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meropenem use evaluation

David C Griffith, Mojgan Sabet, Ziad Tarazi, Olga Lomovskaya, Michael N Dudley
Vaborbactam is a novel beta-lactamase inhibitor with activity against important beta-lactamases, in particular, serine carbapenemases, and is currently approved in combination with meropenem as Vabomere™ for the treatment of complicated urinary tract infections, including pyelonephritis. This combination is highly active against Gram-negative pathogens, especially KPC-producing, carbapenem-resistant, Enterobacteriaceae The objective of these studies was to evaluate vaborbactam pharmacokinetics (PK) and pharmacodynamics (PD) relationships for efficacy in a neutropenic mouse thigh infection model and as well in an in vitro hollow fiber infection model, in combination with a fixed exposure of meropenem using KPC-containing strains of Enterobacteriaceae For both models, the meropenem dosage regimen was designed to simulate a 2 g dose administered every eight hours (q8h) by three hour infusion...
November 5, 2018: Antimicrobial Agents and Chemotherapy
Sofie A M Dhaese, Andras Farkas, Pieter Colin, Jeffrey Lipman, Veronique Stove, Alain G Verstraete, Jason A Roberts, Jan J De Waele
Background: Several population pharmacokinetic (PopPK) models for meropenem dosing in ICU patients are available. It is not known to what extent these models can predict meropenem concentrations in an independent validation dataset when meropenem is infused continuously. Patients and methods: A PopPK model was developed with concentration-time data collected from routine care of 21 ICU patients (38 samples) receiving continuous infusion meropenem. The predictability of this model and seven other published PopPK models was studied using an independent dataset that consisted of 47 ICU patients (161 samples) receiving continuous infusion meropenem...
October 30, 2018: Journal of Antimicrobial Chemotherapy
J F García-Rodríguez, B Bardán-García, M F Peña-Rodríguez, H Álvarez-Díaz, A Mariño-Callejo
There are few prospective studies with sufficient duration in time to evaluate clinical and antibiotic resistance impact of antibiotic stewardship programs (ASP). This is a descriptive study between January 2012 and December 2017, pre-post intervention. A meropenem ASP was initiated in January 2015; in patients who started treatment with meropenem, an infectious disease physician performed treatment recommendations to prescribers. Prospective information was collected to evaluate adequacy of meropenem prescription to local guidelines and to compare results between cases with accepted or rejected intervention...
October 26, 2018: European Journal of Clinical Microbiology & Infectious Diseases
Satoshi Nishida, Yasuo Ono
Introduction: The pathogenicity of fatal-outbreak Acinetobacter baumannii isolates has not been fully investigated. This study aimed to compare the pathogenicity between A. baumannii clinical isolates, including multidrug-resistant A. baumannii (MDRA). Materials and methods: Antibiotic susceptibility was determined by the broth microdilution method, and drug-resistant genes were characterized by PCR and sequencing. The pathogenicity of A. baumannii and antibiotic responses were evaluated using the Galleria mellonella infection model...
2018: Infection and Drug Resistance
Tze-Peng Lim, Reyna Wang, Gang Quan Poh, Tse-Hsien Koh, Thean-Yen Tan, Winnie Lee, Jocelyn Qi-Min Teo, Yiying Cai, Thuan-Tong Tan, Pui Lai Rachel Ee, Andrea L Kwa
Objectives: Treatment for nosocomial bloodstream infections (BSI) caused by multidrug-resistant (MDR) Gram-negative bacteria (GNB) is challenging. Rising antimicrobial resistance, especially in extended spectrum beta-lactamase production, inadvertently increases empiric carbapenem consumption. Three antipseudomonal carbapenems (imipenem, meropenem [MER], and doripenem [DOR]) are available commercially against MDR GNB in Singapore. The study aims to determine the most optimal empiric carbapenem dosing regimens (CDR) and evaluate their cost-effectiveness for GNB-BSI in the face of increasing MDR GNB...
2018: Infection and Drug Resistance
V Ramasubramanian, P Murlidharan, S Nambi, S Pavithra, S Puthran, T Petigara
Outpatient parenteral antimicrobial therapy (OPAT) programs are becoming an increasingly popular trend in clinical practice as they offer several benefits to both patients and health-care setups. While OPAT is an established clinical practice in the Western world, the concept itself is alien to patients in India as they prefer the security of hospitals to receive antibiotics over OPAT. We evaluated the clinical response and cost comparison of ertapenem under OPAT versus inpatient settings in patients with extended-spectrum beta-lactamase (ESBL)-positive acute pyelonephritis (APN) given the increasing importance of optimizing both hospital beds and overall cost of patient care in India...
September 2018: Indian Journal of Nephrology
Patrícia R Neves, Lauro Vieira Perdigão Neto, Roberta Cristina Ruedas Martins, Jéssica F Ramos, Gleice Leite, Flavia Rossi, Sabri Saeed Sanabani, Vanderson Rocha, Marjorie Vieira Batista, Thais Guimaraes, Anna S Levin, Sílvia F Costa
OBJECTIVES: Based on pulsed field gel electrophoresis profile, whole genome sequencing (WGS) of 8 CarbR P. aeruginosa strains from a bone marrow transplant unit, in São Paulo, Brazil, was carried out to investigate which resistance and virulence genes are present as well as determine the multilocus sequence types (ST). METHODS: Initial susceptible pattern was obtained by Vitek 2. Minimal inhibitory concentrations (MICs) were determined by broth microdilution for amikacin, meropenem and colistin...
September 20, 2018: Journal of Global Antimicrobial Resistance
C Hernández-Avilés, R Serafini, C C Love, S R Teague, K A LaCaze, S D Lawhon, J Wu, T L Blanchard, D D Varner
Two experiments were conducted to evaluate the effects of antibiotic-containing extender of on sperm quality and control of bacterial growth. In Experiment 1, ejaculates were diluted in extender containing no antibiotics, potassium penicillin G-amikacin disulfate (PEN-AMIK), ticarcillin disodium-potassium clavulanate (TICAR-CLAV), piperacillin sodium/tazobactam sodium (PIP-TAZ), or meropenem (MERO). In freshly extended semen, only slight differences were detected among some antibiotic treatments for total sperm motility, curvilinear velocity, and viable acrosome-intact sperm (P < 0...
August 28, 2018: Theriogenology
Menglan Zhou, Yao Wang, Chang Liu, Timothy Kudinha, Xiaolin Liu, Yanping Luo, Qiwen Yang, Hongli Sun, Jihong Hu, Ying-Chun Xu
Objective: The objective of this study was to evaluate the performance of five commonly used automated antimicrobial susceptibility testing (AST) systems in China (Vitek 2, Phoenix, Microscan, TDR, and DL). Materials and methods: Two "unknown" isolates, S1 (ESBL-producing Escherichia coli ) and S2 (KPC-producing Klebsiella pneumoniae ), were sent to 886 hospitals in China for identification and AST. Using broth microdilution method (BMD) as gold standard, minimum inhibitory concentrations (MICs) were determined...
2018: Infection and Drug Resistance
Kouji Aimiya, Takayoshi Mamiya, Katsunori Tabuchi, Toshiyuki Kita, Masayuki Hiramatsu
Meropenem (MEPM) is a broad-spectrum antibiotic prescribed to patients with moderate or severe pneumonia. It is well recognized that appropriate medicine reduces the burden on not only young patients but elderly ones as well. We enrolled 56 patients aged 75 and over who were diagnosed with moderate or severe pneumonia (body temperature: ≧37.5 °C; white blood cell (WBC) count: ≧10,000/μL; C-reactive protein (CRP): ≧4 mg/dL) on the basis of Clinical Evaluation Methods for New Antimicrobial Agents to Treat Respiratory Infections defined by the Japanese Society of Chemotherapy, at the National Hospital Organization Kanazawa Medical Center from January 1, 2007 to May 31, 2010...
August 2018: Nagoya Journal of Medical Science
Raghdaa A Ramadan, Manar G Gebriel, Heba M Kadry, Ahmed Mosallem
Background: Carbapenamase producing Acinetobacter baumannii and Pseudomonas aeruginosa are emerging worldwide limiting the use of carbapenems as effective and safe drugs. Purpose: To characterize different carbapenemase genes carried by carbapenem-resistant (CR) A. baumannii and P. aeruginosa isolates and to evaluate the in vitro effect of some colistin-based combinations by E-test method in Zagazig University Hospitals ICU isolates. Methods: CR A...
2018: Infection and Drug Resistance
Khalid Eljaaly, Mushira A Enani, Jaffar A Al-Tawfiq
Imipenem and meropenem are the recommended antipseudomonal carbapenems for nosocomial pneumonia per clinical practice guidelines. However, these agents have a relatively broader spectrum of activity than other antibiotics and need to be reserved. Carbapenems might cause higher rate of superinfection. The aim of this study was to compare the rate of superinfection between patients who received imipenem or meropenem versus those who received non-carbapenem treatment. PubMed, EMBASE, Cochrane Library databases and two trial registries were searched for relevant randomized controlled trials of hospitalized adults with pneumonia through February 24, 2017 without date or language restrictions...
November 2018: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
Amy D Robertson, Chenghui Li, Drayton A Hammond, Tiffany A Dickey
INTRODUCTION: Vancomycin (VAN) is associated with an increased risk of acute kidney injury (AKI). Evidence is conflicting regarding the risk of AKI when VAN is combined with an antipseudomonal β-lactam. OBJECTIVES: To determine the comparative incidence of AKI when VAN is combined with piperacillin-tazobactam (PTZ) or meropenem (MER). METHODS: This was a retrospective cohort study of acutely ill adults receiving the combination of VAN and PTZ or MER for at least 48 hours between November 1, 2014, and October 31, 2016, in a tertiary care hospital...
September 2, 2018: Pharmacotherapy
Maria Foti, Antonino Siclari, Antonietta Mascetti, Vittorio Fisichella
Antimicrobial-resistant (AMR) bacteria are a threat to global health. Epidemiological studies are necessary to gain a more detailed understanding of the transmission modality of resistant bacteria to wild animals and their diffusion into the environment to ensure a broader evaluation of the epidemiological role of wildlife. The study aimed to identify little-known epidemiological aspects by focusing on the isolation of Enterobacteriaceae in order to bring knowledge on the bacterial flora of wild mammals living in the National Park of Aspromonte (Calabria, Italy)...
August 28, 2018: Environmental Toxicology and Pharmacology
Laszlo Otvos, Eszter Ostorhazi, Dora Szabo, Steven D Zumbrun, Lynda L Miller, Stephanie A Halasohoris, Puvi D Desai, Sharon M Int Veldt, Carl N Kraus
As monotherapy, modified proline-rich antimicrobial peptides (PrAMPs) protect animals from experimental bacteremia in a dose-dependent manner. We evaluated the in vitro synergy of a modified PrAMP, A3-APO, a dimer, previously shown to inhibit the 70 kDa bacterial heat shock protein DnaK, with imipenem or colistin against two antibiotic-resistant pathogens; a carbapenemase-expressing Klebsiella pneumoniae strain K97/09 and Acinetobacter baumannii (ATCC BAA-1605). Combining antimicrobials resulted in synergy for PrAMP/colistin combination against both K...
2018: Frontiers in Chemistry
Gloria Wong, Scott Briscoe, Brett McWhinney, Mumtaz Ally, Jacobus Ungerer, Jeffrey Lipman, Jason A Roberts
Objectives: To describe the achievement of unbound β-lactam antibiotic concentration targets in a therapeutic drug monitoring (TDM) programme in critically ill patients, and the factors associated with failure to achieve a target concentration. Patients and methods: Plasma samples and clinical data were obtained for analysis from a single centre prospectively. Unbound concentrations of ceftriaxone, cefazolin, meropenem, ampicillin, benzylpenicillin, flucloxacillin and piperacillin were directly measured using ultracentrifugation...
August 17, 2018: Journal of Antimicrobial Chemotherapy
Ling-Ling Zhu, Quan Zhou
Background: Sporadic studies in antimicrobial therapy have evaluated the effects of infusion rates on therapeutic and economic outcomes, and new findings may challenge the regular infusion regimen. Methods: Focusing on studies comparing the outcomes of different infusion regimens, the relevant literature was identified by searching PubMed, Web of Science, and Scopus from January 1, 2013 to March 1, 2018. Papers were finally chosen using a PRISMA flowchart. Results: Antimicrobials with the superiority of prolonged infusion to standard infusion in terms of efficacy and safety include meropenem, doripenem, imipenem, cefepime, ceftazidime, piperacillin/tazobactam, linezolid, and vancomycin...
2018: Infection and Drug Resistance
Sahand Imani, Hergen Buscher, Richard Day, Sheridan Gentili, Graham R D Jones, Debbie Marriott, Ross Norris, Indy Sandaradura
To determine whether target concentration non-attainment can be anticipated in critically ill patients prior to initiating empiric β-lactam antibiotic therapy based on readily available clinical factors. Retrospective review of consecutive patients treated with piperacillin or meropenem and who underwent therapeutic drug monitoring (TDM) at St Vincent's Hospital (Sydney, Australia) between January 2013 and December 2015 was performed. Predefined subgroups were patients who received continuous renal replacement therapy (CRRT) and those who did not (non-CRRT)...
November 2018: European Journal of Clinical Microbiology & Infectious Diseases
Xinyu Liu, Shengjie Dong, Yuru Ma, Hu Xu, Hongxia Zhao, Qingzhi Gao
BACKGROUND: There is an urgent need to develop novel inhibitors against clinically widespread extended-spectrum β-lactamases (ESBLs) to meet the challenges of the ever-evolving threat of antibiotic resistances. Most existing ESBL inhibitors sharing a common chemical feature of β-lactam ring in their molecule, this structural characteristic makes them intrinsically susceptible to enzymatic breakdown by the resistance mechanisms employed by the bacteria. OBJECTIVE: The aim of this study was to screen and discover novel lead compounds by using L-proline as initial scaffold to create a "non-sulfur, non-β-lactam" new chemotypes for potential ESBL inhibitors...
August 16, 2018: Medicinal Chemistry
Rodrigo M Burgos, Mark J Biagi, Keith A Rodvold, Larry H Danziger
Meropenem/vaborbactam (M/V) represents the first carbapenem and β-lactamase inhibitor combination approved for treatment of complicated urinary tract infections (cUTIs), including pyelonephritis. Vaborbactam is a novel boronic acid, β-lactamase inhibitor with a high affinity for serine β-lactamases, including Klebsiella pneumoniae carbapenemase (KPC). This combination, Vabomere™, was approved in August 2017 by the United States Food and Drug Administration for the treatment of cUTIs in patients 18 years or older, including pyelonephritis, caused by the following susceptible microorganisms: Escherichia coli, K...
October 2018: Expert Opinion on Drug Metabolism & Toxicology
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