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Continuous piperacilline

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https://www.readbyqxmd.com/read/29746711/a-monte-carlo-simulation-approach-for-beta-lactam-dosing-in-critically-ill-patients-receiving-prolonged-intermittent-renal-replacement-therapy
#1
Soo Min Jang, Katherine N Gharibian, Susan J Lewis, William H Fissell, Ashita J Tolwani, Bruce A Mueller
Cefepime, ceftazidime, and piperacillin/tazobactam are commonly used beta-lactam antibiotics in the critical care setting. For critically ill patients receiving prolonged intermittent renal replacement therapy (PIRRT), limited pharmacokinetic data are available to inform clinicians on the dosing of these agents. Monte Carlo simulations (MCS) can be used to guide drug dosing when pharmacokinetic trials are not feasible. For each antibiotic, MCS using previously published pharmacokinetic data derived from critically ill patients was used to evaluate multiple dosing regimens in 4 different prolonged intermittent renal replacement therapy effluent rates and prolonged intermittent renal replacement therapy duration combinations (4 L/h × 10 hours or 5 L/h × 8 hours in hemodialysis and hemofiltration modes)...
May 10, 2018: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29735823/antimicrobial-susceptibility-profiles-of-gram-negative-bacteria-causing-infections-collected-across-india-during-2014-2016-study-for-monitoring-antimicrobial-resistance-trend-report
#2
Balaji Veeraraghavan, Mark Ranjan Jesudason, John Antony Jude Prakasah, Shalini Anandan, Rani Diana Sahni, Agila Kumari Pragasam, Yamuna Devi Bakthavatchalam, Rajesh Joseph Selvakumar, T N Dhole, Camilla Rodrigues, Indranil Roy, Sangeetha Joshi, Bhaskar Narayan Chaudhuri, D S Chitnis
Background: The emergence of antibiotic resistance among bacterial pathogens in the hospital and community has increased the concern to the health-care providers due to the limited treatment options. Surveillance of antimicrobial resistance (AMR) in frequently isolated bacterial pathogens causing severe infections is of great importance. The data generated will be useful for the clinicians to decide empiric therapy on the local epidemiological resistance profile of the antimicrobial agents...
January 2018: Indian Journal of Medical Microbiology
https://www.readbyqxmd.com/read/29730948/piperacillin-population-pharmacokinetics-in-critically-ill-adults-during-sustained-low-efficiency-dialysis
#3
Salmaan Kanji, Jason A Roberts, Jiao Xie, Abdulaziz Alobaid, Sheryl Zelenitsky, Swapnil Hiremath, Guijun Zhang, Irene Watpool, Rebecca Porteous, Rakesh Patel
BACKGROUND: Sustained low-efficiency dialysis (SLED), is increasingly being used in intensive care units (ICUs) but studies informing drug dosing for such patients is lacking. OBJECTIVE: To describe the population pharmacokinetics (PKs) of piperacillin/tazobactam in critically ill adults receiving SLED and to provide dosing recommendations. METHODS: This prospective population PK study was conducted in adult ICU patients prescribed piperacillin/tazobactam while receiving SLED; 321 blood samples were obtained from 34 participants during and between approximately 50 SLED treatments for quantification of piperacillin and tazobactam concentrations in plasma...
May 1, 2018: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/29693543/urinary-tract-infection-by-acinetobacter-baumannii-and-pseudomonas-aeruginosa-evolution-of-antimicrobial-resistance-and-therapeutic-alternatives
#4
Gemma Jiménez-Guerra, Victor Heras-Cañas, Miguel Gutiérrez-Soto, María Del Pilar Aznarte-Padial, Manuela Expósito-Ruiz, José María Navarro-Marí, José Gutiérrez-Fernández
PURPOSE: Acinetobacter baumannii and Pseudomonas aeruginosa are responsible for numerous nosocomial infections. The objective of this study was to determine the development of their susceptibility to ten antibiotics and the antibiotic consumption of patients with suspicion of urinary tract infection (UTI). METHODOLOGY: A retrospective study was conducted on the susceptibility profiles of A. baumannii and P. aeruginosa isolates from 749 urine samples gathered between January 2013 and December 2016, and on the consumption of imipenem, meropenem and piperacillin-tazobactam between 2014 and 2016...
April 25, 2018: Journal of Medical Microbiology
https://www.readbyqxmd.com/read/29651861/the-first-characterized-carbapenem-resistant-bacteroides-fragilis-strain-from-croatia-and-the-case-study-for-it
#5
Maja Bogdan, Ljilijana Perić, Katalin Ördög, Dubravka Vuković, Edit Urbán, József Sóki
An imipenem-resistant Bacteroides fragilis strain was isolated from the blood of a 72-year-old male patient with a urinary bladder tumor in Osijek, Croatia. This strain was also resistant to ampicillin, piperacillin/tazobactam, cefoxitin, clindamycin, tetracycline, and harbored cfiA, ermF, and tetQ genes where the high-level expression of the cfiA carbapenem-resistant gene was driven by an IS1187 element. Interestingly, despite the carbapenem-resistant feature of the B. fragilis from blood, the patient relatively easily recovered from the bacteremia...
April 13, 2018: Acta Microbiologica et Immunologica Hungarica
https://www.readbyqxmd.com/read/29626676/current-epidemiology-genetic-evolution-and-clinical-impact-of-extended-spectrum-%C3%AE-lactamase-producing-escherichia-coli-and-klebsiella-pneumoniae
#6
REVIEW
Yong Chong, Shinji Shimoda, Nobuyuki Shimono
The worldwide spread of extended-spectrum β-lactamase (ESBL)-producing bacteria, particularly Escherichia coli and Klebsiella pneumoniae, is a critical concern for the development of therapies against multidrug-resistant bacteria. Since the 2000s, detection rates of CTX-M types ESBL-producing E. coli in the community have been high, possibly contributing to their nosocomial detection. Various factors, such as environmental sources, food animals, and international travel, accelerate the global ESBL spread in the community...
April 4, 2018: Infection, Genetics and Evolution
https://www.readbyqxmd.com/read/29590376/incidence-of-nephrotoxicity-among-pediatric-patients-receiving-vancomycin-with-either-piperacillin-tazobactam-or-cefepime-a-cohort-study
#7
Kathryn M Cook, Jessica Gillon, Alison G Grisso, Ritu Banerjee, Natalia Jimenez-Truque, Elizabeth J Phillips, Sara L Van Driest
Background: Recent studies in adults have found an incidence of acute kidney injury (AKI) in patients treated with a combination of vancomycin and piperacillin-tazobactam (TZP) that is greater than that expected with either medication alone. The purpose of this study was to determine whether combination therapy with vancomycin and TZP is associated with an incidence of AKI in pediatric patients higher than that in those on combination therapy with vancomycin and cefepime. Methods: We performed a retrospective single-center matched-cohort study of pediatric patients who received vancomycin in combination with TZP or cefepime between January 2015 and June 2016...
March 26, 2018: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/29578073/de-escalation-and-discontinuation-of-empirical-antibiotic-treatment-in-a-cohort-of-allogeneic-hematopoietic-stem-cell-transplantation-recipients-during-the-pre-engraftment-period
#8
Giulia Gustinetti, Annamaria Raiola, Riccardo Varaldo, Federica Galaverna, Francesca Gualandi, Valerio Del Bono, Andrea Bacigalupo, Emanuele Angelucci, Claudio Viscoli, Malgorzata Mikulska
OBJECTIVES: to investigate rates and outcomes of antibiotic de-escalation during pre-engraftment neutropenia in allogeneic hematopoietic stem cell transplantation (HSCT) recipients. METHODS: 110 consecutive HSCT performed between 01/2013-03/2014 were analysed. De-escalation was defined as narrowing the spectrum of antibiotic treatment either within (early) or after 96 hours (late) from starting antibiotics. Discontinuation, considered a form of de-escalation, was defined as stopping antibiotics before engraftment...
March 22, 2018: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/29506150/pharmacokinetics-of-piperacillin-in-critically-ill-patients-with-acute-kidney-injury-receiving-sustained-low-efficiency-diafiltration
#9
Mahipal G Sinnollareddy, Michael S Roberts, Jeffrey Lipman, Sandra L Peake, Jason A Roberts
Background: Piperacillin is a β-lactam penicillin antibiotic commonly used for the empirical therapy of sepsis and other hospital-acquired infections. However, knowledge regarding the effect of sustained low-efficiency diafiltration (SLED-f), a technique increasingly being used in ICUs, on piperacillin pharmacokinetics (PK) and dosing in critically ill patients is lacking. Objectives: To describe the PK of piperacillin during SLED-f and compare the results with those reported for other forms of renal replacement therapies...
March 1, 2018: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/29488547/-evaluation-of-antimicrobial-consumption-in-a-neonatology-unit-a-team-work-to-promote-the-rational-use-of-antibiotics
#10
Elisa Jiménez, Nicolás Valls, Patricio Astudillo, Cristian Valls, Gabriel Cavada, Alejandra Sandoval, Angélica Alegría, Gabriela Ortega, Daniela Núñez, Patricia Mena
BACKGROUND: Antibiotics (ATB) are drugs widely used in hospitalized newborns. The indiscriminate use of ATBs promote the rise of resistant bacteria to the most commonly indicated antimicrobials. In addition, ATB prescription presents associations to morbidity, such as bronchopulmonary dysplasia, necrotizing enterocolitis, late sepsis and even death. All of the above leads to an increase in health care costs. AIM: To record and to evaluate trends of antibiotic use over time in hospitalized NB in the Neonatology Unit at Dr...
December 2017: Revista Chilena de Infectología: órgano Oficial de la Sociedad Chilena de Infectología
https://www.readbyqxmd.com/read/29387345/higher-third-generation-cephalosporin-prescription-proportion-is-associated-with-lower-probability-of-reducing-carbapenem-use-a-nationwide-retrospective-study
#11
Allison Muller, Xavier Bertrand, Anne-Marie Rogues, Muriel Péfau, Serge Alfandari, Rémy Gauzit, Catherine Dumartin, Houssein Gbaguidi-Haore
Background: The ongoing extended spectrum β-lactamase-producing Enterobacteriaceae (ESBL-PE) pandemic has led to an increasing carbapenem use, requiring release of guidelines for carbapenem usage in France in late 2010. We sought to determine factors associated with changes in carbapenem use in intensive care units (ICUs), medical and surgical wards between 2009 and 2013. Methods: This ward-level multicentre retrospective study was based on data from French antibiotic and multidrug-resistant bacteria surveillance networks in healthcare facilities...
2018: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/29363049/beta-lactams-in-continuous-infusion-for-gram-negative-bacilli-osteoarticular-infections-an-easy-method-for-clinical-use
#12
Alba Ribera, Laura Soldevila, Raul Rigo-Bonnin, Fe Tubau, Ariadna Padullés, Joan Gómez-Junyent, Javier Ariza, Oscar Murillo
Continuous infusion (CI) of beta-lactams could optimize their pharmacokinetic/pharmacodynamic indices, especially in difficult-to-treat infections. PURPOSE: To validate an easy-to-use method to guide beta-lactams dosage in CI (formula). METHODS: A retrospective analysis was conducted of a prospectively collected cohort (n = 24 patients) with osteoarticular infections caused by Gram-negative bacilli (GNB) managed with beta-lactams in CI. Beta-lactams dose was calculated using a described formula (daily dose = 24 h × beta-lactam clearance × target "steady-state" concentration) to achieve concentrations above the MIC...
April 2018: Infection
https://www.readbyqxmd.com/read/29277531/population-pharmacokinetics-of-continuous-infusion-of-piperacillin-in-critically-ill-patients
#13
Sofie A M Dhaese, Jason A Roberts, Mieke Carlier, Alain G Verstraete, Veronique Stove, Jan J De Waele
Dosing recommendations for continuous infusion of piperacillin, a broad-spectrum beta-lactam antibiotic, are mainly guided by outputs from population pharmacokinetic models constructed with intermittent infusion data. However, the probability of target attainment in patients receiving piperacillin by continuous infusion may be overestimated when drug clearance estimates from population pharmacokinetic models based on intermittent infusion data are used, especially when higher doses (e.g. 16 g/24 h or more) are simulated...
April 2018: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/29237787/point-counterpoint-piperacillin-tazobactam-should-be-used-to-treat-infections-with-extended-spectrum-beta-lactamase-positive-organisms
#14
Audrey N Schuetz, Sergio Reyes, Pranita D Tamma
INTRODUCTIONBeta-lactam/beta-lactamase inhibitor combination antimicrobials (BLBLIs) are among the most controversial classes of antibiotic agents available for the treatment of infections caused by extended-spectrum-beta-lactamase (ESBL)-producing Gram-negative bacteria (ESBL-GNR). Piperacillin-tazobactam (PTZ) is one of the most frequently utilized antibiotic agents for empirical Gram-negative bacterial coverage and remains active against a large proportion of ESBL-GNR strains. Furthermore, good antimicrobial stewardship practices encourage the use of carbapenem-sparing treatment regimens for infections due to ESBL-GNR...
March 2018: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/29222426/surveillance-of-antibiotic-resistance-among-common-clostridium-difficile-ribotypes-in-hong-kong
#15
Viola C Y Chow, Thomas N Y Kwong, Erica W M So, Yolanda I I Ho, Sunny H Wong, Raymond W M Lai, Raphael C Y Chan
Incidence of Clostridium difficile infection (CDI) is rapidly increasing and it poses a major health burden globally. However, data regarding the epidemiology of CDI in Asia are limited. We aimed to characterize the antimicrobial susceptibility patterns of common ribotypes of toxigenic C. difficile in Hong Kong. Fifty-three PCR ribotypes were identified among 284 toxigenic C. difficile clinical isolates. The five most prevalent ribotypes were 002 (13%), 017 (12%), 014 (10%), 012 (9.2%), and 020 (9.5%). All tested C...
December 8, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29158999/recurrent-primary-suprahepatic-abscess-due-to-providencia-stuartii-a-rare-phenomenon
#16
Kyawzaw Lin, Aung Naing Lin, Sandar Linn, Madhavi Reddy, Anjali Bakshi
Gram-negative urease-producing bacilli, Providencia stuartii (P. stuartii), is reported in urinary tract infections, gastroenteritis, and bacteremia in humans but they rarely present with a hepatic abscess. We present a rare case of a recurrent suprahepatic cyst due to P. stuartii in a 45-year-old female, intravenous ( IV) heroin abuser with chronic hepatitis B and C. A 45-year-old female with 10 days status post right suprahepatic abscess drainage presented with recurrent, right, upper quadrant abdominal pain for one day...
September 16, 2017: Curēus
https://www.readbyqxmd.com/read/29153975/optimisation-of-empirical-antimicrobial-therapy-in-patients-with-haematological-malignancies-and-febrile-neutropenia-how-long-study-an-open-label-randomised-controlled-phase-4-trial
#17
Manuela Aguilar-Guisado, Ildefonso Espigado, Almudena Martín-Peña, Carlota Gudiol, Cristina Royo-Cebrecos, José Falantes, Lourdes Vázquez-López, María Isabel Montero, Clara Rosso-Fernández, María de la Luz Martino, Rocío Parody, José González-Campos, Sebastián Garzón-López, Cristina Calderón-Cabrera, Pere Barba, Nancy Rodríguez, Montserrat Rovira, Enrique Montero-Mateos, Jordi Carratalá, José Antonio Pérez-Simón, José Miguel Cisneros
BACKGROUND: Continuation of empirical antimicrobial therapy (EAT) for febrile neutropenia in patients with haematological malignancies until neutrophil recovery could prolong the therapy unnecessarily. We aimed to establish whether EAT discontinuation driven by a clinical approach regardless of neutrophil recovery would optimise the duration of therapy. METHODS: We did an investigator-driven, superiority, open-label, randomised, controlled phase 4 clinical trial in six academic hospitals in Spain...
December 2017: Lancet Haematology
https://www.readbyqxmd.com/read/29153444/retrospective-evaluation-of-piperacillin-tazobactam-imipenem-cilastatin-and-meropenem-used-on-surgical-floors-at-a-tertiary-care-hospital-in-saudi-arabia
#18
Eman Youssif, Mohammed Aseeri, Sahal Khoshhal
BACKGROUND: The appropriate use of broad-spectrum antibiotics, including appropriate de-escalation, is essential to reduce the emergence of antibiotic resistance. In surgical floors antibiotics are prescribed for prophylaxis (mostly, single dose), empirical treatment (started if infection is suspected till bacteria are identified with its sensitivity to antibiotics), or treatment of well-defined infection of previously isolated bacteria with its sensitivity to antibiotics. In this study, we aimed to evaluate the use of broad-spectrum antibiotics based on requests for cultures and de-escalation based on sensitivity results of culture tests at tertiary care hospital...
November 15, 2017: Journal of Infection and Public Health
https://www.readbyqxmd.com/read/28962545/species-distribution-and-antibiotic-susceptibility-profile-of-bacterial-uropathogens-among-patients-complaining-urinary-tract-infections
#19
Adane Bitew, Tamirat Molalign, Meseret Chanie
BACKGROUND: Urinary tract infection is the second most common type of infection and the problem is further compounded by the emergence of drug resistance in bacterial uropathogens. The aim of this study was to determine the spectrum of bacterial uropathogens and their drug resistant pattern. METHODS: A single institutional cross-sectional study was carried out at Arsho Advanced Medical laboratory from September 2015 to May 2016. A total of 712 urine samples were collected, inoculated onto primary isolation culture media, incubated at 37 °C for 18-24 h, and significant bacteriuria was determined...
September 29, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28868509/-targeted-prophylaxis-impact-of-rectal-swab-culture-directed-prophylaxis-on-infectious-complications-after-transrectal-ultrasound-guided-prostate-biopsy
#20
Prabhjot Singh, Ashish Kumar, Siddharth Yadav, Lok Prakash, Brusabhanu Nayak, Rajeev Kumar, Arti Kapil, Prem Nath Dogra
PURPOSE: To assess the prevalence of fluoroquinolone resistance among patients undergoing transrectal ultrasound (TRUS)-guided prostate biopsy and the impact of rectal swab culture-directed antibiotic prophylaxis on postbiopsy infectious complications. MATERIALS AND METHODS: We prospectively analyzed all patients undergoing TRUS-guided prostate biopsy from April 2013 to February 2015. Antibiotic prophylaxis was tailored to the results of rectal swab cultures. If the organism was fluoroquinolone-sensitive, oral ciprofloxacin 500 mg with tinidazole 600 mg was prescribed...
September 2017: Investigative and Clinical Urology
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