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Papers by Nicholas Adomakoh

Antimicrobial Agents and Chemotherapy, 1992

Open Forum Infectious Diseases, 2017

who received 2 primary PCV13 doses and a PHiD-CV booster (PPS), for each serotype common to both ... more who received 2 primary PCV13 doses and a PHiD-CV booster (PPS), for each serotype common to both PCVs (except 9V), post-booster immune responses were in similar ranges to those after a 2 + 1 PHiD-CV series (SSS) (Figure 1B). In children who received 1 PCV13 dose followed by 2 PHiD-CV doses (PSS), for most common serotypes, the percentages of children with pneumococcal antibody concentrations ≥0.2 µg/mL were in similar ranges post-priming and postbooster compared with SSS controls (Figure 1). For some serotypes, post-primary (5, 6B, 9V, 23F) and post-booster (4, 5, 6B, 7F, 9V, 23F) antibody GMCs tended to be lower in the PSS than in the SSS group. Protein D carrier antibody GMCs were higher in the SSS group (post-pri: 2025.1 ELU/mL; post-bst: 3658.5 ELU/ mL) than in the PPS (143.2 and 219.7 ELU/mL) and PSS (117.2 and 791.0 ELU/ mL) groups. Conclusion. A 2 + 1 series with 2 PCV13 primary doses followed by a PHiD-CV booster or 1 PCV13 dose followed by a PHiD-CV primary and booster dose elicited pneumococcal immune responses in line with those induced by a 2 + 1 series with PHiD-CV alone, albeit with a trend for lower antibody GMCs for some serotypes. The clinical relevance of this trend is unknown. Funding. GlaxoSmithKline Biologicals SA

Journal of Hospital Infection, 2020

Background: Clostridioides difficile infection (CDI) increases the risk of complications and mort... more Background: Clostridioides difficile infection (CDI) increases the risk of complications and mortality. We assessed the magnitude of these outcomes in a large cohort of English patients with initial and recurrent CDI. Aim: To compare the risk of complications and all-cause mortality, within 12 months, among hospitalized patients !18 years old with hospital-associated-(HA-) CDI and recurrent CDI. Methods: Patients with HA-CDI during 2002e2013 were identified using inpatient hospital data linked to primary care and death data. Each HA-CDI case was frequency matched to two hospitalized patients without CDI on age group, sex, calendar year of admission, admission method and number of hospital care episodes. A second CDI episode starting on days 13e56 was defined as recurrence. Risks of mortality and complications at 12 months were analysed using Cox proportional hazard models. Findings: We included 6862 patients with HA-CDI and 13,724 without CDI. Median age was 81.0 years (IQR 71.0e87.0). Patients with HA-CDI had more comorbidities than those without CDI, and significantly higher risks of mortality (adjusted hazard ratio (95% confidence interval) 1.77 (1.67e1.87)) and complications (1.66 (1.46e1.88)) within 12 months from hospital admission. Of those with HA-CDI, 1140 (16.6%) experienced CDI recurrence. Patients with recurrent versus non-recurrent CDI also had significantly increased risk of mortality (1.32 (1.20e1.45)) and complications (1.37 (1.01e1.84)) in the 12 months from the initial CDI. Conclusions: HA-CDI (versus no CDI) and recurrent CDI are both associated with significantly higher risks of complications or death within 12 months of the initial CDI episode.

Journal of Antimicrobial Chemotherapy, 2018

ObjectivesInflammatory bowel disease (IBD) poses an increased risk for Clostridium difficile infe... more ObjectivesInflammatory bowel disease (IBD) poses an increased risk for Clostridium difficile infection (CDI). Fidaxomicin has demonstrated non-inferiority to vancomycin for initial clinical cure of CDI in patients without IBD; however, lack of data has caused concerns regarding potential systemic absorption of fidaxomicin in patients with IBD.MethodsThe plasma pharmacokinetics (PK) of fidaxomicin and its primary metabolite OP-1118 were evaluated in a multicentre, open-label, single-arm, Phase IIIb/IV study enrolling patients with active IBD and CDI. Patients received fidaxomicin, 200 mg twice daily for 10 days. The primary and secondary endpoints were, respectively, plasma and stool PK of fidaxomicin and OP-1118 on Days 1, 5 and 10 of treatment. Other secondary endpoints included safety of fidaxomicin treatment (assessed until Day 180). ClinicalTrials.gov identifier: NCT02437591.ResultsMedian Tmax of fidaxomicin and OP-1118 for the PK analysis set (PKAS; 24 patients) was 1–2 h acros...

The Lancet. Infectious diseases, 2018

Clostridium difficile infection causes severe complications and frequently recurs. An extended-pu... more Clostridium difficile infection causes severe complications and frequently recurs. An extended-pulsed fidaxomicin regimen might facilitate sustained clinical cure by prolonging C difficile suppression and supporting gut microbiota recovery. We aimed to compare clinical outcomes of extended-pulsed fidaxomicin with standard vancomycin. In this randomised, controlled, open-label, superiority study, we recruited hospitalised adults aged 60 years and older with confirmed C difficile infection at 86 European hospitals. Patients were randomly assigned (1:1) using an interactive web response system to receive extended-pulsed fidaxomicin (200 mg oral tablets, twice daily on days 1-5, then once daily on alternate days on days 7-25) or vancomycin (125 mg oral capsules, four times daily on days 1-10), stratified by baseline C difficile infection severity, cancer presence, age (≥75 years vs <75 years), and number of previous C difficile infection occurrences. The primary endpoint was sustaine...

African journal of medicine and medical sciences, 2006

This paper examines the concept of a developing nation that has a high HIV prevalence and lacks a... more This paper examines the concept of a developing nation that has a high HIV prevalence and lacks appropriate laboratory infrastructure necessary to cope with a treatment and care program. Several issues are discussed including personal experience in the context of project management for the creation and coordination of a facility aimed at providing the laboratory support required for the appropriate delivery and monitoring of HAART. Key issues about political will and prioritization are discussed in concert with current international guidelines and mechanisms of technology transfer and human resource development. The paper gives the benefit of the teams experience in coordinating the project, dealing specifically with issues such as the process of equipment procurement, staff recruitment, and capacity building. The need for the highest level of quality control and standard operating practices are discussed in the context of limited regional expertise and manpower support. Emphasis is...

JAIDS Journal of Acquired Immune Deficiency Syndromes, 2012