Antimicrobial rotation

One method that has seen only limited use is antimicrobial rotation. Defined as the prospective and purposeful altering of antimicrobial selection in an effort to prevent or delay the emergence and spread of bacterial resistance, this technique has evolved over the last several decades. Although antimicrobial rotation is simply a variation of antimicrobial control, its motive is focused on resistance... 

ESSENTIAL ELEMENTS OF AN OPTIMAL ANTIMICROBIAL ROTATION PROGRAM... 

EVIDENCE-BASED REVIEW OF THE IMPACT OF ANTIMICROBIAL ROTATION... 

Gelone et al. conducted a 3-year prospective study of antimicrobial rotation in three intensive care units at Temple University (the START trial).This study, like those described above, used a before and after approach. Daily rounds were performed, and the following were assessed on every patient 1) demographics 2) antibiotic regimen and dosing 3) the presence of infection (based on predefined criteria) and 4) organ-... 

Mani, R., Tang, M., Wu, X., et al. (2006) Membrane-bound dimer structure of a beta-hairpin antimicrobial peptide from rotational-echo double-resonance solid-state NMR. Biochemistry, 45(27), 8341-8349. 

Raymond et al. reported on a rotation study in a surgical intensive care unit with a different twist.Patients were stratified as either having sepsis/peritonitis or pneumonia, and empiric therapy was cycled every 3 months by syndrome. Fourteen hundred fifty-six admissions and 540 infections were treated over a 2-year period. With similar severity of illness during the before and after periods (mean APACHE II = 19), the authors demonstrated a reduction of length of stay from a mean of 62 days to 39 days, a reduction of vancomycin-resistant enterococcal and methicillin-resistant staphylococcal infection from 14 per 100 admissions to 8 per 100 admissions and death due to any cause dropped from 25 in the before period to 18 in the rotation period. Antimicrobial susceptibility and several other key parameters needed to evaluate the effectiveness of this program were not reported. 

In the case of cytosporone C (Figure 5.29), its structure was solved by X-ray analysis. According to Clardy et al., the space group in which it crystallized required cytosporone C to be isolated as a racemic mixture. Although the specific rotations of cytosporones were not reported, it could be speculated that cytosporones in general might have been isolated as racemates. This speculation aroused my curiosity to scrutinize whether there would be any difference between the enantiomers of cytosporone E (144) with regard to their antimicrobial activity. 

The cyclic peptide approach to nanotubes has some advautages over all other methods. In addition to diameter control, one can highlight that the properties of the outer surface of the nanotube can easily be modified by varying the amino acid side chains. In addition, due to the Cn symmetry of the backbone skeleton, nonsymmet-rical CPs can form an infinite number of different SPN (Figure 23b). This phenomenon is based on the interstrand rotation between two consecutive CPs, to form nonequivalent interactions for each j8-sheet. Appropriate unit design and optimization of conditions for self-assembly allows the nanotube properties to be tailored for specific applications. As a result, SPN can be used as (or in) porous solid materials, soluble cylindrical supermolecules, ion channels and other transmembrane pores, soUd-supported ion sensors, antimicrobial and cytotoxic agents, and nanocluster composites. A recent review published by Granja et al. includes the most relevant examples in this area. ... 

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