Archive for October 26, 2015

Ceftaroline fosamil: A super-cephalosporin?

Cleve Clin J Med. 2015 Jul;82(7):437-44.

Ghamrawi RJ1, Neuner E2, Rehm SJ3,4.

Author information

1Clinical Pharmacist Specialist, Adult Antimicrobial Stewardship Department of Pharmacy, University Hospitals Case Medical Center, Cleveland, OH, USA.

2Infectious Diseases Clinical Specialist, Department of Pharmacy, Cleveland Clinic, Cleveland, OH, USA. E-mail: neunere@ccf.org

3Department of Infectious Disease, Cleveland Clinic, Cleveland, OH, USA.

4Clinical Assistant Professor, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, USA.

Abstract

Ceftaroline is a broad-spectrum cephalosporin used to treat infections caused by a variety of microorganisms, including methicillin-resistant Staphylococcus aureus (MRSA) and multidrug-resistant Streptococcus pneumoniae.

However, it is not active against Pseudomonas aeruginosa, Bacteroides fragilis, and carbapenem-resistant Enterobacteriaceae.

Its approved indications include community-acquired bacterial pneumonia and bacterial infections of skin and skin structures.

It has also been used off-label to treat osteomyelitis, endocarditis, and meningitis caused by ceftaroline-susceptible organisms.

PDF

http://www.ccjm.org/view-pdf.html?file=uploads/media/Ghamrawi_CeftarolineFosamil

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October 26, 2015 at 9:41 pm

Empiric therapy for hospital-acquired, Gram-negative complicated intra-abdominal infection and complicated urinary tract infections: a systematic literature review of current and emerging treatment options.

BMC Infect Dis. 2015 Aug 5;15:313.

Golan Y1.

Author information

1Tufts Medical Center, Department of Medicine, Division of Geographic Medicine and Infectious Disease, 800 Washington St, Boston, MA, 02446, USA. ygolan@tuftsmedicalcenter.org

Abstract

BACKGROUND:

Empiric therapy for healthcare-associated infections remains challenging, especially with the continued development of Gram-negative organisms producing extended-spectrum β-lactamases (ESBLs) and the threat of multi-drug-resistant organisms. Current treatment options for resistant Gram-negative infections include carbapenems, tigecycline, piperacillin-tazobactam, cefepime, ceftazidime, and two recently approved therapies, ceftolozane-tazobactam and ceftazidime-avibactam.

METHODS:

This systematic literature review surveys the published clinical trial evidence available since 2000 in support of both current and emerging treatment options in the settings of complicated intra-abdominal infection (cIAI) and complicated urinary tract infection (cUTI). When available, clinical cure rates for patients with infections from ESBL-producing strains are provided, as is information about efficacy against Pseudomonas aeruginosa.

RESULTS:

Clinical trial evidence to guide selection of empiric antibiotic therapy in patients with complicated, hospital-acquired, Gram-negative IAIs and UTIs is limited. Though most of the clinical trials explored in this overview enrolled patients with complicated infections, often patients with severe infections and multiple comorbidities were excluded.

CONCLUSIONS:

Practitioners in the clinical setting who are treating patients with complicated, hospital-acquired, Gram-negative IAIs and UTIs need to consider the possibility of polymicrobial infections, antibiotic-resistant organisms, and/or severely ill patients with multiple comorbidities. There is a severe shortage of evidence-based research to guide the selection of empiric antibiotic therapy for many patients in this setting. New therapies recently approved or in late-stage development promise to expand the number of options available for empiric therapy of these hospital-acquired, Gram-negative infections.

PDF

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4526420/pdf/12879_2015_Article_1054.pdf

October 26, 2015 at 9:37 pm

Carbapenem-Resistant Enterobacteriaceae in Children, United States, 1999–2012

Emerging Infectious Diseases NOV 2015 V.21 N.11

Research

Latania K. Logan, John P. Renschler, Sumanth Gandra, Robert A. Weinstein, Ramanan Laxminarayan, and for the Centers for Disease Control Prevention Epicenters Program

Rush University Medical Center, Chicago, Illinois, USA (L.K. Logan, R.A. Weinstein); John H. Stroger, Jr. Hospital of Cook County, Chicago (L.K. Logan, R.A. Weinstein); Center for Disease Dynamics, Economics and Policy, Washington, DC, USA (J.P. Renschler, S. Gandra, R. Laxminarayan); Public Health Foundation of India, New Delhi, India (R. Laxminarayan); Princeton University, Princeton, New Jersey, USA (R. Laxminarayan)

The prevalence of carbapenem-resistant Enterobacteriaceae (CRE) infections is increasing in the United States. However, few studies have addressed their epidemiology in children.

To phenotypically identify CRE isolates cultured from patients 1–17 years of age, we used antimicrobial susceptibilities of Enterobacteriaceae reported to 300 laboratories participating in The Surveillance Network–USA database during January 1999–July 2012.

Of 316,253 isolates analyzed, 266 (0.08%) were identified as CRE. CRE infection rate increases were highest for Enterobacter species, blood culture isolates, and isolates from intensive care units, increasing from 0.0% in 1999–2000 to 5.2%, 4.5%, and 3.2%, respectively, in 2011–2012.

CRE occurrence in children is increasing but remains low and is less common than that for extended-spectrum β-lactamase–producing Enterobacteriaceae.

The molecular characterization of CRE isolates from children and clinical epidemiology of infection are essential for development of effective prevention strategies.

PDF

http://wwwnc.cdc.gov/eid/article/21/11/pdfs/15-0548.pdf

October 26, 2015 at 8:35 am


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