Archive for July 2, 2017

Old and new antibiotics for therapy of multidrug resistant bacteria.

Rev Esp Quimioter. Sept 2016 V.29 Suppl 1 P.39-42.

[Article in Spanish]

Pintado V1.

Author information

1 Vicente Pintado, Servicio de Enfermedades Infecciosas. Hospital Ramón y Cajal. Madrid, Spain. vicente.pintado@salud.madrid.org

Abstract

The lack of new antibiotics for multidrug-resistant bacteria is a matter of concern in microorganisms such as Pseudomonas aeruginosa, ESBL- and carbapenemase-producing Enterobacteriaceae, Acinetobacter baumannii, methicillin-resistant Staphylococcous aureus and vancomycin-resistant Enterococcus faecium.

This situation has conditioned the reuse of “old” antibiotics (colistin, fosfomycin), the use of more recent antibiotics with new indications or dosage regimens (tigecycline, meropenem) and the introduction of “new” antibiotics (β-lactams, lipoglycopeptides, oxazolidinones) that are the subject of this review.

PDF

http://seq.es/seq/0214-3429/29/sup1/9pintado.pdf

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July 2, 2017 at 9:33 pm

The efficacy and safety of tigecycline for the treatment of bloodstream infections: a systematic review and meta-analysis.

Ann Clin Microbiol Antimicrob. April 5, 2017 V.16 N.1 P.24.     

Wang J1, Pan Y1, Shen J2, Xu Y1.

Author information

1 Department of Clinical Laboratory, The First Affiliated Hospital of Anhui Medical University, Anhui Medical University, Hefei, 230022, Anhui, China.

2 Department of Clinical Laboratory, The First Affiliated Hospital of Anhui Medical University, Anhui Medical University, Hefei, 230022, Anhui, China. shenjilu@126.com

Abstract

Patients with bloodstream infections (BSI) are associated with high mortality rates. Due to tigecycline has shown excellent in vitro activity against most pathogens, tigecycline is selected as one of the candidate drugs for the treatment of multidrug-resistant organisms infections.

The purpose of this study was to evaluate the effectiveness and safety of the use of tigecycline for the treatment of patients with BSI. The PubMed and Embase databases were systematically searched, to identify published studies, and we searched clinical trial registries to identify completed unpublished studies, the results of which were obtained through the manufacturer.

The primary outcome was mortality, and the secondary outcomes were the rate of clinical cure and microbiological success. 24 controlled studies were included in this systematic review. All-cause mortality was lower with tigecycline than with control antibiotic agents, but the difference was not significant (OR 0.85, [95% confidence interval (CI) 0.31-2.33; P = 0.745]). Clinical cure was significantly higher with tigecycline groups (OR 1.76, [95% CI 1.26-2.45; P = 0.001]).

Eradication efficiency did not differ between tigecycline and control regimens, but the sample size for these comparisons was small. Subgroup analyses showed good clinical cure result in bacteremia patients with CAP. Tigecycline monotherapy was associated with a OR of 2.73 (95% CI 1.53-4.87) for mortality compared with tigecycline combination therapy (6 studies; 250 patients), without heterogeneity.

Five studies reporting on 398 patients with Klebsiella pneumoniae carbapenemase-producing K. pneumoniae BSI showed significantly lower mortality in the tigecycline arm than in the control arm. The combined treatment with tigecycline may be considered the optimal option for severely ill patients with BSI.

PDF

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5382384/pdf/12941_2017_Article_199.pdf

July 2, 2017 at 9:31 pm

Resistance to Colistin in Klebsiella Pneumoniae: A 4.0 Strain?

Infect Dis Rep. May 31, 2017 V.9 N.2 P.7104.     

Granata G1, Petrosillo N1.

Author information

1 Clinical and Research Department, National Institute for Infectious Diseases “L. Spallanzani” – IRCCS, Rome, Italy.

Abstract

The global rise of multidrug-resistant gram-negative bacteria represents an increasing threat to patient safety. From the first observation of a carbapenem-resistant gram-negative bacteria a global spread of extended-spectrum beta-lactamases and carbapenemases producing Klebsiella pneumoniae has been observed.

Treatment options for multidrug-resistant K. pneumoniae are actually limited to combination therapy with some aminoglycosides, tigecycline and to older antimicrobial agents. Unfortunately, the prevalence of colistin-resistant and tigecycline-resistant K. pneumoniae is increasing globally. Infection due to colistin-resistant K. pneumoniae represents an independent risk factor for mortality.

Resistance to colistin in K. pneumoniae may be multifactorial, as it is mediated by chromosomal genes or plasmids. The emergence of transmissible, plasmid-mediated colistin resistance is an alarming finding.

The absence of new agents effective against resistant Gram-negative pathogens means that enhanced surveillance, compliance with infection prevention procedures, and antimicrobial stewardship programs will be required to limit the spread of colistin-resistant K. pneumoniae.

PDF

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5472342/pdf/idr-9-2-7104.pdf

 

July 2, 2017 at 9:29 pm

Pharmacokinetics of ertapenem following intravenous and subcutaneous infusions in patients.

Antimicrob Agents Chemother. 2010 Feb;54(2):924-6.       

Frasca D1, Marchand S, Petitpas F, Dahyot-Fizelier C, Couet W, Mimoz O.

Author information

1 INSERM, ERI-23, Pôle Biologie Santé, 40 Avenue du Recteur Pineau, Poitiers, France.

Abstract

Steady-state pharmacokinetics of ertapenem were compared in patients after 1-g intravenous and subcutaneous (s.c.) infusions.

Bioavailability was 99%+/-18% after s.c. administration, but peaks were reduced by about (43+/-29 versus 115+/-28 microg/ml) and times to peak were delayed.

Simulations based on unbound concentrations show that time over the MIC should always be longer than 30% to 40% of the dosing interval, suggesting that s.c. infusion could be an alternative in patients with reduced vascular acces …

PDF

http://aac.asm.org/content/54/2/924.full.pdf+html

July 2, 2017 at 2:17 pm


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