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Vaishali Gaikwad, Tejash Gohel, Shrijeet Panickar, Vijay Chincholkar, Santosh Mangalkar
INTRODUCTION: Staphylococcus is one of the most common causes of nosocomial infection, especially pneumonia, surgical site infections, blood stream infections, and continues to be a major cause of community-acquired infections. The emergence of penicillin resistance followed by the development and spread of strains resistant to the semisynthetic penicillins such as methicillin, oxacillin and nafcillin, macrolides, tetracycline, and aminoglycosides has made the treatment of staphylococcal infection a global challenge...
October 2016: Indian Journal of Pathology & Microbiology
G Ralph Corey, Francis F Arhin, Matthew A Wikler, Daniel F Sahm, Barry N Kreiswirth, José R Mediavilla, Samantha Good, Claude Fiset, Hai Jiang, Greg Moeck, Heidi Kabler, Sinikka Green, William O'Riordan
Oritavancin is a lipoglycopeptide antibiotic with bactericidal activity against Gram-positive pathogens, including methicillin-resistant Staphylococcus aureus (MRSA). The phase 3 studies SOLO I and SOLO II demonstrated comparable efficacy and safety of a single dose of oritavancin compared with 7-10 days of twice-daily vancomycin in adults with acute bacterial skin and skin-structure infections (ABSSSIs). The present analysis assessed clinical responses by pathogen at 48-72 h and at study days 14-24 in SOLO patients within the pooled data set...
September 13, 2016: International Journal of Antimicrobial Agents
Daina Zeng, Dmitri Debabov, Theresa L Hartsell, Raul J Cano, Stacy Adams, Jessica A Schuyler, Ronald McMillan, John L Pace
The glycopeptide antimicrobials are a group of natural product and semisynthetic glycosylated peptides that show antibacterial activity against Gram-positive organisms through inhibition of cell-wall synthesis. This is achieved primarily through binding to the d-alanyl-d-alanine terminus of the lipid II bacterial cell-wall precursor, preventing cross-linking of the peptidoglycan layer. Vancomycin is the foundational member of the class, showing both clinical longevity and a still preferential role in the therapy of methicillin-resistant Staphylococcus aureus and of susceptible Enterococcus spp...
September 23, 2016: Cold Spring Harbor Perspectives in Medicine
Rodrigo E Mendes, Mariana Castanheira, David J Farrell, Robert K Flamm, Helio S Sader, Ronald N Jones
OBJECTIVES: The objective of this study was to evaluate the prevalence and in vitro susceptibility of enterococci and VRE among bloodstream infections in European and US hospitals over time. METHODS: Isolates recovered from the blood of infected patients in Europe (72 996) and the USA (67 725) between 2001 and 2014 were included in the prevalence analysis. A subset (2349) collected during 2011-13 was used for the in vitro activity analysis. RESULTS: Enterococcus faecium rates increased in Europe (from 1...
September 8, 2016: Journal of Antimicrobial Chemotherapy
John A Bosso, Anthony M Casapao, Jonathan Edwards, Kenneth Klinker, Christopher McCoy, David P Nicolau, Katherine K Perez, Andrew Marcarelli, Deeksha Dua
This article was written with the aim to establish a consensus clinical pathway for long-acting lipoglycopeptide antibiotics such as oritavancin (Orbactiv®) and dalbavancin (Dalvance®) for the treatment of acute bacterial skin and skin structure infections (ABSSSI). Seven infectious diseases pharmacy specialists from a variety of facilities across the United States (US) participated in a roundtable discussion to consider the use of newer single-dose long-acting lipoglycopeptides, and integrate them into clinical pathways for ABSSSI...
October 2016: Hospital Practice (Minneapolis)
Daniel H Deck, Jennifer M Jordan, Thomas L Holland, Weihong Fan, Matthew A Wikler, Katherine A Sulham, G Ralph Corey
No abstract text is available yet for this article.
September 2016: Infectious Diseases and Therapy
Leonard R Duncan, Helio S Sader, Robert K Flamm, Ronald N Jones, Rodrigo E Mendes
Oritavancin has been approved in the United States and European Union for the treatment of acute bacterial skin and skin structure infections caused by several Gram-positive pathogens including Staphylococcus aureus. In this study, the in vitro activity of oritavancin and comparator agents was assessed against 1008 isolates of contemporary invasive community- or healthcare-associated S. aureus (790 and 218 isolates, respectively). All sampled contemporary (2013-2014) S. aureus isolates were susceptible at ≤0...
November 2016: Diagnostic Microbiology and Infectious Disease
Daniel G Meeker, Karen E Beenken, Weston B Mills, Allister J Loughran, Horace J Spencer, William B Lynn, Mark S Smeltzer
We used in vitro and in vivo models of catheter-associated biofilm formation to compare the relative activity of antibiotics effective against methicillin-resistant Staphylococcus aureus (MRSA) in the specific context of an established biofilm. The results demonstrated that, under in vitro conditions, daptomycin and ceftaroline exhibited comparable activity relative to each other and greater activity than vancomycin, telavancin, oritavancin, dalbavancin, or tigecycline. This was true when assessed using established biofilms formed by the USA300 methicillin-resistant strain LAC and the USA200 methicillin-sensitive strain UAMS-1...
October 2016: Antimicrobial Agents and Chemotherapy
Daniel H Deck, Jennifer M Jordan, Thomas L Holland, Weihong Fan, Matthew A Wikler, Katherine A Sulham, G Ralph Corey
INTRODUCTION: Introduction of new antibiotics enabling single-dose administration, such as oritavancin may significantly impact site of care decisions for patients with acute bacterial skin and skin structure infections (ABSSSI). This analysis compared the efficacy of single-dose oritavancin with multiple-dose vancomycin in patients categorized according to disease severity via modified Eron classification and management setting. METHODS: SOLO I and II were phase 3 studies evaluating single-dose oritavancin versus 7-10 days of vancomycin for treatment of ABSSSI...
September 2016: Infectious Diseases and Therapy
Dilip Nathwani, Matthew Dryden, Javier Garau
Skin and soft-tissue infections (SSTIs) are a common indication for antibiotic use in Europe and are associated with considerable morbidity. Treatment of SSTIs, occasionally complicated by infection with meticillin-resistant Staphylococcus aureus, can be resource intensive and lead to high healthcare costs. For patients treated in an inpatient setting, once the acute infection has been controlled, a patient may be discharged on suitable oral antibiotic therapy or outpatient parenteral antibiotic therapy. The recently confirmed efficacy of single-dose (e...
August 2016: International Journal of Antimicrobial Agents
Dalia Deak, Kevin Outterson, John H Powers, Aaron S Kesselheim
A weak antibiotic pipeline and the increase in drug-resistant pathogens have led to calls for more new antibiotics. Eight new antibiotics were approved by the U.S. Food and Drug Administration (FDA) between January 2010 and December 2015: ceftaroline, fidaxomicin, bedaquiline, dalbavancin, tedizolid, oritavancin, ceftolozane-tazobactam, and ceftazidime-avibactam. This study evaluates the development course and pivotal trials of these antibiotics for their innovativeness, development process, documented patient outcomes, and cost...
September 6, 2016: Annals of Internal Medicine
Andrew W Hahn, Rupali Jain, David H Spach
Antimicrobial drug-resistance continues to force adaptation in our clinical practice. We explore new evidence regarding adjunctive antibiotic therapy for skin and soft tissue abscesses as well as duration of therapy for intra-abdominal abscesses. As new evidence refines optimal practice, it is essential to support clinicians in adopting practice patterns concordant with evidence-based guidelines. We review a simple approach that can 'nudge' clinicians towards concordant practices. Finally, the use of novel antimicrobials will play an increasingly important role in contemporary therapy...
July 2016: Medical Clinics of North America
Ivar S Jensen, Elizabeth Wu, Weihong Fan, Thomas P Lodise, David P Nicolau, Scott Dufour, Philip L Cyr, Katherine A Sulham
BACKGROUND: It is estimated that acute bacterial skin and skin structure infections (ABSSSI) account for nearly 10% of hospital admissions and 3.4-3.8 million emergency department visits per year in the United States. Analyses of hospital discharge records indicate 74% of ABSSSI admissions involve empiric treatment with methicillin-resistant Staphylococcus aureus (MRSA) active antibiotics. Analysis has shown that payer costs could be reduced if moderate-to-severe ABSSSI patients were treated to a greater extent in the observational unit followed by discharge to outpatient parenteral antibiotic therapy (OPAT)...
June 2016: Journal of Managed Care & Specialty Pharmacy
Rosanna Li, Michael D Nailor
The FDA guidance published in 2013 provided requirements for conducting ABSSSI trials. In 2014, dalbavancin, oritavancin, and tedizolid were introduced into the market after phase III noninferiority clinical trials against vancomycin (for the lipoglycopeptides) and linezolid (for tedizolid), demonstrating clinical efficacy for the treatment of ABSSSI. Great interest exists for these agents because of the postulated financial impact. Due to favorable pharmacokinetics which allow for less frequent medication administration and shorter treatment durations, these agents may prove to reduce hospital admissions and length of stay...
March 2016: Connecticut Medicine
Achim J Kaasch, Harald Seifert
Oritavancin is a new lipoglycopeptide antibacterial agent with an exceptionally long terminal half-life and a rapid bactericidal effect. Multiple mechanisms of action lead to a broad activity against Gram-positive bacteria, such as staphylococci, streptococci and enterococci, including methicillin-resistant Staphylococcus aureus. Its long terminal half-life allows for single-dose treatment of acute bacterial skin and skin structure infections. Oritavancin was found to be safe and effective in treating acute bacterial skin and skin structure infections in adults and it is currently approved in the USA and in Europe for this indication...
July 2016: Future Microbiology
Jay W Mason, S Eralp Bellibas, Nuo-Yu Huang, Carlos R Sanabria, Borje Darpo
The purpose of this study was to measure oritavancin's electrocardiographic effects at a supratherapeutic dose of 1600 mg I.V. over 3 hours. 150 healthy volunteers were randomized to receive placebo, oritavancin or oral moxifloxacin 400 mg in a parallel designed thorough QT study. A supratherapeutic mean maximum oritavancin concentration (Cmax) of 232 μg/ml was achieved. There was no significant effect on baseline and placebo corrected (dd) QTcF, QRS or heart rate. ddPR was slightly increased at most time points, with a maximum mean change of 7...
May 3, 2016: Clinical Pharmacology in Drug Development
A Russo, E Concia, F Cristini, F G De Rosa, S Esposito, F Menichetti, N Petrosillo, M Tumbarello, M Venditti, P Viale, C Viscoli, M Bassetti
In 2013 the US Food and Drug Administration (FDA) issued recommendations and guidance on developing drugs for treatment of skin infection using a new definition of acute bacterial skin and skin-structure infection (ABSSSI). The new classification includes cellulitis, erysipelas, major skin abscesses and wound infection with a considerable extension of skin involvement, clearly referring to a severe subset of skin infections. The main goal of the FDA was to better identify specific infections where the advantages of a new antibiotic could be precisely estimated through quantifiable parameters, such as improvement of the lesion size and of systemic signs of infection...
April 2016: Clinical Microbiology and Infection
Adam Belley, David Lalonde Seguin, Francis Arhin, Greg Moeck
Antibacterial agents that kill nondividing bacteria may be of utility in treating persistent infections. Oritavancin and dalbavancin are bactericidal lipoglycopeptides that are approved for acute bacterial skin and skin structure infections in adults caused by susceptible Gram-positive pathogens. Using time-kill methodology, we demonstrate that oritavancin exerts bactericidal activity against methicillin-resistant Staphylococcus aureus (MRSA) isolates that are maintained in a nondividing state in vitro, whereas dalbavancin and the glycopeptide vancomycin do not...
July 2016: Antimicrobial Agents and Chemotherapy
Alison S VanEperen, John Segreti
Methicillin-resistant Staphylococcus aureus (MRSA) continues to be an important pathogen worldwide, with high prevalence of infection in both community and hospital settings. Timely and appropriate choice of empirical therapy in the setting of MRSA infection is imperative due to the high rate of associated morbidity and mortality with MRSA infections. Initial choices should be made based on the site and severity of the infection, most notably moderate skin and soft tissue infections which may be treated with oral antibiotics (trimethoprim-sulfamethoxazole, clindamycin, doxycycline/minocycline, linezolid) in the outpatient setting, versus choice of parenteral therapy in the inpatient setting of more invasive or severe disease...
June 2016: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
Rodrigo E Mendes, David J Farrell, Helio S Sader, Robert K Flamm, Ronald N Jones
Oritavancin (MIC50/90, 0.03/0.06 to 0.12 μg/ml) had potent activity against linezolid-resistant staphylococci, as well as Enterococcus faecalis and Enterococcus faecium (oritavancin MIC50/90, 0.015/0.12 μg/ml against both species). All linezolid-resistant isolates were inhibited by oritavancin at ≤0.12 μg/ml. These results confirmed the absence of cross-resistance between linezolid and oritavancin in staphylococci and enterococci.
June 2016: Antimicrobial Agents and Chemotherapy
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