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meropenem use evaluation

Harald Seifert, Joseph Blondeau, Michael J Dowzicky
We report contemporary (2014-2016) Tigecycline Evaluation and Surveillance Trial (T.E.S.T.) global data on activity of tigecycline and comparators against WHO 'priority pathogens', and global trends (2004-2016) in antimicrobial resistance. MICs were determined using CLSI broth microdilution methodology. Antimicrobial resistance was determined using CLSI breakpoints (FDA breakpoints for tigecycline). Data are reported for Africa, Asia, Europe, North America and South America. From 2014-2016, Africa, Asia and South America reported highest resistance rates among Acinetobacter baumannii; North America lowest (all antimicrobials tested)...
July 13, 2018: International Journal of Antimicrobial Agents
Mohamed Farouk Ahmed Abdelsalam, Maged Salah Abdalla, Hanan Salah El-Din El-Abhar
OBJECTIVES: In clinical practice, colistin is used as a combination therapy to improve its antibacterial activity, despite the consequent increase in toxicity. This pilot prospective study aimed to evaluate the effectiveness and adverse effects of using colistin alone at a loading dose of 9 million international units (MIU), followed by 3 MIU/q8h vs colistin with meropenem 1g/q8h in treating multidrug-resistant (MDR) Klebsiella pneumoniae-induced hospital-acquired pneumonia (HAP) or ventilator-associated pneumonia (VAP)...
July 13, 2018: Journal of Global Antimicrobial Resistance
Alexandra Jacobs, Fabio Silvio Taccone, Jason A Roberts, Frédérique Jacobs, Frederic Cotton, Fleur Wolff, Jacques Creteur, Jean-Louis Vincent, Maya Hites
Augmented renal clearance is commonly observed in septic patients and may result in insufficient β-lactam serum concentrations. The aims of this study were to evaluate potential correlations between drug concentrations or total body clearance of β-lactam antibiotics and measured creatinine clearance, and to quantify the need for drug dosage adjustments in septic patients with different levels of augmented renal clearance. We reviewed 256 antibiotic measurements (512 drug concentrations) from a cohort of 215 critically ill patients with a measured creatinine clearance ≥ 120 mL/min, and who received therapeutic drug monitoring of meropenem, cefepime, ceftazidime or piperacillin from October 2009 until December 2014 at Erasme Hospital...
July 9, 2018: Antimicrobial Agents and Chemotherapy
Ghoncheh Vahidi, Mostafa Mohammadi, Lida Shojaei, Masoud Ramezani, Sirus Jafari, Hossein Khalili
Introduction: Few data regarding antibiotic stewardship programs in critically ill patients are available. In the present study, the consequence of changing an empirical antibiotic regimen from a carbapenem (meropenem) to a noncarbapenem antibiotic (piperacillin-tazobactam) was evaluated in critically ill patients with a suspicion of sepsis. Methods: This open-label randomized clinical trial was conducted during May 2015-January 2017 at the general Intensive Care Unit of the Imam Khomeini Hospital Complex, Tehran, Iran...
April 2018: International Journal of Critical Illness and Injury Science
Nabeela Ahmed, Shin-Pung Jen, Diana Altshuler, John Papadopoulos, Vinh P Pham, Yanina Dubrovskaya
Extended infusion (EI) administration of β-lactams can improve target attainment in critically ill patients with altered pharmacokinetics/pharmacodynamics. To optimize meropenem dosing in patients with severe sepsis/septic shock, our Antimicrobial Stewardship Program implemented a EI meropenem (EIM) protocol in an 18-bed Medical Intensive Care Unit in March 2014. In this retrospective study, we compared intensive care unit (ICU) mortality and clinical response in patients who received meropenem for ≥72 hours administered per EIM protocol of 1 g over 3 hours every 8 hours versus intermittent infusion (IIM) protocol of 500 mg over 30 minutes every 6 hours...
January 1, 2018: Journal of Intensive Care Medicine
Daiana de Lima-Morales, Helena Ávila, Tatiana Soldi, Tanise Vendruscolo Dalmolin, Larissa Lutz, Valério Aquino, Alexandre Prehn Zavascki, Afonso Luís Barth
The aim of this study was to evaluate the two rapid colorimetric methods (CNPt-Direct and Blue-Carba) for the detection of carbapenemase production directly from blood culture in a routine microbiology laboratory. The methods were initially evaluated on spiked blood cultures with 61 carbapenemase-positive isolates. Afterwards they were used in blood cultures (314 samples were evaluated) obtained from patients in a routine microbiology laboratory, during a period of 6 months. The colorimetric methods were compared to the conventional culture of blood...
June 27, 2018: Journal of Clinical Microbiology
Ronilda D'Cunha, Thanh Bach, Beth Ann Young, Peizhi Li, Demet Nalbant, Jun Zhang, Patricia Winokur, Guohua An
Although the stability of β-lactam antibiotics is a known issue, none of the previously reported bioanalytical methods had an adequate evaluation on their stability. In the current study, the stability of cefepime, meropenem, piperacillin, and tazobactam under various conditions was comprehensively evaluated. The evaluated parameters include stock solution stability, short-term stability, long-term stability, freeze-thaw stability, processed sample stability and whole blood stability. When stored at -20 °C, the stock solution of meropenem in methanol is stable for up to 3 weeks, and the stock solutions of cefepime, piperacillin, and tazobactam are stable for up to 6 weeks...
June 25, 2018: Antimicrobial Agents and Chemotherapy
L R Koopmans, H Finlayson, A Whitelaw, E H Decloedt, A Dramowski
BACKGROUND: Data on antimicrobial use among hospitalised children in Africa is very limited owing to the absence of electronic prescription tracking. METHODS: We evaluated antimicrobial consumption rates, antimicrobial spectrum used and indications for therapy on a paediatric ward and the paediatric intensive care unit (PICU) at Tygerberg Hospital, Cape Town, South Africa. Antimicrobial prescription and patient demographic data was prospectively collected from 10 May 2015 to 11 November 2015...
June 20, 2018: International Journal of Infectious Diseases: IJID
Pınar Zarakolu, Çağlayan Merve Ayaz, Gökhan Metan
Carbapenem resistant Acinetobacter baumannii is a bacterium that causes various hospital acquired infections, primarily ventilator-associated pneumonia and bloodstream infections. The multidrug resistance problem of the bacteria all over the world, is also a problem in our center. As the treatment options are decreasing combination therapies become a current issue. It is believed that in vitro synergy tests may guide to the selection of antibiotic combinations. The aim of this study was to present the antibiotic combinations used in the treatment of carbapenem resistant A...
April 2018: Mikrobiyoloji Bülteni
Krzysztof Skowron, Joanna Kwiecińska-Piróg, Katarzyna Grudlewska, Agnieszka Świeca, Zbigniew Paluszak, Justyna Bauza-Kaszewska, Ewa Wałecka-Zacharska, Eugenia Gospodarek-Komkowska
The aim of this research was to investigate the occurrence of Listeria monocytogenes in fish and fish processing plant and to determine their transmission, virulence and antibiotic resistance. L. monocytogenes was isolated according to the ISO 11290-1. The identification of L. monocytogenes was confirmed by multiplex PCR method. Genetic similarity of L. monocytogenes strains was determined with the Pulsed-Filed Gene Electrophoresis (PFGE) method. The multiplex PCR was used for identification of L. monocytogenes serogroups and detection of selected virulence genes (actA, fbpA, hlyA, iap, inlA, inlB, mpl, plcA, plcB, prfA)...
June 13, 2018: International Journal of Food Microbiology
Raz Nawzad Mohammad, Sherko Ali Omer
Background and Objectives: Urinary tract infections are common infections that can be caused by many bacterial pathogens. The susceptibility of such pathogens to antimicrobial agents is identified by different methods including disk diffusion test, direct sensitivity testing and determination minimum inhibitory concentration. The present study was conducted to isolate and identify bacteria cultured from urine samples and compare the results of direct sensitivity test (DST) against Kirby-Bauer's disk diffusion antimicrobial sensitivity (AST) with respect to reliability, time and cost...
February 2018: Iranian Journal of Microbiology
Wen Bin Jin, Chen Xu, Qipeng Cheng, Xiao Lin Qi, Wei Gao, Zhiwei Zheng, Edward W C Chan, Yun-Chung Leung, Tak Hang Chan, Kwok-Yin Wong, Sheng Chen, Kin-Fai Chan
The worldwide prevalence of NDM-1-producing bacteria has drastically undermined the clinical efficacy of the last line antibiotic of carbapenems, prompting a need to devise effective strategy to preserve their clinical value. Our previous studies have shown that ebselen can restore the efficacy of meropenem against a laboratory strain that produces NDM-1. Here we report the construction of a focused compound library of 1,2-benzisoselenazol-3(2H)-one derivatives which comprise a total of forty-six candidate compounds...
June 6, 2018: European Journal of Medicinal Chemistry
Dee Shortridge, Michael A Pfaller, Mariana Castanheira, Robert K Flamm
This study evaluated the in vitro activity of ceftolozane-tazobactam and comparators against 2647 Enterobacteriaceae and 355 Pseudomonas aeruginosa nonduplicate isolates collected from hospitalized patients with bloodstream infections in US hospitals from 2013 to 2015.Ceftolozane-tazobactam (95.5% susceptible), amikacin (99.2% susceptible), and meropenem (98.4% susceptible) were the most active against Enterobacteriaceae. For Enterobacteriaceae, 1.4% (n = 37) were carbapenem-resistant (CRE), and 10.2% (n = 271) exhibited an extended-spectrum β-lactamase (ESBL) non-CRE phenotype...
May 18, 2018: Diagnostic Microbiology and Infectious Disease
Jean-Winoc Decousser, Paul-Louis Woerther, Claude-James Soussy, Marguerite Fines-Guyon, Michael J Dowzicky
Background: A high level of antibiotic consumption in France means antimicrobial resistance requires rigorous monitoring. The Tigecycline Evaluation and Surveillance Trial (T.E.S.T.) is a global surveillance study that monitors the in vitro activities of tigecycline and a panel of marketed antimicrobials against clinically important Gram-positive and Gram-negative isolates. Methods: Annually clinically relevant strains were prospectively included in the survey through a national network of hospital-based laboratories...
2018: Antimicrobial Resistance and Infection Control
Mary Ann Powles, Andrew Galgoci, Andrew Misura, Lawrence Colwell, Karen H Dingley, Wei Tang, Jin Wu, Timothy Blizzard, Mary Motyl, Katherine Young
The World Health Organization has identified antimicrobial resistance as a global public health threat as the prevalence and spread of antibiotic resistance among bacterial pathogens worldwide are staggering. Carbapenems, such as imipenem and meropenem have been used to treat multidrug-resistant bacteria; however, since the development of resistance to carbapenems, β-lactam antibiotics in combination with β-lactamase inhibitors (BLI) has been one of the most successful strategies to enhance the activity of β-lactam antibiotics...
June 4, 2018: Antimicrobial Agents and Chemotherapy
Thandokuhle Ntombela, Zeynab Fakhar, Collins U Ibeji, Thavendran Govender, Glenn E M Maguire, Gyanu Lamichhane, Hendrik G Kruger, Bahareh Honarparvar
Tuberculosis remains a dreadful disease that has claimed many human lives worldwide and elimination of the causative agent Mycobacterium tuberculosis also remains elusive. Multidrug-resistant TB is rapidly increasing worldwide; therefore, there is an urgent need for improving the current antibiotics and novel drug targets to successfully curb the TB burden. L,D-Transpeptidase 2 is an essential protein in Mtb that is responsible for virulence and growth during the chronic stage of the disease. Both D,D- and L,D-transpeptidases are inhibited concurrently to eradicate the bacterium...
June 2018: Journal of Computer-aided Molecular Design
Siân E Robson, Alison Cockburn, Jacqueline Sneddon, Abdulrhman Mohana, Marion Bennie, Alexander B Mullen, William Malcolm, Jennifer Armstrong, Andrea Patton, Ronald Andrew Seaton
Background: Concern about increasing carbapenem and piperacillin/tazobactam use led the Scottish Antimicrobial Prescribing Group (SAPG) to develop national guidance on optimal use of these agents, and to implement a quality improvement programme to assess the impact of guidance on practice. Objectives: To evaluate how SAPG guidance had been implemented by health boards, assess how this translated into clinical practice, and investigate clinicians' views and behaviours about prescribing carbapenems and alternative agents...
May 24, 2018: Journal of Antimicrobial Chemotherapy
Menglan Zhou, Danchen Wang, Timothy Kudinha, Qiwen Yang, Shuying Yu, Ying-Chun Xu
Objectives: To evaluate the performance of four phenotypic methods in the detection of carbapenemase-producing Enterobacteriaceae (CPE) in China. Methods: We evaluated the performance of four carbapenemase detection methods, the modified Hodge test (MHT), Carba NP test, meropenem hydrolysis assay (MHA) with 1 and 2-hour incubation, and modified carbapenem inactivation method (mCIM) with meropenem, imipenem, and ertapenem, on 342 carbapenem-resistant Enterobacteriaceae (CRE) in China. Polymerase chain reaction was used as the gold standard...
May 16, 2018: Journal of Clinical Microbiology
Lianjie Xiong, Z Kevin Lu, April Miller Quidley, Bebbyn S Alford, P Brandon Bookstaver
OBJECTIVES: The study compared estimated creatinine clearance (eCrCl) between the Cockcroft-Gault (CG) equation and the Jelliffe, Chiou, and Brater equations designed for estimation in dynamic renal function and resulting antimicrobial dosing concordance of five antimicrobials (cefepime, meropenem, piperacillin/tazobactam, vancomycin, and fluconazole) commonly used in the intensive care unit (ICU). METHODS: Electronic medical records were used to identify the target patient population...
May 2018: Southern Medical Journal
Max Andresen, Joaquin Araos, Kwok-Yin Wong, Yun-Chung Leung, Lok-Yan So, Wai-Ting Wong, Salvador Cabrera, Camila Silva, Leyla Alegria, Alejandro Bruhn, Dagoberto Soto
INTRODUCTION: The use of antibiotics is mandatory in patients during extracorporeal membrane oxygenation (ECMO) support. Clinical studies have shown high variability in the antibiotic concentrations, as well as sequestration of them by the ECMO circuit, suggesting that the doses and/or interval administration used during ECMO may not be adequate. Thus, a fast response sensor to estimate antibiotic concentrations in this setting would contribute to improve dose adjustments. The biosensor PenP has been shown to have a dynamic range, sensitivity and specificity useful for pharmacokinetic (PK) tests in healthy subjects...
May 4, 2018: Sensors
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