Posts filed under ‘Antimicrobianos’

Prophylactic Antimicrobial Therapy for Acute Aspiration Pneumonitis

Clinical Infectious Diseases August 15, 2018 V.67 N.4 P.513-518

EDITOR’S CHOICE

Vlad Dragan; Yanliang Wei; Marion Elligsen; Alex Kiss; Sandra A N Walker

In a cohort of patients with acute aspiration pneumonitis, antibiotics within 48 hours of macroaspiration was not associated with reduced mortality compared to supportive care only, yet resulted in the need for more frequent antibiotic escalation and fewer antibiotic-free days.

FULL TEXT

https://academic.oup.com/cid/article/67/4/513/4846855

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August 12, 2018 at 8:17 pm

Gepotidacin for the Treatment of Uncomplicated Urogenital Gonorrhea: A Phase 2, Randomized, Dose-Ranging, Single-Oral Dose Evaluation

Clinical Infectious Diseases August 15, 2018 V.67 N.4 P.505-512

Stephanie N Taylor; David H Morris; Ann K Avery; Kimberly A Workowski; Byron E Batteiger

In this phase 2 study, single oral doses of gepotidacin were ≥95% effective for bacterial eradication in culture-proven uncomplicated urogenital gonorrhea. New antibiotics for drug-resistant Neisseria gonorrhoeae are urgently needed. With additional evaluation, gepotidacin may provide an alternative therapeutic option.

FULL TEXT

https://academic.oup.com/cid/article/67/4/504/4958398

PDF (CLIC en PDF)

August 12, 2018 at 8:16 pm

Regional Spread of an Outbreak of Carbapenem-Resistant Enterobacteriaceae Through an Ego Network of Healthcare Facilities

Clinical Infectious Diseases August 1, 2018 V.67 N.3 P.407-410

EDITOR’S CHOICE

Michael J Ray; Michael Y Lin; Angela S Tang; M Allison Arwady; Mary Alice Lavin

Using social network analysis to construct an ego network around a hospital that experienced an outbreak of a rare carbapenem-resistant Enterobacteriaceae, we accurately predicted which hospitals outbreak patients would subsequently visit and, therefore, the hospitals that reported additional cases.

FULL TEXT

https://academic.oup.com/cid/article/67/3/407/4836930

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August 12, 2018 at 8:14 pm

Should Acute Q-Fever Patients be Screened for Valvulopathy to Prevent Endocarditis?

Clinical Infectious Diseases August 1, 2018 V.67 N.3 P.360-366

Marit M A de Lange; Laura E V Gijsen; Cornelia C H Wielders; Wim van der Hoek; Arko Scheepmaker

We found no difference in occurrence of chronic Q-fever between patients with or without a newly detected valvulopathy at time of acute Q-fever diagnosis. Thus, universal screening is not justified and would lead to unnecessary and undesirable long-term antibiotic use.

FULL TEXT

https://academic.oup.com/cid/article/67/3/360/4877027

PDF (CLIC en PDF)

August 12, 2018 at 8:13 pm

Vancomycin Prophylaxis for Total Joint Arthroplasty: Incorrectly Dosed and Has a Higher Rate of Periprosthetic Infection Than Cefazolin.

Clin Orthop Relat Res. 2017 Jul;475(7):1775-1778.

Soriano A1.

Author information

1 Service of Infectious Diseases, IDIBAPS, Hospital Clinic Universitari, University of Barcelona, C/ Villarroel 170, Barcelona, Catalonia, 08036, Spain. asoriano@clinic.cat.

PDF

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5449340/pdf/11999_2017_Article_5355.pdf

August 1, 2018 at 8:17 am

Moxifloxacin plus rifampin as an alternative for levofloxacin plus rifampin in the treatment of a prosthetic joint infection with Staphylococcus aureus.

Int J Antimicrob Agents. 2018 Jan;51(1):38-42.                     

Wouthuyzen-Bakker M1, Tornero E2, Morata L3, Nannan Panday PV4, Jutte PC5, Bori G6, Kampinga GA7, Soriano A3.

Author information

1 Department of Internal Medicine / Infectious Diseases, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands. Electronic address:m.wouthuyzen-bakker@umcg.nl.

2 Department of Orthopaedic Surgery, Sant Joan de Déu, Barcelona, Spain.

3 Service of Infectious Diseases, Hospital Clínic, University of Barcelona, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.

4 Department of Clinical Pharmacy, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands.

5 Department of Orthopaedic Surgery, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands.

6 Department of Orthopaedic Surgery and Traumatology, Hospital Clinic, University of Barcelona, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.

7 Department of Medical Microbiology and Infection Prevention, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands.

Abstract

OBJECTIVES:

The combination of a fluoroquinolone with rifampin is one of the cornerstones in the treatment of prosthetic joint infections (PJI) caused by staphylococci. Moxifloxacin is highly active against methicillin-susceptible Staphylococcus aureus (MSSA) and, therefore, is an attractive agent to use. However, several studies reported a lowering in serum moxifloxacin levels when combined with rifampin. The clinical relevance remains unclear. We determined the outcome of patients with early acute PJI caused by MSSA treated with either moxifloxacin/rifampin or levofloxacin/rifampin.

METHODS:

Medical files of patients treated with moxifloxacin/rifampin (University Medical Centre Groningen) or levofloxacin/rifampin (Hospital Clinic Barcelona) were retrospectively reviewed (2005-2015). Treatment failure was defined as the need for revision surgery and/or suppressive therapy, death by infection or a relapse of infection during follow-up.

RESULTS:

Differences in baseline characteristics between the two cohorts were observed, but prognostic parameters for failure, as defined by the KLIC-score (Kidney failure, Liver cirrhosis, Index surgery, C-reactive protein and Cemented prosthesis), were similar in the two groups (2.9 [1.5 SD] for the moxifloxacin group vs. 2.2 [1.2 SD] for the levofloxacin group [P = 0.16]). With a mean follow-up of 50 months (36 SD) in the moxifloxacin group, and 67 months (50 SD) in the levofloxacin group (P = 0.36), treatment was successful in 89% vs. 87.5%, respectively (P = 0.89). None of the failures in the moxifloxacin group were due to rifampin- or moxifloxacin-resistant S. aureus strains.

CONCLUSION:

Our data indicate that moxifloxacin combined with rifampin is as clinically effective as levofloxacin/rifampin for early acute PJI caused by MSSA.

PDF

https://www.ijaaonline.com/article/S0924-8579(17)30210-8/pdf

July 31, 2018 at 6:52 pm

The Effect of Preoperative Antimicrobial Prophylaxis on Intraoperative Culture Results in Patients with a Suspected or Confirmed Prosthetic Joint Infection: a Systematic Review.

J Clin Microbiol. 2017 Sep;55(9):2765-2774.                    

Wouthuyzen-Bakker M1, Benito N2, Soriano A3.

Author information

1 Department of Medical Microbiology and Infection Prevention, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands m.wouthuyzen-bakker@umcg.nl.

2 Infectious Diseases Unit, Department of Internal Medicine, Hospital de la Santa Creu i Sant Pau, Institut d’Investigació Biomèdica Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.

3 Service of Infectious Diseases, Hospital Clínic, University of Barcelona, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.

Abstract

Obtaining reliable cultures during revision arthroplasty is important to adequately diagnose and treat a prosthetic joint infection (PJI). The influence of antimicrobial prophylaxis on culture results remains unclear. Since withholding prophylaxis increases the risk for surgical site infections, clarification on this topic is critical. A systematic review was performed with the following research question: in patients who undergo revision surgery of a prosthetic joint, does preoperative antimicrobial prophylaxis affect the culture yield of intraoperative samples in comparison with nonpreoperative antimicrobial prophylaxis? Seven articles were included in the final analysis. In most studies, standard diagnostic culture techniques were used. In patients with a PJI, pooled analysis showed a culture yield of 88% (145/165) in the prophylaxis group versus 95% (344/362) in the nonprophylaxis group (P = 0.004). Subanalysis of patients with chronic PJIs showed positive cultures in 88% (78/89) versus 91% (52/57), respectively (P = 0.59). In patients with a suspected chronic infection, a maximum difference of 4% in culture yield between the prophylaxis and nonprophylaxis groups was observed. With the use of standard culture techniques, antimicrobial prophylaxis seems to affect cultures in a minority of patients. Along with the known risk of surgical site infections due to inadequate timing of antimicrobial prophylaxis, we discourage the postponement of prophylaxis until tissue samples are obtained in revision surgery. Future studies are necessary to conclude whether the small percentage of false-negative cultures after prophylaxis can be further reduced with the use of more-sensitive culture techniques, like sonication.

PDF

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5648712/pdf/zjm2765.pdf

 

July 31, 2018 at 6:50 pm

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