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Purpose: To analyze the effectiveness of coating of abutments with antimicrobial agents and their influence on the physicochemical and biologic properties of the coated materials. Materials and Methods: This work was registered in Open Science Framework (osf.io/6tkcp) and followed the PRISMA protocols. A search of two independent reviewers of articles published up to October 29, 2021, was performed in the Embase, PubMed, Science Direct, and Scopus databases. Results: The databases found a total of 1,474 references. After excluding the duplicates, 1,050 remained. After reading the titles and abstracts and applying the inclusion criteria, 13 articles remained and were read in full. A total of 8 articles were included in this systematic review. Different antimicrobial agents have been used to coat abutments, including graphene oxide, polydopamine, titanium and zirconium nitride, lactoferrin, tetracycline, silver, and doxycycline with varied release times. Titanium-coated silver showed a better antimicrobial agent release time of up to 28 days. Chemical analysis confirmed the presence of antimicrobials on the surface after coating. Different pathogenic microorganisms, such as Streptococcus sanguinis, Streptococcus oralis, and Staphylococcus aureus, were inhibited when in contact with the coated surface. Conclusions: This review showed that there is still no consensus on which is the better antimicrobial agent and which coated materials have the better performance. However, the association of surface coating of abutments with antimicrobials is feasible and can benefit many patients, which can support their clinical use to favor the healing process and prevent infections that can lead to treatment failure with dental implants. [ABSTRACT FROM AUTHOR]

Background: Wolbachia is present in all life stages of Dirofilaria immitis. Wolbachia surface protein (WSP) can be highly immunogenic and induce acute inflammatory reactions in the host upon worm death. To avoid the abrupt release of Wolbachia and its antigens from deceased parasites, the American Heartworm Society (AHS) has recommended using doxycycline (DOXY) and having a 1-month wait period between the DOXY treatment and the adulticidal process for Wolbachia elimination. Studies have shown that the 28 day, 10 mg/kg twice daily (BID) administration of DOXY can effectively clear Wolbachia in the bloodstream of the host. The 1-month wait period is hypothesized to allow for further reduction of Wolbachia. However, the levels of Wolbachia in adult parasites after the DOXY treatment remain unknown. Methods: Forty-five purposely bred dogs were intravenously transplanted with 20 Dirofilaria immitis adults, consisting of 12 females and 8 males. The dogs were divided into nine groups of five dogs each. Two groups each received 5, 7.5, or 10 mg/kg DOXY BID orally for 28 days, and ivermectin (IVM) monthly (6 µg/kg.) Three groups remained untreated as controls. Study animals were necropsied on day 0, day 30, and day 60, following the start of treatment. Adult worms were collected at necropsy and preserved for analysis. Quantitative polymerase chain reaction (qPCR) and immunohistochemistry for WSP were performed on worms collected at each time point. The data were analyzed using a linear mixed model (LMM). Multiple comparisons were adjusted using Tukey's test. Results: The qPCR results showed that all treatment doses significantly reduced Wolbachia levels compared with the control groups at 30 and 60 days. The intradose comparison indicated a significant decrease on day 60 compared with day 30. No significant differences were found between different doses on the two examination dates. Immunohistochemistry indicated the markedly reduced presence of Wolbachia in treatment groups. Conclusions: All DOXY dosages can be considered effective in reducing Wolbachia on both tested dates (30 and 60 days). On the basis of the further reduction of Wolbachia levels in adult D. immitis, the 1-month rest period in the AHS heartworm treatment guidelines is beneficial. Wolbachia can still be detected on day 60 in all dosage groups. [ABSTRACT FROM AUTHOR]

Background: Antibiotic resistance is a growing global threat due to antibiotic overuse and limited treatment options. Multidrug-resistant bacteria, like Staphylococcus aureus and Escherichia coli, increase infection complexity and mortality. This study explores nanocomposite films of ZIF-8 nanoparticles and Doxycycline (Dox) to enhance antibacterial efficacy. In this study, nanocomposite films composed of chitosan (CS) and polyethylene glycol (PEG), incorporating zeolitic imidazolate framework-8 (ZIF-8) nanoparticles and DOX, were developed. These films were characterized by their morphological, mechanical, antibacterial, and drug-release properties. Antibacterial efficacy was evaluated using disk diffusion, broth microdilution, and checkerboard assay methods to determine MICs and potential synergistic effects. Results: The nanocomposite films demonstrated flexibility, semi-transparency, and a yellowish-brown hue, with films containing ZIF-8 nanoparticles being thicker (79 ± 0.2 μm) than those without (54 ± 0.5 μm). The tensile strength was enhanced with the incorporation of ZIF-8, peaking at 53.12 MPa for the CS-PEG-G-10% DOX-4% ZIF-8 film. XRD analysis confirmed the crystallinity of the ZIF-8 and DOX, with distinct peaks observed for each material. The drug release studies revealed an initial burst followed by sustained release, with higher release rates in acidic environments compared to neutral and alkaline media. The CS-PEG-G-10% DOX-4% ZIF-8 nanocomposite film demonstrated significantly higher antibacterial activity, achieving the lowest MIC values, particularly against S. aureus (22.5 mm inhibition zone) compared to E. coli (14 mm inhibition zone). Additionally, a notable synergistic effect was observed between CS-PEG-G-10% DOX and CS-PEG-G-10% DOX, with FICI values below 0.5. Conclusions: The CS-PEG-G-10% DOX-4% ZIF-8 nanocomposite exhibits enhanced antibacterial efficacy and optimal properties, positioning it as a strong candidate for developing effective treatments against multidrug-resistant pathogens. [ABSTRACT FROM AUTHOR]

Purpose of Review: Doxycycline post-exposure prophylaxis (doxy PEP) has proven to be highly effective in reducing the incidence of sexually transmitted infections (STIs) among men who have sex with men (MSM) and transgender women. In response, the US Centers for Disease Control and Prevention (CDC) issued official clinical guidance on the use of doxy PEP as a preventive intervention in these populations. However, despite strong evidence supporting its use, the potential risks of antimicrobial resistance (AMR) along with its limited accessibility in other key populations, remain significant concerns with doxy PEP. Recent Findings: Real-world data show strong awareness, interest, and usage of doxy PEP among MSM and transwomen. Early ecological studies have revealed population-level reductions in chlamydia and early syphilis incidence following doxy PEP implementation. Ongoing research continues to explore its efficacy in other populations, as well as its impact on both individual and population-level AMR. Summary: Doxy PEP is a well-tolerated and inexpensive intervention that has the potential to substantially reduce bacterial STIs, particularly in priority populations. Its implementation will require careful assessment of equitable uptake, usage patterns, and long-term monitoring of STI incidence and AMR. [ABSTRACT FROM AUTHOR]

Objective: Rare disease Background: Simple (unicameral) bone cysts (SBCs) are benign, fluid-filled bone lesions that are typically solitary and can be unicameral (single chamber) or septated. Most commonly affecting the long bones of children and adolescents, SBCs can be asymptomatic or associated with pain or fractures. Multifocal SBCs, featuring multiple cysts across different bones, are exceptionally rare and pose unique diagnostic and therapeutic challenges. Here, we report an exceptional case of a 20-year-old woman with multifocal SBCs affecting 9 known anatomical sites and discuss the unique diagnostic and therapeutic challenges. Case Report: A 20-year-old woman presented with right proximal tibia pain after a fall. Radiographs and MRI revealed radiolucent lesions in the proximal tibia, distal tibia, and fibula, with additional lesions identified on whole-body scintigraphy in the left proximal and distal tibia, left proximal humerus, and pelvis. Initial biopsy was suggestive of SBCs but inconclusive, and surgical biopsy was required for definitive diagnosis. Histologic evaluation confirmed SBCs, demonstrating cyst walls, cholesterol clefts, and fibrin-like deposits. Treatment included curettage, local adjuvant therapy with argon beam and doxycycline, bone grafting, and doxycycline sclerotherapy for pelvic and distal extremity lesions. At 17 months after treatment, the patient remained asymptomatic, with imaging showing sclerosis and near-complete resolution of the lesions. Conclusions: This report presented a rare case of a young woman with multiple SBCs across 9 anatomical sites. Overall, the management of multifocal SBCs requires a multidisciplinary approach, involving orthopedic surgeons, radiologists, and pathologists for optimal outcomes. [ABSTRACT FROM AUTHOR]

Background: Recent studies that investigated the effects of systemic doxycycline as an adjuvant to scale and root planing (SRP) in the treatment of diabetic periodontitis have yielded controversial results. The aim of this meta-analysis is to evaluate the effect of systemic doxycycline as an adjunct to SRP against SRP alone for improving clinical outcomes of periodontitis in diabetic individuals. Methods: A systematic literature search was performed using PubMed, Cochrane library, China National Knowledge Infrastructure (CNKI), and VIP Data from the beginning of the database until March 2024. For probing depth (PD), clinical attachment level (CAL), plaque index (PI), gingival index (GI), and bleeding on probing (BOP), mean difference (MD) and the 95% confidence interval (CI) were computed. Heterogeneity was assessed using the Q test and the I2 statistic. Evaluation of publication bias was conducted using Egger's and Begg's tests. Results: A total of 12 articles were included for meta-analysis. No statistically significant difference was indicated in the improvement of PD, CAL, PI and GI between a treatment group receiving SRP combined with short-term antimicrobial dose doxycycline and controls receiving SRP alone. However, short-term antimicrobial dose doxycycline plus SRP significantly reduced BOP by 8.14% (95%CI 2.23–14.05) at 3 months. Furthermore, after the adjunctive use of long-term sub-antimicrobial dose doxycycline, significant reductions in GI (MD: 0.72, 95% CI: 0.34–1.10) and BOP (MD: 12.8, 95% CI: 0.24–25.36) were observed at 3 months. The robustness of the results was further confirmed by sensitivity analysis, despite the truth that significant heterogeneity was found among the included studies. Conclusion: Gingival inflammation in diabetic patients can be reduced more successfully by SRP combined with systemic doxycycline than by SRP alone, but this is insufficient in preventing periodontal tissue destruction. [ABSTRACT FROM AUTHOR]

Objectives Mycoplasma genitalium , a sexually transmitted bacterium, faces increasing antibiotic resistance, particularly to azithromycin. However, presence of macrolide resistance-associated mutations (MRAMs) does not evidently implicate azithromycin treatment failure. This study aimed to establish an in vitro co-culture system of M. genitalium isolates and perform phenotypic susceptibility testing for different antibiotics, focusing on azithromycin to evaluate genotypic and phenotypic resistance across MRAMs. Methods Urine specimens testing positive for M. genitalium via nucleic acid amplification were co-cultured with Vero cells. Phenotypic susceptibility testing was performed for eight antibiotics. Growth inhibition and MIC of M. genitalium by azithromycin were compared across different MRAMs. Results M. genitalium was cultured from 20/40 (50.0%) positive urine samples, with phenotypic susceptibility tested in a subset. MICs ranged as follows: azithromycin (0.008–>32 mg/L), levofloxacin (1–4 mg/L), moxifloxacin (<0.25–1 mg/L), sitafloxacin (<0.032–0.25 mg/L), minocycline (<0.25–1 mg/L), doxycycline (<0.125–2 mg/L), spectinomycin (<2.5–>25 mg/L) and lefamulin (<0.004–0.063 mg/L). Isolates with A2058T demonstrated 24-, 7-, 15- and 12-fold increases in growth inhibition compared with A2058G at azithromycin concentrations of 4, 8, 16 and 32 mg/L, respectively (P <  0.01). MRAMs ranked from low to high impact on MIC range were as follows: wildtype (0.008–0.016), A2058T (8–32), A2059G (≥32) and A2058G (>32). Conclusions This study revealed that M. genitalium isolates vary in azithromycin-induced growth inhibition across MRAMs, potentially explaining differences in clinical treatment efficacy. Phenotypic susceptibility testing for other antibiotics demonstrated relatively low MICs. Future studies should incorporate clinical treatment efficacy and symptom severity to optimize treatment for M. genitalium. [ABSTRACT FROM AUTHOR]

Purpose: Doxycycline post-exposure prophylaxis (Doxy-PEP) reduces the likelihood of Chlamydia and early syphilis by approximately two-thirds. Currently, data on the frequency of Doxy-PEP use in men who have sex with men (MSM) are limited. This study aimed to assess knowledge, attitude towards, and frequency of Doxy-PEP use among MSM in Germany. Methods: We conducted a national online survey in Germany from summer to fall 2023, recruiting MSM and transgender women. Participants were invited to complete the online survey through social media, online dating platforms, and print media advertisements with active recruitment and poster advertising in private practices, tertiary outpatient clinics, and MSM community events in Germany. Results: In total, 438 participants completed the survey and were included in the analysis, and 285 (65.1%) were living with the human immunodeficiency virus (HIV) or taking HIV-pre-exposure prophylaxis (PrEP). Overall, 170 participants (38.8%) had heard of Doxy-PEP, and 275 (62.8%) would consider taking it, but only 32 (7.3%) reported having ever taken Doxy-PEP. The most common reason for a negative attitude towards Doxy-PEP were apprehension about insufficient detailed information, and concerns about antibiotic resistance. Doxy-PEP users were more likely to be on HIV-PrEP, had a higher self-reported risk of bacterial sexually transmitted infections (STIs), and often had a history of bacterial STIs. Conclusion: The study demonstrated high awareness and strong interest in Doxy-PEP among MSM in Germany, most of whom were living with HIV or taking HIV-PrEP; however, the actual usage of Doxy-PEP remains low in the summer and fall of 2023. [ABSTRACT FROM AUTHOR]

Purpose:. While doxycycline shows promise as a preventative measure against certain STIs (post-exposure prophylaxis or PEP, and pre-exposure prophylaxis or PrEP), very few medical and scientific associations favor its community use. Nevertheless, sexual health organizations for gay, bisexual and other men who have sex with men (GBMSM) community have noticed an increase in requests of its use. Methods:. The sexual health organization "Stop Sida" in Spain launched an anonymous snapshot survey to evaluate the current use of doxycycline as prevention strategy (both PEP and PrEP) in Spain through its social networks and its support groups in telegram. Results:. 150 valid answers were obtained from different parts of Spain. 82 respondents (54,6% of total) had ever taken doxycycline, out of which 29 (35,4%) indicated the use as doxy-PEP and 7 (8,5%) as doxy-PrEP. The self-reported rate of STI diagnoses (mainly of syphilis and chlamydia) in the past 12 months was lower among those participants who reported having used doxy-PEP compared with those who did not report using doxy-PEP. The most common ways to obtain the doxycycline were telling a specialist that they have had a risky contact or by using leftover pills from a previous treatment. Conclusion: The current study is the first study to describe the use of doxycycline as a preventive strategy among the GBMSM community in Spain, and the first designed, launched and analyzed entirely by an NGO dealing with sexual health for the GBMSM community. The results obtained are aligned with other studies in other parts of Europe, such as Germany. [ABSTRACT FROM AUTHOR]

Featured Application: This study demonstrates the ambient-condition wet-chemical functionalization of photocatalytic ZnO thin films with a palladium cocatalyst through UV-induced chemical photofixation of Pd2+ ions. This approach enhances ZnO photocatalytic efficiency in the degradation of an antibiotic model contaminant in both distilled and tap water. The method presented enables targeted functionalization of ZnO-based photocatalysts for effective water decontamination applications. In this work, we demonstrate the co-catalytic modification of ZnO films via the photodeposition of palladium (Pd) to enhance the photocatalytic degradation of doxycycline (DC). Pristine ZnO films were synthesized using a sol–gel method and deposited onto glass substrates via dip-coating. The films were subsequently modified with Pd through chemical photodeposition under UV light, which facilitated the photoreduction of an aqueous 5 × 10−3 M Pd2+ precursor. The influence of varying UV photodeposition doses (2.5, 5, and 10 J/cm2) on the morphology and chemical composition of the Pd-modified films was investigated to control Pd surface coverage and chemical state. Characterization techniques included scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDS), and X-ray photoelectron spectroscopy (XPS). At low UV doses (2.5 J/cm2), approximately 1.6 at.% of Pd was photodeposited, primarily as PdO, while higher UV doses (5–10 J/cm2) increased the metallic Pd0 content. The photocatalytic degradation of DC was evaluated in both distilled and tap water, where Pd/ZnO films demonstrated significantly higher removal efficiency (40–380% higher) than pristine ZnO films, with those containing higher Pd0 levels exhibiting the greatest activity. Across all samples, removal efficiency in tap water was approximately double that in distilled water. [ABSTRACT FROM AUTHOR]

Background/aims: Excessive use of antibiotics has led to development of antibiotic resistance and other antibiotic-associated complications. Dermatologists prescribe more antibiotics per clinician than any other major specialty, with much of this use for acne. Alternative acne treatments are available but are used much less often than antibiotics, at least partially because dermatologists feel that they are less effective. Spironolactone, a hormonal therapy with antiandrogen effects that can address the hormonal pathogenesis of acne, may represent a therapeutic alternative to oral antibiotics for women with acne. However, the comparative effects of spironolactone and oral antibiotics in the treatment of acne have not been definitively studied. The Spironolactone versus Doxycycline for Acne: A Comparative Effectiveness, Noninferiority Evaluation (SD-ACNE) trial aims to answer whether spironolactone, in addition to standard topical therapy, is noninferior to doxycycline (an oral antibiotic) for women with acne. Several interesting challenges arose in the development of this study, including determining acceptability of the comparative regimens to participating dermatologists, identifying data to support a noninferiority margin, and establishing a process for unblinding participants after they completed the study while maintaining the blind for study investigators. Methods: We present the scientific and clinical rationale for the decisions made in the design of the trial, including input from key stakeholders through a Delphi consensus process. Results: The Spironolactone versus Doxycycline for Acne: A Comparative Effectiveness, Noninferiority Evaluation trial (NCT04582383) is being conducted at a range of community and academic sites in the United States. To maximize external validity and inform clinical practice, the study is designed with broad eligibility criteria and no prohibition of use of topical medications. Participants in the trial will be randomized to receive either spironolactone 100 mg/day or doxycycline hyclate 100 mg/day for 16 weeks. The primary outcome is the absolute decrease in inflammatory lesion count, and we have established a noninferiority margin of four inflammatory lesions. Secondary outcomes include the percentage of participants achieving Investigator Global Assessment success, change in quality of life, and microbiome changes and diversity. Conclusions: The Spironolactone versus Doxycycline for Acne: A Comparative Effectiveness, Noninferiority Evaluation trial will have substantial implications for the treatment of acne and antibiotic stewardship. In addition, this study will provide important information on the effect of these systemic agents on the development of changes to the microbiome and antibiotic resistance in a healthy population of patients. [ABSTRACT FROM AUTHOR]

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