text:
Key Clinical Activities for Quality Asthma Care
Recommendations of the National Asthma Education and
Prevention Program
Prepared by
Seymour G. Williams, M.D.1
Diana K. Schmidt, M.P.H.2
Stephen C. Redd, M.D.1
William Storms, M.D.3
1Division of Environmental Hazards and Health Effects
National Center for Environmental Health, CDC
Atlanta, Georgia
2National Heart, Lung, and Blood Institute
National Institutes of Health
Bethesda, Maryland
3Colorado Springs, Colorado
The material in this report originated in the National Center for Environmental Health, Richard J. Jackson, M.D., Director; Division of Environmental Hazards and Health Effects, Michael A. McGeehin, Ph.D., Director.
In 1997, the National Asthma Education and Prevention Program (NAEPP), coordinated by the National Heart, Lung, and Blood Institute, published the second Expert Panel Report (EPR-2): Guidelines for the Diagnosis and Management of Asthma (National Heart, Lung, and Blood Institute, National Asthma Education and Prevention Program. Expert Panel Report 2: Guidelines for the diagnosis and management of asthma. Bethesda MD: US Department of Health and Human Services, National Institutes of Health, 1997; publication no. 97-4051. Available at http://www.nhlbi.nih.gov/guidelines/asthma/asthgdln.pdf) . Subsequently, the NAEPP Expert Panel identified key questions regarding asthma management that were submitted to an evidence practice center of the Agency for Healthcare Research and Quality to conduct a systematic review of the evidence. The resulting evidence report was used by the Expert Panel to update recommendations for clinical practice on selected topics. These recommendations (EPR--Update 2002) were published in 2002. (National Heart, Lung, and Blood Institute, National Asthma Education and Prevention Program. Guidelines for the diagnosis and management of asthma---update on selected topics 2002. J Allergy Clin Immunol 2002;110[November 2002, part 2]. Available at http://www.nhlbi.nih.gov/guidelines/asthma/index.htm) .
To improve the implementation of these guidelines, a working group of the Professional Education Subcommittee of the NAEPP extracted key clinical activities that should be considered as essential for quality asthma care in accordance with the EPR-2 guidelines and the EPR--Update 2002. The purpose was to develop a report that would help purchasers and planners of health care define the activities that are important to quality asthma care, particularly in reducing symptoms and preventing exacerbations, and subsequently reducing the overall national burden of illness and death from asthma. This report is intended to help employer health benefits managers and other health-care planners make decisions regarding delivery of health care for persons with asthma. Although this report is based on information directed to clinicians; it is not intended to substitute for recommended clinical practices for caring for persons with asthma, nor is it intended to replace the clinical decision-making required to meet individual patient needs. Readers are referred to the EPR-2 for the full asthma guidelines regarding diagnosis and management of asthma or to the abstracted Practical Guide (National Heart, Lung, and Blood Institute, National Asthma Education and Prevention Program. Practical guide for the diagnosis and management of asthma. Bethesda MD: US Department of Health and Human Services, National Institutes of Health, 1997; publication no. 97-4053. Available at http://www.nhlbi.nih.gov/health/prof/lung/asthma/practgde.htm) and to the EPR--Update 2002.
The 1997 EPR-2 guidelines and EPR--Update 2002 were derived from a consensus of leading asthma researchers from academic, clinical, federal, and voluntary institutions and based on scientific evidence supported by the literature. The 10 key activities highlighted here correspond to the four recommended-as-essential components of asthma management: assessment and monitoring, control of factors contributing to asthma severity, pharmacotherapy, and education for a partnership in care. The key clinical activities are not intended for acute or hospital management of patients with asthma but rather for the preventive aspects of managing asthma long term. This report was developed as a collaborative activity between CDC and the NAEPP.
The National Asthma Education and Prevention Program (NAEPP), administered and coordinated by the National Heart, Lung, and Blood Institute, began developing a consensus set of science-based guidelines for diagnosis and management of asthma shortly after its establishment in 1989. With wide participation of asthma specialists from academia, research, and clinical care, as well as representatives from voluntary health organizations and federal agencies, the first Expert Panel Report: Guidelines for the Diagnosis and Management of Asthma was produced in 1991 (1); a revision, the EPR-2, was published in 1997 (2), and an update to the EPR-2 was published in 2002 (3).
The EPR-2 and EPR--Update 2002 comprise the prevailing science-based consensus concerning accurate information for health-care providers regarding asthma diagnosis and management. The EPR-2 has been disseminated nationwide and abstracted into a practical guide, a best practices pediatric guide, and a pocket guideline. However, although these asthma care principles have been widely endorsed, they have not been adequately applied (4--8).
This report is a companion to the NAEPP Expert Panel Reports. It identifies a core set of 10 key clinical activities essential for ensuring that health care delivered to patients with asthma emphasizes the prevention aspect of care and addresses the components of care recommended in the Expert Panel Reports. The action steps listed for each key clinical activity suggest specific ways to accomplish the respective activity.
The process of developing a core set of key clinical activities involved a detailed review of the EPR-2 guidelines and input from persons researching their implementation (1--3, 9--11). These activities were identified in the context of the currently proposed asthma-specific measures for managed care (12), as well as the national health goals of Healthy People 2010 (13) (Box 1) and the strategic plan of the U.S. Department of Health and Human Services (DHHS), Action Against Asthma (14). These reports complement each other to help health-care professionals, policymakers, patients, and the public work together to improve asthma care for the overall population and reduce asthma-related morbidity and mortality.
Essential Components of Care and Associated Key Clinical Activities
The four essential components of asthma management---assessment and monitoring, controlling factors contributing to asthma severity, pharmacotherapy, and education for partnership in care---are distilled from the NAEPP EPR-2 Guidelines for the Diagnosis and Management of Asthma (Table 1). In addition, 10 key clinical activities are described and listed, each according to the essential component it represents. Action steps are suggested to help accomplish each of the clinical activities. The intent of this report is to help employer health benefits managers and health-care planners make decisions regarding delivery of quality health care for persons with asthma.
Assessment and Monitoring
Key Clinical Activity 1.
Establish Asthma Diagnosis
After a person seeks medical care for symptoms that suggest asthma, the diagnosis of asthma should be clearly established and the baseline severity of the disease classified to help establish the recommended course of therapy. For symptomatic adults and children aged >5 years who can perform spirometry, asthma can be diagnosed after a medical history and physical examination documenting an episodic pattern of respiratory symptoms and from spirometry that indicates partially reversible airflow obstruction (>12% increase and 200 mL in forced expiratory volume in 1 second [FEV1] after inhaling a short-acting bronchodilator or receiving a short [2--3 week] course of oral corticosteroids).
Alternative diagnoses of symptoms that suggest asthma, including conditions affecting the upper and lower airways (e.g., upper airway obstruction/foreign body, bronchitis, pneumonia/bronchiolitis, chronic obstructive pulmonary disease, tumor/neoplasm, pulmonary embolism, congestive heart failure, vocal cord dysfunction, or viral lower respiratory tract infection) should be ruled out and may require additional tests. For the patient with a probable diagnosis of asthma after initial evaluation (i.e., symptomatic with normal spirometry and no alternative diagnosis), presumptive treatment may be necessary to reach a final diagnosis. Referral to a specialist (see Key Clinical Activity 4) may be necessary if the diagnosis is in doubt, other conditions are aggravating the asthma, or the contribution of occupational or environmental exposures needs to be confirmed.
For infants and children aged <5 years, the diagnostic steps are the same except that spirometry, the most objective measure of lung function, is not feasible for this age group. Therefore, young children with asthma symptoms should be treated as having suspected asthma once alternative diagnoses are ruled out. Their medical histories and physical examinations should be expanded to look for factors associated with the development of chronic persistent asthma: more than three episodes of wheezing in the past year that lasted more than 1 day and affected sleep, AND parental history of asthma or physician-diagnosed atopic dermatitis, or two of the following: physician-diagnosed allergic rhinitis, wheezing apart from colds, or peripheral blood eosinophilia (15). Over time, the diagnosis may become apparent or referral to a specialist may be necessary to perform additional testing to exclude other diagnoses.
Many children aged <6 years who wheeze with respiratory tract infections respond well to asthma therapy (16) even though the diagnosis may be unconfirmed until persistence or recurrence of signs and symptoms is established. Approximately one third of children who wheeze with respiratory infections develop asthma that persists after age 6 (17).
Key Clinical Activity 2.
Classify Severity of Asthma
Because asthma is characterized by varying signs and symptoms, for appropriate treatment and monitoring, the severity of such signs and symptoms must be classified at the initial and all subsequent visits. Initially and before treatment has been optimized, clinical signs, symptoms, and peak flow monitoring or spirometry are used to classify severity (Table 2) (Box 2). After the patient's asthma is stable, severity is subsequently classified according to the level of medication required to maintain treatment goals (Table 3).
Health-care providers should have the knowledge, equipment, staff or access to needed resources to aid in classification and proper management of all patients with asthma.
Key Clinical Activity 3.
Schedule Routine Follow-Up Care
Patients with asthma experience varying symptoms and severity because of the nature of asthma, their exposure to environmental allergens or irritants, or insufficient adherence to their medication regimen. For these reasons, they require adjustments in therapy and regular follow-up visits. The first follow-up visit should be scheduled within the month after initial diagnosis. Routine visits thereafter should be scheduled every 1--6 months, depending on the severity of asthma and the patient's ability to maintain control of symptoms.
Routine care includes clinical assessment of airway function over time. Spirometry is recommended at the initial assessment and at least every 1--2 years after treatment is initiated and the symptoms and peak expiratory flow have stabilized. Spirometry as a monitoring measure may be performed more frequently, if indicated, on the basis of severity of symptoms and the disease's lack of response to treatment.
At all follow-up visits, the physician reviews the patient's medication use and management plan, including self-monitoring records. Also at each visit, the physician should assess the patient's self-management skills, including correct technique for use of inhalers, spacers, and peak flow meters, as applicable. See Education for Partnership in Care (Key Clinical Activities 9 and 10) for more detailed discussion regarding the asthma management plan and patient self-management.
All patients should have access to and be instructed in the use of devices needed to administer medication or monitor their asthma (e.g., inhalers, spacers, nebulizers, and peak flow meters [PFMs]). Several devices may be required to ensure optimal treatment. Patients who use inhaled corticosteroids delivered by metered-dose inhalers should use a spacer to increase consistency of the dose and to minimize the possibility of local side effects. Some patients cannot easily coordinate actuation and inhalation using a metered-dose inhaler; spacers enable easier and more effective administration of medication. Spacers with face masks and nebulizers are both available for young children.
PFMs are recommended for patients with moderate or severe, persistent asthma and those with a history of severe exacerbations to help them monitor their symptoms during daily management as well as their response to home treatment during an exacerbation.
Key Clinical Activity 4.
Assess for Referral to Specialty Care
Referral to an asthma specialist for consultation or comanagement is recommended in the following circumstances:
- A single life-threatening asthma exacerbation occurs.
- Treatment goals for the patient's asthma are not being met after 3 weeks to 6 months of treatment, or earlier if the physician concludes that the asthma is not responding to current therapy.
- Atypical signs and symptoms make asthma diagnosis unclear, or other conditions are complicating asthma or its diagnosis.
- The patient has a history suggesting that asthma is being provoked by occupational factors, an environmental inhalant, or an ingested substance.
- The initial diagnosis is severe, persistent asthma.
- Additional diagnostic testing is indicated.
- The patient is a child aged <3 years with moderate or severe persistent asthma.
- The patient is a candidate for immunotherapy.
- The patient or family requires additional education or guidance in managing asthma complications or therapy, following the treatment plan, or avoiding asthma triggers.
- The patient requires continuous oral corticosteroid therapy or high-dose inhaled corticosteroids, or has required more than two courses of oral corticosteroids in 1 year.
Specialty care for asthma may be provided by an allergist, pulmonologist, or other physician with expertise in asthma management. Patients undergoing specialty care may be comanaged by the referring physician or monitored by the referring physician in accordance with the specialty care physician's treatment regimen.
Identifying and Controlling Factors Contributing to Asthma Severity
Key Clinical Activity 5.
Recommend Measures to Control Asthma Triggers
Environmental tobacco smoke (ETS) and house dust mite, cockroach, and cat and dog allergens can worsen asthma (or trigger asthma exacerbations) in sensitized and exposed persons (18). Irritant or allergen sensitivity can be determined by the patient's exposure and symptom history and confirmed with skin or blood testing. Allergy testing for perennial indoor allergens is recommended for persons with persistent asthma who are taking daily medications. After sensitivity is determined, avoidance of the trigger is recommended, and allergen abatement might be indicated. Ways to reduce allergen and irritant exposure should be reviewed and agreement sought with the patient to initiate measures. Examples of trigger avoidance include using dust mite impermeable pillow and mattress covers, removing furry pets, and taking measures to eliminate cockroaches (Box 3).
No patient with asthma should smoke or be exposed to ETS. Physicians should review smoking status at the initial visit and all subsequent visits and, if patients smoke or are regularly exposed to ETS, should encourage and refer them to stop smoking.
Exercise-induced bronchoconstriction describes the transient narrowing of airways associated with physical exertion in persons with asthma (17). Exercise-induced bronchoconstriction may be prevented with optimal long-term control of asthma. If the patient remains symptomatic during exercise, specific medications can be taken before exercise to prevent exercise-induced bronchoconstriction.
Key Clinical Activity 6.
Treat or Prevent All Comorbid Conditions
Allergic rhinitis, sinusitis, gastroesophageal reflux, and sensitivity to certain medicines, including aspirin, nonsteroidal antiinflammatory drugs (NSAIDs), and beta blockers, can exacerbate asthma symptoms. Health-care providers should evaluate their asthma patients for these conditions and inquire about their medications, especially when asthma symptoms persist or worsen despite medication adjustments.
Health-care providers should provide annual influenza vaccinations to patients with persistent asthma to prevent a respiratory infection that can exacerbate asthma. However, patients who are clinically allergic to egg should not get the vaccine.
Key Clinical Activity 7.
Prescribe Medications According to Severity
Current evidence indicates that daily long-term control medications are necessary to prevent exacerbations and chronic symptoms for all patients with persistent asthma, whether the persistent asthma is mild, moderate, or severe. Inhaled corticosteroids are preferred because they are the most effective antiinflammatory medication available for treating the underlying inflammation characteristic of persistent asthma. For patients with mild persistent asthma, other long-term medications---cromolyn, leukotriene modifiers, nedocromil, and theophylline---are available but have not been demonstrated to be as effective as inhaled corticosteroids. Patients with moderate or severe disease usually require additional medication combined with inhaled corticosteroids for daily long-term control. All patients with asthma require a short-acting bronchodilator medication for managing acute symptoms or exacerbations when they occur; severe exacerbations require the addition of systemic (oral) corticosteroids to treat the increased inflammation present (see EPR-2 for additional information about managing exacerbations of asthma).
The dosage and type of medications are crucial because asthma treatment is adjusted according to the level of asthma severity. Once therapy goals are achieved, a gradual reduction in treatment should be carefully undertaken to identify the minimum dose required to maintain control (Table 3).
On the basis of the severity of asthma in an individual patient, various medication delivery and monitoring devices may be necessary (see Key Clinical Activity 3 for discussion of spacers/holding chambers, nebulizers, and peak flow and symptom monitoring).
Key Clinical Activity 8.
Monitor Use of ß2-Agonist Drugs
Patients whose need increases for short-acting inhaled ß2-agonist to control serious day and night symptoms probably have inadequately controlled asthma. Although patients may need short-acting inhaled ß2-agonist during upper respiratory viral infections and exercise-induced bronchoconstriction, using more than one canister of short-acting ß2-agonist drugs per month is usually considered above expected use. At every patient visit, the health-care provider should review ß2-agonist medication use, including the patient's understanding of the dosage instructions, inhaler technique, and reasons for increased use. For patients using more ß2-agonist drugs than expected, daily long-term control therapy should be increased as needed, either by initiating or increasing daily long-term control therapy (Table 3).
Education for Partnership in Care
Key Clinical Activity 9.
Develop a Written Asthma Management Plan
As part of the overall management of patients with asthma, the health-care provider, in consultation with the patient or the parent or guardian of a child with asthma, should develop a written plan as part of educating patients regarding self management, especially for patients with moderate or severe persistent asthma and those with a history of severe exacerbation. The National Heart, Lung, and Blood Institute provides more specific advice on asthma management plans, emphasizing the provider/patient partnership (available at http://www.nhlbi.nih.gov/health/public/lung/asthma/asthma.htm#plan). Writing the management plan helps clarify expectations for treatment (Box 4) and provides patients with an easy reference for remembering how to manage their asthma. The action plan should include written instructions on recognizing symptoms and signs of worsening asthma; taking appropriate medicines (type, dose, and frequency); recognizing when to seek medical care; and monitoring response to medications. Symptom-based plans may be equally effective as plans based on peak flow monitoring, although some patient preferences and circumstances (e.g., inability to recognize or report signs and symptoms of worsening asthma) may warrant a choice of peak flow monitoring. The management plan should be reviewed and adjusted, as needed, at every visit. For children, a copy of the plan should be given to each care giver and the child's school.
Key Clinical Activity 10.
Provide Routine Education on Patient Self-Management
Asthma education is essential for successful management of the disease. Effective asthma education is developed in a patient--provider partnership, tailored to the individual patient's needs relative to cultural or ethnic beliefs and practices. At a minimum, competent asthma education enlists and encourages family support, includes instructions on self-management skills (Box 5), and is integrated with routine ongoing care. It is provided, either as group or individual patient programs, to all patients and parents/guardians of children who have had a diagnosis of asthma.
A patient's ability to take asthma medications is a necessary skill of self-management. Patients and parents/guardians of children with asthma need to know the rationale behind daily long-term and quick-relief medications, how to take medications correctly, and how to adjust the dosage if asthma symptoms occur.
Instructions and verification on the proper use of any medication delivery devices and PFMs (for patients with moderate or severe persistent asthma) should be provided at the initial and each subsequent visit. Instruction should include how to interpret peak flow results and take action according to the asthma management plan.
To help patients avoid or control environmental factors that worsen their asthma, education should focus first on identifying simple measures. Once the patient notices improved asthma control, more complicated or extensive measures can be undertaken. Including members of the family in these discussions may be helpful because implementing avoidance and control measures often affects all family members. This is especially true with ETS education.
The 10 key clinical activities for quality asthma care, derived from the NAEPP EPR-2 and EPR-Update 2002, offer guidance for health-care managers and planners in making decisions regarding the resources necessary to ensure quality health care for persons with asthma. Managers and planners using these guides should understand the resources needed for appropriate diagnosis and treatment of asthma and the corresponding clinical activities recommended to ensure proper care and control of asthma. Action steps listed for each activity suggest specific ways to accomplish the respective activities. Adoption of the key clinical activities will lead to more appropriate health care for persons with asthma.
- National Heart, Lung, and Blood Institute, National Asthma Education and Prevention Program. Expert Panel Report: guidelines for the diagnosis and management of asthma. Bethesda MD: US Department of Health and Human Services, National Institutes of Health 1991; pub. No. 91-3042.
- National Heart, Lung, and Blood Institute, National Asthma Education and Prevention Program. Expert panel report 2: guidelines for the diagnosis and management of asthma. Bethesda MD: US Department of Health and Human Services, National Institutes of Health, 1997; publication no. 97-4051. Available at http://www.nhlbi.nih.gov/guidelines/asthma/asthgdln.pdf.
- National Heart, Lung, and Blood Institute, National Asthma Education and Prevention Program. Quick reference for the NAEPP Expert Panel Report: Guidelines for the diagnosis and management of asthma---Update on selected topics 2002. Bethesda MD: US Department of Health and Human Services, National Institutes of Health, 2002; publication no. 02-5075. Available at http://www.nhlbi.nih.gov/guidelines/asthma/index.htm.
- Meng Y-Y, Leung K-M, Berkbigler D, Halbert RJ, Legorreta AP. Compliance with U.S. asthma management guidelines and specialty care: a regional variation or national concern? J Eval Clin Pract 1999;5:213--21.
- Legorreta AP, Christian-Herman J, O'Connor RD, Hasan MM, Evans R, Leung K-M. Compliance with national asthma management guidelines and specialty care: a health maintenance organization experience. Arch Intern Med 1998;158:457--64.
- Picken HA, Greenfield S, Teres D, Hirway PS, Landis JN. Effect of local standards on the implementation of national guidelines for asthma: primary care agreement with national asthma guidelines. J Gen Intern Med 1998;13:659--63.
- Moy JN, Grant EN, Turner-Roan K, Li T, Weiss KB. Asthma care practices, perceptions, and beliefs of Chicago-area asthma specialists. Chicago Asthma Surveillance Initiative Project Team. Chest 1999;116:154S--62S.
- Warman KL, Silver EJ, McCourt MP, Stein REK. How does home management of asthma exacerbations by parents of inner-city children differ from NHLBI guideline recommendations? Pediatrics 1999;103:422--7.
- Schmidt DK, Fulwood R, Lenfant C. The National Asthma Education and Prevention Program. Partnering with local asthma coalitions to implement the guidelines. Chest 1999;116:235S--6S.
- FitzGerald JM. Development and implementation of asthma guidelines. Can Respir J 1998;5(Suppl A):85A--8A.
- Homer C, Susskind O, Alpert HR, et al. An evaluation of an innovative multimedia educational software program for asthma management: report of a randomized, controlled trial. Pediatrics 2000;106:210--5.
- National Committee for Quality Assurance. Use of appropriate medications for people with asthma. Health plan employer data and information set. 2000 Asthma measure. Washington DC: National Committee for Quality Assurance, 2001. Available at http://www.ncqa.org/somc2001/asthma/somc_2001_asthma.html.
- US Department of Health and Human Services. Healthy People 2010. 2nd ed. With understanding and improving health and objectives for improving health. (2 vols). Washington, DC: US Department of Health and Human Services, 2000. Available at http://www.healthypeople.gov.
- US Department of Health and Human Services, Office of the Assistant Secretary for Planning. Action against asthma---a strategic plan for the Department of Health and Human Services. Washington DC: US Department of Health and Human Services, 2000. Available at http://aspe.hhs.gov/sp/asthma.
- Castro-Rodriguez JA, Holberg CJ, Wright AL, Martinez FD. A clinical index to define risk of asthma in young children with recurrent wheezing. Am J Respir Crit Care Med 2000;162:1403--6.
- Martinez FD, Wright AL, Taussig LM, et al. Asthma and wheezing in the first six years of life. N Engl J Med 1995;332:133--8.
- American Academy of Allergy, Asthma and Immunology. Pediatric asthma: promoting the best practice. Guide for managing asthma in children. Milwaukee, WI: American Academy of Allergy, Asthma, and Immunology, 1999.
- Institute of Medicine. Committee on the Assessment of Asthma and Indoor Air. Clearing the air: asthma and indoor air exposures. Washington, DC: National Academy Press, 2000:9.
- Hansen-Flaschen J, Schotland H. New treatments for exercise-induced asthma. N Engl J Med 1998;339:192--3.
National Asthma Education and Prevention Program (NAEPP)
Professional and Patient/Public Education Subcommittee
October 2001
Chairperson: William Storms, M.D., American College of Allergy, Asthma, and Immunology, Colorado Springs, Colorado.
Co-Chairperson: Barbara P. Yawn, M.D., American Academy of Family Physicians, Rochester, Minnesota.
Liaison Representatives: Agency for Healthcare Policy and Research, Denise Dougherty, Ph.D., Rockville, Maryland; Allergy and Asthma Network/Mothers of Asthmatics, Inc., Nancy J. Sander, Fairfax Virginia; American Academy of Allergy, Asthma, and Immunology, Gail Shapiro, M.D., Seattle, Washington; American Academy of Physician Assistants, Gabriel R. Ortiz, M.P.A.S., El Paso, Texas; American Association of Occupational Health Nurses, Pam Carter, Charlottesville, Virginia; American Association for Respiratory Care, Thomas J. Kallstrom, Cleveland, Ohio; American College of Chest Physicians, John P. Mitchell, M.D., Davis, California; American College of Emergency Physicians, Robert M. Nowak, M.D., Detroit, Michigan; American Lung Association, Noreen M. Clark, Ph.D., Ann Arbor, Michigan; American Pharmaceutical Association, Dennis M. Williams, Pharm.D., Chapel Hill, North Carolina; American Society of Health-System Pharmacists, Leslie Hendeles, Pharm.D., Gainesville, Florida; American Thoracic Society, Stephen Lazarus, M.D., San Francisco, California; Association of State and Territorial Directors of Health Promotion and Public Health Education, Barbara L. Hager, M.P.H., Little Rock, Arkansas; Asthma and Allergy Foundation of America, Richard Carson, Washington, DC; National Black Nurses' Association, Inc., Susan B. Clark, M.N., Los Angeles, California; National Center for Environmental Health, CDC, Stephen Redd, M.D., Seymour Williams, M.D., Atlanta, Georgia; National Center for Health Statistics, CDC, Lara Akinbami, M.D., Hyattsville, Maryland; National Institute for Occupational Safety and Health, CDC, Edward L. Petsonk, M.D., Morgantown, West Virginia; National Heart, Lung, and Blood Institute (NHLBI), National Institutes of Health, Diana Schmidt, M.P.H., Virginia Taggart, M.P.H., Bethesda, Maryland; NHLBI Ad Hoc Committee on Minority Populations, Ruth I. Quartey, M.A, Bethesda, Maryland; National Institute of Allergy and Infectious Diseases, National Institutes of Health, Kenneth Adams, Ph.D., Bethesda Maryland; National Medical Association, Michael Lenoir, M.D.,Oakland, California; Society for Academic Emergency Medicine, Carlos A. Camargo, M.D., Dr.P.H., Boston, Massachusetts; U.S. Department of Education, Debra Little, Washington, DC; U.S. Environmental Protection Agency, Tracey Mitchell, Washington, DC; Food and Drug Administration, Robert J. Meyer, M.D., Rockville, Maryland; U.S. Public Health Service, Olivia Carter-Pokras. Ph.D., Rockville, Maryland.
Members of the Document Development Working Group
American Academy of Family Physicians, Barbara Yawn, M.D., Rochester, Minnesota; American College of Allergy, Asthma and Immunology, William Storms, M.D., Colorado Springs, Colorado; American College of Chest Physicians, John P. Mitchell, M.D., Davis, California; American Society of Health System Pharmacists, Leslie Hendeles, Pharm.D., Gainesville, Florida; Centers for Disease Control and Prevention, Stephen Redd, M.D., Seymour Williams, M.D., Atlanta, Georgia; National Institutes of Health, Diana Schmidt, M.P.H., Virginia Taggart, M.P.H., Bethesda, Maryland; Society for Academic Emergency Medicine, Carlos Carmago, Boston, Massachusetts; Environmental Protection Agency, Tracey Mitchell, Washington, DC.
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ATLANTA, February 19, 2013 – With technology increasingly blurring the lines between work and home and women assuming more prominent roles at work, a survey released today by Randstad US reveals that constant connectivity does not mean increased productivity for women workers.
Randstad's latest Engagement Index study reveals that while 42 percent of women believe it is increasingly difficult to disconnect from work while at home, the majority (68 percent) do not believe that the blurring of lines between work and home has increased their productivity.
"As enhanced technologies and increased access to information continues to blur the lines between our professional and personal lives, many workers mistake being busy for being productive," said Linda Galipeau, Randstad CEO of North America. "These are two very different concepts that when looked at from an organizational standpoint—could have serious implications for a company's bottom line. We are only productive if we're producing the results that are most impactful to our goals. Being that we live in a multi-tasking world, it is important to work smarter and hone in on those high-impact efforts that will create more meaningful results. This is incredibly important, especially as women and men can now perform their jobs from almost anywhere."
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Flexible Working Arrangements and Policies Among Prime Benefits For Women
Women Cite the Top Asset in Growing Their Careers
On-the-Job Relationships Impact Career Happiness
Randstad recently launched its Women Powering Business section on its Workforce360 thought leadership site. This section includes the latest research and trends shaping the way women work. For more information, as well as other research insights, advice and career resources, visit www.randstadusa.com/workforce360.
The Randstad Engagement Index is comprised of findings from quarterly waves of research targeting employees and annual surveys of employers. The sixth wave of findings was conducted November 1-13, 2012 from a national sample of 3,417 aged 18 and older who are currently employed full time from Ipsos' U.S. online panel were interviewed online.
Weighting was used to balance demographics and ensure samples reflect the U.S. population of working adults.
Employees and employers were surveyed to compare notable differences in perceptions and attitudes. Multiple waves of research allow for trending and to track changes in perceptions and attitudes over time. Research into employee attitudes and perceptions will be conducted quarterly. Research into employer attitudes and perceptions will be conducted on an annual basis.
About Ipsos Public Affairs
Ipsos Public Affairs is a non-partisan, objective, survey-based research practice which conducts strategic research initiatives for a diverse number of American and international organizations, based on public opinion research. They are the international polling agency of record for Thomson Reuters, the world's leading source of intelligent information for businesses and professionals. To learn more, visit: www.ipsos-pa.com.
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Genomes and Genes
Summary: A lipopeptide antibiotic that inhibits gram-positive bacteria.
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Publications281 found, 100 shown here
- Genetic basis for daptomycin resistance in enterococciKelli L Palmer
Departments of Ophthalmology and Microbiology and Molecular Genetics, Harvard Medical School, Boston, Massachusetts, USA
Antimicrob Agents Chemother 55:3345-56. 2011..The lipopeptide antibiotic daptomycin is approved to treat Gram-positive bacterial infections, including those caused by enterococci...
- Genetic basis for in vivo daptomycin resistance in enterococciCesar A Arias
Department of Internal Medicine, Division of Infectious Diseases, University of Texas Medical School at Houston, Houston, TX 77030, USA
N Engl J Med 365:892-900. 2011b>Daptomycin is a lipopeptide with bactericidal activity that acts on the cell membrane of enterococci and is often used off-label to treat patients infected with vancomycin-resistant enterococci...
- Correlation of daptomycin bactericidal activity and membrane depolarization in Staphylococcus aureusJared A Silverman
Cubist Pharmaceuticals, Inc, Lexington, Massachusetts 02421, USA
Antimicrob Agents Chemother 47:2538-44. 2003The objective of this study was to further elucidate the role of membrane potential in the mechanism of action of daptomycin, a novel lipopeptide antibiotic...
- Transcriptional profiling reveals that daptomycin induces the Staphylococcus aureus cell wall stress stimulon and genes responsive to membrane depolarizationArunachalam Muthaiyan
Microbiology Group, Department of Biological Sciences, Illinois State University, Normal, IL 61790 4120, USA
Antimicrob Agents Chemother 52:980-90. 2008b>Daptomycin is a lipopeptide antibiotic that has recently been approved for treatment of gram-positive bacterial infections. The mode of action of daptomycin is not yet entirely clear...
- Whole genome characterization of the mechanisms of daptomycin resistance in clinical and laboratory derived isolates of Staphylococcus aureusAnton Y Peleg
Department of Microbiology, School of Biomedical Sciences, Monash University, Melbourne, Australia
PLoS ONE 7:e28316. 2012b>Daptomycin remains one of our last-line anti-staphylococcal agents. This study aims to characterize the genetic evolution to daptomycin resistance in S. aureus.
- Genetic changes that correlate with reduced susceptibility to daptomycin in Staphylococcus aureusLisa Friedman
Cubist Pharmaceuticals, Inc, Lexington, MA 02421, USA
Antimicrob Agents Chemother 50:2137-45. 2006b>Daptomycin is a lipopeptide antibiotic with potent activity against gram-positive bacteria...
- An RpoB mutation confers dual heteroresistance to daptomycin and vancomycin in Staphylococcus aureusLongzhu Cui
Department of Bacteriology, Faculty of Medicine, Juntendo University, 2 1 1 Hongo, Bunkyo ku, Tokyo 113 8421, Japan
Antimicrob Agents Chemother 54:5222-33. 2010..the establishment of a Staphylococcus aureus laboratory strain, 10 3d1, having reduced susceptibility to daptomycin and heterogeneous vancomycin-intermediate S. aureus (VISA) phenotype...
- Antimicrobial susceptibility of Gram-positive bacterial isolates from the Asia-Pacific region and an in vitro evaluation of the bactericidal activity of daptomycin, vancomycin, and teicoplanin: a SENTRY Program Report (2003-2004)Douglas J Biedenbach
JMI Laboratories, 345 Beaver Kreek Centre, Suite A, North Liberty, IA 52317, USA
Int J Antimicrob Agents 30:143-9. 2007..Program during 2003-2004 to determine their susceptibility to several antimicrobial classes, including daptomycin. Daptomycin, vancomycin and teicoplanin minimum inhibitory concentrations (MICs) and minimum bactericidal ..
- Correlation between Reduced Daptomycin Susceptibility and Vancomycin Resistance in Vancomycin-Intermediate Staphylococcus aureusLongzhu Cui
Department of Bacteriology, Faculty of Medicine, Juntendo University, 2 1 1 Hongo, Bunkyo ku, Tokyo, Japan 113 8421
Antimicrob Agents Chemother 50:1079-82. 2006We present here findings of a strong positive correlation between reduced daptomycin susceptibility and vancomycin resistance in vancomycin-intermediate Staphylococcus aureus (VISA)...
- Analysis of cell membrane characteristics of in vitro-selected daptomycin-resistant strains of methicillin-resistant Staphylococcus aureusNagendra N Mishra
Division of Infectious Diseases, Los Angeles Biomedical Research Institute at Harbor University of California at Los Angeles Medical Center, 1124 West Carson St, Torrance, California 90502, USA
Antimicrob Agents Chemother 53:2312-8. 2009Our previous studies of clinical daptomycin-resistant (Dap(r)) Staphylococcus aureus strains suggested that resistance is linked to the perturbations of several key cell membrane (CM) characteristics, including the CM order (fluidity), ..
- Treatment failure resulting from resistance of Staphylococcus aureus to daptomycinDaniel J Skiest
Baystate Medical Center, Division of Infectious Diseases, 759 Chestnut St, Springfield, MA 01199, USA
J Clin Microbiol 44:655-6. 2006b>Daptomycin, a new cyclic lipopeptide, was recently approved for the treatment of infections by gram-positive organisms, including infections with methicillin-resistant Staphylococcus aureus (MRSA)...
- Correlation of daptomycin resistance in a clinical Staphylococcus aureus strain with increased cell wall teichoic acid production and D-alanylationUte Bertsche
Interfacultary Institute of Microbiology and Infection Medicine, Microbial Genetics, University of Tubingen, Auf der Morgenstelle 28, 72076 Tubingen, Germany
Antimicrob Agents Chemother 55:3922-8. 2011Cell wall thickening is a common feature among daptomycin-resistant Staphylococcus aureus strains. However, the mechanism(s) leading to this phenotype is unknown...
- Cell wall thickening is not a universal accompaniment of the daptomycin nonsusceptibility phenotype in Staphylococcus aureus: evidence for multiple resistance mechanismsSoo Jin Yang
Los Angeles Biomedical Research Institute, Torrance, California 90502, USA
Antimicrob Agents Chemother 54:3079-85. 2010The mechanism(s) of daptomycin (DAP) resistance (DAPr) is incompletely defined...
- Enhanced expression of dltABCD is associated with the development of daptomycin nonsusceptibility in a clinical endocarditis isolate of Staphylococcus aureusSoo Jin Yang
Los Angeles Biomedical Research Institute at Harbor UCLA, Torrance, CA 90502, USA
J Infect Dis 200:1916-20. 2009..we investigated the transcriptional profiles of the mprF and dlt genes in the context of cell-surface charge and daptomycin nonsusceptibility...
- Impact of high-inoculum Staphylococcus aureus on the activities of nafcillin, vancomycin, linezolid, and daptomycin, alone and in combination with gentamicin, in an in vitro pharmacodynamic modelKerry L LaPlante
Anti Infective Research Laboratory, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, Michigan 48201, USA
Antimicrob Agents Chemother 48:4665-72. 2004..Staphylococcus aureus (MSSA and MRSA, respectively) on the activities of nafcillin, linezolid, vancomycin, and daptomycin, alone and in combination with gentamicin in an in vitro pharmacodynamic model with simulated endocardial ..
- Failures in clinical treatment of Staphylococcus aureus Infection with daptomycin are associated with alterations in surface charge, membrane phospholipid asymmetry, and drug bindingTiffanny Jones
Los Angeles Biomedical Research Institute at Harbor UCLA, 1124 West Carson Street, Bldg RB2, Room 225, Torrance, CA 90502, USA
Antimicrob Agents Chemother 52:269-78. 2008Increasingly frequent reports have described the in vivo loss of daptomycin susceptibility in association with clinical treatment failures. The mechanism(s) of daptomycin resistance is not well understood...
- Characterization of a daptomycin-nonsusceptible vancomycin-intermediate Staphylococcus aureus strain in a patient with endocarditisKathleen Julian
Penn State Milton S Hershey Medical Center, Room C6833, BMR Bldg, Mailcode H036, 500 University Dr, Hershey, PA 17033, USA
Antimicrob Agents Chemother 51:3445-8. 2007We analyzed the emergence of daptomycin nonsusceptibility in a patient with persistent vancomycin-intermediate Staphylococcus aureus (VISA) bacteremia...
- Comparative genome sequencing of an isogenic pair of USA800 clinical methicillin-resistant Staphylococcus aureus isolates obtained before and after daptomycin treatment failureSusan Boyle-Vavra
Department of Pediatrics, University of Chicago, KCBD 4152, 900 E 57th Street, Chicago, IL 60657, USA
Antimicrob Agents Chemother 55:2018-25. 2011We describe here a clinical daptomycin treatment failure in a patient with recurrent methicillin-resistant Staphylococcus aureus (MRSA) bacteremia in whom daptomycin was administered after a failed empirical treatment course with ..
- Acute eosinophilic pneumonia secondary to daptomycin: a report of three casesBecky A Miller
Division of Infectious Diseases, Duke University Medical Center, Durham, North Carolina, USA
Clin Infect Dis 50:e63-8. 2010We describe 3 cases of daptomycin-induced pulmonary toxic effects that are consistent with drug-induced acute eosinophilic pneumonia...
- VraSR two-component regulatory system contributes to mprF-mediated decreased susceptibility to daptomycin in in vivo-selected clinical strains of methicillin-resistant Staphylococcus aureusShrenik Mehta
Division of Infectious Diseases, Department of Internal Medicine, Virginia Commonwealth University, Richmond, Virginia, USA
Antimicrob Agents Chemother 56:92-102. 2012b>Daptomycin (DAP) is a new class of cyclic lipopeptide antibiotic highly active against methicillin-resistant Staphylococcus aureus (MRSA) infections...
- In vitro cross-resistance to daptomycin and host defense cationic antimicrobial peptides in clinical methicillin-resistant Staphylococcus aureus isolatesNagendra N Mishra
LA Biomedical Research Institute at Harbor UCLA, 1124 West Carson Street, Bldg RB2, Room 230, Torrance, CA 90502, USA
Antimicrob Agents Chemother 55:4012-8. 2011..that methicillin-resistant Staphylococcus aureus (MRSA) isolates developing reduced susceptibilities to daptomycin (DAP; a calcium-dependent molecule acting as a cationic antimicrobial peptide [CAP]) may also coevolve reduced ..
- Daptomycin exposure and the probability of elevations in the creatine phosphokinase level: data from a randomized trial of patients with bacteremia and endocarditisSujata M Bhavnani
Institute for Clinical Pharmacodynamics, Ordway Research Institute, Albany, New York, USA
Clin Infect Dis 50:1568-74. 2010The objective of this analysis was to evaluate the relationship between daptomycin exposure and the probability of an elevation in the creatine phosphokinase (CPK) level (hereafter, "CPK elevation") in patients with Staphylococcus aureus ..
- Effects of prior effective therapy on the efficacy of daptomycin and ceftriaxone for the treatment of community-acquired pneumoniaPeter E Pertel
Cubist Pharmaceuticals, Lexington, Massachusetts 02421, USA
Clin Infect Dis 46:1142-51. 2008We sought to compare daptomycin with ceftriaxone for the treatment of patients with community-acquired pneumonia (CAP).
- Nine-hospital study comparing broth microdilution and Etest method results for vancomycin and daptomycin against methicillin-resistant Staphylococcus aureusHelio S Sader
JMI Laboratories, 345 Beaver Kreek Centre, North Liberty, IA 52317, USA
Antimicrob Agents Chemother 53:3162-5. 2009Vancomycin and daptomycin MIC results for 1,800 randomly selected oxacillin (methicillin [meticillin])-resistant Staphylococcus aureus (MRSA) bloodstream isolates from nine U.S...
- Serial daptomycin selection generates daptomycin-nonsusceptible Staphylococcus aureus strains with a heterogeneous vancomycin-intermediate phenotypeIlana Lopes Baratella da Cunha Camargo
Department of Bacteriology, Faculty of Medicine, Juntendo University, 2 1 1 Hongo, Bunkyo ku, Tokyo 113 8421, Japan
Antimicrob Agents Chemother 52:4289-99. 2008In order to better understand the mechanism of daptomycin resistance, we generated a daptomycin-nonsusceptible derivative strain, strain 10*3d1 (MIC = 3...
- Daptomycin nonsusceptible enterococci: an emerging challenge for cliniciansTheodoros Kelesidis
Department of Medicine, Division of Infectious Diseases, David Geffen School of Medicine at UCLA, 10833 Le Conte Ave, Los Angeles, CA 90095, USA
Clin Infect Dis 52:228-34. 2011b>Daptomycin is the only antibiotic with in vitro bactericidal activity against vancomycin-resistant Enterococcus (VRE) that is approved by the Food and Drug Administration (FDA)...
- Bactericidal agents in the treatment of MRSA infections--the potential role of daptomycinG L French
Department of Infection, King s College London, St Thomas Hospital, London SE1 7EH, UK
J Antimicrob Chemother 58:1107-17. 2006..b>Daptomycin, the first of the cyclic lipopeptides, shows rapid bactericidal activity against S...
- Antimicrobial susceptibility of Gram-positive bacteria isolated from US medical centers: results of the Daptomycin Surveillance Program (2007-2008)Helio S Sader
JMI Laboratories, North Liberty, IA 52317, USA
Diagn Microbiol Infect Dis 65:158-62. 2009..to 2008 in hospitals located in the United States were tested by reference broth microdilution methods against daptomycin and comparison agents. Methicillin (oxacillin) resistance rates were 55.9% and 74...
- Comparative activities of daptomycin, linezolid, and tigecycline against catheter-related methicillin-resistant Staphylococcus bacteremic isolates embedded in biofilmIssam Raad
The University of Texas M D Anderson Cancer Center, Department of Infectious Diseases, Infection Control and Employee Health, Houston, TX 77030, USA
Antimicrob Agents Chemother 51:1656-60. 2007..In this in vitro study, we investigated the efficacies of the newer antibiotics daptomycin, linezolid, and tigecycline, in comparison with those of vancomycin, minocycline, and rifampin, against ..
- Intermediate vancomycin susceptibility in a community-associated MRSA cloneChristopher J Graber
Division of Infectious Diseases, University of California, San Francisco General Hospital, 94110, USA
Emerg Infect Dis 13:491-3. 2007..Staphylococcus aureus (MRSA) with intermediate susceptibility to vancomycin and reduced susceptibility to daptomycin. The strain was isolated from the bone of a 56-year-old man with lumbar osteomyelitis after a 6-week treatment ..
- Impact of sarA on daptomycin susceptibility of Staphylococcus aureus biofilms in vivoElizabeth C Weiss
Department of Microbiology and Immunology, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
Antimicrob Agents Chemother 53:4096-102. 2009..sarA) has an impact on the susceptibility of established Staphylococcus aureus biofilms to treatment with daptomycin in vivo...
- Occurrence of vancomycin-tolerant and heterogeneous vancomycin-intermediate strains (hVISA) among Staphylococcus aureus causing bloodstream infections in nine USA hospitalsHelio S Sader
JMI Laboratories, North Liberty, IA, USA
J Antimicrob Chemother 64:1024-8. 2009The bactericidal activities of vancomycin and daptomycin were evaluated in a large collection of methicillin-resistant Staphylococcus aureus (MRSA) bacteraemia strains from nine major USA medical centres.
- Soft tissue and bone penetration abilities of daptomycin in diabetic patients with bacterial foot infectionsFriederike Traunmüller
Department of Surgery, Division of Plastic Surgery, Medical University of Graz, Auenbruggerplatz 29, A 8036 Graz, Austria
J Antimicrob Chemother 65:1252-7. 2010In the attempt to overcome increasing glycopeptide- and methicillin-resistant soft tissue infections, daptomycin is presently considered as an attractive alternative to the class of glycopeptides...
- In vitro activity of daptomycin, linezolid and rifampicin on Staphylococcus epidermidis biofilmsBruna Leite
IBB Institute for Biotechnology and Bioengineering, Centre of Biological Engineering, University of Minho, Campus de Gualtar, 4710 057 Braga, Portugal
Curr Microbiol 63:313-7. 2011..b>Daptomycin and linezolid belong to the novel antibiotic therapies that are active against gram-positive cocci...
- Efficacy of daptomycin in implant-associated infection due to methicillin-resistant Staphylococcus aureus: importance of combination with rifampinAnne Kathrin John
Infectious Diseases Service, Department of Internal Medicine, University Hospital and University of Lausanne, Rue du Bugnon 46, Lausanne, Switzerland
Antimicrob Agents Chemother 53:2719-24. 2009..We compared the activity of daptomycin (alone and with rifampin [rifampicin]) with the activities of other antimicrobial regimens against MRSA ATCC ..
- Clinical experience with daptomycin in Europe: the first 2.5 yearsArmando Gonzalez-Ruiz
Microbiology Department, Darent Valley Hospital, Dartford and Gravesham NHS Trust, Dartford, UK
J Antimicrob Chemother 66:912-9. 2011To describe the patient populations and infections being treated with daptomycin, as well as the efficacy and safety outcomes.
- Daptomycin resistance mechanisms in clinically derived Staphylococcus aureus strains assessed by a combined transcriptomics and proteomics approachAdrien Fischer
Genomic Research Laboratory, University Hospitals of Geneva and University of Geneva, Geneva, Switzerland
J Antimicrob Chemother 66:1696-711. 2011The development of daptomycin resistance in Staphylococcus aureus is associated with clinical treatment failures. The mechanism(s) of such resistance have not been clearly defined.
- Activities of clindamycin, daptomycin, doxycycline, linezolid, trimethoprim-sulfamethoxazole, and vancomycin against community-associated methicillin-resistant Staphylococcus aureus with inducible clindamycin resistance in murine thigh infection and in viKerry L LaPlante
Anti Infective Research Laboratory, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, Michigan 48201, USA
Antimicrob Agents Chemother 52:2156-62. 2008..45 to 1.3 logs). Overall, administration of daptomycin followed by vancomycin demonstrated the most significant kill against all strains in both models...
- Reduction in membrane phosphatidylglycerol content leads to daptomycin resistance in Bacillus subtilisAnna Barbara Hachmann
Department of Microbiology, Wing Hall, Cornell University, Ithaca, NY 14853 8101, USA
Antimicrob Agents Chemother 55:4326-37. 2011b>Daptomycin (DAP) is a cyclic lipopeptide that disrupts the functional integrity of the cell membranes of Gram-positive bacteria in a Ca(2+)-dependent manner...
- Cost-effectiveness analysis of linezolid, daptomycin, and vancomycin in methicillin-resistant Staphylococcus aureus: complicated skin and skin structure infection using Bayesian methods for evidence synthesisMark Bounthavong
Veterans Affairs San Diego Healthcare System, San Diego, CA 92161, USA
Value Health 14:631-9. 2011....
- High-dose daptomycin for treatment of complicated gram-positive infections: a large, multicenter, retrospective studyRavina Kullar
Anti Infective Research Laboratory, Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Detroit, Michigan, USA
Pharmacotherapy 31:527-36. 2011To evaluate the clinical response and safety of high-dose daptomycin for treatment of complicated gram-positive infections.
- Safety and efficacy of daptomycin in the treatment of osteomyelitis: results from the CORE RegistryJ A Crompton
Cubist Pharmaceuticals, Lexington, MA 02421, USA
J Chemother 21:414-20. 2009..Limited data is available describing the long-term safety and efficacy of daptomycin. the safety population was drawn from CORE 2005 and 2006, a retrospective, observational, multicenter study...
- High-dose daptomycin in documented Staphylococcus aureus infectionsMatteo Bassetti
Infectious Diseases Division, San Martino Hospital and University of Genoa School of Medicine, Genoa, Italy
Int J Antimicrob Agents 36:459-61. 2010b>Daptomycin is approved at a dose of 4-6 mg/kg/day for the treatment of complicated skin and soft-tissue infection and Staphylococcus aureus bloodstream infection...
- Influence of morbid obesity on the single-dose pharmacokinetics of daptomycinManjunath P Pai
College of Pharmacy, MSC09 5360, 1 University of New Mexico, Albuquerque, NM 87131 0001, USA
Antimicrob Agents Chemother 51:2741-7. 2007The present study characterized the single-dose pharmacokinetics of daptomycin dosed as 4 mg/kg of total body weight (TBW) in seven morbidly obese and seven age-, sex-, race-, and serum creatinine-matched healthy subjects...
- In vitro activities of Daptomycin, Linezolid, and Quinupristin-Dalfopristin against a challenge panel of Staphylococci and Enterococci, including vancomycin-intermediate staphylococcus aureus and vancomycin-resistant Enterococcus faeciumLaura A Jevitt
Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
Microb Drug Resist 9:389-93. 2003We assessed the in vitro activities of daptomycin, linezolid, and quinupristin-dalfopristin (QD) against a contemporary challenge panel of 88 staphylococcal and 90 enterococcal isolates...
- LC-MS/MS characterization of phospholipid content in daptomycin-susceptible and -resistant isolates of Staphylococcus aureus with mutations in mprFAileen Rubio
Cubist Pharmaceuticals, 65 Hayden Avenue, Lexington, MA 02421, USA
Mol Membr Biol 29:1-8. 2012b>Daptomycin (DAP) is a cyclic lipopeptide antibiotic used for the treatment of certain Staphylococcus aureus infections. Although rare, strains have been isolated that are DAP resistant...
- Daptomycin versus vancomycin for bloodstream infections due to methicillin-resistant Staphylococcus aureus with a high vancomycin minimum inhibitory concentration: a case-control studyCarol L Moore
Department of Internal Medicine, Division of Infectious Diseases, Henry Ford Hospital, Detroit, Michigan, USA
Clin Infect Dis 54:51-8. 2012..Consensus guidelines recommend considering use of alternative agents for infections involving a higher vancomycin MIC, despite few data to support this approach...
- Efficacy of usual and high doses of daptomycin in combination with rifampin versus alternative therapies in experimental foreign-body infection by methicillin-resistant Staphylococcus aureusC Garrigós
Infectious Diseases Service, Hospital Universitari de Bellvitge, Feixa Llarga s n, L Hospitalet de Llobregat, 08907 Barcelona, Spain
Antimicrob Agents Chemother 54:5251-6. 2010..The aim of this study was to evaluate the efficacies of daptomycin at usual and high doses (equivalent to 6 and 10 mg/kg of body weight/day, respectively, in humans) and in ..
- Efficacy of high doses of daptomycin versus alternative therapies against experimental foreign-body infection by methicillin-resistant Staphylococcus aureusO Murillo
Laboratory of Experimental Infection, Infectious Diseases Service, IDIBELL, Hospital Universitari de Bellvitge, Feixa Llarga s n, 08907 L Hospitalet de Llobregat, Barcelona, Spain
Antimicrob Agents Chemother 53:4252-7. 2009Since the currently approved dose of daptomycin (6 mg/kg of body weight/day) has been associated with clinical failures and resistance development, higher doses for some difficult-to-treat infections are being proposed...
- Efficacy of vancomycin and daptomycin against Staphylococcus aureus isolates collected over 29 yearsMaria D Appleman
Department of Pathology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
Diagn Microbiol Infect Dis 66:441-4. 2010We investigated vancomycin and daptomycin efficacy for Staphylococcus aureus isolates at our institution by testing 221 methicillin-sensitive and 299 methicillin-resistant isolates recovered from serious infections between 1979 and 2007 ..
- Daptomycin treatment of Staphylococcus aureus experimental chronic osteomyelitisMark S Rouse
Division of Infectious Diseases, Department of Internal Medicine, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN 55905, USA
J Antimicrob Chemother 57:301-5. 2006..b>Daptomycin is a cyclic lipopeptide anti-infective with activity against MRSA, approved for treatment of complicated skin ..
- Resistance or decreased susceptibility to glycopeptides, daptomycin, and linezolid in methicillin-resistant Staphylococcus aureusEsteban Nannini
Division of Infectious Diseases, School of Medicine, Universidad Nacional de Rosario, Rosario, Argentina
Curr Opin Pharmacol 10:516-21. 2010..Nonsusceptibility to daptomycin has been associated with changes in the structure and function of the cell envelope and surface charge...
- Daptomycin-oxacillin combinations in treatment of experimental endocarditis caused by daptomycin-nonsusceptible strains of methicillin-resistant Staphylococcus aureus with evolving oxacillin susceptibility (the "seesaw effect")Soo Jin Yang
LA Biomedical Research Institute at Harbor UCLA, 1124 West Carson Street, RB 2, Rm 230, Torrance, CA 90502, USA
Antimicrob Agents Chemother 54:3161-9. 2010In vivo development of daptomycin resistance (DAPr) among Staphylococcus aureus strains, especially methicillin-resistant S. aureus (MRSA) strains, in conjunction with clinical treatment failures, has emerged as a major problem...
- Evaluation of daptomycin pharmacodynamics and resistance at various dosage regimens against Staphylococcus aureus isolates with reduced susceptibilities to daptomycin in an in vitro pharmacodynamic model with simulated endocardial vegetationsWarren E Rose
Department of Pharmacy Practice, Anti Infective Research Laboratory, Eugene Applebaum College of Pharmacy and Health Sciences, Detroit Receiving Hospital, Detroit, Michigan 48201, USA
Antimicrob Agents Chemother 52:3061-7. 2008..We evaluated the impact of simulated standard- and high-dose daptomycin in combination with gentamicin or rifampin against daptomycin-susceptible and nonsusceptible matched strains of ..
- Daptomycin: a review 4 years after first approvalRobert Sauermann
Department of Clinical Pharmacology, Division of Clinical Pharmacokinetics, Medical University of Vienna, Vienna, Austria
Pharmacology 81:79-91. 2008b>Daptomycin is the first approved member of a new class of antibiotics, namely the cyclic lipopeptides. Daptomycin has rapid bactericidal activity against Gram-positive pathogens...
- Characterisation of a Staphylococcus aureus strain with progressive loss of susceptibility to vancomycin and daptomycin during therapyFred C Tenover
Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Atlanta, GA 30333, USA
Int J Antimicrob Agents 33:564-8. 2009..aureus (MRSA) bacteraemia developed endocarditis, failed a second course of vancomycin and then failed daptomycin therapy...
- Evaluation of ceftaroline activity versus daptomycin (DAP) against DAP-nonsusceptible methicillin-resistant Staphylococcus aureus strains in an in vitro pharmacokinetic/pharmacodynamic modelMolly Steed
Anti Infective Research Laboratory, School of Medicine, Wayne State University, Detroit, Michigan 48201, USA
Antimicrob Agents Chemother 55:3522-6. 2011..potential role of ceftaroline, a new broad-spectrum cephalosporin, as a therapeutic option for the treatment of daptomycin-nonsusceptible (DNS) methicillin-resistant Staphylococcus aureus (MRSA) infections...
- Efficacy of daptomycin combined with rifampicin for the treatment of experimental meticillin-resistant Staphylococcus aureus (MRSA) acute osteomyelitisM Lefebvre
Universite de Nantes, Faculte de Medecine, EA3826, 1 rue Gaston Veil, F 44035 Nantes, France
Int J Antimicrob Agents 36:542-4. 2010b>Daptomycin exhibits rapid bactericidal activity against Gram-positive organisms, including meticillin-resistant Staphylococcus aureus (MRSA). Daptomycin in combination with rifampicin needs to be assessed in bone infection...
- Novel daptomycin combinations against daptomycin-nonsusceptible methicillin-resistant Staphylococcus aureus in an in vitro model of simulated endocardial vegetationsMolly E Steed
Anti Infective Research Laboratory, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, 259 Mack Ave, Detroit, MI 48201, USA
Antimicrob Agents Chemother 54:5187-92. 2010Reduced susceptibility to daptomycin has been reported in patients with infections due to methicillin-resistant Staphylococcus aureus (MRSA)...
- Initial low-dose gentamicin for Staphylococcus aureus bacteremia and endocarditis is nephrotoxicSara E Cosgrove
Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, USA
Clin Infect Dis 48:713-21. 2009..This study evaluated the association between this practice and nephrotoxicity...
- Daptomycin in experimental murine pneumococcal meningitisBarry B Mook-Kanamori
Division of Infectious Disease, Department of Internal Medicine, College of Medicine, Mayo Clinic, Rochester, MN, USA
BMC Infect Dis 9:50. 2009b>Daptomycin, a lipopeptide antibiotic, could be an alternative to vancomycin for treatment of pneumococcal meningitis...
- Safety and clinical outcomes when utilizing high-dose (> or =8 mg/kg) daptomycin therapyPamela A Moise
Cubist Pharmaceuticals Inc, Lexington, MA 02421, USA
Ann Pharmacother 43:1211-9. 2009b>Daptomycin is approved for the treatment of skin and skin-structure infections (4 mg/kg) and Staphylococcus aureus bacteremia, including right-sided endocarditis (6 mg/kg)...
- Daptomycin for the treatment of enterococcal bacteraemia: results from the Cubicin Outcomes Registry and Experience (CORE)John F Mohr
Cubist Pharmaceuticals, Inc, 65 Hayden Avenue, Lexington, MA 02421, USA
Int J Antimicrob Agents 33:543-8. 2009..Studies in vitro as well as animal and case studies suggest that daptomycin may be effective in enterococcal infections...
- Safety of high-dose intravenous daptomycin treatment: three-year cumulative experience in a clinical programD A Figueroa
Department of Pharmacy, New York Hospital Queens, Flushing, New York 11355, USA
Clin Infect Dis 49:177-80. 2009There are limited safety data for high-dose and long-term daptomycin treatment (16mg/kg administered for >or=14 days). We present our experience in 61 patients.
- A potential role for daptomycin in enterococcal infections: what is the evidence?Rafael Canton
Servicio de Microbiologia, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria IRYCIS, Madrid, Spain
J Antimicrob Chemother 65:1126-36. 2010..b>Daptomycin is a first-in-class cyclic lipopeptide that has proven efficacy for the treatment of Gram-positive infections...
- Daptomycin: mechanisms of action and resistance, and biosynthetic engineeringRichard H Baltz
Discovery Biology, Cubist Pharmaceuticals, Inc, 65 Hayden Avenue, Lexington, MA 02421, USA
Curr Opin Chem Biol 13:144-51. 2009b>Daptomycin is a lipopeptide antibiotic used clinically to treat infections caused by Gram-positive bacteria. Laboratory studies have shown that Staphylococcus aureus resistance to daptomycin occurs stepwise and slowly...
- Daptomycin non-susceptible meticillin-resistant Staphylococcus aureus USA 300 isolateMadhukiran H Murthy
Department of Internal Medicine and Infectious Disease, University of Nebraska Medical Center, Omaha, USA
J Med Microbiol 57:1036-8. 2008b>Daptomycin is a novel bactericidal agent active against Gram-positive pathogens including meticillin-resistant Staphylococcus aureus (MRSA)...
- Evaluation of vancomycin and daptomycin potency trends (MIC creep) against methicillin-resistant Staphylococcus aureus isolates collected in nine U.S. medical centers from 2002 to 2006Helio S Sader
JMI Laboratories, North Liberty, IA 52317, USA
Antimicrob Agents Chemother 53:4127-32. 2009..We evaluated the possible occurrence of MIC creep when testing vancomycin and daptomycin against methicillin (oxacillin)-resistant Staphylococcus aureus (MRSA) by using precise incremental reference ..
- Emergence of a clinical daptomycin-resistant Staphylococcus aureus isolate during treatment of methicillin-resistant Staphylococcus aureus bacteremia and osteomyelitisFrancisco M Marty
Division of Infectious Diseases, Brigham and Women s Hospital, 75 Francis Street, PBB A4, Boston, MA 02115, USA
J Clin Microbiol 44:595-7. 2006The emergence of a clinically daptomycin-resistant Staphylococcus aureus isolate occurred during treatment of methicillin-resistant S. aureus bacteremia and probable vertebral osteomyelitis...
- Synergy of daptomycin with oxacillin and other beta-lactams against methicillin-resistant Staphylococcus aureusKenneth H Rand
Department of Pathology, Immunology and Laboratory Medicine, University of Florida, Gainesville, Florida 32610, USA
Antimicrob Agents Chemother 48:2871-5. 2004We previously observed marked synergy between daptomycin and both rifampin and ampicillin against vancomycin-resistant enterococci (VRE)...
- Resistance studies with daptomycinJ A Silverman
Cubist Pharmaceuticals, Inc, Cambridge, Massachusetts 02139, USA
Antimicrob Agents Chemother 45:1799-802. 2001We studied the in vitro emergence of resistance to daptomycin using three methods: spontaneous resistance incidence, serial passage in the presence of increasing drug concentrations, and chemical mutagenesis...
- Daptomycin versus standard therapy for bacteremia and endocarditis caused by Staphylococcus aureusVance G Fowler
Duke University Medical Center, Durham, NC 27710, USA
N Engl J Med 355:653-65. 2006..Alternative therapies for Staphylococcus aureus bacteremia and endocarditis are needed...
- Clinical experience with daptomycin for the treatment of patients with osteomyelitisKenneth C Lamp
Cubist Pharmaceuticals, Inc, Lexington, Massachusetts, USA
Am J Med 120:S13-20. 2007Data from a registry were analyzed to describe the clinical experience with daptomycin (Cubicin; Cubist Pharmaceuticals, Inc., Lexington, MA) for the treatment of patients with osteomyelitis...
- Regulation of mprF in daptomycin-nonsusceptible Staphylococcus aureus strainsSoo Jin Yang
LA Biomedical Research Institute at Harbor UCLA, 1124 West Carson Street, RB 2, Rm 230, Torrance, CA 90502, USA
Antimicrob Agents Chemother 53:2636-7. 2009..strains to study (i) regulation of mprF-mediated phosphatidylglycerol lysinylation in the contexts of in vitro daptomycin (DAP) nonsuceptibility and (ii) the role of mprF mutation in endovascular virulence...
- Comparison of the pharmacokinetics, safety and tolerability of daptomycin in healthy adult volunteers following intravenous administration by 30 min infusion or 2 min injectionAbhijit Chakraborty
Novartis Institutes for BioMedical Research, East Hanover, NJ, USA
J Antimicrob Chemother 64:151-8. 2009..separate populations of healthy adult volunteers investigated the pharmacokinetics, safety and tolerability of daptomycin (Cubicin; Novartis Pharma AG, Basel, Switzerland) administered as a 2 min intravenous (iv) injection, relative ..
- Activities of daptomycin and vancomycin alone and in combination with rifampin and gentamicin against biofilm-forming methicillin-resistant Staphylococcus aureus isolates in an experimental model of endocarditisKerry L LaPlante
University of Rhode Island, Department of Pharmacy Practice, Providence, RI 02908, USA
Antimicrob Agents Chemother 53:3880-6. 2009..Staphylococcus aureus (MRSA) isolates obtained from patients with IE and to evaluate the in vitro activities of daptomycin and vancomycin alone and in combination with rifampin (rifampicin) or gentamicin while monitoring the isolates ..
- Mechanistic and structural basis of stereospecific Cbeta-hydroxylation in calcium-dependent antibiotic, a daptomycin-type lipopeptideMatthias Strieker
Department of Chemistry Biochemistry, Philipps University of Marburg, Marburg, Germany
ACS Chem Biol 2:187-96. 2007Non-ribosomally synthesized lipopeptide antibiotics of the daptomycin type are known to contain unnatural beta-modified amino acids, which are essential for bioactivity...
- Activities of high-dose daptomycin, vancomycin, and moxifloxacin alone or in combination with clarithromycin or rifampin in a novel in vitro model of Staphylococcus aureus biofilmJorge Parra-Ruiz
Wayne State University, Anti Infective Research Laboratory, Detroit, Michigan 48201, USA
Antimicrob Agents Chemother 54:4329-34. 2010..vancomycin (VAN) plus rifampin (RIF), moxifloxacin (MOX), and high doses (10 mg/kg of body weight/day) of daptomycin (DAP) alone or combined with RIF or clarithromycin (CLA)...
- Dosing of daptomycin in intensive care unit patients with acute kidney injury undergoing extended dialysis--a pharmacokinetic studyJan T Kielstein
Department of Nephrology and Hypertension, Medical School Hannover, Germany
Nephrol Dial Transplant 25:1537-41. 2010b>Daptomycin is a new intravenous cyclic lipopeptide antibiotic, licensed for the treatment of complicated skin and soft tissue infections caused by Gram-positive organisms including both susceptible and resistant strains of Staphylococcus ..
- The safety and efficacy of daptomycin for the treatment of complicated skin and skin-structure infectionsRobert D Arbeit
Cubist Pharmaceuticals, Lexington, Massachusetts 02421, USA
Clin Infect Dis 38:1673-81. 2004b>Daptomycin is the first available agent from a new class of antibiotics, the cyclic lipopeptides, that has activity against a broad range of gram-positive pathogens, including organisms that are resistant to methicillin, vancomycin, and ..
- Daptomycin-resistant Enteroccoccus faecium in a patient with no prior exposure to daptomycinM H Fraher
J Hosp Infect 65:376-8. 2007
- Daptomycin-resistant, methicillin-resistant Staphylococcus aureus bacteremiaA Mangili
Division of Geographic Medicine and Infectious Diseases, Department of Medicine, Tufts New England Medical Center, Tufts University School of Medicine, Boston, Massachusetts 02111, USA
Clin Infect Dis 40:1058-60. 2005We describe a patient who developed daptomycin-resistant, methicillin-resistant Staphylococcus aureus (MRSA) during an episode of presumed septic thrombophlebitis of the portal vein...
- De novo daptomycin nonsusceptibility in a clinical isolateEmil P Lesho
J Clin Microbiol 44:673. 2006
- In vitro activity of ceftaroline against community-associated methicillin-resistant, vancomycin-intermediate, vancomycin-resistant, and daptomycin-nonsusceptible Staphylococcus aureus isolatesLouis Saravolatz
St John Hospital and Medical Center, 19251 Mack Ave, Suite 333, Detroit, MI 48236, USA
Antimicrob Agents Chemother 54:3027-30. 2010..aureus (VISA), vancomycin-resistant S. aureus (VRSA), heteroresistant VISA (hVISA), and daptomycin-nonsusceptible S. aureus (DNSSA) isolates...
- The bacterial defensin resistance protein MprF consists of separable domains for lipid lysinylation and antimicrobial peptide repulsionChristoph M Ernst
Cellular and Molecular Microbiology Division, Interfaculty Institute of Microbiology and Infection Medicine, University of Tubingen, Tubingen, Germany
PLoS Pathog 5:e1000660. 2009..a crucial role in Staphylococcus aureus virulence and it is involved in resistance to the CAMP-like antibiotic daptomycin. MprF is a large membrane protein that modifies the anionic phospholipid phosphatidylglycerol with l-lysine, ..
- Daptomycin for the treatment of surgical site infectionsRonald S Chamberlain
Department of Surgery, St Barnabas Medical Center, Livingston, NJ 07039, USA
Surgery 146:316-24. 2009..The increasing frequency of methicillin-resistant Staphylococcus aureus (MRSA) as a cause of surgical site infections, and decreased susceptibility to vancomycin, highlight the need for alternative therapies...
- Daptomycin inoculum effects and mutant prevention concentration with Staphylococcus aureusBrian Quinn
Public Health Research Institute and Department of Microbiology and Molecular Genetics, UMDNJ New Jersey Medical School, 225 Warren Street, Newark, NJ 07103, USA
J Antimicrob Chemother 60:1380-3. 2007..Large bacterial inocula known to reduce susceptibility have not been studied for effects on MPC determination...
- Mechanisms of resistance to daptomycin in Enterococcus faeciumClemente I Montero
Microbiology Service, Department of Laboratory Medicine, Warren G Magnuson Clinical Center, National Institutes of Health, US Department of Health and Human Services, 10 Center Drive, MSC 1508, Bethesda, Maryland 20892 1508, USA
Antimicrob Agents Chemother 52:1167-70. 2008In this study, we investigated the clonal emergence of daptomycin-resistant Enterococcus faecium strains isolated from a patient with leukocyte adhesion deficiency syndrome...
- Daptomycin in the treatment of patients with infective endocarditis: experience from a registryDonald P Levine
Wayne State University, University Health Center, Detroit, Michigan, USA
Am J Med 120:S28-33. 2007b>Daptomycin (Cubicin; Cubist Pharmaceuticals, Inc...
- Daptomycin in bone and joint infections: a review of the literatureDennis A K Rice
St Joseph s Candler Health System, Savannah, GA, USA
Arch Orthop Trauma Surg 129:1495-504. 2009To review the pharmacology, pharmacokinetics, efficacy, and safety of daptomycin, a novel antibiotic for the treatment of bone and joint infections, a literature search of relevant articles was conducted.
- Consequences of daptomycin-mediated membrane damage in Staphylococcus aureusJoanne Karen Hobbs
Antimicrobial Research Centre and Institute of Molecular and Cellular Biology, University of Leeds, Leeds LS2 9JT, UK
J Antimicrob Chemother 62:1003-8. 2008The proposed lethal action of daptomycin on Staphylococcus aureus results from the loss of K(+) and membrane depolarization. However, whether these events alone cause cell death has been questioned...
- Comparative efficacy of daptomycin and vancomycin in the therapy of experimental foreign body infection due to Staphylococcus aureusPierre Vaudaux
Division of Infectious Diseases, Geneva University Hospital, CH 1211 Geneva 14, Switzerland
J Antimicrob Chemother 52:89-95. 2003The therapeutic activity of daptomycin was compared with that of vancomycin in a rat model of subcutaneously implanted tissue cages chronically infected with strain Rev1, a spontaneous methicillin-susceptible revertant of the methicillin-..
- Rapid bactericidal activity of daptomycin against methicillin-resistant and methicillin-susceptible Staphylococcus aureus peritonitis in mice as measured with bioluminescent bacteriaLawrence I Mortin
Cubist Pharmaceuticals Inc, Lexington, MA 02421, USA
Antimicrob Agents Chemother 51:1787-94. 2007The rising rates of antibiotic resistance accentuate the critical need for new antibiotics. Daptomycin is a new antibiotic with a unique mode of action and a rapid in vitro bactericidal effect against gram-positive organisms...
- Daptomycin rapidly penetrates a Staphylococcus epidermidis biofilmPhilip S Stewart
Center for Biofilm Engineering, Department of Chemical and Biological Engineering, Montana State University, Bozeman, MT 59717 3980, USA
Antimicrob Agents Chemother 53:3505-7. 2009Fluorescently tagged daptomycin accessed the interior of Staphylococcus epidermidis biofilm cell clusters within minutes. The diffusion coefficient of daptomycin in the biofilm was 28% of its value in pure water...
- Effects of daptomycin in combination with other antimicrobial agents: a review of in vitro and animal model studiesJudith N Steenbergen
Cubist Pharmaceuticals Inc, Lexington, MA 02421, USA
J Antimicrob Chemother 64:1130-8. 2009This review summarizes the in vitro and animal model data available on antibiotic combinations with daptomycin. The majority of studies focus on the clinically relevant combinations of daptomycin with rifampicin or with gentamicin...
- Daptomycin nonsusceptibility in Staphylococcus aureus with reduced vancomycin susceptibility is independent of alterations in MprFSatish K Pillai
Department of Infectious Disease, Cleveland Clinic Foundation, Mailstop S32, Cleveland, OH 44195, USA
Antimicrob Agents Chemother 51:2223-5. 2007A previous study documented the presence of mutations in mprF that accompanied the loss of daptomycin susceptibility among Staphylococcus aureus isolates following exposure to the drug...
- Emergence of daptomycin resistance in Enterococcus faecium during daptomycin therapyJames S Lewis
Antimicrob Agents Chemother 49:1664-5. 2005
- Pharmacodynamics of daptomycin in a murine thigh model of Staphylococcus aureus infectionA Louie
Division of Infectious Diseases, Albany Medical College, Albany, New York 12208, USA
Antimicrob Agents Chemother 45:845-51. 2001b>Daptomycin is a lipopeptide antibiotic with activity against gram-positive bacteria, including Staphylococcus aureus. We defined the pharmacodynamic parameters that determine the activity of daptomycin for S...
- Genetic analysis of factors affecting susceptibility of Bacillus subtilis to daptomycinAnna Barbara Hachmann
Department of Microbiology, Wing Hall, Cornell University, Ithaca, New York 14853 8101, USA
Antimicrob Agents Chemother 53:1598-609. 2009b>Daptomycin is the first of a new class of cyclic lipopeptide antibiotics used against multidrug-resistant, gram-positive pathogens...
- Regulation of mprF by antisense RNA restores daptomycin susceptibility to daptomycin-resistant isolates of Staphylococcus aureusAileen Rubio
Cubist Pharmceuticals, Lexington, MA 02421, USA
Antimicrob Agents Chemother 55:364-7. 2011Mutations in mprF have been shown to result in reduced susceptibility to daptomycin and other cationic antibacterials...
- Effects of tigecycline and daptomycin on murine gut colonization by Candida albicansGeorge Samonis
Division of Medicine, University of Crete, Crete, Greece
Mycoses 51:324-7. 2008..Both groups were subsequently given tigecycline or daptomycin or normal saline subcutaneously for 10 days...
Research Grants50
- Clinical Research Training in Infectious DiseasesDavid Snydman; Fiscal Year: 2007..The goal of this training program will be to develop independent infectious diseases clinical research investigators highly skilled in clinical research methodologies and application. ..
- Modification of daptomycin by combinatorial biosynthesisPaul Brian; Fiscal Year: 2005The antibiotic daptomycin is produced by the Gram-positive bacterium Streptomyces roseosporus and is the first in a new class of investigational drugs called lipopeptides that is being developed by Cubist for the treatment of serious and ..
- Development of furanones for treatment of anthraxMartin Blaser; Fiscal Year: 2005..Ciprofloxacin or daptomycin will be used as comparitors, and synergies with the furanones explored as well...
- Structure activity relationships around lipopeptidesPaul Brian; Fiscal Year: 2003..The most notable lipopeptide from the 10-membered ring group is daptomycin that is currently progressing through clinical trials...
- Reducing Antimicrobial Use Associated with Ventilator Associated Pneumonia and CaSara Cosgrove; Fiscal Year: 2009..We hypothesize that this approach will enhance appropriate use of antimicrobials for both VAP and CAUTI and improve patient outcomes by reducing the known sequelae of antimicrobial overuse. ..
- Reducing Antimicrobial Use Associated with Ventilator Associated Pneumonia and CaSARA ELIZABETH COSGROVE; Fiscal Year: 2010..We hypothesize that this approach will enhance appropriate use of antimicrobials for both VAP and CAUTI and improve patient outcomes by reducing the known sequelae of antimicrobial overuse. ..
- Novel antibacterial agents for treatment of TularemiaNachum Kaplan; Fiscal Year: 2004..tularensis microbiological data and animal model data to warrant inclusion of the information on the product label as a narrow spectrum agent that could be used in the event of a F. tularensis release. ..
- Staphylococcal Adaptations to Platelet Microbicidal ProteinArnold Bayer; Fiscal Year: 2007..The research in this proposal seeks to understand how bacteria can withstand the exposures to an important part of the host defense system (natural peptide antibiotics). This may enable design of new of strategies to kill such bacteria. ..
- Cytology and function of ParA in E. coliJOSEPH A POGLIANO; Fiscal Year: 2010..The findings from this analysis of a representative ParAB plasmid partitioning system should have wide implications for our understanding of plasmid and chromosome segregation. ..
- DNA segregation during Bacillus growth and developmentJOSEPH POGLIANO; Fiscal Year: 2009..These studies will allow the development of better genetic tools and plasmid vectors useful for manipulating many Bacillus species. ..
- DNA segregation during Bacillus growth and developmentJOSEPH A POGLIANO; Fiscal Year: 2010..These studies could therefore help identify targets for new narrow spectrum antibiotics, since blocking plasmid stability will in certain infections decrease pathogenicity. ..
- Staphylococcal Adaptations to Platelet Microbicidal ProteinArnold S Bayer; Fiscal Year: 2010..This may enable design of new of strategies to kill such bacteria. ..
- STAPHYLOCIDAL MECHANISM OF PLATELET MICROBICIDAL PROTEINArnold Bayer; Fiscal Year: 2006..aureus strains for killing, as well as to circumvent innate homeostatic mechanisms used by the organism for survival. ..
- STAPHYLOCIDAL MECHANISM OF PLATELET MICROBICIDAL PROTEINArnold Bayer; Fiscal Year: 2000..tPMP will also serve as a design template for development of synthetic congeners with potent antimicrobial activity. ..
- Staphylococcal Adaptations to Platelet Microbicidal ProteinArnold Bayer; Fiscal Year: 2009..This may enable design of new of strategies to kill such bacteria. ..
- DNA segregation during Bacillus growth and developmentJOSEPH POGLIANO; Fiscal Year: 2007..These studies will allow the development of better genetic tools and plasmid vectors useful for manipulating many Bacillus species. ..
- DNA segregation during Bacillus growth and developmentJOSEPH POGLIANO; Fiscal Year: 2007..These studies will allow the development of better genetic tools and plasmid vectors useful for manipulating many Bacillus species. ..
- Genetic Basis of Virulence of Community MRSA Clone USA300Henry F Chambers; Fiscal Year: 2010..By knocking each of these genes out and testing for loss of virulence, we hope to learn which genes code for virulence. Once these genes are identified, strategies to block their effects may be developed. ..
- PENICILLIN INTERACTIVE PROTEINS OF STAPHYLOCOCCUS AUREUSHenry Chambers; Fiscal Year: 2003..To augment information about where PBPs localize, when they are expressed during the cell cycle will be determined by Northern blotting. ..
- Evaluating Trichophyton tonsurans Carriage and InfectionSusan Abdel Rahman; Fiscal Year: 2006..abstract_text> ..
- Mentored Patient-Oriented Research Careeer Development AwardDebra Poutsiaka; Fiscal Year: 2007..abstract_text> ..
- Intra-species regulatory functions of fsrSatish Pillai; Fiscal Year: 2004..abstract_text> ..
- Genetic Analysis of HIV ComplicationsAlexandra Mangili; Fiscal Year: 2007....
- FUNGAL PROTEIN/GLYCOPROTEIN EXPRESSION IN TINEA CAPITISSusan Abdel Rahman; Fiscal Year: 2003..abstract_text> ..
- B-lactam mediated SOS response and expression of resistance in clinical MRSAAdriana E Rosato; Fiscal Year: 2010....


text:
Category: science
Marathon craziness
I dislike running. A LOT. I can walk *really* fast and probably match the pace of all 6+ footers out there with little effort but I cannot run for long. To be precise, I can run for 15 seconds before my lungs liquefy and start pouring out my nostrils... Well, they don't, actually, but that's what it feels like. It's almost as bad as trying to get used to spectacles and have the ground tilt and be all wobbly for a couple weeks. I can't take that feeling! As a result, I don't run, or wear spectacles. Usually, people try to show me the merits of joining the band of
And now I have scientific proof to wave in their faces (atleast for the runners... I am sure, one of these days, I will find something against spectacles as well.)
I spotted this editorial that gives an overview of studies that show that if you just run because your friends have suddenly started running or you feel like running can make up for your decades of binging on chicken wings or smoking your lungs to a nice ebony black, it doesn't help. ::READ PDF::
In fact, you end up with an increased risk of coronary atherosclerosis or myocardial scar formation due to mini-infarctions (that's a heart attack and things leading up to heart attacks). Running, for people who have not slowly conditioned their muscles over a long period of time, is injurious to their heart.
Instead, come to dance class with me! ;-)
^NB: Have you ever noticed that 95% of male actors that you look up in imdb has usually played a role in that HBO series? When they made the series, did they recruit everyone from every acting school across the planet?!
Permalink: http://estrip.org/articles/read/tinypliny/54030/Marathon_craziness.html
Words: 385
Location: Buffalo, NY
Last Modified: 04/11/11 10:19
Category: buffalo
Dear Snow,
Permalink: http://estrip.org/articles/read/tinypliny/54017/Dear_Snow_.html
Words: 12
Location: Buffalo, NY
Last Modified: 04/10/11 12:30
Category: eating in
How to make an edible rainbow...
Permalink: http://estrip.org/articles/read/tinypliny/54016/How_to_make_an_edible_rainbow_.html
Words: 7
Location: Buffalo, NY
Last Modified: 04/10/11 12:26
Category: e:strip
E:Strip: In the light and in the dark!
~30 mb of compressed text
~2 gigs of compressed pictures
~8 years of words, thoughts and perspectives.
Permalink: http://estrip.org/articles/read/tinypliny/54015/E_Strip_In_the_light_and_in_the_dark_.html
Words: 20
Location: Buffalo, NY
Last Modified: 04/10/11 12:38
Category: eating in
Neufchâtel Cheese
Neufchâtel Cheese!
with salt or maybe a little pepper or homemade garam masala or all by itself.
100x more tasty and 10000x more awesome than those ridiculous Greek yogurts.
Permalink: http://estrip.org/articles/read/tinypliny/53999/Neufch_tel_Cheese.html
Words: 39
Location: Buffalo, NY
Last Modified: 04/08/11 03:07
Category: dance
I am incredibly sore everywhere. My biceps and triceps are sore, upper back muscles that I never knew existed are suddenly making themselves known and my inner thighs and calves that went to their extremes are crying out now... In spite of all this, I feel awesome. It is this sense of absolute and inexplicable delight at feeling completely drained out and exhausted.
And the music... I felt like I was floating in heaven. Kolleen Fischer from the Configuration Dance Studio has some excellent taste in classical music. Every little piece was perfectly chosen to the ballet moves we were executing. There were some well-loved piano pieces and some unknown but absolutely delightful pieces from the romantic and classical period (written for the orchestra but played on the piano). (I really must get hold of her playlist!)
If I were to describe it more precisely, it was like an (exorbitantly expensive at $17) hour of flowing and active super-intense yoga with a minutely detailed French nomenclature set to some brilliant classical music pieces. I guess this is where I am happily blowing through my tax returns.
Permalink: http://estrip.org/articles/read/tinypliny/53983/Ballet.html
Words: 194
Location: Buffalo, NY
Last Modified: 04/05/11 12:23
Category: eating in
Awesome Arugula Alternative
Turnip Greens.
They top my all-time-favourite greens-list in mixed salads and fun snacks.
Permalink: http://estrip.org/articles/read/tinypliny/53974/Awesome_Arugula_Alternative.html
Words: 35
Location: Buffalo, NY
Last Modified: 04/03/11 10:29
Category: the odes
Now buy that porcelain donkey!
Permalink: http://estrip.org/articles/read/tinypliny/53968/Now_buy_that_porcelain_donkey_.html
Words: 9
Location: Buffalo, NY
Last Modified: 04/03/11 12:57
Category: linux
Partition Question
Question 1:
I have three partitions on my laptop:
Let's suppose that I am distro-hopping and want to install some crazy distro on my "experimentation" laptop. Let's further suppose that this new distro is not really similar (in terms of kernel as well as windows manager) to the older distro which was on the laptop.
If I don't format my /home partition, will the older settings (brightness, power management, folder options, screensaver, desktop background etc) be preserved on all old-distro-> new-distro transitions? Why or why not?
Question 2:
Why is it that the installation programs for all linuxes (linuxi?) don't allow me to tick the format checkbox for the swap partition while installing? All the other partitions have "tick-able" format checkboxes.
Permalink: http://estrip.org/articles/read/tinypliny/53967/Partition_Question.html
Words: 128
Location: Buffalo, NY
Last Modified: 04/03/11 12:47
Category: music
Bizet done the Bartoli way
Cecilia Bartoli performs Bizet's Près des ramparts de Séville or the Séguedille from the opera, "Carmen", accompanied by Jean-Yves Thibaudet on the piano...
Permalink: http://estrip.org/articles/read/tinypliny/53962/Bizet_done_the_Bartoli_way.html
Words: 65
Location: Buffalo, NY
Last Modified: 04/02/11 09:25
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Thousands gather for traditional Boxing Day hunt (From Oxford Mail)
Get involved: send your photos, videos, news & views by texting OXFORD NEWS to 80360 or email us
Thousands gather for traditional Boxing Day Heythrop hunt in Chipping Norton
Updated 2:13pm Thursday 26th December 2013 in News By Freddie Whittaker
AROUND 6,000 people have gathered today for the traditional Boxing Day Heythrop hunt in Chipping Norton.
The square outside the Fox Hotel was packed with riders, dogs and Chipping Norton residents who went along to see the hunt off.
Despite criticisms from animal rights campaigners about the event, there were no signs of protest there this morning.
Riders followed a scent trail that had been laid out earlier in the day.
The Bicester and Whaddon Chase Hound Club hunt was also due to take place east of Bicester today.
The Kimblewick Hunt, previously the Vale of Aylesbury with Garth and South Berks Hunt, which covers parts of Oxfordshire, was due to meet at Cholsebury Common at midday.
Comments (2)
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4:15pm Thu 26 Dec 13
Myron Blatz says...
11:18pm Thu 26 Dec 13
LetsBeRational says...
Myron Blatz wrote:What's that got to do with this article. I don't mind people complaining about government policy, that is a benefit of living in a democracy and more people should voice their concerns, but keep it to relevant articles.
Do you think local lad Dave is aware of all these angry people hunting for him in light of his Government's policies, and the massive cuts to public services which are affecting the daily lives of millions?
Comments are closed on this article.