Phenoxymethylpenicillin Research Articles

Assessment of the Safety of Alternative Antibiotics in Children with Confirmed Beta-Lactam Antibiotic Allergy

Introduction: Beta-lactam antibiotics (BLAs) are the most common cause of drug hypersensitivity reactions in children, and it is important to find safe alternative antibiotics for these children. This study evaluates the selection, safety to alternative antibiotics in patients with confirmed BLA allergies based on diagnostic tests. Methods: At the Pediatric Immunology and Allergy Clinic of Ankara Bilkent City Hospital, a retrospective evaluation of diagnostic tests (including skin prick, intradermal, and drug provocation tests) was conducted to identify alternative antibiotics for patients with confirmed BLA. Patients were also contacted by telephone to assess their use of these alternative drugs. Results: The study included 80 patients with confirmed beta-lactam allergy (BLA). The BLAs causing reactions were categorized into two groups: penicillins (75%, n = 60) and cephalosporins (25%, n = 20). Among the penicillins, amoxicillin-clavulanic acid (ACA) was the most common at 68.8%, while among the cephalosporins, ceftriaxone was the most common at 16.3%. Of the 55 patients with ACA allergy, 53 underwent controlled administration with clarithromycin, with 52 showing no reaction. In addition, no reaction was observed in patients who received DPT with cefuroxime (n: 16), phenoxymethyl penicillin (n: 9), cefdinir (n: 1), and cefixime (n: 1), while there was no reaction in the controlled administration with clindamycin. Alternative treatments were tested in 13 patients with a confirmed ceftriaxone allergy. No adverse reactions were observed in 9 patients who underwent DPT with ACA and in 10 patients who were exposed to clarithromycin under controlled conditions. Finally, 54 of the 80 patients (67.5%) were successfully contacted and none reported a reaction to the alternative drugs. Conclusion: For patients with confirmed BLA, macrolides may be considered as preferred alternatives. In addition, beta-lactams with different side chains may be safe alternatives after diagnostic evaluation, taking into account the risk of cross-reactivity.

PSXIII-1 Sensory additives improved the recovery of commercially marketed and transported unweaned dairy beef calves at rearing farm arrival

Abstract Calf recovery after arrival at the rearing farm in unweaned calves is impaired by periods of stress, feed restriction and fasting during marketing and transportation. The use of feed additives to enhance intake at arrival could be a strategy to minimize those negative effects. A total of 72 calves (71.4 ± 1.72 kg) gathered in a commercial assembly center and transported 9 h to a rearing farm were used to evaluate the effect of a sensory additive (SA) on performance in calves fed 2 L of milk replacer twice daily at 12.5% and ad libitum concentrate feed. Calves were allocated in 8 pens and distributed in 2 treatments (4 pens/treatment): calves fed a concentrate without SA since the beginning of the study (arrival to the rearing farm after transport) until weaning (CON; n = 36); calves fed a concentrate containing SA (SEN; n = 36) from arrival until weaning. Calf body weight (BW) and pen intake were recorded weekly. On d 21 of the study, calves were partially weaned and only milk replacer was offered in the morning, and on d 28 all calves were completely weaned. The study lasted 35 d. Data were analyzed with a mixed-effects model. Average daily gain was greater (P = 0.04) for SEN calves compared with CON calves (0.68 ± 0.019 kg/d and 0.61 ± 0.019 kg/d, respectively). Final BW of SEN calves (95.5 ± 0.89 kg) tended (P = 0.06) to be greater compared with BW of CON calves (93.1 ± 0.89 kg). Finally, average concentrate intake was greater for SEN calves (0.89 ± 0.023 kg/d) compared with CON calves (0.79 ± 0.023 kg/d). Unweaned dairy beef calves receiving sensory additive improved concentrate intake and growth at farm arrival improving their recovery.

An Adsorption Based Downstream Processing Approach for Penicillin V from a Penicillium chrysogenum BIONCL I22 Culture Filtrate.

Penicillin V (phenoxy methyl penicillin) is highly sought after among natural penicillins because of its exceptional acid stability and effectiveness against common skin and respiratory infections. Given its wide-ranging therapeutic uses, there is a need to establish a greener method for its maximum recovery to reduce the carbon footprint. Here, we have identified and validated optimized operational conditions for resin-based penicillin V recovery. It was observed that Amberlite XAD4 had the highest penicillin V hydrophobic adsorption capacity among the other screened resins. Kinetic and isothermal studies using linear and nonlinear regression analysis showed that the adsorption process well fitted with pseudo-second-order kinetics (R 2 = 0.9816) and the Freundlich adsorption isotherm model (R 2 = 0.9871). Adsorption equilibrium was attained within 4 h, while maximum adsorption was observed at 3 mg/mL penicillin V concentration. Furthermore, the optimized extraction protocol was compared with the conventional butyl acetate-based downstream processing. Under optimum conditions resin-based penicillin V recovery was 2-fold higher as compared to the solvent extraction method and the resin could be reused for over six cycles without compromising the yield. These findings signify substantial progress toward the development of an environmentally sustainable approach for penicillin V recovery and a potentially viable method for extractive fermentation.

Penicillin V versus amoxicillin for pneumonia in children—a Swedish nationwide emulated target trial

ObjectivesAlthough most countries recommend amoxicillin for paediatric pneumonia, there is a long tradition of treatment with penicillin V (PcV) in Sweden, thus not empirically covering Haemophilus influenzae. There are, however, large regional differences in treatment practice. The aim was to compare clinical outcomes (treatment failure and severe complications), in children aged 1–59 months treated with PcV vs. amoxicillin for pneumonia. MethodsThis population-based emulated target trial included all children born in Sweden between 2001 and 2021, using national health, sociodemographic, and population registers. All pneumonia cases from hospitals and paediatric outpatient clinics in children aged 1–59 months treated as outpatients with PcV or amoxicillin between July 2005 and December 2021, were identified. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for treatment failure (newly dispensed antibiotic prescription or pneumonia-associated hospitalization day 1–14) and severe complications (lung complications, an invasive bacterial disease, admission to intensive care unit or death day 1–28) were calculated with logistic regression analysis. ResultsPcV was prescribed in 14 766 cases and amoxicillin in 10 566. Treatment failure occurred in 7.7% with PcV vs. 4.7% with amoxicillin, aOR 1.76 (95% CI: 1.54–2.00). Severe complications were rare, with no significant difference between PcV and amoxicillin (0.3% vs. 0.2%, aOR 0.96, 95% CI: 0.53–1.73). Sensitivity and interaction analyses showed consistent results. DiscussionPcV treatment compared with amoxicillin, was associated with an increased risk for treatment failure but not for severe complications. The absolute risks for adverse outcomes were low in both groups suggesting a minor role of H. influenzae in paediatric pneumonia.

Intramuscular versus enteral penicillin prophylaxis to prevent progression of rheumatic heart disease: Study protocol for a noninferiority randomized trial (the GOALIE trial)

Rheumatic Heart Disease (RHD) persists as a major cardiovascular driver of mortality and morbidity among young people in low-and middle-income countries. Secondary antibiotic prophylaxis (SAP) with penicillin remains the cornerstone of RHD control, however, suboptimal treatment adherence undermines most secondary prevention programs. Many of the barriers to optimal SAP adherence are specific to the intramuscular form of penicillin and may potentially be overcome by use of oral penicillin. This noninferiority trial is comparing the efficacy of intramuscular to oral penicillin SAP to prevent progression of mild RHD at 2 years. The Intramuscular vs Enteral Penicillin Prophylaxis to Prevent Progression of Rheumatic Heart Disease (GOALIE) trial is randomizing Ugandan children aged 5 to 17 years identified by echocardiographic screening with mild RHD (Stage A or B as defined by 2023 World Heart Federation criteria) to Benzathine Benzyl Penicillin G (BPG arm, every-28-day intramuscular penicillin) or Phenoxymethyl Penicillin (Pen V arm, twice daily oral penicillin) for a period of 2 years. A blinded echocardiography adjudication panel of 3 RHD experts and 2 cardiologists is determining the echocardiographic stage of RHD at enrollment and will do the same at study completion by consensus review. Treatment adherence and study retention are supported through peer support groups and case management strategies. The primary outcome is the proportion of children in the Pen V arm who progress to more advanced RHD compared to those in the BPG arm. Secondary outcomes are patient-reported outcomes (treatment acceptance, satisfaction, and health related quality of life), costs, and cost-effectiveness of oral compared to intramuscular penicillin prophylaxis for RHD. A total sample size of 1,004 participants will provide 90% power to demonstrate noninferiority using a margin of 4% with allowance for 7% loss to follow-up. Participant enrollment commenced in October 2023 and final participant follow-up is expected in December 2026. The graphical abstract (Fig. 1) summarizes the flow of echocardiographic screening, participant enrollment and follow-up. The GOALIE trial is critical in global efforts to refine a pragmatic approach to secondary prevention for RHD control. GOALIE insists that the inferiority of oral penicillin be proven contemporarily and against the most important near-term clinical outcome of progression of RHD severity. This work also considers other factors that could influence the adoption of oral prophylaxis and change the calculus for acceptable efficacy including patient-reported outcomes and costs. ClinicalTrials.gov: NCT05693545.

The Impact of Abrupt and Fenceline-Weaning Methods on Cattle Stress Response, Live Weight Gain, and Behaviour.

The impact of abrupt (AB) and fenceline (FL) weaning methods on cattle stress response, live weight gain, and behaviour were determined across 14 days. Thirty-two cow-calf pairs were fitted with ear tag sensors (to continuously record behaviour) and allocated to two weaning treatments. After separation, FL calves were maintained in a pen adjacent to the FL cow paddock. The AB calves were transported to a pen removing all contact with the cows. After 7 d, FL cows were transported away from all calf pens. Body weights and salivary samples were collected for all animals on experimental days 0, 7, and 14. Fenceline-weaned calves had a greater duration of rest and rumination with reduced high activity across the first 3 days after separation as compared to abruptly weaned calves in line with the greater occurrences of pacing observed for AB calves. Fenceline-separated cows had greater levels of rest across the first 7 days but similar levels of rumination compared to abruptly separated cows. Fenceline-separated cow activity levels tended to be greater and eating levels were similar across the first three days. Body weight (BW) and cortisol concentrations were similar for AB and FL cattle, but FL cows had lower overall weight gain than the abrupt cows likely due to reduced eating time on days four to seven. Together, these results suggest that calves be fenceline-weaned for three days followed by total separation.

Systemic antibiotics for symptomatic apical periodontitis and acute apical abscess in adults.

Systemic antibiotics for symptomatic apical periodontitis and acute apical abscess in adults.

The influence of the probiotic “Bioseven” on indicators of survival and growth of calves in the early postnatal period

Dairy cattle breeding is one of the promising areas of agriculture. With a systematic approach and modern technologies, it is a highly profitable agrarian business that is dynamically developing. According to experts, the competitiveness and profitability of the industry can be increased due to the use of natural feed additives and preparations to obtain ecologically safe products for humans. Among them, preparations of microbiological origin are increasingly used, in particular, probiotics, which contain living microorganisms useful for the macroorganism. These drugs are used for prophylactic or therapeutic purposes. It is known that most microorganisms inhabiting the intestines are safe and do not cause diseases, but there is a constant competition between bacteria of different species for space and nutrients. The inconsistency of the microclimate parameters in the calf pens had a direct negative effect on the calf's body, especially in the early postnatal period. In particular, the deviation from the temperature balance, increased air humidity, and the presence of drafts caused a violation of the heat exchange processes of the calves' body with hypothermia and overheating of the body, and, as a result, provoked the frequent occurrence of respiratory diseases. In addition, increased air humidity and high microbial pollution caused the emergence of diseases with functional disorders in the digestive tract due to an imbalance of normal flora and increased activity of the development of transit microbes from the external environment, which negatively affected the homeostasis of the calves' body, weakened the natural resistance of calves, their growth, preservation and often led to the death of animals. Oral use of the probiotic “Bioseven” in a dose of 5.0 g (1.5·109 CFU/cm3) based on 10 kg of live weight ensured the complete preservation of the herd of young calves, accelerated their growth energy, as evidenced by exterior indicators of the animals of the experimental group against the control and probable (P < 0.05) average daily gains in live weight – 1.236 ± 0.37 kg/day versus 1.002 ± 0.41 kg/day in the control group of calves. In further studies, we used a dose of the probiotic “Bioseven” – 5.0 g (1.5·109 CFU/cm3) based on 10 kg of live weight, as the optimal dose of the experimental drug, established by the results of research. Comparative results of studies of growth indicators in the calves of the experimental group showed a significant advantage in the actual probable (Р < 0.01) increase in their live weight during the experimental period, which exceeded the similar indicators of the control by 23.6 %. The results of studies of indicators of average daily live weight gain were significantly (Р < 0.05) higher than those of control calves by 28.5 % (Р < 0.01), which testified to the effectiveness of the use of the probiotic “Bioseven” in young calves. Taking into account the obtained results, it becomes clear that the components of the probiotic drug “Bioseven” have a positive effect on the formation of cicatricial digestion in calves.

Using an automated tail movement sensor device to predict calving time in dairy cows

This study aimed to evaluate the effectiveness of an automated tail movement sensor device (Moocall; Bluebell, Dublin, Ireland) to predict time of calving in dairy cows. At a commercial dairy farm in southern Ontario, Moocall (MC) devices were attached with the device's strap, and an additional elastic wrap, to the tail of cows approximately 3 d before their expected calving date. The MC has 2 types of alarm, a high activity alarm in the previous hour (1HA), and a high activity alarm in the previous 2 h (2HA); these alarms were sent and registered to the MC software. The calving and close-up pens were video monitored to determine the exact time of the onset of stage II of calving (amniotic sac visible at the vulva) and the end of stage II of calving (total expulsion of the calf). A total of 49 cows were enrolled, but we excluded 13 animals from the analysis as they had 3 or more MC drops from the tail (n = 6), a swollen tail (n = 3), or the MC device was lost (n = 4); this left 36 cows. In total, the device dropped off 21 (42%) cows. The average number of alarms (1HA and 2HA) per cow before stage II of calving was 2.7 ± 2.3 (± standard error). The first alarm after fitting the device on the tail was used to determine the device's sensitivity and specificity. Depending on the interval before the onset of parturition (i.e., 2, 4, 8, 12 h) in which the alarm was triggered, sensitivity varied from 5% to 72% and specificity from 50% to 93%. The false positive rate varied between 6% and 50% depending on the interval from the alarm to the onset of parturition. The high false positive and device drop rates (despite the addition of the elastic wrap) may compromise the applicability of this sensor device in a commercial setting.

Medium-term storage of calf beddings affects bacterial community and effectiveness to inactivate zoonotic bacteria

Land-spreading of animal faecal wastes -such as animal beddings- can introduce zoonotic enteropathogens into the food system environment. The study evaluated the effectiveness of animal beddings naturally contaminated by calf manure to reduce E. coli O157:H7 or Salmonella enterica. The two pathogens were introduced separately as a four strains-cocktail and at high (>6.5 Log10 g-1) concentration into bedding materials, and their inactivation over a 10 weeks-period was monitored by using a Most Probable Number (MPN) enumeration method. Inactivation of E. coli O157:H7 was more effective in the bedding inoculated immediately after collection from calf pens than in the beddings inoculated after a 2 months-pre-storage period: E. coli O157:H7 levels were reduced by 6.6 Log10 g-1 in unstored bedding (0.5 Log10 g-1 recovered; 95%CI: 0.0–1.2), and by 4.9 Log10 g-1 in pre-stored bedding (2.2 Log10 g-1 recovered; 95%CI: 1.5–2.8) with a significant (p<0.05) difference between unstored and pre-stored. S. enterica was inactivated less effectively as counts were reduced by one order of magnitude, with no significant difference in inactivation between unstored and pre-stored beddings. Low levels of naturally occurring E. coli O157 and Salmonella spp. were detected in the non-inoculated beddings, as well as in the straw prior to use in the animal facility. To better understand the possible biological processes involved, the bacterial community present in the beddings was characterised by short-read 16S rRNA sequencing. Pre-storage of the bedding affected the composition but not the diversity of the bacterial community. Analyses of the key bacterial phyla suggested that the presence of a diverse and stable bacterial community might facilitate inactivation of the introduced pathogens, and a possible role of bacterial orders associated with lignocellulolytic resources. Overall, the study contributed to the understanding of the fate of zoonotic bacteria introduced in animal beddings during storage and identified bedding storage practices pre-and post-use in animal facilities that could be important to prevent the risk of zoonosis dissemination to the environment or to the dairy herds.

2267. Evaluation of Antibiotic Prescribing Trends from a Dental Clinic After Implementation of a Dental Antimicrobial Stewardship Initiative

Abstract Background Inappropriate antibiotic prescribing by dentists is as high as 80% and in the U.S., dentists rank third for writing the most antibiotic prescriptions. At NewYork-Presbyterian Brooklyn Methodist (NYP-BMH), the Antimicrobial Stewardship Program (ASP) and Division of Dental Medicine collaborated to create a clinical practice guideline regarding antibiotic use in dentistry that was implemented in May 2021 and is reinforced with annual education to dental prescribers. The purpose of this study is to compare outpatient antibiotic prescribing trends pre- and post-guideline implementation. Methods Patients presenting to NYP-BMH dental clinic for an emergent indication and prescribed an antibiotic from January-April of 2019-2021 (pre) and January-April of 2022 (post) were included. The primary outcome was appropriateness of antibiotic therapy. Secondary outcomes included a comparison of antibiotic selection, dosing and duration of therapy. A subgroup analysis of patients with reported penicillin allergies was conducted to compare alternative agents prescribed. Results A total of 119 patients in the pre and 100 patients in the post-guideline period were included. The primary outcome of appropriate antibiotic prescriptions significantly improved after guideline implementation (pre 45% vs post 64%, p< 0.01). The majority of antibiotic indications were treatment-related and the most common dental diagnosis was caries. The most common antibiotic prescribed in the study was amoxicillin. Compared to pre-guideline, there was significant decreased utilization of penicillin VK (pre 3.4% vs post 0%, p=0.05) and amoxicillin-clavulanate post-guideline (pre 16% vs post 8%, p=0.02). A wide variety of dosing regimens were utilized with more guideline-concordant regimens utilized post-guideline (pre 59% vs post 72%, p=0.04). On average, shorter durations of therapy were prescribed post-guideline (pre 6.8 days vs post 5.7 days, p< 0.02). Penicillin-allergic patients were prescribed less clindamycin after guideline implementation. Conclusion ASP initiatives and collaboration with outpatient dental clinics can improve appropriate antibiotic prescribing. As ASPs look to expand into ambulatory care settings, dental clinics should be prioritized. Disclosures All Authors: No reported disclosures

A Markov Chain Model for Determining the Optimal Time to Move Pregnant Cows to Individual Calving Pens.

The use of individual calving pens in modern farming is widely recognized as a good practice for promoting good animal welfare during parturition. However, determining the optimal time to move a pregnant cow to a calving pen can be a management challenge. Moving cows too early may result in prolonged occupancy of the pen, while moving them too late may increase the risk of calving complications and production-related diseases. In this paper, a simple random walk type Markov Chain Model to predict the optimal time for moving periparturient cows to individual calving pens was proposed. Behavior changes such as lying time, standing time, and rumination time were analyzed using a video monitoring system, and we formulated these changes as the states of a Markov Chain with an absorbing barrier. The model showed that the first time entering an absorbing state was the optimal time for a pregnant cow to be moved to a calving pen. The proposed method was validated through a series of experiments in a real-life dairy farm, showing promising results with high accuracy.

Determination of Structural Characteristics of Large-Scale Dairy Farms: Example of Yozgat Province

This research was carried out to determine the status of dairy cattle farms in Yozgat province, which has significant potential in animal husbandry, to evaluate the positive and negative aspects of the existing barns, and to put forward suggestions for solving the problems. The research was completed by conducting observation and physical measurement studies in 28 dairy cattle farms with more than 50 milking animals, which we classified as large-scale, with the data obtained through questionnaires. Most dairy farms were established in the last ten years and received investment and grant support from various public institutions. It has been observed that the criteria suitable for animal welfare, especially in ventilation and building materials, are not followed by avoiding investment costs in farms established with equity capital. In the dairy farms established by receiving grants and investment support, it was observed that the stables were built in conditions suitable for animal welfare. Still, the herd management system was not established, and the records were not kept healthy because the farm owners and employees of the farms were insufficient in dairy cattle breeding knowledge, which would increase the costs. Although the majority of the examined enterprises did not have structural and technical problems, the absence of a birth partition in 21.43%, an individual calf pen in 25%, a ventilation shaft in 3.57%, and a manure pit slope in 28.57% was seen as an obstacle for these dairy farms to be modern enterprises. It is recommended that the economic sustainability of dairy cattle farms, which is a long-term investment branch, does not only depend on having sufficient equipment in terms of structural features but also on farm owners and employees should have sufficient knowledge and infrastructure on dairy cattle breeding and training should be provided to the relevant people.

Readmissions after appointments with nurse prescribers: A register-based study.

Increasing number of nurse prescribers could be part of a solution to the shortage of physicians, improve access to treatment and curb the rise in healthcare costs; however, readmissions after nurse prescribers' appointments are under-researched. To describe and compare clients' initial appointments with nurse prescribers and physicians. In addition, client readmissions within 60 days in the target organisation after nurse prescribers' and physicians' appointments were investigated. Retrospective register-based follow-up study. Data included client appointments (n = 3986) with nurse prescribers and physicians, and clients' readmissions (n = 9038) from 1 January 2018 to 31 December 2019 from one hospital district in Finland. Data were analysed statistically using frequencies, percentages, rate ratios and cross-tabulation. STROBE checklist was used. Initial appointments including trimethoprim, pivmecillinam, phenoxymethyl penicillin, chloramphenicol, fusidic acid and cephalexin prescriptions with nurse prescribers (n = 36) were 2131, and physicians (n = 140) 1855. On average, client readmissions (within 60 days) per initial appointment were 2.10 after appointments with nurse prescribers and 2.46 after physicians. After initial appointments, including phenoxymethyl penicillin prescriptions, with nurse prescribers, clients had more readmissions in all age groups than after initial appointments with physicians. However, in all, after initial appointments with physicians, clients had a higher proportion of readmissions. Clients have fewer readmissions after appointments with nurse prescribers than physicians, including the same prescriptions. Nurse prescribers' skills may not have been fully utilised. Physicians treated many patients whose diseases nurse prescribers might have been able to treat based on the nurse prescribers' rights. However, physician clients may have more demanding service requirements.

Effects of Ventilation Fans and Type of Partitions on the Airflow Speeds of Animal Occupied Zone and Physiological Parameters of Dairy Pre-Weaned Calves Housed Individually in a Barn

Calves raised in barns are usually kept in individual pens separated by either solid or mesh partitions. To quantify the effects that the two types of partition have on airflow speed in an axial-ventilated-barn, the indoor environment of a calf barn was simulated using computational fluid dynamics (CFD) with validation accomplished by means of direct measurement. To ascertain the effects that two types of partition have on the physiological parameters and health of pre-weaned calves, 24 calves (3–11-day-olds) were selected, equally divided into four groups and sequestered as follows: calves placed in pens separated by solid partitions receiving “low-speed” or “high-speed” airflow; calves separated by mesh partitions receiving “low-speed” or “high-speed” airflow. The results of the CFD simulation showed that the percentage of airflow speed that exceeded 0.5 m s−1 at a height of 0.4 m above the floor of the animal occupied zone where calves were separated by mesh partitions was 88%, while the speed was 66–70% for calves separated by solid partitions. The duration of treatment provided to the calves in the MP-LA (mesh partitions and subjected to a low-speed airflow) and MP-HA (mesh partitions and subjected to a high-speed airflow) groups, were both lower than the SP-LA (solid partitions and subjected to a low-speed airflow) and SP-HA (solid partitions and subjected to a high-speed airflow) groups. We conclude that when the fan is operating, contact between calves separated by mesh partitions produces no negative impact on the health of calves; furthermore, this arrangement can provide a higher airflow speed than that delivered to calves raised in pens separated by solid partitions, especially to those calves in pens farther from the fans.

Isolation and Molecular Characterization of Indigenous Penicillium chrysogenum/rubens Strain Portfolio for Penicillin V Production.

Beta (β)-lactam antibiotic is an industrially important molecule produced by Penicillium chrysogenum/rubens. Penicillin is a building block for 6-aminopenicillanic acid (6-APA), an important active pharmaceutical intermediate (API) used for semi-synthetic antibiotics biosynthesis. In this investigation, we isolated and identified Penicillium chrysogenum, P. rubens, P. brocae, P. citrinum, Aspergillus fumigatus, A. sydowii, Talaromyces tratensis, Scopulariopsis brevicaulis, P. oxalicum, and P. dipodomyicola using the internal transcribed spacer (ITS) region and the β-tubulin (BenA) gene for precise species identification from Indian origin. Furthermore, the BenA gene distinguished between complex species of P. chrysogenum and P. rubens to a certain extent which partially failed by the ITS region. In addition, these species were distinguished by metabolic markers profiled by liquid chromatography-high resolution mass spectrometry (LC-HRMS). Secalonic acid, Meleagrin, and Roquefortine C were absent in P. rubens. The crude extract evaluated for PenV production by antibacterial activities by well diffusion method against Staphylococcus aureus NCIM-2079. A high-performance liquid chromatography (HPLC) method was developed for simultaneous detection of 6-APA, phenoxymethyl penicillin (PenV), and phenoxyacetic acid (POA). The pivotal objective was the development of an indigenous strain portfolio for PenV production. Here, a library of 80 strains of P. chrysogenum/rubens was screened for PenV production. Results showed 28 strains capable of producing PenV in a range from 10 to 120 mg/L when 80 strains were screened for its production. In addition, fermentation parameters, precursor concentration, incubation period, inoculum size, pH, and temperature were monitored for the improved PenV production using promising P. rubens strain BIONCL P45. In conclusion, P. chrysogenum/rubens strains can be explored for the industrial-scale PenV production.

Pre-Weaned Calf Rearing on Northern Irish Dairy Farms-Part 2: The Impact of Hygiene Practice on Bacterial Levels in Dairy Calf Rearing Environments.

Pre-weaned dairy calves are very susceptible to disease in the first months of life due to having a naïve immune system and because of the numerous physiological stressors they face. Hygiene management is a key element in minimizing enteric disease risk in calves by reducing their exposure to pathogens. Samples of milk, concentrate feed and drinking water, boot swabs of bedding and swabs of feed equipment were collected from 66 dairy farms as part of a survey of calf rearing practice and housing design. All the samples were cultured to determine total viable counts (TVC), total coliforms (TCC) and Escherichia coli as indicators of hygiene. Target ranges for levels of TVC, TCC and E. coli were defined from the literature and the sample results compared against them. The TVC targets in milk, MR and water were <4.0 log10 CFU/mL. TCC and E. coli targets of <1.1 log10 CFU/mL (the detection limit) were used for milk, MR, concentrate feed and feeding equipment. For water, the TCC and E. coli targets were <1.0 log10 CFU/100 mL. The targets used for bedding boot swabs were <6.3 log10 TVC CFU/mL and <5.7 log10 TCC or E. coli CFU/mL. Farm management factors were included as fixed effects in a generalized linear mixed model to determine the probability of samples being within each hygiene indicator target range. Milk replacer samples obtained from automatic feeders were more likely to be within the TVC target range (0.63 probability) than those prepared manually (0.34) or milk samples taken from the bulk tank (0.23). Concentrate feed samples taken from buckets in single-calf pens were more likely to have E. coli detected (0.89) than samples taken from group pen troughs (0.97). A very small proportion of water samples were within the indicator targets (TVC 9.8%, TCC 6.0%, E. coli 10.2%). Water from self-fill drinkers had a lower likelihood of being within the TVC target (0.03) than manually filled buckets (0.14), and water samples from single pens were more likely to be within TCC target ranges (0.12) than those from group pens (0.03). However, all self-fill drinkers were located in group pens so these results are likely confounded. Where milk feeders were cleaned after every feed, there was a greater likelihood of being within the TVC target range (0.47, compared with 0.23 when not cleaned after every feed). Detection of coliforms in milk replacer mixing utensils was linked with reduced probability of TVC (0.17, compared with 0.43 when coliforms were not detected) and TCC (0.38, compared with 0.62), which was within target in feeders. Key factors related to increased probability of bedding samples being within TCC target range were use of group calf pens (0.96) rather than single-calf pens (0.80), use of solid floors (0.96, compared with 0.76 for permeable floors) and increased space allowance of calves (0.94 for pens with ≥2 m2/calf, compared with 0.79 for pens with <2 m2/calf). Bedding TVC was more likely to be within the target range in group (0.84) rather than in single pens (0.66). The results show that hygiene levels in the calf rearing environment vary across farms and that management and housing design impact hygiene.

Assessment of Calf Management and Hygiene Practices Adopted in Large and Small-Scale Dairy Farms in Wondo Genet Area, Southern Ethiopia.

Although calf management is the cornerstone of dairy cattle productivity and profitability, little attention is given by researchers particularly in developing nations including Ethiopia. Therefore, this research was conducted to characterize calf management and hygiene practices adopted by dairy farmers at Wondo Genet, a potential milk shed for southern Ethiopia. Calf management and hygiene practice-related data were collected from 57 dairy farms through a semi-structured pre-tested questionnaire and personal observation. All sampled farms were visited once by technical staff and administered the questionnaire by face-to-face interview during the period February 2017 to December 2019. The obtained data were analyzed using descriptive statistics. The majority (96.5%) of the farms had a slatted calf pen floor that was made of concrete. Although more than half of the farms (57.9%) had a good calf pen drainage system, only some (n = 8, 14%) are cleaned on a daily basis. All the calves (100%) had a history of calf scour, 96% survived from cowdriosis (heartwater). The majority of the calves born in the dairy farms (68.5%) received colostrum within 30 minutes of birth, but most of them (82.5%) were fed with waste milk till weaning age. Although the majority of the farms separately house recently born calves, 24.6% of the farms raise their calves together with other domestic animals. Dairy farm owners in the study area adopted some established risky calf management and hygiene practices that might lead to high calf morbidity/mortality in the farm. Awareness creation and further study to identify the specific causes of mortality and morbidity should be in place to improve the management and hygiene of calves and implement specific control and preventive measures.

Clinical course of pharyngotonsillitis with group A streptococcus treated with different penicillin V strategies, divided in groups of Centor Score 3 and 4: a prospective study in primary care

BackgroundSore throat is a common reason for prescribing antibiotics in primary care, and 10 days of treatment is recommended for patients with pharyngotonsillitis with group A streptococcus (GAS). Our group recently showed that penicillin V (PcV) four times daily for 5 days was non-inferior in clinical outcome to PcV three times daily for 10 days. This study compares duration, intensity of symptoms, and side effects in patients with a Centor Score (CS) of 3 or 4 respectively, after treatment with PcV for 5 or 10 days and evaluates whether all patients with pharyngotonsillitis with a CS of 3 or 4 should be treated for 5 days or if severity of symptoms or CS suggest a longer treatment period.MethodData on symptoms and recovery from patient diaries from 433 patients included in a RCT comparing PcV 800 mg × 4 for 5 days or PcV 1 g × 3 for 10 days was used. Patients six years and older with CS-3 or CS-4 and positive rapid antigen detection test for GAS-infection were grouped based on CS and randomized treatment. Comparisons for categorical variables were made with Pearson’s chi-squared test or Fisher’s exact test. Continuous variables were compared with the Mann–Whitney U test.ResultsPatients with CS-3 as well as patients with CS-4 who received PcV 800 mg × 4 for 5 days self-reported that they recovered earlier compared to patients with CS-3 or CS-4 who received treatment with PcV 1 g × 3 for 10 days. In addition, the throat pain as single symptom was relieved 1 day earlier in patients with CS-4 and 5 days of treatment compared to patients with CS-4 and 10 days of treatment. No differences in side effects between the groups were found.ConclusionIntense treatment with PcV four times a day for 5 days seems clinically beneficial and strengthens the suggestion that the 4-dose regimen with 800 mg PcV for 5 days may be the future treatment strategy for GAS positive pharyngotonsillitis irrespectively of CS-3 or CS-4.Trail registration ClinicalTrials.gov ID: NCT02712307 (3 April 2016).

Air Quality, Management Practices and Calf Health in Italian Dairy Cattle Farms.

Simple SummaryCalf mortality is an important factor of economic loss in dairy operations. Among the factors which can affect calf health, air quality in calf housing has rarely been studied. In the present research, the relations among air quality in the calf pens, management practices, microclimatic conditions and calf health and mortality were studied in 25 Italian dairy cattle farms. Microbial air quality in the calf pens was found to be related to temperature and humidity, design and position of the pen, some management practices and calf health and mortality. Maintaining dry bedding and controlling microclimatic conditions in the calf pen can be useful practices to promote good air microbiological quality in the calf pen, improving calf health and reducing mortality.Among factors that can affect calf health, microbial quality of the pen air is poorly studied. In 25 Italian dairy farms, data concerning air quality in the calf pens, hygiene of pens and equipment, microclimatic conditions, calf health and management were collected during the winter season (January-March 2020 and December-March 2021). The average air Standard Plate Count (SPC) of 85 pens was 4.51 (SD = 0.52) log10 cfu/m3 whereas the average air ammonia concentration was 0.66 (SD = 0.53) ppm. Positive correlations were found between average Temperature Humidity Index (THI) in the pen and air SPC, night maximum THI and air SPC and between SPC and yeast, mould and ammonia concentration in the pen air. The concentrations of E. coli, Enterobacteriaceae and yeasts in the pen air were higher and calf cough increased as the renewal interval of bedding material became longer. High bedding dry matter and low THI were associated with low air SPC, good calf health scores and low mortality. Maintaining low bedding humidity and controlling microclimatic conditions can contribute to enhancing air microbiological quality in the pen and reduce calf diseases and mortality.