the incidence and risk factors of hematologic adverse effects of piperacillin-tazobactam (TZP). Materials and Methods: Adult patients who used TZP for more than 10 days were included in the study. Results: The incidence of leukopenia, neutropenia, and eosinophilia in 110 TZP therapy episodes was found to be 16.3%, 10%, and 10%, respectively. Lower Charlson Comorbidity Index score, lower initial leukocyte count, combination of TZP with another antibiotic, and total duration of TZP therapy were found to be independent risk factors for leukopenia, while initial higher eosinophil count (IHEC) and usage of TZP for >20 days were independent risk factors for neutropenia and IHEC and total duration of TZP therapy were independent risk factors for eosinophilia. Conclusion: Longer duration of therapy, combination with other antibiotics, younger age with fewer comorbidities, and IHEC could result in hematologic adverse effects in patients treated with TZP. Patients with IHEC may be more prone to allergic reactions, so immunological mechanisms may facilitate the development of hematological adverse effects of TZP

(Trans)cribing History: The Oral Histories of Transgender Clergy in America

Popular American rhetoric around religion and LGBTQ issues puts the two at odds. The Bible has been the center of many debates over sexuality, gender identity, and faith. However, very few conversations have included or revolved around the authentic experiences of LGBTQ people of faith. Nine participants from various Protestant backgrounds shared their narratives with me and spoke on issues of gender and faith. This report is an in-depth summary of a short oral history project of transgender clergy (as well as candidates for ordination or exemplary church members)

Doripenem: A New Carbapenem in Clinical Practice

Doripenem is the newest addition to the carbapenems, the most active class of antibiotics against many resistant pathogens. This review focuses on the antimicrobial, pharmacological and clinical aspects of doripenem. Its spectrum of activity is similar to that of meropenem and imipenem. According to the Turkish data of comparative activity of carbapenem (COMPACT) study, doripenem inhibited 64% of Pseudomonas aeruginosa at MIC 2 mu g/ml, whereas meropenem and imipenem inhibited 56.2%, and 48.2% of the isolates, respectively. Unlike imipenem or meropenem, doripenem is stable for 12 hours at room temperature and may be delivered safely as a 4-hour extended infusion. This practice of administration lengthens the duration of time that the concentration of doripenem remains above the MICs of less susceptible pathogens. Based on animal models, doripenem has less epileptogenic activity than imipenem. Doripenem has been approved for use in treatment of complicated intraabdominal infection, complicated urinary tract infection, hospital-acquired pneumonia, and ventilator-associated pneumonia that are caused by susceptible pathogens

An infectiological approach to gall bladder and biliary tract infections

Infections of the biliary tract are diseases that cause high morbidity and mortality in case of the lack of right and timely intervention. It is not suprising to see that some bacteria, which have multi-drug resistance, are causative agents for infections of biliary tract due to the overuse of broad- spectrum antibiotics in the community during the recent years. Properly determining the risk group, carrying out rapid diagnostic intervention in case of necessity, isolating the causative agent and appropriate antibiotic usage for these infections would be lifesaving. The aim of this article is to take a look at the diagnostic and therapeutic methods of infections of the biliary tract from the past till today and review the antibotic resistance among etiologic agents and difficulties in the management

Sepsis ve Septik Şokta Güncekl Tedavi

Sepsis, ağır sepsis ve septik şok medikal acil klinik tablolardandır. Yoğun çabaya ve yapılan birçok klinik çalışmaya rağmen 1960’lardan bu yana optimal tedavide çok az değişiklik olmuştur. Erken klinik şüphe ve titiz yürütülen tanısal tetkikler sepsis tedavisinde önemlidir. Her iki bakteri türünü de (Gram-pozitif ve negatif) hedef alan geniş spektrumlu antibiyotik tedavisinin en kısa sürede başlanması, enfeksiyon kaynağının hızlı bir şekilde ortadan kaldırılması ya da drene edilmesi, hipotansiyonu ve doku perfüzyon bozukluğunu düzeltmek için sıvı ve vazopressörlerin kullanılması, septik şok tedavisinin üç temel öğesidir. Yeni birçok tedavi seçeneği denenmesine rağmen hiçbiri sepsis tedavisinde istenilen yeri alamamıştır