geoffrey modest medical blogs

  A recent article found that the combination of lopinavir with an azole antifungal (itraconazole) may effectively treat multidrug-resistant Candida  species, including C. auris, which has recently come to light as a huge potential problem (see  candida auris lopinavir plus azole works  antimicagentchemo2020  in dropbox, or  DOI:  10.1128/AAC.00684-20 )     Details:   -- this is basically a laboratory study, so I will not go into lots of detail   -- they assessed fluconazole chemosensitization    by 1,547 FDA approved drugs and clinical molecules against azole-resistant  C. aureus     Results:   --lopinavir exhibited potent synergistic interactions with azole drugs, especially with itraconazole but also with fluconazole and  voriconazole   (lopinavir's combination with itraconazole  worked on all C. auris clades, fluconazole only on clade 1, and  voriconazole worked only on clades 1 ...

since i am doing a few blogs on antibiotic overuse and concerns about increasing drug-resistant bacteria, i thought i would add another one on antibiotic-resistant E. coli causing urinary tract infections, per the NY Times on 7/14/19 (see  https://www.nytimes.com/2019/07/13/health/urinary-infections-drug-resistant.html?smid=nytcore-ios-share  ) Details/Comments: --UTIs are among the most common infections in the world --the number of hospitalizations from UTIs has increased 52% from 1998-2011, especially for women and older patients (see  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5414046/  ) --there has been increasing E coli resistance to trimethoprim/sulfamethoxazole (TMP/SMX), with the NY City Dept of Health reporting 1/3 are resistant (as we have certainly seen in Boston over the past few decades) and 1/5 are resist an t to 5 other common treatments     --a Lancet editorial on the 2018 NICE (National Institute for Health and Care Excell...