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  1. Fulltext Bactericidal Effect of Pterostilbene Alone and in Combination with Gentamicin against Human Pathogenic Bacteria
    Lee WX, Basri DF, Ghazali AR
    Molecules, 2017 Mar 17;22(3).
    PMID: 28304328 DOI: 10.3390/molecules22030463
    The antibacterial activity of pterostilbene in combination with gentamicin against six strains of Gram-positive and Gram-negative bacteria were investigated. The minimum inhibitory concentration and minimum bactericidal concentration of pterostilbene were determined using microdilution technique whereas the synergistic antibacterial activities of pterostilbene in combination with gentamicin were assessed using checkerboard assay and time-kill kinetic study. Results of the present study showed that the combination effects of pterostilbene with gentamicin were synergistic (FIC index < 0.5) against three susceptible bacteria strains: Staphylococcus aureus ATCC 25923, Escherichia coli O157 and Pseudomonas aeruginosa 15442. However, the time-kill study showed that the interaction was indifference which did not significantly differ from the gentamicin treatment. Furthermore, time-kill study showed that the growth of the tested bacteria was completely attenuated with 2 to 8 h treatment with 0.5 × MIC of pterostilbene and gentamicin. The identified combinations could be of effective therapeutic value against bacterial infections. These findings have potential implications in delaying the development of bacterial resistance as the antibacterial effect was achieved with the lower concentrations of antibacterial agents.
    Matched MeSH terms: Gentamicins/pharmacology*; Gentamicins/chemistry
  2. Fulltext Antibiotic susceptibility of staphylococcus epidermidis among undergraduate students in malaysia public university health campus
    Abu Zarrin, A.M., Nor Munirah, M.A., Mohammad Izwan, E.O., Abdullah, A.S., Hanani, A.Y.
    Medicine & Health, 2020;15(1):166-176.
    MyJurnal
    Staphylococcus epidermidis (S. epidermidis) menjadi salah satu keprihatinan utama dalam pengurusan hospital berikutan kebolehannya menyebabkan jangkitan perolehan hospital terutamanya daripada alatan perubatan yang tercemar. Pengurusan jangkitan S. epidermidis semakin mencabar dengan peningkatan kes kerintangan terhadap antibiotik sejak kebelakangan ini. Laporan terhad mengenai kerintangan terhadap antibiotik oleh S. epidermidis di kalangan kumpulan komuniti yang sihat meninggalkan satu persoalan mengenai tahap penyebaran bakteria rintang antibiotik di kalangan komuniti. Oleh itu, kajian ini bertujuan untuk mengenalpasti corak rentan antibiotik oleh S. epidermidis yang dipencilkan daripada pelajar-pelajar sihat di salah satu kampus kesihatan di universiti awam. Sebanyak 96 sampel sapuan telapak tangan telah diambil dan melalui beberapa ujikaji termasuk ujian pengenalpastian secara mikroskopik, biokimia dan juga ujian rentan antiobiotik untuk eryhtromycin, oxacillin, gentamicin, penicillin dan tetracycline menerusi ujian Kirby Bauer. Sejumlah 43 sampel menunjukkan kehadiran S. epidermidis (44.8%), di mana 72.1% daripada jumlah pencilan bakteria ini menunjukkan kerintangan terhadap sekurang-kurangnya satu jenis antibiotik. Tahap kerintangan tertinggi dan terendah masing-masing didapati pada penicillin dan gentamicin. Walaupun tiada perbezaan yang signifikan antara corak rentan antibiotik antara kumpulan jantina, tahap kerintangan antibiotik yang tinggi di kalangan komuniti sihat menunjukkan terdapat keperluan terhadap kajian lanjut kerana penyebaran strain bakteria rintang antibiotik boleh berlaku kepada populasi komuniti lain dengan lebih meluas dan tanpa disedari.
    Matched MeSH terms: Gentamicins
  3. Phenotypic and genetic characterization of multidrug-resistant Staphylococcus aureus in the tropics of Southeast Asia
    Zulkeflle SNM, Yusaimi YA, Sugiura N, Iwamoto K, Goto M, Utsumi M, et al.
    Microbiology (Reading), 2016 12;162(12):2064-2074.
    PMID: 27902427 DOI: 10.1099/mic.0.000392
    Antibiotic resistance has become a major public health problem throughout the world. The presence of antibiotic-resistant bacteria such as Staphylococcus aureus and antibiotic resistance genes (ARGs) in hospital wastewater is a cause for great concern today. In this study, 276 Staph. aureus isolates were recovered from hospital wastewater samples in Malaysia. All of the isolates were screened for susceptibility to nine different classes of antibiotics: ampicillin, ciprofloxacin, gentamicin, kanamycin, erythromycin, vancomycin, trimethoprim and sulfamethoxazole, chloramphenicol, tetracycline and nalidixic acid. Screening tests showed that 100 % of Staph.aureus isolates exhibited resistance against kanamycin, vancomycin, trimethoprim and sulfamethoxazole and nalidixic acid. Additionally, 91, 87, 50, 43, 11 and 8.7 % of isolates showed resistance against erythromycin, gentamicin, ciprofloxacin, ampicillin, chloramphenicol and tetracycline, respectively. Based on these results, 100 % of isolates demonstrated multidrug-resistant (MDR) characteristics, displaying resistance against more than three classes of antibiotics. Of 276 isolates, nine exhibited resistance to more than nine classes of tested antibiotics; these were selected for antibiotic susceptibility testing and examined for the presence of conserved ARGs. Interestingly, a high percentage of the selected MDR Staph.aureus isolates did not contain conserved ARGs. These results indicate that non-conserved MDR gene elements may have already spread into the environment in the tropics of Southeast Asia, and unique resistance mechanisms against several antibiotics may have evolved due to stable, moderate temperatures that support growth of bacteria throughout the year.
    Matched MeSH terms: Gentamicins/pharmacology
  4. A clinical and economic study of community-acquired pneumonia between single versus combination therapy
    Hasali MA, Ibrahim MI, Sulaiman SA, Ahmad Z, Hasali JB
    Pharm World Sci, 2005 Jun;27(3):249-53.
    PMID: 16096896
    BACKGROUND: Pneumonia is one of the leading causes of morbidity and mortality among children in many developing countries. It is reported that 12.9 million children under 5 years of age died world-wide in 1990 and one-third of these deaths or 4.3 million annually were attributed to acute respiratory infection with pneumonia.

    OBJECTIVES: On this basis, a study was conducted in a district hospital to study the therapy outcomes of antibiotic regimens used in pediatric community-acquired pneumonia (CAP) management and to conduct a cost-effectiveness analysis (CE) between IV ampicillin versus combination therapy of IV ampicillin and IV gentamicin.

    METHOD: A prospective, randomized, controlled, single blind study was conducted in a pediatric ward in a 80-bed district hospital. Pediatric patients diagnosed with CAP aged 2 months to 5 years old were randomly and equally divided into two treatment arms: ampicillin versus ampicillin plus gentamicin. The dose of IV ampicillin used in this study was 100 mg/kg/day divided every 6 h and 5 mg/kg of IV gentamicin as a single daily dose. Both clinical and economic evaluations were carried out to compare both treatment arms.

    RESULTS: With the inclusion and exclusion criteria, only 40 patients diagnosed with CAP were included in the study. The results showed that the two treatment arms were significantly different (P < 0.05) in terms of duration of patients on ampicillin, number of days of hospitalization and time to switch to oral therapy. A significant difference was noted between the two treatment modalities in terms of effectiveness and cost (P < 0.05).

    CONCLUSION: Overall, the endpoint of this study showed that the total cost per patient of ampicillin-treated group is cheaper than the total cost with the combination therapy (ampicillin plus gentamicin) and reduced unnecessary exposure to adverse effects or toxicities. Besides that, addition of gentamicin in the treatment modalities will only increase the cost of treatment without introducing any changes in the treatment outcome.

    Matched MeSH terms: Gentamicins/economics; Gentamicins/therapeutic use
  5. Fulltext Methicillin-resistant Staphylococcus aureus nosocomial infection trends in Hospital Universiti Sains Malaysia during 2002-2007
    Al-Talib HI, Yean CY, Al-Jashamy K, Hasan H
    Ann Saudi Med, 2010 Sep-Oct;30(5):358-63.
    PMID: 20697171 DOI: 10.4103/0256-4947.67077
    Methicillin-resistant Staphylococcus aureus (MRSA) is a major nosocomial pathogen that causes severe morbidity and mortality in many hospitals worldwide. The aim of the present study was to assess the burden of MRSA nosocomial infection, its association with factors of interest, and its antimicrobial susceptibility.
    Matched MeSH terms: Gentamicins/pharmacology
  6. Fulltext 13-year-old exposed interlocking nail: a case report
    Chua, Y.C.J., Lim, L.A., Hudzairy, A.
    Malays Orthop J, 2009;3(1):91-94.
    MyJurnal
    We are reporting a case of post-traumatic chronic osteomyelitis of the tibia with an open wound exposing an intra medullar nail implant for 13 years. The patient presented with fresh ipsilateral tibia plateau fracture. He was treated by removal of the implant, debridement and local placement of Gentamicin-impregnated PMMA beads according to guidelines of two-stage Belfast technique . After five months of wound treatment, the exposed bone was covered by healthy granulation tissue and the patient was able to fully bear weight.
    Matched MeSH terms: Gentamicins
  7. Identification and mechanism determination of the efflux pump subunit amrB gene mutations linked to gentamicin susceptibility in clinical Burkholderia pseudomallei from Malaysian Borneo
    Hussin A, Nathan S, Shahidan MA, Nor Rahim MY, Zainun MY, Khairuddin NAN, et al.
    Mol Genet Genomics, 2024 Feb 21;299(1):12.
    PMID: 38381232 DOI: 10.1007/s00438-024-02105-w
    The bacterium Burkholderia pseudomallei is typically resistant to gentamicin but rare susceptible strains have been isolated in certain regions, such as Thailand and Sarawak, Malaysia. Recently, several amino acid substitutions have been reported in the amrB gene (a subunit of the amrAB-oprA efflux pump gene) that confer gentamicin susceptibility. However, information regarding the mechanism of the substitutions conferring the susceptibility is lacking. To understand the mechanism of amino acid substitution that confers susceptibility, this study identifies the corresponding mutations in clinical gentamicin-susceptible B. pseudomallei isolates from the Malaysian Borneo (n = 46; Sarawak: 5; Sabah: 41). Three phenotypically confirmed gentamicin-susceptible (GENs) strains from Sarawak, Malaysia, were screened for mutations in the amrB gene using gene sequences of gentamicin-resistant (GENr) strains (QEH 56, QEH 57, QEH20, and QEH26) and publicly available sequences (AF072887.1 and BX571965.1) as the comparator. The effect of missense mutations on the stability of the AmrB protein was determined by calculating the average energy change value (ΔΔG). Mutagenesis analysis identified a polymorphism-associated mutation, g.1056 T > G, a possible susceptible-associated in-frame deletion, Delta V412, and a previously confirmed susceptible-associated amino acid substitution, T368R, in each of the three GENs isolates. The contribution of Delta V412 needs further confirmation by experimental mutagenesis analysis. The mechanism by which T368R confers susceptibility, as elucidated by in silico mutagenesis analysis using AmrB-modeled protein structures, is proposed to be due to the location of T368R in a highly conserved region, rather than destabilization of the AmrB protein structure.
    Matched MeSH terms: Gentamicins/pharmacology
  8. Cytotoxicity and scanning electron microscopy study of gentamycin-coated HA effect on biofilm
    Au LF, Othman F, Mustaffa R, Vidyadaran S, Rahmat A, Besar I, et al.
    Med J Malaysia, 2008 Jul;63 Suppl A:16-7.
    PMID: 19024962
    Biofilms are adherent, multi-layered colonies of bacteria that are typically more resistant to the host immune response and routine antibiotic therapy. HA biomaterial comprises of a single-phased hydroxyapatite scaffold with interconnected pore structure. The device is designed as osteoconductive space filler to be gently packed into bony voids or gaps following tooth extraction or any surgical procedure. Gentamycin-coated biomaterial (locally made hydroxyapatite) was evaluated to reduce or eradicate the biofilm on the implant materials. The results indicated that the HA coated with gentamycin was biocompatible to human osteoblast cell line and the biofilm has been reduced after being treated with different concentrations of gentamycin-coated hydroxyapatite (HA).
    Matched MeSH terms: Gentamicins/pharmacology*
  9. Fulltext Atypical contact lens related corneal ulcer caused by pasteurella multocida
    Fatin Hanisah, F., Umi Kalthum, M. N., Rona Asnida, N., Jemaima, C. H.
    Journal of Surgical Academia, 2018;8(1):43-46.
    MyJurnal
    A 55-year-old healthy lady with history of regular contact lens (CL) use presented with 10 days history of
    progressive left eye blurring of vision, redness and pain. There was good CL hygiene practiced with no history of
    swimming, trauma or contact with domestic pets. Left eye vision was hand movement and right eye was 1/60,
    pinhole 6/18. On the left eye, there was a central, oval-shaped corneal infiltrate with an overlying large epithelial
    defect and stromal oedema, with significant anterior chamber cells and fibrin. B-mode ultrasound showed no vitritis.
    Intensive topical benzylpenicillin 10000iu/ml and topical gentamycin 1.4% hourly, homatropine 2% three times
    daily, oral doxycycline and oral ascorbic acid were started. The gram stain results showed gram positive cocci
    growth. Her ulcer improved with the treatment and preservative-free dexamethasone 0.1% once daily was
    commenced to reduce inflammation and scarring. Interestingly, culture was reported as Pasteurella maltocida, a
    gram negative bacilli sensitive to penicillin, and so treatment was continued until the ulcer completely healed. She
    had central corneal scarring with best corrected vision of 6/24 in the left eye but was not keen on further surgery to
    improve her vision. Although it has not been previously reported, Pasteurella multocida can cause CL related
    corneal ulcer with severe anterior chamber inflammation. This diagnosis should be considered even if there is trivial
    contact or no history of exposure to domestic animals.
    Matched MeSH terms: Gentamicins
  10. Fulltext Pneumonia and concurrent eggs retention in a river terrapin (Batagur baska)
    Inirah, C.I., Donny, Y., Azlan, C.A., Teoh, H.X., Jesse, F.F.A.
    Jurnal Veterinar Malaysia, 2017;29(1):13-17.
    MyJurnal
    A case report of pneumonia and egg retention in a river terrapin was presented in this paper. A 20 year-old river terrapin (Batagur baska) was presented with complaint of coughing with blood discharge, wheezing breathing and inappetance. Plain radiograph showed both right and left lung lobes were consolidated due to pneumonia 90% and 70%, respectively. Tentative diagnosis of pneumonia due to opportunistic bacterial infection of Chromobacterium sp. and Plesiomonas shigelloides was made in this case based on bacterial isolation and response to antibiotic and antiinflammatory drugs. Enrofloxacin and flunixin meglumine were administered from Day-1 to -5. Enrofloxacin was then changed to gentamicin since it showed resistance in those bacteria. No clinical changes were observed. Gentamicin was given at rate 2.5 mg/kg once a week intramuscularly and prednisolone 2 mg/kg once on Day-6 given intramuscularly, showed a response on Day-10 of hospitalisation with the evidence of reduction in lung consolidation by almost 90% clear of lung lobes from pneumonia. Sixteen thin-shelled eggs were also observed in the coelomic cavity on radiographic images. Active laying season, prolonged laying period and the history of laying only two eggs a week before presenting to hospital gives a highly suggestive diagnosis of egg retention syndrome. To encourage laying, the terrapin was given a daily parenteral calcium supplement, oxytocin 5 IU/kg intramuscularly (Day-10 hospitalisation) and was released for sunbath and to sand twice daily. The eggs were completely laid on Day-11 and the overall terrapin condition was greatly improved 2 weeks post-hospitalisation.
    Matched MeSH terms: Gentamicins
  11. Effect of high saturated free fatty acids feeding on progression of renal failure in rat model of experimental nephrotoxicity
    Ibraheem ZO, Sattar MA, Abdullah NA, Rathore HA, Johns EJ
    Bosn J Basic Med Sci, 2012 Feb;12(1):26-32.
    PMID: 22364300
    The current study evaluates the impact of high saturated fat feeding in rat model of experimental nephrotoxicity induced by gentamicin. Sprague-Dawley rats weighing 200 g were randomized into four groups; the first one received the standard rodents chow for 8 weeks and was treated as control, the second group (HFD)received an experimental high fat diet rich in palm kernel oil (40% of Calories as fat) for the same period. The third group (HFDG) was given 80 mg/kg (body weight)/day gentamicin sulphate intraperitoneally during the last 24 days of the feeding period while the fourth group was given gentamicin as above along with the standard rodents chow. Renal function was assessed through measuring serum creatinine, creatinine clearance and absolute and fractional excretion of both sodium and potassium. At the end, rats underwent a surgical procedure for blood pressure measurement. Renal function study showed a stronger nephrotoxicity for HFDG group. Hypertension was observed in HFD group while the pressure declined after gentamicin co-administration. Overall, changing the feeding behavior toward using more SAFFAs for rats injected with gentamicin promotes the progression of renal failure.
    Matched MeSH terms: Gentamicins/toxicity*
  12. Melioidosis presenting as prostatitis--a case report from Sabah
    Kan SPK, Kay RWW
    Trans R Soc Trop Med Hyg, 1978;72(5):522-4.
    PMID: 725999 DOI: 10.1016/0035-9203(78)90175-X
    Previous reports of melioidosis in Sabah are reviewed and a detailed account of a case, presenting as prostatitis, in a 40-year-old British male is given. The history suggested that the organism, Pseudomonas pseudomallei, was transmitted by a fly which entered the eye. Diagnosis was delayed and treatment presented some difficulty, the organism being relatively insensitive to amplicillin and gentamicin. Co-trimoxazole was the most effective, followed by minocycline. Cure was eventually achieved and after four years the patient was fit and normal, except for sterility.
    Matched MeSH terms: Gentamicins/therapeutic use
  13. A physiological approach to renal clearance: From premature neonates to adults
    Holford N, O'Hanlon CJ, Allegaert K, Anderson B, Falcão A, Simon N, et al.
    Br J Clin Pharmacol, 2024 Apr;90(4):1066-1080.
    PMID: 38031322 DOI: 10.1111/bcp.15978
    AIMS: We propose using glomerular filtration rate (GFR) as the physiological basis for distinguishing components of renal clearance.

    METHODS: Gentamicin, amikacin and vancomycin are thought to be predominantly excreted by the kidneys. A mixed-effects joint model of the pharmacokinetics of these drugs was developed, with a wide dispersion of weight, age and serum creatinine. A dataset created from 18 sources resulted in 27,338 drug concentrations from 9,901 patients. Body size and composition, maturation and renal function were used to describe differences in drug clearance and volume of distribution.

    RESULTS: This study demonstrates that GFR is a predictor of two distinct components of renal elimination clearance: (1) GFR clearance associated with normal GFR and (2) non-GFR clearance not associated with normal GFR. All three drugs had GFR clearance estimated as a drug-specific percentage of normal GFR (gentamicin 39%, amikacin 90% and vancomycin 57%). The total clearance (sum of GFR and non-GFR clearance), standardized to 70 kg total body mass, 176 cm, male, renal function 1, was 5.58 L/h (95% confidence interval [CI] 5.50-5.69) (gentamicin), 7.77 L/h (95% CI 7.26-8.19) (amikacin) and 4.70 L/h (95% CI 4.61-4.80) (vancomycin).

    CONCLUSIONS: GFR provides a physiological basis for renal drug elimination. It has been used to distinguish two elimination components. This physiological approach has been applied to describe clearance and volume of distribution from premature neonates to elderly adults with a wide dispersion of size, body composition and renal function. Dose individualization has been implemented using target concentration intervention.

    Matched MeSH terms: Gentamicins/pharmacokinetics
  14. Development of biofilm-targeted antimicrobial wound dressing for the treatment of chronic wound infections
    Ng SF, Leow HL
    Drug Dev Ind Pharm, 2015;41(11):1902-9.
    PMID: 25758412 DOI: 10.3109/03639045.2015.1019888
    It has been established that microbial biofilms are largely responsible for the recalcitrance of many wound infections to conventional antibiotics. It was proposed that the efficacy of antibiotics could be optimized via the inhibition of bacterial biofilm growth in wounds. The combination of antibiofilm agent and antibiotics into a wound dressing may be a plausible strategy in wound infection management. Xylitol is an antibiofilm agent that has been shown to inhibit the biofilm formation. The purpose of this study was to develop an alginate film containing xylitol and gentamicin for the treatment of wound infection. Three films, i.e. blank alginate film (SA), alginate film with xylitol (F5) and alginate film with xylitol and gentamicin (AG), were prepared. The films were studied for their physical properties, swelling ratio, moisture absorption, moisture vapor transmission rate (MVTR), mechanical and rheology properties, drug content uniformity as well as in vitro drug release properties. Antimicrobial and antibiofilm in vitro studies on Staphylococcus aureus and Pseudomonas aeruginosa were also performed. The results showed that AG demonstrates superior mechanical properties, rheological properties and a higher MVTR compared with SA and F5. The drug flux of AG was higher than that of commercial gentamicin cream. Furthermore, antimicrobial studies showed that AG is effective against both S. aureus and P. aeruginosa, and the antibiofilm assays demonstrated that the combination was effective against biofilm bacteria. In summary, alginate films containing xylitol and gentamicin may potentially be used as new dressings for the treatment of wound infection.
    Matched MeSH terms: Gentamicins
  15. Effect of imidazolium-based ionic liquids on bacterial growth inhibition investigated via experimental and QSAR modelling studies
    Ghanem OB, Mutalib MI, El-Harbawi M, Gonfa G, Kait CF, Alitheen NB, et al.
    J Hazard Mater, 2015 Oct 30;297:198-206.
    PMID: 25965417 DOI: 10.1016/j.jhazmat.2015.04.082
    Tuning the characteristics of solvents to fit industrial requirements has currently become a major interest in both academic and industrial communities, notably in the field of room temperature ionic liquids (RTILs), which are considered one of the most promising green alternatives to molecular organic solvents. In this work, several sets of imidazolium-based ionic liquids were synthesized, and their toxicities were assessed towards four human pathogens bacteria to investigate how tunability can affect this characteristic. Additionally, the toxicity of particular RTILs bearing an amino acid anion was introduced in this work. EC50 values (50% effective concentration) were established, and significant variations were observed; although all studied ILs displayed an imidazolium moiety, the toxicity values were found to vary between 0.05 mM for the most toxic to 85.57 mM for the least toxic. Linear quantitative structure activity relationship models were then developed using the charge density distribution (σ-profiles) as molecular descriptors, which can yield accuracies as high as 95%.
    Matched MeSH terms: Gentamicins/chemistry
  16. Effect of gestational age on gentamicin pharmacokinetic parameters in the newborn
    Farizaturradiah O, Mohamed Z, Sim SM, Lim CT
    JUMMEC, 1997;2:35-38.
    Matched MeSH terms: Gentamicins
  17. Fulltext Detection of antibiotic resistance in probiotics of dietary supplements
    Wong A, Ngu DY, Dan LA, Ooi A, Lim RL
    Nutr J, 2015;14:95.
    PMID: 26370532 DOI: 10.1186/s12937-015-0084-2
    Probiotics are live microorganisms that confer nutrition- and health-promoting benefits if consumed in adequate amounts. Concomitant with the demand for natural approaches to maintaining health is an increase in inclusion of probiotics in food and health products. Since probiotic bacteria act as reservoir for antibiotic resistant determinants, the transfer of these genes to pathogens sharing the same intestinal habitat is thus conceivable considering the fact that dietary supplements contain high amounts of often heterogeneous populations of probiotics. Such events can confer pathogens protection against commonly-used drugs. Despite numerous reports of antibiotic resistant probiotics in food and biological sources, the antibiogram of probiotics from dietary supplements remained elusive.
    Matched MeSH terms: Gentamicins/pharmacology
  18. Fulltext Monitoring of serum gentamicin level in a general hospital
    Hussin Z, Lim VKE
    Med J Malaysia, 1982 Jun;37(2):104-7.
    PMID: 7132829
    Gentamicin is an aminoglycoside antibiotic which is commonly used in the treatment of serious Gram-negative infections. However, gentamicin like other aminoglycosides, has a narrow therapeutic index and is potentially ototoxic and nephrotoxic. Blood levels following administration of gentamicin has been shown to be highly unpredictable and monitoring of gentamicin levels is necessary to ensure effective therapeutic levels as well as to avoid toxicity. The Department of Microbiology, Universiti Kebangsaan Malaysia offers such a monitoring service. This paper analyses the results of 135 such estimations performed between August 1979 and May 1981. It is shown that a significant proportion of patients were receiving either too much or too little gentamicin. Empirical determinations of dosages is unsatisfactory and as the microbiological assay method of determining gentamicin levels is both easy to perform and inexpensive, such a service should be offered by all general hospitals in Malaysia.
    Matched MeSH terms: Gentamicins/blood*
  19. Fulltext A forgotten clinical sign making a comeback
    Chiam KH, A Hing CT, Low LL
    Med J Malaysia, 2014 Feb;69(1):40-1.
    PMID: 24814630 MyJurnal
    We report a case of Staphylococcus aureus infective endocarditis in a patient presenting with fever and rare cutaneous manifestations of Osler Nodes and Janeway Lesions. There had not been any distinct risk factors. His echocardiography subsequently revealed vegetation at the anterior mitral valve leaflet. As Staphylococcus aureus infective endocarditis is of utmost significance in morbidity and mortality, a sharp clinical acumen and follow up investigations is required alongside a prolonged course of antibiotics. Our patient was then started on intravenous cloxacillin for 28 days and gentamicin for 5 days to which he made good progress and recovery.
    Matched MeSH terms: Gentamicins
  20. Fulltext Drug Utilization on Neonatal Wards: A Systematic Review of Observational Studies
    Rosli R, Dali AF, Abd Aziz N, Abdullah AH, Ming LC, Manan MM
    Front Pharmacol, 2017;8:27.
    PMID: 28228724 DOI: 10.3389/fphar.2017.00027
    Despite limited evidence on safety and efficacy of drug use in neonates, drugs are extensively used in this age group. However, the availability of information on drug consumption in neonates, especially inpatient neonates, is limited. This paper systematically reviews published studies on drug utilization in hospitalized neonates. A systematic literature review was carried out to identify observational studies published from inception of databases used till August 2016. Four search engines, namely Medline, CINAHL, Embase, and PubMed, were used. Publications written in English that described drug utilization in neonatal wards were selected. Assessment of the data was based on the category of the study design, the objective of study and the method used in reporting drug consumption. A total of 20 drug utilization studies were identified, 12 of which focused on all drug classes, while the other eight evaluated antimicrobials. Studies were reported in Europe (n = 7), the United States (n = 6), India (n = 5), Brazil (n = 1), and Iran (n = 1). Substantial variance with regard to study types (study design and methods), data source, and sample size were found among the selected studies. Of the studies included, 45% were cross-sectional or retrospective, 40% were prospective studies, and the remaining 15% were point prevalence surveys. More than 70% of the studies were descriptive studies, describing drug consumption patterns. Fifteen per cent of the descriptive studies evaluated changes in drug utilization patterns in neonates. Volume of units was the most prevalent method used for reporting all drug categories. The ATC/DDD system for reporting drug use was only seen in studies evaluating antimicrobials. The most commonly reported drugs across all studies are anti-infectives for systemic use, followed by drugs for the cardiovascular system, the nervous system and the respiratory system. Ampicillin and gentamicin were the most prescribed antimicrobials in hospitalized neonates. The present review reveals that neonates are exposed to a high number of drugs and various methods are used to report drug consumption in this age group. The best measure of drug consumption to quantify prevalence of drug use in neonates remains to be identified and additional research in this area is warranted.
    Matched MeSH terms: Gentamicins
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