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antibiotics for intra abdominal infections

Juan Camilo Gomez-Ospina, James A Zapata-Copete, Monica Bejarano, Herney Andrés García-Perdomo
OBJECTIVE: To determine the effectiveness and harms of using antibiotic prophylaxis (ABP) versus placebo/no intervention in patients undergoing elective laparoscopic cholecystectomy (eLCC) to prevent surgical site infection (SSI). METHODS: We searched MEDLINE (OVID), EMBASE, LILACS, and the Cochrane Central Register of Controlled Trials (CENTRAL) from inception to October 2017. We included clinical trials which involved adults at low risk undergoing eLCC and compared ABP versus placebo/no intervention...
March 19, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Yoshio Takesue, Shinya Kusachi, Hiroshige Mikamo, Junko Sato, Akira Watanabe, Hiroshi Kiyota, Satoshi Iwata, Mitsuo Kaku, Hideaki Hanaki, Yoshinobu Sumiyama, Yuko Kitagawa, Kazuhiko Nakajima, Takashi Ueda, Motoi Uchino, Toru Mizuguchi, Yoshiyasu Ambo, Masafumi Konosu, Keiichiro Ishibashi, Akihisa Matsuda, Kazuo Hase, Yasushi Harihara, Koji Okabayashi, Shiko Seki, Takuo Hara, Koshi Matsui, Yoichi Matsuo, Minako Kobayashi, Shoji Kubo, Kazuhisa Uchiyama, Junzo Shimizu, Ryohei Kawabata, Hiroki Ohge, Shinji Akagi, Masaaki Oka, Toshiro Wakatsuki, Katsunori Suzuki, Kohji Okamoto, Katsunori Yanagihara
The principle of empirical therapy for patients with intra-abdominal infections (IAI) should include antibiotics with activity against Enterobacteriaceae and Bacteroides fragilis group species. Coverage of Pseudomonas aeruginosa, Enterobacter cloacae, and Enterococcus faecalis is also recommended for hospital-associated IAI. A nationwide survey was conducted to investigate the antimicrobial susceptibility of pathogens isolated from postoperative IAI. All 504 isolates were collected at 26 institutions and referred to a central laboratory for susceptibility testing...
March 16, 2018: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
Jennifer Broom, Chin Li Tee, Alex Broom, Mark D Kelly, Tahira Scott, David A Grieve
BACKGROUND: Antimicrobial therapy for intra-abdominal infections is often inappropriately prolonged. An intervention addressing factors influencing the duration of intravenous antibiotic use was undertaken. This study reports the antibiotic prescribing patterns before and after the intervention and a qualitative analysis of the experience of the intervention. METHODS: Quantitative: A retrospective audit of patients with complicated intra-abdominal infection before and after a multifaceted persuasive intervention was performed...
March 6, 2018: ANZ Journal of Surgery
Daniele Roberto Giacobbe, Matteo Bassetti, Francesco Giuseppe De Rosa, Valerio Del Bono, Paolo Antonio Grossi, Francesco Menichetti, Federico Pea, Gian Maria Rossolini, Mario Tumbarello, Pierluigi Viale, Claudio Viscoli
Ceftolozane/tazobactam (C/T) is a new antibiotic resulting from the combination of a novel cephalosporin, structurally similar to ceftazidime, with tazobactam, a well-known beta-lactamase inhibitor. C/T remains active against extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae and multi-drug resistant (MDR) P. aeruginosa, and has been recently approved for the treatment of complicated intra-abdominal infections (cIAI) and complicated urinary tract infections (cUTI). A trial on hospital-acquired pneumonia is ongoing...
March 9, 2018: Expert Review of Anti-infective Therapy
Philippe Montravers, Florence Tubach, Thomas Lescot, Benoit Veber, Marina Esposito-Farèse, Philippe Seguin, Catherine Paugam, Alain Lepape, Claude Meistelman, Joel Cousson, Antoine Tesniere, Gaetan Plantefeve, Gilles Blasco, Karim Asehnoune, Samir Jaber, Sigismond Lasocki, Herve Dupont
PURPOSE: Shortening the duration of antibiotic therapy (ABT) is a key measure in antimicrobial stewardship. The optimal duration of ABT for treatment of postoperative intra-abdominal infections (PIAI) in critically ill patients is unknown. METHODS: A multicentre prospective randomised trial conducted in 21 French intensive care units (ICU) between May 2011 and February 2015 compared the efficacy and safety of 8-day versus 15-day antibiotic therapy in critically ill patients with PIAI...
February 26, 2018: Intensive Care Medicine
Andrew Kozlov, Lorenzo Bean, Emilie V Hill, Lisa Zhao, Eric Li, Gary P Wang
Background: Intra-abdominal abscesses are localized collections of pus, which generally arise from a breach in the normal mucosal defense barrier that allows bacteria from gastrointestinal tract, and less commonly from the gynecologic or urinary tract, to induce inflammation, resulting in an infection. The microbiology of these abscesses is usually polymicrobial, associated with the primary disease process. However, the microbial identity, diversity and richness in intra-abdominal abscesses have not been well characterized, due in part to the difficulty in cultivating commensal organisms using standard culture-based techniques...
February 2018: Open Forum Infectious Diseases
Nick Daneman, Asgar H Rishu, Ruxandra Pinto, Pierre Aslanian, Sean M Bagshaw, Alex Carignan, Emmanuel Charbonney, Bryan Coburn, Deborah J Cook, Michael E Detsky, Peter Dodek, Richard Hall, Anand Kumar, Francois Lamontagne, Francois Lauzier, John C Marshall, Claudio M Martin, Lauralyn McIntyre, John Muscedere, Steven Reynolds, Wendy Sligl, Henry T Stelfox, M Elizabeth Wilcox, Robert A Fowler
BACKGROUND: Shorter-duration antibiotic treatment is sufficient for a range of bacterial infections, but has not been adequately studied for bloodstream infections. Our systematic review, survey, and observational study indicated equipoise for a trial of 7 versus 14 days of antibiotic treatment for bloodstream infections; a pilot randomized clinical trial (RCT) was a necessary next step to assess feasibility of a larger trial. METHODS: We conducted an open, pilot RCT of antibiotic treatment duration among critically ill patients with bloodstream infection across 11 intensive care units (ICUs)...
February 17, 2018: Trials
Tetsu Ohnuma, Yoshiro Hayashi, Kazuto Yamashita, John Marquess, Alan Kawarai Lefor, Masamitsu Sanui
Although a majority of patients in the intensive care unit (ICU) receive antibiotics, little is known about patterns of antibiotic use in ICUs in Japan. The objective of this study was to evaluate the pattern of antibiotic use in ICUs. A nationwide one-day cross-sectional surveillance of antibiotic use in the ICU was conducted three times between January 2011 and December 2011. All patients aged ≧16-years old were included. Data from 52 ICUs and 1148 patients were reviewed. There were 1028 prescriptions for intravenous antibiotics...
February 1, 2018: International Journal of Antimicrobial Agents
Chau-Chyun Sheu, Shang-Yi Lin, Ya-Ting Chang, Chun-Yuan Lee, Yen-Hsu Chen, Po-Ren Hsueh
The spread of extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae has become a major public health threat worldwide. Area covered: A thorough systematic literature review describing the current evidence and future prospects of therapeutic options for infections caused by ESBL-producing Enterobacteriaceae. Expert commentary: The methods of detecting ESBLs have been evolving. The Clinical and Laboratory Standards Institute and the European Committee on Antimicrobial Susceptibility Testing lowered the MIC breakpoints of cephalosporins against ESBL-producing Enterobacteriaceae in 2010...
March 2018: Expert Review of Anti-infective Therapy
Xiaofang Sun, Shaohan Wu, Ting Xie, Jianping Zhang
RATIONALE: An open abdomen complicated with small-bowel fistulae becomes a complex wound for local infection, systemic sepsis and persistent soiling irritation by intestinal content. While controlling the fistulae drainage, protecting surrounding skin, healing the wound maybe a challenge. PATIENT CONCERNS: In this paper we described a 68-year-old female was admitted to emergency surgery in general surgery department with severe abdomen pain. Resection part of the injured small bowel, drainage of the intra-abdominal abscess, and fashioning of a colostomy were performed...
December 2017: Medicine (Baltimore)
Zheng-Hao Huang, Yu-Chen Chiu, Li-Lu Ho, Hsiu-Lung Fan, Chun-Chi Lu
RATIONALE: Adult-onset Still disease (AOSD) is a rare systemic inflammatory disease of unknown etiology characterized by evanescent salmon-pink rash, spiking fever, arthralgia/ arthritis, and lymphadenopathy. AOSD sometimes was fatal when it is complicated by macrophage activation syndrome (MAS) or hemophagocytic lymphohistiocytosis (HLH). Nonetheless, the literature provides no recommendations for treatment of AOSD patients with severe sepsis. PATIENT CONCERNS: A previously healthy 65-year-old man with history of AOSD was referred to our hospital for persistent right lower quadrant abdominal pain for 2 days...
February 2018: Medicine (Baltimore)
Qingjuan Shang, Qiankun Geng, Xuebing Zhang, Chunbao Guo
The aim of this study was to evaluate the efficacy of combined therapy with metronidazole and broad-spectrum antibiotics for patients with perforated appendicitis who underwent surgical intervention.Broad-spectrum antibiotic therapy is warranted in the treatment of perforated appendicitis. Metronidazole has been used as anaerobic antimicrobial therapy. However, few studies about the use of metronidazole in perforated appendicitis have been reported.The medical records of 249 patients treated with metronidazole combined with broad-spectrum antibiotics following perforated appendicitis surgery were reviewed retrospectively and compared with the medical records of 149 patients treated only with broad-spectrum antibiotics...
November 2017: Medicine (Baltimore)
Alejandra Ugarte-Torres, Mark R Gillrie, Thomas P Griener, Deirdre L Church
Background: Eggerthella lenta is a non-sporulating anaerobic gram-positive bacilli associated with polymicrobial intra-abdominal infections. Recently, E. lenta has been recognized as an important cause of anaerobic blood-stream infections (BSI) associated with high mortality. E. lenta has been reported to have high minimal inhibitory concentrations (MICs) to piperacillin-tazobactam (TZP), a broad-spectrum antibiotic with anaerobic coverage commonly used in multiple centers for empiric treatment of abdominal sepsis...
January 24, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Stephanie Royer, Kimberley M DeMerle, Robert P Dickson, Hallie C Prescott
BACKGROUND: Infection is a leading cause of hospitalization with high morbidity and mortality, but there are limited data to guide the duration of antibiotic therapy. PURPOSE: Systematic review to compare outcomes of shorter versus longer antibiotic courses among hospitalized adults and adolescents. DATA SOURCES: MEDLINE and Embase databases, 1990-2017. STUDY SELECTION: Inclusion criteria were human randomized controlled trials (RCTs) in English comparing a prespecified short course of antibiotics to a longer course for treatment of infection in hospitalized adults and adolescents aged 12 years and older...
January 25, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
Dafina Mahmutaj, Shaip Krasniqi, Bedri Braha, Dalip Limani, Burim Neziri
AIM: This study aims to evaluate the algorithm of procalcitonin (PCT) and its role on the duration of antibiotics prescription for intra-abdominal infections. MATERIALS AND METHODS: This study is a prospective controlled study that is conducted in groups of 50 hospitalised patients and 50 controlled group patients. RESULTS: The results indicated that the average duration of antibiotic delivery to the PCT group was -10.6 days (SD ± 6.6 days), while in the control group -13...
December 15, 2017: Open Access Macedonian Journal of Medical Sciences
Stefan Wirth, Sherif G S Emil, Arnis Engelis, Valeri Digtyar, Margarita Criollo, Carl DiCasoli, Heino Stass, Stefan Willmann, Richard Nkulikiyinka, Ulrike Grossmann
BACKGROUND: This study was designed to evaluate primarily the safety and also the efficacy of moxifloxacin (MXF) in children with complicated intra-abdominal infections (cIAIs). METHODS: In this multicenter, randomized, double-blind, controlled study, 451 pediatric patients aged 3 months to 17 years with cIAIs were treated with intravenous/oral MXF (N = 301) or comparator (COMP, intravenous ertapenem followed by oral amoxicillin/clavulanate; N = 150) for 5 to 14 days...
January 18, 2018: Pediatric Infectious Disease Journal
Swati Patolia, Getahun Abate, Nirav Patel, Setu Patolia, Sharon Frey
Background: The incidence of multidrug-resistant (MDR) organisms is increasing along with mortality. Identifying risk factors for the development of MDR Gram-negative bacilli (GNB) bacteremia could greatly impact patient care and management. Methods: Data from the electronic health record of patients with GNB over 13-month period were collected at a single university medical center. Baseline demographic data, risk factor, microbiological data, recurrence of bacteremia, and mortality were recorded...
January 2018: Therapeutic Advances in Infectious Disease
Mengmeng Chen, Minjie Zhang, Peixian Huang, Qiongyu Lin, Cheng Sun, Hongke Zeng, Yiyu Deng
The aim of this study is to compare the efficacy and safety of novelBL/BLIs with alternative antibiotics for the treatment of cIAI and cUTI. Area covered: We performed a systematic review and meta-analysis of all randomized controlled trials comparing novel BL/BLIs with other antibiotics for the treatment of cIAI and cUTI. The primary outcome included clinical and microbiological treatment success. Expert commentary: We found that novel BL/BLIs obtained a similar clinical outcome with other antibiotics in CE population (OR = 1...
February 2018: Expert Review of Anti-infective Therapy
Sara A Buckman, Isaiah R Turnbull, John E Mazuski
BACKGROUND: Sepsis is life-threatening organ dysfunction caused by a dysregulated host response to infection. Early recognition and treatment are the cornerstones of management. METHODS: Review of the English-language literature. RESULTS: For both sepsis and septic shock "antimicrobials [should be] be initiated as soon as possible and within one hour" (Surviving Sepsis Campaign). The risk of progression from severe sepsis to septic shock increases 8% for each hour before antibiotics are started...
February 2018: Surgical Infections
Christina Le, Frank Chu, Ronald Dunlay, Julian Villar, Peter Fedullo, Gabriel Wardi
STUDY OBJECTIVE: To determine the frequency and cause of inadequate initial antibiotic therapy with vancomycin and piperacillin-tazobactam in patients with severe sepsis and septic shock in the emergency department (ED), characterize its impact on patient outcomes, and identify patients who would benefit from an alternative initial empiric regimen. METHODS: Retrospective cohort study conducted between 2012 and 2015 in which 342 patients with culture-positive severe sepsis or septic shock who received initial vancomycin and piperacillin-tazobactam were reviewed to determine appropriateness of antimicrobial therapy, risk factors for inappropriate use, and outcome data...
December 29, 2017: American Journal of Emergency Medicine
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