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Vancomycin vs cefazolin

Michael Saulino, David J Anderson, Jennifer Doble, Reza Farid, Fatma Gul, Peter Konrad, Aaron L Boster
INTRODUCTION: Troubleshooting helps optimize intrathecal baclofen (ITB) therapy in cases of underdose, overdose, and infection. METHODS: An expert panel of 21 multidisciplinary physicians currently managing >3200 ITB patients was convened, and using standard methodologies for guideline development, created an organized approach to troubleshooting ITB. They conducted a structured literature search that identified 263 peer-reviewed papers, and used results from an online survey of 42 physicians currently managing at least 25 ITB patients each...
August 2016: Neuromodulation: Journal of the International Neuromodulation Society
Davie Wong, Titus Wong, Marc Romney, Victor Leung
BACKGROUND: Prior studies suggested that vancomycin may be inferior to β-lactams for the empiric treatment of methicillin-susceptible S. aureus (MSSA) bacteremia. We assessed whether empiric therapy with β-lactams compared to vancomycin was associated with differences in clinical outcomes in patients with MSSA bacteremia. METHODS: We conducted a retrospective cohort study of adult inpatients with their first episode of MSSA bacteremia at two tertiary care hospitals in Vancouver, Canada, between 2007 and 2014...
2016: BMC Infectious Diseases
Bruno C Silva, Camila E Rodrigues, Regina Crm Abdulkader, Rosilene M Elias
BACKGROUND: Nephrologists have increasingly participated in the conversion from temporary catheters (TC) to tunneled-cuffed catheters (TCCs) for hemodialysis. OBJECTIVE: To prospectively analyze the outcomes associated with TCC placement by nephrologists with expertise in such procedure, in different time periods at the same center. The impact of vancomycin or cefazolin as prophylactic antibiotics on the infection outcomes was also tested. PATIENTS AND METHODS: Hemodialysis patients who presented to such procedure were divided into two cohorts: A (from 2004 to 2008) and B (from 2013 to 2015)...
2016: International Journal of Nephrology and Renovascular Disease
Marian L Gaviola, Wesley D McMillian, Suzanne Elizabeth Ames, Jeffrey A Endicott, Wallace Kemper Alston
BACKGROUND: Topical vancomycin may be an effective intervention to decrease the risk of postoperative surgical site infections (SSIs). The primary objective of this study was to evaluate the impact of topical vancomycin with intravenous (IV) cefazolin compared with IV cefazolin alone on the incidence of SSI in instrumented multilevel spinal fusion (MLSF) surgery. METHODS: This was a retrospective cohort study of patients 18 years and older who underwent instrumented MLSF surgery between January 1, 2010, and July 31, 2014...
January 2016: Pharmacotherapy
Josef Yayan, Beniam Ghebremedhin, Kurt Rasche
BACKGROUND: Staphylococci can cause wound infections and community- and nosocomial-acquired pneumonia, among a range of illnesses. Staphylococcus aureus and methicillin-resistant S. aureus (MRSA) have been rapidly increasing as a cause of infections worldwide in recent decades. Numerous reports indicate that S. aureus and MRSA are becoming resistant to many antibiotics, which makes them very dangerous. Therefore, this study retrospectively investigated the resistance to antimicrobial agents in all hospitalized patients suffering from community- or nosocomial-acquired pneumonia due to S...
2015: PloS One
Simon W Young, Tim Roberts, Sarah Johnson, James P Dalton, Brendan Coleman, Siouxsie Wiles
BACKGROUND: In human TKA studies, intraosseous regional administration (IORA) of prophylactic antibiotics achieves local tissue antibiotic concentrations 10 times greater than systemic administration. However, it is unclear if such high concentrations provide more effective prophylaxis. QUESTIONS/PURPOSES: We asked: (1) What prophylaxis dosage and route (intravenous [IV] versus IORA of prophylactic antibiotics) produce less in vivo bacterial burden compared with no-antibiotic controls? (2) Compared with controls, what prophylaxis dosage and route yield fewer colony-forming units (CFUs) in euthanized animals in a model of TKA? (3) Is prophylactic IORA of antibiotics more effective than same-dose IV antibiotic administration in reducing CFUs? METHODS: Mice (six to nine per group) were block randomized to one of six prophylaxis regimens: control, systemic cefazolin (C100IV), IORA of cefazolin (C100IORA), systemic vancomycin (V110IV), low-dose systemic vancomycin (V25IV), and low-dose IORA of vancomycin (V25IORA)...
November 2015: Clinical Orthopaedics and related Research
Marin L Schweizer, Hsiu-Yin Chiang, Edward Septimus, Julia Moody, Barbara Braun, Joanne Hafner, Melissa A Ward, Jason Hickok, Eli N Perencevich, Daniel J Diekema, Cheryl L Richards, Joseph E Cavanaugh, Jonathan B Perlin, Loreen A Herwaldt
IMPORTANCE: Previous studies suggested that a bundled intervention was associated with lower rates of Staphylococcus aureus surgical site infections (SSIs) among patients having cardiac or orthopedic operations. OBJECTIVE: To evaluate whether the implementation of an evidence-based bundle is associated with a lower risk of S. aureus SSIs in patients undergoing cardiac operations or hip or knee arthroplasties. DESIGN, SETTING, AND PARTICIPANTS: Twenty hospitals in 9 US states participated in this pragmatic study; rates of SSIs were collected for a median of 39 months (range, 39-43) during the preintervention period (March 1, 2009, to intervention) and a median of 21 months (range, 14-22) during the intervention period (from intervention start through March 31, 2014)...
June 2, 2015: JAMA: the Journal of the American Medical Association
Kimberly G Blumenthal, Robert A Parker, Erica S Shenoy, Rochelle P Walensky
BACKGROUND: Methicillin-sensitive Staphylococcus aureus (MSSA) bacteremia is a morbid infection. First-line MSSA therapies (nafcillin, oxacillin, cefazolin) are generally avoided in the 10% of patients reporting penicillin (PCN) allergy, but most of these patients are not truly allergic. We used a decision tree with sensitivity analyses to determine the optimal evaluation and treatment for patients with MSSA bacteremia and reported PCN allergy. METHODS: Our model simulates 3 strategies: (1) no allergy evaluation, give vancomycin (Vanc); (2) allergy history-guided treatment: if history excludes anaphylactic features, give cefazolin (Hx-Cefaz); and (3) complete allergy evaluation with history-appropriate PCN skin testing: if skin test negative, give cefazolin (ST-Cefaz)...
September 1, 2015: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Minli Zhu, Qianhong Hu, Jingyun Mai, Zhenlang Lin
OBJECTIVE: To study the clinical characteristics, pathogenic bacteria, and antibiotics resistance of neonatal purulent meningitis in order to provide the guide for early diagnosis and appropriate treatment. METHOD: A retrospective review was performed and a total of 112 cases of neonatal purulent meningitis (male 64, female 58) were identified in the neonatal intensive care unit of Yuying Children's Hospital of Wenzhou Medical University seen from January 1, 2004 to December 31, 2013...
January 2015: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
Joseph D Lamplot, Gaurav Luther, Emily Landon Mawdsley, Hue H Luu, David Manning
We investigate the effectiveness of a comprehensive aseptic protocol in reducing surgical site infection (SSI) after knee arthroplasty in a single medical center with a high prevalence of MRSA. A database of all patients in a single center undergoing primary knee arthroplasty between 2005 and 2011 was reviewed for SSI using Centers for Disease Control criteria and AAOS guidelines. All patients were treated with an aseptic protocol consisting of the following: preoperative 2% mupirocin nasal ointment and 0.4% chlorhexidine surgical site wipes, modified instrument care, perioperative prophylactic vancomycin and cefazolin, and surgical site skin preparation with chlorhexidine, alcohol, and iodophor...
October 2015: Journal of Knee Surgery
Lauren Rodriguez, Hee Soo Jung, James A Goulet, Ashley Cicalo, David A Machado-Aranda, Lena M Napolitano
BACKGROUND: Evidence-based guidelines for prophylactic antibiotic use in open fractures recommend short-course, narrow-spectrum antibiotics for Gustilo Grade I or II open fractures and broader gram-negative coverage for Grade III open fractures. No studies to date have assessed the impact of these guidelines on infection rates in open fractures. Infection rates before and after the new protocol implementation were examined. METHODS: A new protocol was implemented including antibiotic prophylaxis based on grade of open fracture: Grade I/II fractures, cefazolin (clindamycin if allergy); Grade III fractures, ceftriaxone (clindamycin and aztreonam if allergy) for 48 hours...
September 2014: Journal of Trauma and Acute Care Surgery
Harold L Lazar, Ara Ketchedjian, Miguel Haime, Karl Karlson, Howard Cabral
OBJECTIVE: This study was undertaken to determine whether topical vancomycin would further reduce the incidence of sternal infections in the presence of perioperative antibiotics and tight glycemic control. METHODS: A total of 1075 consecutive patients undergoing cardiac surgery from December 2007 to August 2013 receiving topical vancomycin (2.5 g in 2 mL of normal saline) applied as a slurry to the cut edges of the sternum were compared with 2190 patients from December 2003 to November 2007 who did not receive topical vancomycin...
September 2014: Journal of Thoracic and Cardiovascular Surgery
Allen M Haraway, J Quentin Clemens, Chang He, Cynthia Stroup, Humphrey O Atiemo, Anne P Cameron
INTRODUCTION AND HYPOTHESIS: After SNM implantation the most significant complication that can occur is wound infection, which typically requires removal of all components. Such infections have been reported in 5-11 % of patients, but little is known about risk factors. The objective of this analysis is to determine our postoperative wound infection rate after SNM implantation, and examined various potential predictive factors. Our hypothesis is that perioperative antibiotic selection is related to the risk of infections...
December 2013: International Urogynecology Journal
Carla C Saveli, Steven J Morgan, Robert W Belknap, Erin Ross, Philip F Stahel, George W Chaus, David J Hak, Walter L Biffl, Bryan Knepper, Connie S Price
OBJECTIVE: To develop preliminary data on Staphylococcus aureus colonization and surgical site infections (SSIs) in patients with open fractures who received standard antibiotic prophylaxis compared with a regimen including targeted methicillin-resistant Staphylococcus aureus (MRSA) coverage. DESIGN: Randomized prospective clinical trial. PATIENTS: Adult patients who presented to the emergency department with an open fracture between April 2009 and July 2011...
October 2013: Journal of Orthopaedic Trauma
Eric B Smith, Rachael Wynne, Ashish Joshi, Hans Liu, Robert P Good
In an effort to reduce methicillin-resistant Staphylococcus aureus (MRSA) and overall periprosthetic joint infections (PJI), we switched the perioperative prophylactic antibiotic during total knee arthroplasty and total hip arthroplasty from cefazolin to vancomycin in June 2008. We retrospectively reviewed the total and MRSA PJI in 5036 primary total joint arthroplasties, as well as the cure rate of PJI from January 2006 to June 2008 (Ancef Period) and June 2008 to December 2010 (Vanco Period). With vancomycin, total PJI was significantly reduced (1...
September 2012: Journal of Arthroplasty
E R Levy, S Swami, S G Dubois, R Wendt, R Banerjee
OBJECTIVE AND DESIGN: Antimicrobial use in hospitalized children has not been well described. To identify targets for antimicrobial stewardship interventions, we retrospectively examined pediatric utilization rates for 48 antimicrobials from 2007 to 2010 as well as appropriateness of vancomycin and cefepime use in 2010. PATIENTS AND SETTING: All children hospitalized between 2007 and 2010 at the Mayo Clinic Children's Hospital, a 120-bed facility within a larger adult hospital in Rochester, Minnesota...
April 2012: Infection Control and Hospital Epidemiology
Claude J Renaud, Xuling Lin, Srinivas Subramanian, Dale A Fisher
Methicillin-sensitive Staphylococcus aureus (MSSA) bacteremia is a leading cause of infection in hemodialysis (HD) patients. Cloxacillin, cefazolin, and vancomycin are the mainstay antimicrobials. Cloxacillin administration leads to frequent drug dosing, longer length of stay (LOS), and higher cost, while resistance and poorer outcomes are associated with vancomycin use. Dosing cefazolin during HD allows for prolonged blood therapeutic levels. We assessed the outcomes and safety of a strategy of treating MSSA bacteremia with 2-3 g cefazolin on HD only...
January 2011: Hemodialysis International
Sridevi Govindarajulu, Carmel Mary Hawley, Stephen P McDonald, Fiona G Brown, Johan B Rosman, Kathryn J Wiggins, Kym M Bannister, David W Johnson
Staphylococcus aureus peritonitis is a serious complication of peritoneal dialysis (PD). Since reports of the course and treatment of S. aureus peritonitis have generally been limited to small, single-center studies, the aim of the current investigation was to examine the frequency, predictors, treatment, and clinical outcomes of this condition in all 4675 patients receiving PD in Australia between 1 October 2003 and 31 December 2006. 3594 episodes of peritonitis occurred in 1984 patients and 503 (14%) episodes of S...
May 2010: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
Min-li Zhu, Ge Zheng, Jin-ni Chen, Zhen-lang Lin, Jiang-hu Zhu, Jin Lin
OBJECTIVE: Late onset neonatal septicemia (systemic infection after 72 hours of life) remains a major cause of neonatal morbidity and mortality. Early treatment with appropriate antibiotics is critical since infected infants can deteriorate rapidly. The aim of this study was to review the pathogens responsible for late onset neonatal septicemia (LONS) and their antimicrobial susceptibilities in order to guide the initial selection of appropriate antibiotics for infants with suspected LONS...
February 2008: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
E Tacconelli, M A Cataldo, A Albanese, M Tumbarello, E Arduini, T Spanu, G Fadda, C Anile, G Maira, G Federico, R Cauda
International guidelines suggest that a high prevalence of meticillin-resistant Staphylococcus aureus (MRSA) infections should influence the use of vancomycin for surgical prophylaxis. In order to compare the efficacy and adverse effects of vancomycin versus cefazolin as antimicrobial prophylaxis for insertion of cerebrospinal fluid (CSF) shunts, a randomised prospective clinical trial was performed. Over a 16-month period, all consecutive adult patients who underwent CSF shunt insertion at a university hospital with a high prevalence of MRSA infections were included...
August 2008: Journal of Hospital Infection
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