Posts filed under ‘Resistencia bacteriana’

Prophylactic Antimicrobial Therapy for Acute Aspiration Pneumonitis

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


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.




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.



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


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.



August 12, 2018 at 8:14 pm

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

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.



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.


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.


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.


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


July 31, 2018 at 6:52 pm

Pneumonia associated with mechanical ventilation. Update and recommendations inter- Societies SADI-SATI.

Medicina (B Aires). 2018;78(2):99-106.

Article in Spanish

Cornistein W1, Colque ÁM2, Staneloni MI3, Monserrat Lloria M4, Lares M5, González AL5, Fernández Garcés A6, Carbone E7.

Author information

1 Hospital General de Agudos Dr. Cosme Argerich, Hospital Universitario Austral, Buenos Aires, Argentina. E-mail:

2 Complejo Médico Churruca Visca, Buenos Aires, Argentina.

3 Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.

4 Hospital Prof. Alejandro Posadas, Buenos Aires, Argentina.

5 Hospital Interzonal General de Agudos San Martín de La Plata, Argentina.

6 Clínica AMEBPBA (Mutual de Empleados del Banco de la Provincia de Buenos Aires), Argentina.

7 Hospital Aeronáutico Central, Buenos Aires, Argentina.


Representatives of the Argentine Society of Infectious Diseases (SADI) and the Argentine Society of Intensive Therapy (SATI) worked together on the development of specific recommendations for the diagnosis, treatment and prevention of ventilator-associated pneumonia (VAP). The methodology used was the analysis of the literature published in the last 15 years, complemented with the opinion of experts and local data. This document aims to offer basic tools to optimize diagnosis based on clinical and microbiological criteria, orientation in empirical and targeted antibiotic schemes, news on posology and administration of antibiotics in critical patients and to promote effective measures to reduce the risk of VAP. It also offers a diagnostic and treatment algorithm and considerations on inhaled antibiotics. The joint work of both societies -infectious diseases and intensive care- highlights the concern for the management of VAP and the importance of ensuring improvement in daily practices. This guideline established recommendations to optimize the diagnosis, treatment and prevention of VAP in order to reduce morbidity and mortality, days of hospitalization, costs and resistance to antibiotics due to misuse of antimicrobials.


July 31, 2018 at 3:47 pm

Severe Community-Acquired Pneumonia due to Acinetobacter baumannii in North America: Case Report and Review of the Literature

Open Forum Infectious Diseases, March 2018 V.5 N.3

David P Serota; Mary Elizabeth Sexton; Colleen S Kraft; Federico Palacio

Acinetobacter baumannii is a rare but emerging cause of fulminant community-acquired pneumonia (CAP-AB). We describe a patient from a rural area who developed acute respiratory distress syndrome and septic shock. We describe risk factors and characteristics of this syndrome and review published cases of CAP-AB from North America.



July 30, 2018 at 9:24 am

Potential Adverse Effects of Broad-Spectrum Antimicrobial Exposure in the Intensive Care Unit

Open Forum Infectious Diseases, February 2018 V.5 N.2


Jenna Wiens; Graham M Snyder; Samuel Finlayson; Monica V Mahoney; Leo Anthony Celi


The potential adverse effects of empiric broad-spectrum antimicrobial use among patients with suspected but subsequently excluded infection have not been fully characterized. We sought novel methods to quantify the risk of adverse effects of broad-spectrum antimicrobial exposure among patients admitted to an intensive care unit (ICU).


Among all adult patients admitted to ICUs at a single institution, we selected patients with negative blood cultures who also received ≥1 broad-spectrum antimicrobials. Broad-spectrum antimicrobials were categorized in ≥1 of 5 categories based on their spectrum of activity against potential pathogens. We performed, in serial, 5 cohort studies to measure the effect of each broad-spectrum category on patient outcomes. Exposed patients were defined as those receiving a specific category of broad-spectrum antimicrobial; nonexposed were all other patients in the cohort. The primary outcome was 30-day mortality. Secondary outcomes included length of hospital and ICU stay and nosocomial acquisition of antimicrobial-resistant bacteria (ARB) or Clostridium difficile within 30 days of admission.


Among the study cohort of 1918 patients, 316 (16.5%) died within 30 days, 821 (42.8%) had either a length of hospital stay >7 days or an ICU length of stay >3 days, and 106 (5.5%) acquired either a nosocomial ARB or C. difficile. The short-term use of broad-spectrum antimicrobials in any of the defined broad-spectrum categories was not significantly associated with either primary or secondary outcomes.


The prompt and brief empiric use of defined categories of broad-spectrum antimicrobials could not be associated with additional patient harm.



July 30, 2018 at 9:20 am

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