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Continuous meropenem

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https://www.readbyqxmd.com/read/28337084/therapeutic-drug-monitoring-of-continuous-infusion-doripenem-in-a-pediatric-patient-on-continuous-renal-replacement-therapy
#1
Jeffrey J Cies, Wayne S Moore, Susan B Conley, Paul Shea, Adela Enache, Arun Chopra
An 11-year-old African American male with severe combined immunodeficiency variant, non-cystic fibrosis bronchiectasis, pancreatic insufficiency, chronic mycobacterium avium-intracellulare infection, chronic sinusitis, and malnutrition presented with a 1-week history of fevers. He subsequently developed respiratory decompensation and cefepime was discontinued and doripenem was initiated. Doripenem was the carbapenem used due to a national shortage of meropenem. By day 7 the patient (24.7 kg) had a positive fluid balance of 6925 mL (28% FO), and on days 7 into 8 developed acute kidney injury evidenced by an elevated serum creatinine of 0...
January 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/28333677/y-site-physical-compatibility-of-beta-blocker-infusions-with-intensive-care-unit-admixtures
#2
Jaime A Foushee, Pmichaele Meredith, Laura M Fox, EdwardE Grace
Parenteral beta-blocker therapy via continuous infusion has shown promising results for improved outcomes for patients with septic shock. As patients with septic shock may require multiple intravenous medications, compatibility is necessary to co-infuse these medications through a y-site connector. The purpose of this study was to examine the physical compatibility of select intravenous drugs used for patients with septic shock combined with various intravenous beta-blockers including esmolol, labetalol, and metoprolol through a simulated y-site infusion...
July 2016: International Journal of Pharmaceutical Compounding
https://www.readbyqxmd.com/read/28288784/development-and-validation-of-a-measurement-procedure-based-on-ultra-high-performance-liquid-chromatography-tandem-mass-spectrometry-for-simultaneous-measurement-of-%C3%AE-lactam-antibiotic-concentration-in-human-plasma
#3
Raül Rigo-Bonnin, Alba Ribera, Ariadna Arbiol-Roca, Sara Cobo-Sacristán, Ariadna Padullés, Òscar Murillo, Evelyn Shaw, Rosa Granada, Xosé L Pérez-Fernández, Fe Tubau, Pedro Alía
BACKGROUND: The administration of β-lactam antibiotics in continuous infusion could let optimize the pharmacokinetic/pharmacodynamic parameters, especially in the treatment of serious bacterial infections. In this context, and also due to variability in their plasmatic concentrations, therapeutic drug monitoring (TDM) may be useful to optimize dosing and, therefore, be useful for the clinicians. MATERIAL AND METHODS: We developed and validated a measurement procedure based on ultra-high performance liquid chromatography-tandem mass spectrometry for simultaneous measurement of amoxicillin, ampicillin, cloxacillin, piperacillin, cefepime, ceftazidime, cefuroxime, aztreonam and meropenem concentrations in plasma...
March 10, 2017: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/28264846/substantial-impact-of-altered-pharmacokinetics-in-critically-ill-patients-on-the-antibacterial-effects-of-meropenem-evaluated-via-the-dynamic-hollow-fiber-infection-model
#4
Phillip J Bergen, Jürgen B Bulitta, Carl M J Kirkpatrick, Kate E Rogers, Megan J McGregor, Steven C Wallis, David L Paterson, Roger L Nation, Jeffrey Lipman, Jason A Roberts, Cornelia B Landersdorfer
Critically ill patients frequently have substantially altered pharmacokinetics compared to non-critically ill patients. We investigated the impact of pharmacokinetic alterations on bacterial killing and resistance for commonly used meropenem dosing regimens. A Pseudomonas aeruginosa isolate (MICmeropenem 0.25 mg/L) was studied in the hollow-fiber infection model (inoculum ∼10(7.5) CFU/mL; 10 days). Pharmacokinetic profiles representing critically ill patients with augmented renal clearance (ARC), normal, or impaired renal function (creatinine clearances of 285, 120 or ∼10 mL/min, respectively) were generated for three meropenem regimens (2g, 1g and 0...
March 6, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28167543/carbapenem-minimal-inhibitory-concentrations-in-escherichia-coli-and-klebsiella-species-producing-extended-spectrum-beta-lactamases-esbls-in-critical-care-patients-from-2001-2009
#5
J Kristie Johnson, Gwen L Robinson, Lisa L Pineles, Adebola O Ajao, LiCheng Zhao, Jennifer S Albrecht, Anthony D Harris, Kerri A Thom, Jon P Furuno
Extended spectrum β-lactamase (ESBL) -producing Enterobacteriaceae are increasing in prevalence worldwide. Carbapenem antibiotics are used as a first line of therapy against ESBL-producing Enterobacteriaceae. We examined gastrointestinal colonization of carbapenem-resistant-ESBLs (CR-ESBL) among a cohort of critical care patients. In this cohort of patients, we cultured for ESBL-producing Klebsiella spp. and Escherichia coli and then performed MIC susceptibility testing for imipenem, doripenem, meropenem, and ertapenem on the patient's first isolate...
February 6, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28161295/serotype-distribution-and-antimicrobial-susceptibility-of-streptococcus-pneumoniae-strains-isolated-in-japan-after-introduction-of-the-routine-immunization-program
#6
Haruko Miyazaki, Rie Shibuya, Naoko Midorikawa, Bin Chang, Makoto Ohnishi, Tetsuya Matsumoto
Pneumococcal vaccines have reduced the incidences of Streptococcus pneumoniae infections among children and adults, but a relative increase in the prevalence of non-vaccine serotypes has been reported. To follow the changing epidemiology of pneumococcal diseases, capsular serotyping and antimicrobial susceptibility testing was performed on 534 pneumococcal isolates obtained from a hospital in Japan after routine immunization was launched, between October 2014 and May 2016. Serotype distributions and antimicrobial susceptibilities were evaluated among the total patient population, and were compared by age and sample groups and by serotype group, respectively...
February 1, 2017: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://www.readbyqxmd.com/read/28057163/ceftazidime-avibactam-who-says-you-can-t-teach-an-old-drug-new-tricks
#7
Katie E Barber, Jessica K Ortwine, Ronda L Akins
PURPOSE: Gram-negative resistance continues to rise with treatment options becoming more limited. Ceftazidime/avibactam was recently approved in the United States and Europe, which combines an established third-generation cephalosporin with a new, unique, non-β-lactam β-lactamase inhibitor. This review conducts a thorough examination of structure, pharmacology, spectrum of activity, pharmacokinetics/pharmacodynamics, in vitro and clinical efficacy and safety/tolerability of ceftazidime/avibactam, as well as detailed future directions for the agent...
October 2016: Journal of Pharmacy & Pharmaceutical Sciences: a Publication of the Canadian Society for Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28018690/multiple-renal-abscesses-due-to-esbl-extended-spectrum-beta-lactamase-producing-escherichia-coli-causing-acute-pyelonephritis-and-bacteremia-a-case-report-with-a-good-outcome-no-drainage-required
#8
Abdalla Khalil, Musaad Qurash, Asem Saleh, Rasha Ali, Mohamed Elwakil
Extended-spectrum beta-lactamase-producing Enterobacteriaceae urinary tract infections are challenging infections with increased mortality, morbidity, and failure of therapy. A 44-year-old Saudi male diabetic patient was seen at the ER of IMC Hospital with features of acute pyelonephritis: fever, burning urine, and left flank pain for three days. He was treated for cystitis at the Endocrine Clinic two weeks prior to his ER visit with nitrofurantoin and levofloxacin orally according to urine culture and sensitivity result...
2016: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/28012683/might-real-time-pharmacokinetic-pharmacodynamic-optimisation-of-high-dose-continuous-infusion-meropenem-improve-clinical-cure-in-infections-caused-by-kpc-producing-klebsiella-pneumoniae
#9
Federico Pea, Paola Della Siega, Piergiorgio Cojutti, Assunta Sartor, Massimo Crapis, Claudio Scarparo, Matteo Bassetti
The effect of real-time pharmacokinetic/pharmacodynamic (PK/PD) optimisation of high-dose continuous-infusion meropenem on the clinical outcome of patients receiving combination antimicrobial therapy for treatment of KPC-producing Klebsiella pneumoniae (KPC-Kp) infections was retrospectively assessed. Data for all patients with KPC-Kp-related infections who received antimicrobial combination therapy containing high-dose continuous-infusion meropenem optimised by means of therapeutic drug monitoring (TDM) were retrieved...
February 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/27966034/population-pharmacokinetics-of-meropenem-in-elderly-patients-dosing-simulations-based-on-renal-function
#10
Muhammad Usman, Otto R Frey, Georg Hempel
OBJECTIVES: The aim of this study was to evaluate different dosage regimens of meropenem in elderly patients in relation with renal function using a population pharmacokinetic (popPK) model. METHODS: The data of 178 elderly patients treated with meropenem was collected from different sources. A popPK model was developed by using NONMEM® and the influence of different covariates on meropenem CL and V1 was observed. Monte Carlo dosing simulations were performed at steady state to observe the % T > MIC for targets of 40, 60 and 80% of dosage intervals at different levels of creatinine clearance (CLCR)...
March 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/27867083/trends-in-antimicrobial-resistance-among-bacteroides-species-and-parabacteroides-species-in-the-united-states-from-2010-2012-with-comparison-to-2008-2009
#11
REVIEW
D R Snydman, N V Jacobus, L A McDermott, E J C Goldstein, L Harrell, S G Jenkins, D Newton, R Patel, D W Hecht
The susceptibility trends for Bacteroides fragilis and related species against various antibiotics were determined using data from 3 years of surveillance (2010-2012) on 779 isolates referred by 7 medical centers. The antibiotic test panel included imipenem, ertapenem, meropenem, ampicillin-sulbactam, piperacillin-tazobactam, cefoxitin, clindamycin, moxifloxacin, tigecycline, linezolid, chloramphenicol and . MICs were determined using the agar dilution CLSI reference method. Carbapenem resistance remained low (range 1...
November 17, 2016: Anaerobe
https://www.readbyqxmd.com/read/27851486/1851-continuous-infusion-of-meropenem-in-a-patient-on-ecmo-and-crrt
#12
Yasir Alqaqaa, Robert Witcher, Michelle Ramirez, Jason Fisher, Laura Malaga-Dieguez, Arun Chopra
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27703820/therapeutic-drug-monitoring-of-meropenem-in-neonate-with-necrotizing-enterocolitis-a-challenge
#13
Steven De Keukeleire, Daniëlle Borrey, Wim Decaluwe, Marijke Reynders
Necrotizing enterocolitis (NEC) continues to be a major cause of neonatal morbidity and mortality. We describe the added value of therapeutic drug monitoring by presenting the case of a preterm infant with severe NEC treated with meropenem. Dosing strategy will achieve adequate patient outcome when treating pathogens with elevated MIC. As safe as meropenem is, there are not enough data for 40 mg/kg, every 8 h infused over 4 h; accordingly, strict monitoring of blood levels is mandatory. Based on our findings, a 4 h prolonged infusion of 40 mg/kg meropenem, every 8 h, will achieve an adequate patient outcome...
2016: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/27686471/targeted-de-escalation-rounds-may-effectively-and-safely-reduce-meropenem-use
#14
U Ni Riain, M Tierney, C Doyle, A Vellinga, C Fleming, M Cormican
OBJECTIVE: Use of meropenem in our hospital has doubled in recent years. An audit in 2013 showed that although initiation of therapy with meropenem was generally appropriate, therapy was rarely subsequently reviewed and de-escalated where appropriate. Therefore, a structured stewardship initiative focussed on meropenem de-escalation was developed. METHODS: A local guideline for review and de-escalation of meropenem was developed and approved by the Antimicrobial Stewardship Team...
September 29, 2016: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/27613266/scedosporium-apiospermum-a-rare-cause-of-malignant-otitis-externa
#15
Oliver McLaren, Christian Potter
A 79-year-old man, with a history of well-controlled diabetes mellitus, presented with left-sided otalgia. With an initial diagnosis of simple otitis externa, he was discharged on topical drops. He represented 2 months later with worsening otalgia and discharge. A diagnosis of malignant otitis externa was made based on clinical and radiological findings. Intravenous Tazocin and Gentamicin were given based on previous bacterial culture from ear swabs. The patient failed to improve and developed left-sided facial nerve palsy...
September 9, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27580337/diarrhea-associated-pneumococcal-meningitis-with-complicating-hydrocephalus-in-a-child-in-a-resource-limited-setting
#16
Lubaba Shahrin, Mohammod Jobayer Chisti, Sayeeda Huq, Md Munirul Islam, Shafiqul Alam Sarker, Mahmuda Begum, Shukla Saha, Tahmeed Ahmed
INTRODUCTION: Streptococcus pneumonia is the most common and intimidating cause of childhood meningitis. Its delayed diagnosis may be associated with hyponatremia and hypernatremia with fatal outcome. CASE PRESENTATION: A previously healthy nine-month-old Bangladeshi female infant was diagnosed with diarrhea, pneumonia, and convulsion due to hypernatremia. Pneumonia was confirmed by respiratory distress and radiological findings. Routine cerebrospinal fluid study detected pneumococcal meningitis...
August 31, 2016: Journal of Infection in Developing Countries
https://www.readbyqxmd.com/read/27530839/antimicrobial-susceptibility-among-important-pathogens-collected-as-part-of-the-tigecycline-evaluation-and-surveillance-trial-t-e-s-t-in-spain-2004-2014
#17
Francesc Marco, Michael J Dowzicky
Here we report in vitro activity data from the Tigecycline Evaluation and Surveillance Trial (T.E.S.T.) for tigecycline and comparators against Gram-positive and Gram-negative organisms collected from 27 medical centres in Spain between 2004 and 2014. Minimum inhibitory concentrations (MICs) were determined according to the broth microdilution methodology of the Clinical and Laboratory Standards Institute (CLSI) and susceptibility were determined according to European Committee on Antimicrobial Susceptibility Testing (EUCAST) interpretive criteria...
September 2016: Journal of Global Antimicrobial Resistance
https://www.readbyqxmd.com/read/27506202/guillaine-barre-syndrome-a-rare-complication-of-melioidosis-a-case-report
#18
P W M C S B Wijekoon, K A S Bandara, A Kailainathan, N S Chandrasiri, C T Hapuarachchi
BACKGROUND: Melioidosis caused by Burkholderia pseudomellei is an infection with protean clinical manifestations. Guillain-Barré syndrome [GBS] associated with melioidosis is very rare. CASE PRESENTATION: A 42-year-old woman with diabetes presented with abdominal pain, vomiting and intermittent fever for one month. Six months before presentation she had recurrent skin abscesses. Three months before presentation she had multiple liver abscesses which were aspirated in a local hospital...
2016: BMC Infectious Diseases
https://www.readbyqxmd.com/read/27504548/icu-pathogens-a-continuous-challenge
#19
Amira Hafeez, Tehmina Munir, Sara Najeeb, Sabahat Rehman, Mehreen Gilani, Maliha Ansari, Nadia Saad
OBJECTIVE: To determine the frequency and antibiogram of pathogens in an intensive care unit (ICU). STUDY DESIGN: Cross-sectional, observational study. PLACE AND DURATION OF STUDY: Department of Microbiology, Army Medical College, National University of Science and Technology, Islamabad, from January 2013 to January 2014. METHODOLOGY: Clinical samples, received from patients admitted in ICU, were inoculated on various medias like blood agar, chocolate agar, MacConkey agar and urine samples on CLED...
July 2016: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/27346925/marvelous-but-morbid-infective-endocarditis-due-to-serratia-marcescens
#20
Varun K Phadke, Jesse T Jacob
A 46-year-old man with HIV infection and active intravenous drug use presented with approximately two weeks of fevers and body aches. On physical examination he was somnolent, had a new systolic murmur, bilateral conjunctival hemorrhages, diffuse petechiae, and left-sided arm weakness. Echocardiography revealed a large mitral valve vegetation and brain imaging demonstrated numerous embolic infarctions. Blood cultures grew Serratia marcescens. Despite aggressive treatment with meropenem the patient died due to intracranial hemorrhage complicated by herniation...
May 2016: Infectious Diseases in Clinical Practice: IDCP
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