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antibiotic escalation

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https://www.readbyqxmd.com/read/28416559/a-novel-non-antibiotic-nitroglycerin-based-catheter-lock-solution-for-the-prevention-of-intraluminal-central-venous-catheter-infections-in-cancer-patients
#1
Anne-Marie Chaftari, Ray Hachem, Ariel Szvalb, Mahnaz Taremi, Bruno Granwehr, George Michael Viola, Amin Sapna, Andrew Assaf, Numan Yazan, Pankil Shah, Ketevan Gasitashvili, Elizabeth Natividad, Ying Jiang, Rebecca Slack, Ruth Reitzel, Joel Rosenblatt, Elie Mouhayar, Issam Raad
Background: For long-term central lines (CL), the lumen is the major source of central line associated bloodstream infections (CLABSI). Current standard of care for maintaining catheter patency includes flushing the CL with saline or heparin. Neither agent has any antimicrobial activity. Furthermore heparin may enhance staphylococcal biofilm formation. We evaluated the safety and efficacy of a novel non-antibiotic catheter lock solution for the prevention of CLABSI.Patients and Methods: Between November 2015, and February 2016, we enrolled 60 patients with hematologic malignancies who had peripherally inserted central catheter (PICC) to receive the study lock solution...
April 17, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28414662/weil-s-disease-from-a-local-new-orleans-bar
#2
H P Kahn, L Bateman
INTRODUCTION: Leptospirosis is a zoonotic infection that typically presents with fever, myalgias, nausea, and vomiting after contact with contaminated waters or infected animals (typically rodents); and their excrements. Conditions favorable to the transmission of leptospirosis are common in LA and, without treatment, leptospirosis can lead to both liver and renal failure, meningitis, pulmonary hemorrhage and ultimately death. CASE: A 56 year old woman with no past medical history presented to the Emergency Department with weakness, myalgias, jaundice and decreased urine output for one week...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28413497/antibiotic-de-escalation-principle-in-elderly-patients-with-chronic-obstructive-pulmonary-disease-complicated-with-severe-pneumonia
#3
Baohong Xiao, Mei Wang, Xiaoling Hu, Jinfeng Li, Fangfang Wang, Jiaxing Sun
The present study investigated the clinical effect of antibiotic de-escalation therapy in elderly patients with chronic obstructive pulmonary disease (COPD) complicated with severe pneumonia. According to the parity method of hospitalization number, 86 cases were selected and divided into the observation and control group with 43 cases each. Based on empirical antibiotic application, levofloxacin and cephalosporin antibiotics were used in the control group. After treatment for 3 days, the regimen was adjusted to antibiotics active against Gram-positive (G+) and Gram-negative (G-) bacteria such as the third or fourth generation cephalosporin antibiotics, combined with aminoglycoside, or macrolide antibiotics according to their effects...
April 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28402317/simultaneous-and-quantitative-monitoring-of-co-cultured-pseudomonas-aeruginosa-and-staphylococcus-aureus-with-antibiotics-on-a-diffusometric-platform
#4
Chih-Yao Chung, Jhih-Cheng Wang, Han-Sheng Chuang
Successful treatments against bacterial infections depend on antimicrobial susceptibility testing (AST). However, conventional AST requires more than 24 h to obtain an outcome, thereby contributing to high patient mortality. An antibiotic therapy based on experiences is therefore necessary for saving lives and escalating the emergence of multidrug-resistant pathogens. Accordingly, a fast and effective drug screen is necessary for the appropriate administration of antibiotics. The mixed pathogenic nature of infectious diseases emphasizes the need to develop an assay system for polymicrobial infections...
April 12, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28395597/genome-sequencing-and-comparative-analysis-of-an-ndm-1-producing-klebsiella-pneumoniae-st15-isolated-from-a-refugee-patient
#5
Tamara Salloum, Harout Arabaghian, Sahar Alousi, Edmond Abboud, Sima Tokajian
The escalating problem of antibiotic resistance, specifically cabarpenemase and extended-spectrum β-lacatamase (ESBL) producing K. pneumoniae strains, is directly correlated with increased patient morbidity and mortality and prolonged hospitalization and costs. In this study, a comprehensive genomic analysis encompassing the resistomics, virulence repertoire and mobile genetic elements of an NDM-1 positive ESBL-producing K. pneumoniae EA-MEH ST15 isolated from a urine sample collected from a Syrian refugee was conducted...
April 11, 2017: Pathogens and Global Health
https://www.readbyqxmd.com/read/28395369/antibiotics-prescriptions-in-the-neonatal-intensive-care-unit-how-to-overcome-everyday-challenges
#6
D Donà, E Mozzo, V Mardegan, U Trafojer, P Lago, S Salvadori, E Baraldi, C Giaquinto
Antimicrobial prescriptions in neonatal intensive care units (NICUs) represent a point of concern for the emergence of MDROs and for morbidity associated with prolonged antibiotic exposure (e.g., invasive candidiasis, necrotizing enterocolitis, and late-onset sepsis). Antimicrobial stewardship programs (ASPs) have shown to be a valuable tool for the prevention of resistance with the goals of optimizing clinical outcomes while decreasing unnecessary prescribing. The most frequent ASP strategies include the correct collection and interpretation of microbiological specimens, prescription of the narrowest-spectrum antibiotic appropriate for a particular case, and de-escalation or discontinuation of therapy in defined situations...
April 10, 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/28384858/antimicrobial-resistance-surveillance-among-intensive-care-units-of-a-tertiary-care-hospital-in-southern-india
#7
Kailash Moolchandani, Apurba Sankar Sastry, R Deepashree, Sujatha Sistla, B N Harish, Jharna Mandal
INTRODUCTION: Hospital Acquired Infections (HAIs) are the rising threat in the health care facilities across the globe. As most Intesive Care Unit (ICU) patients are frequently on broad spectrum antimicrobials, this induces selective antibiotic pressure which leads to development of Antimicrobial Resistance (AMR) among the microorganisms of ICUs. AIM: To study the occurrence of different types of HAIs in patients admitted to various ICUs of JIPMER and the AMR pattern of the bacterial pathogens isolated from them...
February 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28383517/antibiotic-resistance-in-an-indian-rural-community-a-one-health-observational-study-on-commensal-coliform-from-humans-animals-and-water
#8
Manju Raj Purohit, Salesh Chandran, Harshada Shah, Vishal Diwan, Ashok J Tamhankar, Cecilia Stålsby Lundborg
Antibiotic-resistant bacteria are an escalating grim menace to global public health. Our aim is to phenotype and genotype antibiotic-resistant commensal Escherichia coli (E. coli) from humans, animals, and water from the same community with a 'one-health' approach. The samples were collected from a village belonging to demographic surveillance site of Ruxmaniben Deepchand (R.D.) Gardi Medical College Ujjain, Central India. Commensal coliforms from stool samples from children aged 1-3 years and their environment (animals, drinking water from children's households, common source- and waste-water) were studied for antibiotic susceptibility and plasmid-encoded resistance genes...
April 6, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28375168/severe-adenoviral-pneumonia-in-an-immunocompetent-host-with-persistent-fevers-treated-with-multiple-empiric-antibiotics-for-presumed-bacterial-co-infection-an-antibiotic-stewardship-perspective-on-de-escalation-derailed
#9
Burke A Cunha, John Gian, Natalie C Klein
We present a case of severe adenoviral pneumonia in a 20-year-old immunocompetent host with persistently high fevers. The patient was needlessly given multiple empiric antibiotics for non-existent bacterial co-infection. This case has important antibiotic stewardship lessons for practitioners in approaching fevers in the ICU.
April 4, 2017: Journal of Clinical Medicine
https://www.readbyqxmd.com/read/28365884/de-escalating-antibiotic-use-in-the-inpatient-setting-strategies-controversies-and-challenges
#10
REVIEW
J Daniel Markley, Shaina Bernard, Gonzalo Bearman, Michael P Stevens
PURPOSE OF REVIEW: Antibiotic de-escalation (ADE) is widely accepted as an integral strategy to curtail the global antibiotic resistance crisis. However, there is significant uncertainty regarding the ideal ADE strategy and its true impact on antibiotic resistance. Rapid diagnostic testing has the potential to enhance ADE strategies. Herein, we aim to discuss the current strategies, controversies, and challenges of ADE in the inpatient setting. RECENT FINDINGS: A consensus definition of ADE remains elusive at this time...
April 2017: Current Infectious Disease Reports
https://www.readbyqxmd.com/read/28353453/a-change-for-the-antibacterial-treatment-policy-to-decrease-carbapenem-consumption-at-a-haematopoietic-stem-cell-transplantation-centre
#11
Gõkhan Metan, Leylagül Kaynar, Nuran Yozgat, Ferhan Elmali, Cemile Altay Kürkçüoglu, Emine Alp, Mustafa Çetin
After experiencing a high rate of carbapenem-resistant Gram-negative bacilli infections in febrile neutropenic patients, a two-stage intervention was introduced in the haematopoietic stem cell transplantation (HSCT) centre. During the first eight months of 2014, carbapenems remained the first choice for the empirical treatment of febrile neutropenia while the use of piperacillin/tazobactam (TZP) was encouraged in patients with stable clinical condition. When blood cultures were reported as negative and the patient was clinically stable the carbapenem/TZP treatment was stopped regardless of continuous fever and neutrophil count...
March 1, 2017: Le Infezioni in Medicina
https://www.readbyqxmd.com/read/28348152/pharmacokinetics-and-tolerance-of-the-phage-endolysin-based-candidate-drug-sal200-after-a-single-intravenous-administration-among-healthy-volunteers
#12
Soo Youn Jun, In Jin Jang, Seonghae Yoon, Kyungho Jang, Kyung-Sang Yu, Joo Youn Cho, Moon-Woo Seong, Gi Mo Jung, Seong Jun Yoon, Sang Hyeon Kang
This study is a phase 1, single-center, randomized, double-blind, placebo-controlled, single-dosing, and dose-escalating study of intravenous SAL200. It is a new candidate drug for antibiotic-resistant staphylococcal infections based on a recombinant form of the phage endolysin SAL-1. The study evaluated the pharmacokinetics, pharmacodynamics, and tolerance among healthy male volunteers after the intravenous infusion of single ascending doses of SAL200 (0.1, 0.3, 1, 3, and 10 mg/kg).SAL200 was well tolerated, and no serious adverse events (AEs) were observed in this clinical study...
March 27, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28320724/piperacillin-tazobactam-versus-other-antibacterial-agents-for-treatment-of-bloodstream-infections-due-to-ampc-beta-lactamase-producing-enterobacteriaceae
#13
Lucy Cheng, Brian C Nelson, Monica Mehta, Nikhil Seval, Sarah Park, Marla J Giddins, Qiuhu Shi, Susan Whittier, Angela Gomez-Simmonds, Anne-Catrin Uhlemann
In vivo induction of AmpC beta-lactamases produces high-level resistance to many beta-lactam antibiotics in Enterobacteriaceae, often resulting in the use of carbapenems or cefepime (FEP). The clinical effectiveness of piperacillin-tazobactam (TZP), a weak inducer of AmpC beta-lactamases, is poorly understood. Here we conducted a case-control study of adult inpatients with bloodstream infections (BSIs) due to Enterobacter, Serratia, or Citrobacter spp. from 2009 to 2015 to assess outcomes following treatment with TZP compared to FEP or meropenem (MEM)...
March 20, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28302661/severe-co-trimoxazole-induced-hypoglycaemia-in-a-patient-with-microscopic-polyangiitis
#14
Thomas Edward Conley, Atif Mohiuddin, Noshaba Naz
A 69-year-old man presented to the emergency department with lower respiratory tract infection and febrile neutropaenia. He was recently discharged following a 50-day hospital stay with newly diagnosed microscopic polyangiitis, complicated by pulmonary haemorrhage and severe renal dysfunction requiring renal replacement therapy, plasma exchange and immunosuppression (cyclophosphamide and methylprednisolone). High risk of pneumocystis pneumonia (PCP) led to an escalation in treatment from prophylactic to therapeutic oral co-trimoxazole, alongside broad-spectrum antibiotics...
March 16, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28283187/successful-delayed-coiling-of-a-ruptured-growing-distal-posterior-cerebral-artery-mycotic-aneurysm
#15
C Champeaux, N Walker, J Derwin, A Grivas
Intracranial infectious aneurysm (IIA) is a rare form of cerebrovascular malformation for which obliteration may be undertaken after rupture or non-response to targeted antibiotic therapy. We discuss the case of a 19-year-old man who presented with acute neurologic decline (Glasgow Coma Scale of 8) and endocarditis. CT images demonstrated subarachnoid haemorrhage, hydrocephalus and a mycotic aneurysm on the left posterior cerebral artery. Conservative management was initially decided due to the high risk of stroke and hemianopia...
March 7, 2017: Neuro-Chirurgie
https://www.readbyqxmd.com/read/28271469/lactobacillus-plantarum-and-its-probiotic-and-food-potentialities
#16
Hamza Ait Seddik, Farida Bendali, Frédérique Gancel, Ismail Fliss, Giuseppe Spano, Djamel Drider
The number of studies claiming probiotic health effects of Lactobacillus plantarum is escalating. Lb. plantarum is a lactic acid bacterium found in diverse ecological niches, highlighting its particular capabilities of adaptation and genome plasticity. Another function that needs to be underlined is the capabilities of Lb. plantarum to produce diverse and potent bacteriocins, which are antimicrobial peptides with possible applications as food preservative or antibiotic complementary agents. Taken together, all these characteristics design Lb...
March 7, 2017: Probiotics and Antimicrobial Proteins
https://www.readbyqxmd.com/read/28260599/peritonsillar-abscess-clinical-aspects-of-microbiology-risk-factors-and-the-association-with-parapharyngeal-abscess
#17
REVIEW
Tejs Ehlers Klug
PTA is a collection of pus located between the tonsillar capsule and the pharyngeal constrictor muscle. It is considered a complication of acute tonsillitis and is the most prevalent deep neck infection (approximately 2000 cases annually in Denmark) and cause of acute admission to Danish ENT departments. Teenagers and young adults are most commonly affected and males may predominate over females. However, no studies of age- and gender-stratified incidence rates have previously been published. Furthermore, smoking may be associated with increased risk of peritonsillar abscess (PTA) development, although the magnitude of the association has not been estimated...
March 2017: Danish Medical Journal
https://www.readbyqxmd.com/read/28257317/pulmonary-infections-in-critical-intensive-care-rapid-diagnosis-and-optimizing-antimicrobial-usage
#18
Ivor S Douglas
PURPOSE OF REVIEW: Diagnosis of pulmonary infection, including hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) in the critically ill patient remains a common and therapeutically challenging diagnosis with significant attributable morbidity, mortality, and cost. Current clinical approaches to surveillance, early detection and, conventional culture-based microbiology are inadequate for optimal targeted antibiotic treatment and stewardship. Efforts to enhance diagnosis of HAP and VAP and the impact of these novel approaches on rational antimicrobial selection and stewardship are the focus of recent studies reviewed here...
May 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28254405/early-appendectomy-shortens-antibiotic-course-and-hospital-stay-in-children-with-early-perforated-appendicitis
#19
Hsin-Yu Tsai, Hsun-Chin Chao, Wan-Ju Yu
BACKGROUND: The optimal management of perforated appendicitis in the pediatric population has been controversial. This study aimed to compare the therapeutic efficacy between conservative treatment (CS) and early appendectomy (EA) in pediatric perforated appendicitis, and to determine whether surgical intervention is an optimal treatment modality for early perforated appendicitis in children. METHODS: Patients treated between January 2012 and April 2014, aged 0-18 years, with an imaging-based diagnosis of perforated appendicitis were retrospectively reviewed...
February 1, 2017: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/28249572/efficacy-and-safety-of-de-escalation-therapy-to-ertapenem-for-treatment-of-infections-caused-by-extended-spectrum-%C3%AE-lactamase-producing-enterobacteriaceae-an-open-label-randomized-controlled-trial
#20
Pinyo Rattanaumpawan, Peerawong Werarak, Anupop Jitmuang, Pattarachai Kiratisin, Visanu Thamlikitkul
BACKGROUND: Carbapenem antibiotics are considered the treatment of choice for serious extended-spectrum beta-lactamase (ESBL)-producing Gram-negative bacteria (GNB) infections. The study objectives were to evaluate efficacy and safety of de-escalation therapy to ertapenem for treatment of infections caused by extended-spectrum-β-lactamase-producing Enterobacteriaceae. METHODS: We conducted a randomized controlled trial of adult patients with documented ESBL-producing Enterobacteriaceae infections who had received any group 2 carbapenem for less than 96 h...
March 1, 2017: BMC Infectious Diseases
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