Meropenem-induced hypokalemia and metabolic alkalosis.

Indian J Pharmacol. 2012 Mar  V.44 N.2  P.276-7.

Zaki SA, Shanbag P.

Department of Pediatrics, Lokmanya Tilak Municipal General Hospital and Medical College, Sion, Mumbai, India.

FULL TEXT

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3326932/?tool=pubmed

 

¿Necesitamos guías nacionales sobre el tratamiento de la infección por el virus de la inmunodeficiencia humana?

Enf Inf & Microb Clin  Julio 2012 V.30 N.6 P.281-2

EDITORIAL

Letang, Emilio; Battegay, Manuel

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Chryseobacterium indologenes infection in a newborn: a case report.

J Med Case Rep. 2011 Jan 14;5:10.

Calderón G, García E, Rojas P, García E, Rosso M, Losada A.

Neonatology Unit, ‘Virgen del Rocío’ University Children’s Hospital, Seville, Spain. gmcalderonl@terra.es.

Abstract

INTRODUCTION:

Chryseobacterium indologenes is an uncommon human pathogen. Most infections have been detected in hospitalized patients with severe underlying diseases who had indwelling devices implanted. Infection caused by C. indologenes in a newborn has not been previously reported.

CASE PRESENTATION:

We present a case of ventilator-associated pneumonia caused by C. indologenes in a full-term Caucasian newborn baby boy with congenital heart disease who was successfully treated with piperacillin-tazobactam.

CONCLUSION:

C. indologenes should be considered as a potential pathogen in newborns in the presence of invasive equipment or treatment with long-term broad-spectrum antibiotics. Appropriate choice of effective antimicrobial agents for treatment is difficult because of the unpredictability and breadth of antimicrobial resistance of these organisms, which often involves resistance to many of the antibiotics chosen empirically for serious Gram-negative infections.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3025965/pdf/1752-1947-5-10.pdf

Pharmacokinetic-pharmacodynamic profiling of four antimicrobials against gram-negative bacteria collected from Shenyang, China.

BMC Infect Dis. 2010 Jun 15  V.10  P.171.

Chu YZ, Tian SF, Chen BY, Nian H, Shang H, Sun GQ.

Department of Laboratory Medicine, The First Hospital of China Medical University, Shenyang, 110001, China.

Abstract

BACKGROUND:

To examine common antimicrobial regimens used in eradicating certain nosocomial gram-negative pathogens and determine which ones are likely to be the most suitable as empirical choices in Shenyang, China.

METHODS:

A 5000-subject Monte Carlo simulation was conducted to determine the cumulative fraction of response (CFR) for meropenem, imipenem, cefepime, piperacillin/tazobactam and levofloxacin against Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae, Acinetobacter baumannii and Pseudomonas aeruginosa collected in 2006 and 2007 from Shenyang.

RESULTS:

Meropenem and imipenem had the highest CFRs against the Enterobacteriaceae (97%-100%), followed by cefepime. No antibiotic simulated regimen achieved optimal CFR against P. aeruginosa and A. baumannii. Piperacillin/tazobactam dosed at 4.5 g q8h achieved the lowest CFR against all bacteria.

CONCLUSIONS:

This study suggests that the carbapenems provide the greatest likelihood of clinical success for the Enterobacteriaceae, and combination therapy might be needed when choosing empirical therapy, especially when A. baumannii or P. aeruginosa are suspected.

PDF

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2895603/pdf/1471-2334-10-171.pdf

 

Piperacillin-tazobactam for Pseudomonas aeruginosa infection: clinical implications of an extended-infusion dosing strategy.

Clin Infect Dis. 2007 Feb 1  V.44  N.3  P.357-63.

Lodise TP Jr, Lomaestro B, Drusano GL.

Department of Pharmacy Practice, Albany College of Pharmacy, Albany, NY 12208, USA. lodiset@acp.edu

Abstract

BACKGROUND:

Piperacillin-tazobactam is frequently used to treat Pseudomonas aeruginosa infections in critically ill patients. In an effort to improve clinical outcomes, an extended-infusion dosing scheme for piperacillin-tazobactam therapy was devised using a Monte Carlo simulation and was adopted into clinical practice at AlbanyMedicalCenter (Albany, New York). This study evaluates the clinical implications of extended infusion of piperacillin-tazobactam therapy for critically ill patients with P. aeruginosa infection.

METHODS:

We performed a cohort study of patients who received piperacillin-tazobactam therapy for a P. aeruginosa infection that was susceptible to piperacillin-tazobactam during the period January 2000-June 2004. Prior to February 2002, all patients received intermittent infusions of piperacillin-tazobactam (3.375 g intravenously for 30 min every 4 or 6 h); after this time, all patients received extended infusions of piperacillin-tazobactam (3.375 g intravenously for 4 h every 8 h). Data on demographic characteristics, disease severity, and microbiology were collected, and outcomes were compared between groups.

RESULTS:

A total of 194 patients comprised the 2 study groups: 102 patients received extended infusions of piperacillin-tazobactam, and 92 patients received intermittent infusions of piperacillin-tazobactam. No differences in baseline clinical characteristics were noted between the 2 groups. Among patients with Acute Physiological and Chronic Health Evaluation-II scores > or =17, 14-day mortality rate was significantly lower among patients who received extended-infusion therapy than among patients who received intermittent-infusion therapy (12.2% vs. 31.6%, respectively; P=.04), and median duration of hospital stay after collection of samples for culture was significantly shorter for patients who received extended-infusion therapy than for patients who received intermittent-infusion therapy (21 days vs. 38 days; P=.02).

Conclusions.

These results indicate that extended-infusion piperacillin-tazobactam therapy is a suitable alternative to intermittent-infusion piperacillin-tazobactam therapy, and they strongly suggest that improved outcomes may be realized by administering extended-infusion piperacillin-tazobactam therapy to critically ill patients with P. aeruginosa infection.

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http://cid.oxfordjournals.org/content/44/3/357.full.pdf+html