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antibiotics for intra abdominal infections

Sara A Buckman, Tamara Krekel, Anouk E Muller, John E Mazuski
The treatment of complicated intra-abdominal infections (cIAI) is increasingly challenging due to increased resistance of Gram-negative organisms. These multidrug resistant organisms lead to an increase in morbidity and mortality. This has led to renewed interest in use of older β-lactam antibiotics in combination with newer β-lactamase inhibitors. Ceftazidime-avibactam is one of the newest such combination antibiotics, which has been released for treatment of complicated intra-abdominal infections in combination with metronidazole...
October 19, 2016: Expert Opinion on Pharmacotherapy
Hiroshige Mikamo, Akira Yuasa, Keiko Wada, Bruce Crawford, Naomi Sugimoto
Background.  Carbapenem-resistant Enterobacteriaceae has increased dramatically in the last decade, resulting in infections that are difficult to treat and associated with high mortality rates. To prevent further antibacterial resistance, it is necessary to use carbapenem selectively. A combination of metronidazole with an antimicrobial agent active against aerobes is an alternative effective treatment for patients with complicated intra-abdominal infections (cIAIs). This study aimed to compare efficacy and safety of metronidazole combination therapies and carbapenem and to provide clinical evidence regarding the optimal treatment of cIAI...
September 2016: Open Forum Infectious Diseases
B Lipový, H Řihová, M Hanslianová, I Suchánek, P Brychta
Toxic epidermal necrolysis (TEN) is an autoimmune disease which is usually caused by a reaction to drugs. It affects mainly the skin and mucous membranes. It is a rare condition with a high mortality rate. Fatal outcomes in patients with TEN are mostly due to infectious complications. As antimicrobial drugs may induce this syndrome, the management of this condition is very complicated. Tigecycline is still a relatively new antibiotic approved in Europe for use in complicated intra-abdominal infections and complicated skin and soft tissue infections...
2016: Epidemiologie, Mikrobiologie, Imunologie
Charles E Edmiston, David J Leaper
BACKGROUND: Intra-operative surgical site irrigation (lavage) is common practice in surgical procedures in general, with all disciplines advocating some form of irrigation before incision closure. This practice, however, has been neither standardized nor is there compelling evidence that it effectively reduces the risk of surgical site infection (SSI). This narrative review addresses the laboratory and clinical evidence that is available to support the practice of irrigation of the abdominal cavity and superficial/deep incisional tissues, using specific irrigation solutions at the end of an operative procedure to reduce the microbial burden at wound closure...
September 27, 2016: Surgical Infections
Alberto Hernández-Tejedor, Carmen Débora Merino-Vega, Alfredo Martín-Vivas, Rafael Ruiz de Luna-González, Alberto Delgado-Iribarren, Ángeles Gabán-Díez, Ignacio Temprano-Gómez, Natalia de la Calle-Pedrosa, Ana Isabel González-Jiménez, Alejandro Algora-Weber
INTRODUCTION: Ceftolozane/tazobactam is a novel antibiotic approved for the treatment of complicated intra-abdominal and complicated urinary tract infections. CASE DESCRIPTION: We describe the use of off-label ceftolozane/tazobactam in the management of a multidrug-resistant Pseudomonas aeruginosa bacteremia that was already being treated with colistin and amikacin, the only active antibiotics according to the antibiogram.
September 26, 2016: Infection
Rishi Rattan, Casey J Allen, Robert G Sawyer, John Mazuski, Therese M Duane, Reza Askari, Kaysie L Banton, Jeffrey A Claridge, Raul Coimbra, Joseph Cuschieri, E Patchen Dellinger, Heather L Evans, Christopher A Guidry, Preston R Miller, Patrick J O'Neill, Ori D Rotstein, Michaela A West, Kimberley Popovsky, Nicholas Namias
A prospective, multicenter, randomized controlled trial found that four days of antibiotics for source-controlled complicated intra-abdominal infection resulted in similar outcomes when compared with a longer duration. We hypothesized that patients with specific risk factors for complications also had similar outcomes. Short-course patients with obesity, diabetes, or Acute Physiology and Chronic Health Evaluation II ≥15 from the STOP-IT trial were compared with longer duration patients. Outcomes included incidence of and days to infectious complications, mortality, and length of stay...
September 2016: American Surgeon
Huseyin Agah Terzi, Tayfur Demiray, Mehmet Koroglu, Guner Cakmak, Ihsan Hakki Ciftci, Ahmet Ozbek, Mustafa Altindis
INTRODUCTION: The Streptococcus anginosus group of bacteria are low-virulence bacteria existing as commensals in the oral flora and gastrointestinal tracts of humans. S. anginosus may spread to the blood in individuals with poor oral hygiene in cases of oral infections, such as gingivitis and tooth abscesses, that develop following the loss of mucosal unity. This may lead to infections in the whole body, primarily as brain and liver abscesses. CASE PRESENTATION: A 32-year-old male patient presented with complaints of nausea, vomiting, and diffuse abdominal pain...
June 2016: Jundishapur Journal of Microbiology
P Salgado, F Gilsanz, E Maseda
The rapid spread of multidrug-resistant bacteria has become a serious threat, especially in critical care units, thereby prolonging the hospital stay. Enterobacteriaceae have a high capacity to adapt to any environment. Plasmids are the reason behind their expansion. The choice of empiric therapy for intra-abdominal or urinary infections requires knowledge of the intrinsic microbiological variability of each hospital or critical care unit, as well as the source of infection, safety or antibiotic toxicity, interaction with other drugs, the dosage regimen and the presence of risk factors...
September 2016: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
Marta Vallejo, Diana P Cuesta, Luz E Flórez, Adriana Correa, Carmen E Llanos, Berenice Isaza, Stella Vanegas, Johanna Osorio, Lucía Casanova, María V Villegas
INTRODUCTION: Complicated community-acquired intra-abdominal infections (CA-cIAI) are a common cause of acute abdomen. OBJECTIVE: To identify the clinical and microbiology profile of CA-cIAI in four Colombian hospitals. METHODS: This is a prospective, descriptive study, between 08-2012 and 09-2014, including patients with CA-cIAI > 15 years. Data collected included: socio-demographic, clinical, diagnosis, and isolates of the first culture obtained aseptically during surgery with antimicrobial susceptibility...
June 2016: Revista Chilena de Infectología: órgano Oficial de la Sociedad Chilena de Infectología
A Ikeda, T Konishi, M Ueno, Y Fukunaga, S Nagayama, Y Fujimoto, T Akiyoshi, T Yamaguchi
BACKGROUND: The use of oral prophylactic antibiotics for the prevention of surgical-site infection (SSI) in patients undergoing laparoscopic surgery for colorectal cancer is controversial. The aim of this RCT was to evaluate whether intravenous perioperative antibiotics are inferior to combined preoperative oral and perioperative intravenous antibiotics in this setting. METHODS: Patients undergoing elective laparoscopic colorectal resection in a single cancer centre were assigned randomly to combined preoperative oral antibiotics (metronidazole and kanamycin) and perioperative intravenous antibiotics (cefmetazole) (oral/IV group) or to perioperative intravenous antibiotics (cefmetazole) alone (IV-only group)...
August 23, 2016: British Journal of Surgery
Jose A Hidalgo, Celeste M Vinluan, Nishaal Antony
There has been greater interest in developing additional antimicrobial agents due to the increasing health care costs and resistance resulting from bacterial pathogens to currently available treatment options. Gram-negative organisms including Enterobacteriaceae and Pseudomonas aeruginosa are some of the most concerning threats due to their resistance mechanisms: extended-spectrum beta-lactamase production and Klebsiella pneumoniae carbapenemase enzymes. Ceftazidime is a third-generation broad-spectrum cephalosporin with activity against P...
2016: Drug Design, Development and Therapy
Pedro Torres-González, Edgar Ortiz-Brizuela, Miguel Enrique Cervera-Hernandez, Miriam Bobadilla-Del Valle, Areli Martínez-Gamboa, José Sifuentes-Osornio, Alfredo Ponce-de-Leon
We describe the outcomes and factors associated with OXA-232 producing carbapenem-resistant Enterobacteriaceae infections. A case-control-control study was performed; each case of infection by a carbapenem-resistant/OXA-232 (OXA-232-cases, n=27) was matched by isolation site, species, and date, with 2 cases of infection by carbapenem-susceptible/third-generation cephalosporin-susceptible (TGCS-controls, n=54) and 2 cases by carbapenem-susceptible/ESBL producing Enterobacteriaceae (ESBL-controls, n=54); 66% were urinary tract and 18...
October 2016: Diagnostic Microbiology and Infectious Disease
Nitin Agarwal, Shashank Aroor, Pradeep Saini, Arun Gupta, Navneet Kaur
BACKGROUND: Pyomyositis (PY) is a primary infection of the skeletal muscles, leading to inflammation of the muscle fibers followed by pus formation and even necrosis in late stages. Because of overlap in presentation of intermuscular abscess (IM) and PY, the exact incidence and severity of PY is under-appreciated. PATIENTS AND METHODS: We conducted a prospective analytical study in a tertiary care center in North India from October 2011 to January 2013, recruiting patients with abscesses involving the chest wall, abdomen (parietal wall including back), and extremities...
October 2016: Surgical Infections
Joshua T Thaden, Jason M Pogue, Keith S Kaye
Antimicrobial resistance has been identified by the World Health Organization as "one of the three greatest threats to human health." Gram negative bacteria in particular drive this alarming trend. Carbapenem-resistant Enterobacteriaceae (CRE) such as Escherichia coli, Klebsiella pneumoniae, and Enterobacter species are of particular importance as they are associated with poor clinical outcomes and are common causes for a variety of infections including bacteremia, urinary tract infection, intra-abdominal infections and pneumonia...
July 6, 2016: Virulence
Yunliang Zhang, Xiaoyan Lin, Karen Bush
Eravacycline is a novel, fully synthetic fluorocycline antibiotic of the tetracycline class being developed for the treatment of complicated urinary tract infections and complicated intra-abdominal infections. Eravacycline has activity against many key Gram-negative pathogens, including Enterobacteriaceae resistant to carbapenems, cephalosporins, fluoroquinolones and β-lactam/β-lactamase inhibitor combinations, including strains that are multidrug-resistant. Carbapenem-resistant Enterobacteriaceae (CRE) isolates from 2010 to 2013 (n=110) were characterized for carbapenemase genes by PCR and sequencing...
August 2016: Journal of Antibiotics
P R Ingram, M D M Rawlins, R J Murray, J A Roberts, L Manning
In the context of globally increasing antimicrobial resistance, tigecycline appears to be a useful therapeutic option. The need for prolonged courses for complex infections has prompted consideration of its use via outpatient parenteral antibiotic therapy (OPAT) programmes, although clinical outcomes when used in this setting remain unknown. We retrospectively reviewed the patient characteristics and outcomes of 11 patients who received tigecycline, most commonly delivered as 100 mg once daily, via OPAT at three tertiary Australian hospitals...
October 2016: European Journal of Clinical Microbiology & Infectious Diseases
David Kashan, Nagarajan Muthu, Benjamin Chaucer, Fidencio Davalos, Michael Bernstein, Akella Chendrasekhar
Background: Clostridium perfringens gas gangrene is an extremely rare and fatal infection. Necrosis of the myometrium is rarely seen and has only been recorded in 18 cases to date. Of these 18 reported cases, only 5 have occurred in nonpregnant women. This article presents the 6th case of myometrium necrosis from C. perfringens. Case: A 72-year-old woman, gravida 2, para 2, presented with abdominal pain and vaginal bleeding. After examinations, laboratory testing, and several surgical interventions, she was found to have C...
June 1, 2016: Journal of Gynecologic Surgery
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
Manon Roche, Charléric Bornet, Philippe Monges, Andreas Stein, Sophie Gensollen, Piseth Seng
Some antibiotics are reserved essentially for hospital settings owing to cost effectiveness and in order to fight the emerging antibiotic resistance crisis. In some cases, antibiotics reserved exclusively for use in hospitals may be prescribed in outpatients for serious infections or in the absence of a therapeutic alternative. A 30-day prospective audit of outpatient prescriptions of antibiotics reserved exclusively for use in hospitals was performed. The objective of this study was to evaluate the relevance of outpatient antibiotic prescriptions by measuring appropriateness according to guidelines...
July 2016: International Journal of Antimicrobial Agents
Lei Jia, Jinqi Lu, Xiefeng Ma, Honggang Jiang, Yi Zhu, Yuting Liu, Ying Cai, Yuqi Zhang
OBJECTIVE: To investigate the risk factors of intra-abdominal infection(IAI) after colorectal cancer surgery. METHODS: Clinical and follow-up data of 773 colorectal cancer patients undergoing operation in our hospital from October 2011 to December 2014 were retrospectively analyzed. Patients were divided into intra-abdominal cavity infection group (110 cases, IAI group) and non intra-abdominal infection group(663 cases, non-IAI group). All the patients administered prophylactic antibiotics 30 minutes to 2 hours before operation...
April 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
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