Oral Course Research Articles

Ağız Sağlığı Eğitim Programına Katılan İlköğretim Okulu Öğrencilerinde Diş Kaygısı Paterni

Background/Aims: Dental anxiety is a common problem which develops mostly in childhood. The level of dental anxiety perceived by the primary schoolers were determined with Facial Image Scale (FIS) while receiving oral dental health education in their classroom environment.
 Methods: FIS were applied to 163 third-grade primary schoolers while they were having oral health education course in an interactive way. Gender, white dental attire, and past dental experience(s) were pre-determined variables evaluating the pattern of dental anxiety in the third-grade primary schoolers in this study.
 Results: The overall anxiety level in children was 46.01%, with no significant difference observed between genders (p=0.4593). Students who were educated by instructors wearing white dental attire were more likely to have a 1&2 FIS score (OR: 3.9 (1.3-11.7); p=0.0156). However, students who had past dental experience expressed significantly more 4&5 FIS scores (OR: 4.38 (2.17-8.85); p < 0.001). 
 Conclusions: Regardless of gender white dental attire created a positive perception in 9-year-old students, but the presence of past dental experience and a history of tooth extraction especially under local anesthesia caused negative perception in the study.

Antibiotic associated diarrhea in outpatient pediatric antibiotic therapy

BackgroundAntibiotic-associated diarrhea is one of the most frequent side effects of antimicrobial therapy. We assessed the epidemiological data of antibiotic-associated diarrhea in pediatric patients in our region.MethodsThe prospective multi-center study included pediatric patients who were initiated an oral antibiotic course in outpatient clinics and followed in a well-established surveillance system. This follow-up system constituded inclusion of patient by the primary physician, supply of family follow-up charts to the family, passing the demographics and clinical information of patient to the Primary Investigator Centre, and a close telephone follow-up of patients for a period of eight weeks by the Primary Investigator Centre.ResultsA result of 758 cases were recruited in the analysis which had a frequency of 10.4% antibiotic-associated diarrhea. Among the cases treated with amoxicillin-clavulanate 10.4%, and cephalosporins 14.4% presented with antibiotic-associated diarrhea. In the analysis of antibiotic-associated diarrhea occurrence according to different geographical regions of Turkey, antibiotic-associated diarrhea episodes differed significantly (p = 0.014), particularly higher in The Eastern Anatolia and Southeastern Anatolia. Though most commonly encountered with cephalosporin use, antibiotic-associated diarrhea is not a frequent side effect.ConclusionThis study on pediatric antibiotic-associated diarrhea displayed epidemiological data and the differences geographically in our region.

Dog Owners’ Attitude toward Veterinary Antibiotic Use and Antibiotic Resistance with a Focus on Canine Diarrhea Management

An ad hoc questionnaire was designed in order to investigate AMR knowledge amongst Italian dog owners, owner expectations concerning pharmacological treatment of canine AD, and client attitudes towards and compliance with alternative strategies to antimicrobial administration. A total of 250 questionnaires were returned. Most of respondents were female, aged 36-70 and workers. More than a half of participants owned one dog with mixed breed, with Labrador retriever, golden retriever, dachshund, and border collie being the most represented breeds. On average, each dog was treated with an oral antibiotic 1.044 times per year. Intestinal diseases were among the main reasons (19%) for antibiotic prescription. Oral antibiotic courses without veterinary consultation (21%) and anticipated termination of the therapy (17.1%) were less common than reported elsewhere. The majority of respondents knew the meaning of AMR with a significant inverse association between the level of education and the tendency to administer antimicrobials without consulting a clinician (p = 0.004). Most of the owners expected a rapid recovery of clinical signs after a first episode of AD and accepted natural dietary supplementation for treating the condition. Ninety-five percent of the respondents believed that public funding should be spent to study AMR. Even though an acceptable degree of AMR awareness emerged, we feel that further efforts should be made to increase public AMR knowledge and to stimulate proactive measures to fight the phenomenon. On the other hand, the development of guidelines for the treatment of uncomplicated canine AD would help clinicians to rationalize antimicrobial use.

Ischemic Stroke and Savings in Time to Achieve Functional Recovery: Experience from NeuroAiD.

Despite recent progress with revascularisation interventions after acute ischemic stroke, many patients remain disabled after stroke. Using data from a multi-centre, randomised, double-blind, placebo-controlled trial of a neuro-repair treatment (NeuroAiD/MLC601) with a long-term follow-up, we analysed the savings in time to functional recovery, measured by a modified Rankin Scale (mRS) score of 0 or 1, in patients receiving a 3-month oral course of MLC601. Analysis of time to recovery was assessed by a log-rank test and hazard ratios (HRs) adjusted for prognosis factors. A total of 548 patients with baseline NIHSS scores 8-14, mRS scores ≥ 2 at day 10 post-stroke, and at least one mRS assessment on or after month 1 were included in the analysis (placebo = 261; MLC601 = 287). Time to functional recovery was significantly shortened for patients receiving MLC601 versus patients receiving placebo (log-rank test: p = 0.039). This result was confirmed by Cox regression adjusting for the main baseline prognostic factors (HR: 1.30 [0.99, 1.70]; p = 0.059) and was more pronounced in patients with additional poor prognosis factors. The Kaplan-Meier plot showed that approximately 40% cumulative incidence of functional recovery was achieved within 6 months after stroke onset in the MLC601 group versus 24 months in the placebo group. The main findings are that MLC601 reduced the time to achieve functional recovery, and a 40% functional recovery rate was achieved 18 months earlier compared to placebo.

The Effectiveness of Choline Alfoscerate in the Treatment of Patients with Amnestic Mild Cognitive Impairment: A Comparative Prospective Study

Background: the issues of early diagnosis and therapy of cognitive disorders that do not reach the degree of dementia remain relevant.The purpose of the research was to study the immediate and long-term effects of course cholinergic therapy (choline alfoscerate, CA) in patients with an amnestic mild cognitive impairment (aMCI).Patients and methods: in the course of an open comparative prospective study, the dynamics of cognitive functioning indicators were analyzed in 150 patients with aMCI who received infusion or oral course therapy in comparison with the control group (without treatment). All patients were divided into 3 groups. The first group of patients received an infusion course of CA (Gliatilin), the second group received an oral course of the drug (Gliatilin), the third group (control) did not receive treatment. MRI, clinical-psychological, psychometric, statistical methods were used in the study.Results: it has been shown that course therapy with CA has a positive effect on cognitive functioning in patients with aMCI in both therapeutic groups. The greatest effectiveness was observed in group 1 patients who underwent an infusion course of therapy for a month. In group 2 patients who took CA orally for 2 months, there was also an improvement in cognitive functions, however, in the control group there was a statistically significant decrease in cognitive functioning after 90 days of follow-up, in two cases (4%). This trend continued after a year of follow up. The indicators of improvement of cognitive status compared to the baseline level remained in 41% of cases in patients of group 1 and only in 28% and 2% in patients of group 2 and 3 respectively. Only in group 3 Alzheimer’s disease was diagnosed in 2 patients (4%) after a year of follow-up.Conclusion: the long-term positive effect of CA on cognitive functioning allows us to consider the drug as a possible model of therapy aimed at preventing the progression of cognitive deficits and the development of dementia in people with aMCI.

Intraretinal granuloma in neurocysticercosis

A 7-year-old female with neurocysticercosis treated with systemic antihelminthic therapy approximately 1 year prior to presentation presented with visual distortion in the left eye. She was off antihelminthic therapy and was slowly tapering a long oral steroid course. Visual acuity was 20/25 in the left eye. A 2 mm consolidated intraretinal white lesion at 1 o'clock (A, B) was seen on ultra-wide-field imaging. The lesion was hyper-reflective on spectral-domain optical coherence tomography (SD-OCT) with vitreous cells in the posterior cortical vitreous (C, D).

Does post-COVID reactive arthritis exist? Experience of a tertiary care centre with a review of the literature

BackgroundRheumatological manifestations following COVID-19 are various, including Reactive Arthritis (ReA), which is a form of asymmetric oligoarthritis mainly involving the lower limbs, with or without extra-articular features. The current case series describes the clinical profile and treatment outcome of 23 patients with post-COVID-19 ReA. MethodsA retrospective, observational study of patients with post-COVID-19 arthritis over one year was conducted at a tertiary care centre in India. Patients (n=23) with either a positive polymerase chain reaction test for SARS-CoV2 or an anti-COVID-19 antibody test were included. Available demographic details, musculoskeletal symptoms, inflammatory markers, and treatment given were documented. ResultsSixteen out of 23 patients were female. The mean age of the patients was 42.8 years. Nineteen patients had had symptomatic COVID-19 infection in the past. The duration between onset of COVID-19 symptoms and arthritis ranged from 5 to 52 days with a mean of 25.9 days. The knee was the most involved joint (16 out of 23 cases). Seven patients had inflammatory lower back pain and nine had enthesitis. Most patients were treated with non-steroidal anti-inflammatory drugs (NSAIDs) and steroids – either depot injection or a short oral course. Three patients required treatment with hydroxychloroquine and methotrexate which were eventually stopped. No relapse was reported in any of the patients. ConclusionOn combining our data with 21 other case reports of ReA, a lower limb predominant, oligoarticular, asymmetric pattern of arthritis was seen with a female preponderance. The mean number of joints involved was 2.8. Axial symptoms and enthesitis were often coexistent. Treatment with NSAIDs and intra-articular steroids was effective. However, whether COVID-19 was the definitive aetiology of the arthritis is yet to be proven.

Evaluation of an Undergraduate Oral Surgery Curriculum - A Pilot Study.

Following curricular revisions at the Faculty of Dentistry of the Obafemi Awolowo University, no formal evaluation of its alignment and implementation has been carried out.This study aimed to evaluate the alignment of an Oral surgery curriculum and to determine students' learning experiences and perceptions of the curriculum. This was a mixed-method study conducted at Obafemi Awolowo University, Ile-Ife, Nigeria. This ethically approved study adopted a mixed-method descriptive approach to data collection and analysis. Data collection followed a sequential, phased approach comprising document analysis, curriculum mapping, questionnaire survey, and focus group discussions.Quantitative data collected via questionnaires were analyzed descriptively. Qualitative data from focus group discussions were analyzed using a hybrid deductive-inductive thematic analysis by the researchers to generate relevant themes. The curriculum data reveal that the oral surgery course is well-aligned. Furthermore, each course outcome utilizes different methods of assessments and teaching/learning activities (TLAs). Focus group discussions yielded four themes and two sub-themes. The main themes included curriculum alignment, implemented teaching and learning activities, feedback, and curriculum renewal, while the subthemes were recommended TLAs and student learning experiences. The curriculum evaluation identified strengths of the course as multiple student assessment methods and potential areas for improvement. These improvements included updating the content of the course and including more variety in teaching and learning methods. The authors identified potential learning gaps that require curriculum renewal. Evaluation of the entire program is recommended for comparison.

The use of post-exam feedback in oral radiology: A survey study of dental and dental hygienist schools in Europe.

A combination of summative assessments and post-exam feedback can create a formative environment to support student learning. It remains unknown to what extent feedback sessions are conducted after exams in oral radiology courses for dental and dental hygienist students in Europe. This survey study aimed to explore whether post-exam feedback sessions were conducted, and if so, in what format. A questionnaire was distributed to 76 dental schools in 26 countries and 34 dental hygienist schools in 14 countries in Europe. The questions addressed whether feedback was provided after exams in oral radiology, the feedback format, and whether feedback sessions were formalised or performed for other reasons. Questionnaire responses were received from 33 dental schools in 18 countries, and 20 dental hygienist schools in 11 countries. Information about grades was provided in 23-30% of the schools. Post-exam feedback sessions including opportunities for discussion was provided at 39% of the schools, all with guidelines stating that these sessions should be carried out. The remaining schools provided feedback either on request by individual students or as written examples of correct answers. Almost one third of the dental schools announced grades without providing any post-exam feedback that could support learning. Two fifth utilised feedback sessions to assist students in gaining knowledge and sorting out misconceptions, all according to guidelines. Given the possible learning potential in post-exam feedback with opportunity to discuss, further studies of this format would be valuable, including the role and use of feedback guidelines.

DRUG INTERACTION BETWEEN PAXLOVID AND TACROLIMUS IN AN ADOLESCENT WITH INFLAMMATORY BOWEL DISEASE

Abstract The coronavirus disease of 2019 (COVID-19) caused by SARS-CoV-2 virus led to a worldwide pandemic. Emergency use of an investigational medication, Paxlovid, was approved for patient 12 and older who tested positive for COVID-19 and at high risk for severe infection. Inflammatory Bowel Disease (IBD) is a chronic condition causing inflammation in the gastrointestinal tract. Ulcerative Colitis (UC) is a type of IBD centralized in colon and commonly treated with Immunosuppressive drugs. We present an adolescent with UC treated with paxlovid due to being on tacrolimus who developed with suspected tacrolimus toxicity. CASE REPORT: A 13-year-old female with UC presented to the ED with vomiting and fatigue after paxlovid ttreatment for COVID. The patient’s UC treatment included tacrolimus along with ustekinumab. She had been diagnosed with SARS-CoV-2 and prescribed Paxlovid bid x 5 days due to immunosuppressive status. Tacrolimus was held during treatment. Once paxlovid completed, tacrolimus was restarted. Two days later, patient presented to ER for vomiting, fatigue, headaches and myalgia. Labs revealed a tacrolimus level of >60 ng/ml . Electrolytes and Creatinine were normal. Toxicology felt this was due to interaction between paxlovid and tacrolimus. Patient advised to hold tacrolimus for 48 hours and repeat levels were 15.8 ng/mL. Symptoms resolved and level repeated three days later and was 2.9 ng/mL DISCUSSION: Tacrolimus is an immunosuppressant, commonly used for management of organ transplants but also been found effective in treatment of IBD. Tacrolimus requires close monitoring as toxicity may lead to acute or chronic kidney disease. The normal concentration is between 5-15 ng/mL. Due to rapid escalation of the COVID-19 pandemic, Paxlovid was approved for emergency use for treatment of high-risk patients. It is administered as a 5-day oral course consisting of nirmatrelvir and ritonavir. Our patient was prescribed Paxlovid due to risk secondary to immunosuppression. She was appropriately instructed to stop tacrolimus. Ritonavir is a cytochrome P450 3A inhibitor and can increase plasma concentration of tacrolimus. She restarted tacrolimus treatment 12 hours after her last dose of Paxlovid and presented with symptoms and a level consistent with toxicity. This level was concluded to be due to drug interaction between tacrolimus and Paxlovid. After further withholding of tacrolimus, symptoms improved, and levels normalized. Previous reports in transplant population stress importance of decreasing the dose of tacrolimus or withholding during the course of paxlovid treatment. This case demonstrates the importance of not only ceasing tacrolimus when administering paxlovid, but continuing discontinuation for longer period post completion of therapy to minimize interactions.

Semi-flipped classroom-based learning interventions in a traditional curriculum of oral medicine: students’ perceptions and teaching achievements

BackgroundIn recent years, flipped classes have emerged and become popular in college medical education. However, due to the huge medical learning system and the limited pre-class study time of students, it is difficult to implement in all courses. And then we adopted the semi-flipped classes (SFCs) to evaluate its teaching effect. This study analysed three educational methods that can be used in oral medicine courses: online education, offline education, and semi-flipped classes.MethodsWe used two surveys to evaluate the three educational methods. In the first survey 46 teachers and 238 undergraduates shared their experience of the live-streaming and traditional offline courses offered in the different oral medicine curricula; we used anonymous questionnaires to evaluate their class experience. In the second survey 94 students shared their experience of the semi-flipped and traditional classrooms. Students who attended the SFCs in the experimental group learned about the oral mucosa disease by themselves using an online video course and then participated in offline interaction with teachers. The evaluation of the above educational methods was conducted using the anonymous questionnaires and final exam assessment.ResultsAccording to the first survey, teachers and students both agreed that the overall teaching experience and learning effectiveness in offline education are superior to those in online education. According to the second survey, students who participated in the SFCs performed better in the final exam than those who participated in the simple offline classes. Additionally, the survey showed that the new teaching method helped students gain more knowledge and positively influenced their clinical practice.ConclusionsCompared with the online and offline educational methods, the SFC showed better results in both the questionnaire and final exam assessment. Hence, the effectiveness of medical education can be improved by adopting a teaching mode that combines online and offline teaching methods. Scientific and logical SFCs designs, along with their effective implementation, would eventually make SFCs an important tool for medical education.

Diagnosis of Enteric Fever Cases: Current Challenges of Azithromycin Resistant R717Q Gene in Rajshahi, Bangladesh

Salmonella enterica serovars typhi is a contributing typhoid agent, leading to untreatable infections based upon the rising prevalence of antimicrobial resistance in the said agent. Consequently, the main concern of the health service providers to treat expansively drug-resistant (XDR) enteric fever has been dependent on the only remaining oral drug, Azithromycin, for creating emerging resistance against it. Therefore, a cross-sectional descriptive study was conducted in the Microbiology Department of Rajshahi Medical College, Rajshahi, to identify Salmonella species by Fastidious Antibiotic Neutralization (FAN) method in suspected enteric fever cases along with its antimicrobial susceptibility pattern and molecular detection of Azithromycin resistant R717Q gene. Samples were collected purposively. Regarding the population's age distribution, out of 127 specimens, the predominant 37(29.1%) were found within the age group of 35-44 years. Automated blood culture was found positive in 64(50.39%) population; out of them, Salmonella spp were 38(59.37%) of the population. Among them 29(76.31%) have travel history, took street food 25(65.7%), used tap water for drinking 21(55.2%) and had kancha latrine 24(63.1%). It was found that 18.43% were sensitive and 81.57% resistant to Azithromycin. Azithromycin-resistant Salmonella spp. were detected in 31(81.57%), and among Azithromycin resistant R717Q gene was identified in 9(29.03%). The azithromycin-resistant R717Q gene was identified by conventional PCR. Because of its oral course of administration, Azithromycin is considered the widely used drug in Bangladesh, which is used once on a dose basis a day. In order to contribute to the development of this drug resistance, there could be many reasons, and among them there are the availability over the counter and the imperfectly done treatment. Thus, this study would be helpful to formulate a regional hospital empirical therapy by antimicrobial sensitivity and resistance pattern of the gene for Azithromycin resistance in Rajshahi Medical College Hospital.
 TAJ 2022; 35: No-2: 67-73

Diversification of Teaching Methods in Oral English Course for College Teachers

The importance of oral English course is self-evident to the profession of teachers. Therefore, in the teaching process of college teachers' oral English course, teachers should build a systematic and perfect training model, combine the content of teaching materials, teaching forms, students' actual learning conditions, and create and apply different teaching methods, so that teachers' oral English teaching can be more in line with students' actual learning conditions, and build an efficient classroom. This paper expounds the principles of establishing the training model of teachers' oral English course, analyzes the disadvantages of the traditional teaching model, and finally explores the specific teaching methods.

From Oral to Online Oral: Exploring and Innovating Oral Expression Curriculum in the Context of New Media

This paper discusses the innovation and teaching evaluation of oral expression courses in the context of new media. Through literature review and empirical research, we found that oral expression teaching in the context of new media needs to combine the application of new media technologies to broaden teaching content and methods in order to improve students’ oral expression and practical application abilities. At the same time, the evaluation of oral expression courses should consider students’ performance in various aspects and practical application abilities. Future development of oral expression teaching in the context of new media requires a focus on cultivating students’ application and innovation abilities, combining virtual reality, artificial intelligence and other technologies for innovation. This paper also provides examples of some universities’ practices in oral expression course innovation, which provide some inspiration and ideas for oral expression teaching. We believe that with joint efforts from all parties, oral expression teaching in the context of new media will make better progress and development.

A Feasibility Study on the Intelligent Teaching Model of English Oral Course in Applied Undergraduate Universities under the Background of "Double Innovation and Entrepreneurship"

A Feasibility Study on the Intelligent Teaching Model of English Oral Course in Applied Undergraduate Universities under the Background of "Double Innovation and Entrepreneurship"

Students' perception to an interactive web-based response system in oral and maxillofacial pathology teaching.

This study evaluated dental students' perceptions and adherence to an interactive web-based response system in the teaching of Oral and Maxillofacial Pathology. Between 2018 and 2019, students from a single Brazilian dental school used the Poll Everywhere® app to answer questions on subjects taught during an Oral and Maxillofacial Pathology course. At the end of the academic semester, the students completed a questionnaire containing 10 questions regarding the app's use. The study included 123 students. Regarding the devices used to answer the questions on the app, 117 (95.1%) students used a smartphone and 3 (2.4%) used a laptop. Almost all students (121; 98.4%) agreed that this interactive web-based response system provided the teacher with a better overview of students' understanding and improved their self-assessment of the acquired knowledge of the subjects. Most students (118; 95.9%) preferred classes using this technology and 122 (99.2%) stated that using the app made them feel more engaged in classes. In addition, all students agreed that the app improved student-teacher interactions. Most students (119; 96.7%) considered the digital interactive method more attractive than the conventional teaching approach, and 99 (80.5%) did not have any negative comments regarding the app. In conclusion, the Poll Everywhere® app provides a more dynamic and attractive educational environment for Oral and Maxillofacial Pathology teaching.

Opportunities, associations, and impact of early intravenous to oral antimicrobial switch for hospitalized patients in Ethiopia.

Short intravenous antimicrobial therapy for 2-3 days followed by its per oral comparable antimicrobial course is a crucial part of the antimicrobial stewardship program. However, nothing is known about this practice in Ethiopian hospitals. Therefore, this study assessed the proportion, associations, and outcomes of early intravenous to per oral antimicrobial switch for patients who were admitted to the three wards of Ambo University Referral Hospital. A hospital-based prospective cohort pilot study was conducted. During the 3-month period, 117 patients met initial inclusion criteria and were followed until Day 3 of intravenous antimicrobial. Of these, 92 (78.6%) subsequently met criteria for early intravenous to per oral switch and are the cohort investigated in this study. Written informed consent was sought from participants and/or parents or guardian for ages 15-17 years. Logistic regression models and independent t-tests were done with a significance of p ⩽ 0.05. Out of 92 study participants, early intravenous to per oral antimicrobial switch was done only for 36 (39.1%). The only independent predictors for lack of early intravenous to per oral antimicrobials switch were poly-pharmacy (adjusted odds ratio = 3.4 at 95% confidence interval, 1.036-11.16; p = 0.044). There was a significant difference in terms of mean length of hospital stay (8.80 ± 3.57 versus 3.17 ± 0.74; p < 0.0001), in-hospital complication rate (95% versus 5%; p < 0.0001), and the mean cost of healthcare in Ethiopian Birrs (652.29 ± 403.29 versus 126.67 ± 29.47; p < 0.0001) between the comparator/early intravenous to per oral not switched and early switched group, respectively. The proportion of early intravenous to per oral antimicrobial switch was unsatisfactory. There was a significant difference between the intervention and comparator groups in terms of length of hospital stay, in-hospital complications, and extra cost. Therefore, implementation of interventions that improve the practice of early intravenous to per oral switch is needed urgently.

Investigation of multi-intelligence theory research by systematic review method

The aim of this study is to determine the direction of research on the theory of multiple intelligences in the last 15 years and to introduce the developments in the theory of multiple intelligences based on the results. In the study, 30 articles on the theory of multiple intelligences in Turkey between the years 2006-2021 were examined. Researches; The publication year, the journal in which it was published, the course conducted, the purpose, the method/pattern, the sample, the data collection tools, the data analysis method, the results and the suggestions were examined in accordance with the themes. In the examinations, the researches on the theory of multiple intelligences are generally carried out in numerical courses, the researches are mostly conducted for teaching purposes, the students at the secondary school level are mostly included in the researches, the academic achievement test and multiple intelligence inventory are used as data collection tools, the t-test is used extensively as a data analysis method, showed that positive results were obtained in the vast majority of studies and all kinds of suggestions were presented. Based on these results, suggestions were made such as the need to include more qualitative research, conducting new studies in oral courses, and expanding the literature by conducting new research.

510. Secretory IgA in the Vaginal Mucosa Inhibits Herpes Simplex Virus Infection

Abstract Background HSV2 increases HIV risk and is twice as common among women. We previously showed that cervicovaginal secretions exhibit innate anti-HSV2 activity that was lower in adolescents and women with HIV-- conditions associated with vaginal dysbiosis and increased HSV shedding. Our current study aims to test the hypothesis that vaginal dysbiosis is associated with low anti-HSV activity and to explore the molecules and mechanisms that contribute. Methods Cervicovaginal lavage (CVL) (10 ml normal saline wash) was collected from 20 women who presented with clinical bacterial vaginosis (BV) (Day 0) and then 1 and 4 weeks after completing a 7-day oral metronidazole course; parent study results were reported (PMID 34003290). Anti-HSV2 activity of CVL (diluted 1:4) was determined by plaque reduction assay. CVL IgG, IgA, cytokines and antimicrobial peptides were quantified by ELISA or multiplex Luminex and select microbiota by quantitative real-time PCR. CVL was enriched for IgA and IgG using protein L (binds all Ig) and Protein G (binds only IgG). HSV-specific antibodies in CVL were assessed by ELISA. Statistical analyses including Spearman correlation coefficients (SCC) were performed with GraphPad Prism version 9.1.2 software. Results Anti-HSV2 activity of CVL was highly variable at Day 0 (mean 18.6% SD 36.7) and trended to increase after treatment (mean 22.56% SD 33.8). The anti-HSV2 activity correlated positively with Nugent scores (SCC= -0.28, p= 0.03) and qPCR levels of BV-associated microbes (SCC = -0.2 to -0.3, p&amp;lt; -0.1) but positively with IgA (r= 0.49, p&amp;lt; 0.01) and IgG (r= 0.33, p= 0.01). IgA and IgG were isolated from pools of CVL with high inhibitory activity greater than 40% (n= 8). The anti-HSV2 activity mapped to the IgA fraction (56.5% inhibition) compared to the IgG or non-Ig fraction (0% inhibition) even though, as expected, the CVL concentration of IgG was higher than IgA (8.3μg/mL vs 4.9 μg/mL). The anti-HSV2 activity did not correlate with HSV-specific Ig in CVL. Conclusion Our findings suggest that secretory vaginal IgA contributes to innate anti-HSV2 activity and may trap viral particles to prevent viral entry. We speculate that sialidases, which cleave IgA and are elaborated by BV-associated microbiota, contribute to the low anti-HSV2 activity observed in high-risk cohorts. Disclosures Betsy Herold, MD, Viracor (Eurofins): Advisor/Consultant|X-Vax, Technologies: Advisor/Consultant|X-Vax, Technologies: Grant/Research Support|X-Vax, Technologies: Serve on Scientific Advisory Board for X-Vax, Technologies and receiving reserach funding for related worl. Betsy Herold, MD, Viracor (Eurofins): Advisor/Consultant|X-Vax, Technologies: Advisor/Consultant|X-Vax, Technologies: Grant/Research Support|X-Vax, Technologies: Serve on Scientific Advisory Board for X-Vax, Technologies and receiving reserach funding for related worl.

Long-term oral antibiotic use in people with acne vulgaris in UK primary care: a drug utilization study.

The inappropriate use of antibiotics is understood to contribute to antimicrobial resistance. Oral antibiotics are regularly used to treat moderate-to-severe acne vulgaris. In practice, we do not know the typical length of oral antibiotic treatment courses for acne in routine primary care and what proportion of people receive more than one course of treatment following a new acne diagnosis. To describe how oral antibiotics are prescribed for acne over time in UK primary care. We conducted a descriptive longitudinal drug utilization study using routinely collected primary care data from the Clinical Practice Research Datalink GOLD (2004-2019). We included individuals (8-50 years) with a new acne diagnosis recorded between 1 January 2004 and 31 July 2019. We identified 217 410 people with a new acne diagnosis. The median age was 17 years [interquartile range (IQR) 15-25] and median follow-up was 4.3 years (IQR 1.9-7.6). Among people with a new acne diagnosis, 96 703 (44.5%) received 248 560 prescriptions for long-term oral antibiotics during a median follow-up of 5.3 years (IQR 2.8-8.5). The median number of continuous courses of antibiotic therapy (≥ 28 days) per person was four (IQR 2-6). The majority (n = 59 010, 61.0%) of first oral antibiotic prescriptions in those with a recorded acne diagnosis were between the ages of 12 and 18. Most (n = 71 544, 74.0%) first courses for oral antibiotics were for between 28 and 90 days. The median duration of the first course of treatment was 56 days (IQR 50-93 days) and 18 127 (18.7%) of prescriptions of ≥ 28 days were for < 6 weeks. Among people who received a first course of oral antibiotic for ≥ 28 days, 56 261 (58.2%) received a second course after a treatment gap of ≥ 28 days. The median time between first and second courses was 135 days (IQR 67-302). The cumulative duration of exposure to oral antibiotics during follow-up was 255 days (8.5 months). Further work is needed to understand the consequences of using antibiotics for shorter periods than recommended. Suboptimal treatment duration may result in reduced clinical effectiveness or repeated exposures, potentially contributing to antimicrobial resistance.