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aminoglycoside monotherapy in childs

V N Vavilov, M Yu Averyanova, S N Bondarenko, N V Stancheva, L S Zubarovskaya, B V Afanasyev
AIM: To study the incidence and risk factors of bacterial infections and the efficiency of empirical antibacterial therapy in patients in the early period after allogeneic hematopoietic stem cell transplantation (allo-HSCT). SUBJECTS AND METHODS: The study included 155 patients who had undergone allo-HSCT. Myeloablative conditioning was used in 39% of the patients. All the patients with neutropenia (NP) received antibiotic prophylaxis with fluoroquinolones until recovery of white blood cell counts or before systemic antibiotic therapy...
2015: Terapevticheskiĭ Arkhiv
Seung Beom Han, Seung Won Jung, E Young Bae, Jae Wook Lee, Dong-Gun Lee, Nack-Gyun Chung, Dae Chul Jeong, Bin Cho, Jin Han Kang, Hack-Ki Kim, Yeon-Joon Park
This retrospective study was conducted to evaluate clinical outcomes of bacteremia caused by extended-spectrum β-lactamase (ESBL)-producing Escherichia coli and Klebsiella pneumoniae and their antibiotic susceptibilities in febrile neutropenic children. Clinical characteristics, prognosis, and antibiotic susceptibilities were reviewed and compared between febrile neutropenic children with bacteremia caused by ESBL-producing and non-ESBL-producing E. coli and K. pneumoniae. A total of 61 episodes of E. coli and K...
April 2015: Microbial Drug Resistance: MDR: Mechanisms, Epidemiology, and Disease
Anna C Sick, Sarah Tschudin-Sutter, Alison E Turnbull, Scott J Weissman, Pranita D Tamma
BACKGROUND: Empirical combination antibiotic regimens consisting of a β-lactam and an aminoglycoside are frequently employed in the pediatric population. Data to demonstrate the comparative benefit of empirical β-lactam combination therapy relative to monotherapy for culture-proven Gram-negative bacteremia are lacking in the pediatric population. METHODS: We conducted a retrospective cohort study of children treated for Gram-negative bacteremia at The Johns Hopkins Hospital from 2004 through 2012...
May 2014: Pediatrics
Pranita D Tamma, Alison E Turnbull, Anthony D Harris, Aaron M Milstone, Alice J Hsu, Sara E Cosgrove
IMPORTANCE: Definitive combination antibiotic therapy with a β-lactam and an aminoglycoside for the treatment of gram-negative bacteremia is commonly prescribed in pediatric patients; however, its efficacy and toxicity relative to β-lactam monotherapy are unknown. OBJECTIVE: To determine whether definitive combination antibiotic therapy affects mortality and nephrotoxicity in pediatric patients with gram-negative bacteremia. DESIGN, SETTING, AND PARTICIPANTS: Retrospective cohort study including pediatric patients (aged ≤18 years) with gram-negative bacteremia hospitalized at the Johns Hopkins Children's Center between 2002 and 2011...
October 2013: JAMA Pediatrics
Mical Paul, Yaakov Dickstein, Agata Schlesinger, Simona Grozinsky-Glasberg, Karla Soares-Weiser, Leonard Leibovici
BACKGROUND: Continued controversy surrounds the optimal empirical treatment for febrile neutropenia. New broad-spectrum beta-lactams have been introduced as single treatment, and classically, a combination of a beta-lactam with an aminoglycoside has been used. OBJECTIVES: To compare beta-lactam monotherapy versus beta-lactam-aminoglycoside combination therapy for cancer patients with fever and neutropenia. SEARCH METHODS: The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, Issue 7, 2012), LILACS (August 2012), MEDLINE and EMBASE (August 2012) and the Database of Abstracts of Reviews of Effects (DARE) (Issue 3, 2012)...
June 29, 2013: Cochrane Database of Systematic Reviews
R Cohen, Y Gillet, A Faye
Management of urinary tract infections (UTI) in children is at a crossroads both in regard to the diagnostic methods used, the need to detect vesico-ureteral reflux, the benefit of prophylactic antibiotics and the emergence strains of multiresistant E. coli. The Groupe de Pathologie Infectieuse Pédiatrique of French Society of Pediatrics takes position : (i) to utilize more frequently urinary dipsticks and for urinary cultures, other methods of urine sampling than bag (sample jet, urethral catheterization, supra-pubic puncture) ; (ii) do not alter the initial therapeutic proposals of the former AFSSAPS (despite the percentage of E...
November 2012: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
Hamid Mohammad-Jafari, Mohammed Jafar Saffar, Ibrahim Nemate, Hana Saffar, Ali-Reza Khalilian
UNLABELLED: Urinary tract infections (UTI) are one of the most common infections with an increasing resistance to antimicrobial agents. PURPOSE: Empirical initial antibiotic treatment of UTI must rely on susceptible data from local studies. MATERIALS AND METHODS: Retrospective analysis of isolated bacteria from children with UTIs was performed at the university hospital during years 2006-2009. The findings were compared with data collected in a similar study carried out in 2002-2003...
January 2012: International Braz J Urol: Official Journal of the Brazilian Society of Urology
Arif Manji, Thomas Lehrnbecher, L Lee Dupuis, Joseph Beyene, Lillian Sung
PURPOSE: Carbapenems represent a broad-spectrum alternative to anti-pseudomonal penicillin (APP) combination or single-agent therapy for the management of pediatric febrile neutropenia (FN). Our primary objective was to describe the risk of treatment failure in children treated with an APP or carbapenem as initial empiric treatment for FN. Our secondary objective was to compare outcomes of APP versus carbapenem therapy in this population. METHODS: An electronic search of Ovid Medline, EMBASE, and the Cochrane Central Register of Controlled Trials was performed...
October 2012: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Hacı Ahmet Demir, Tezer Kutluk, Mehmet Ceyhan, Begül Yağcı-Küpeli, Canan Akyüz, Bülent Cengiz, Ali Varan, Ateş Kara, Bilgehan Yalçın, Gülten Seçmeer, Münevver Büyükpamukçu
Febrile neutropenia (FEN) is a leading complication of intensive chemotherapy. With this prospective randomized study, the authors aimed to compare the effectiveness of sulbactam-cefoperazone (SC) versus carbapenems, as empirical monotherapy in febrile neutropenic children with lymphoma and solid tumors. Febrile neutropenic children (age ≤16 years) hospitalized at the authors' center for lymphomas or solid tumors between March 2007 and June 2009 were included in the study. Patients randomly received SC or carbapenem...
May 2011: Pediatric Hematology and Oncology
Javier Solera
Brucellosis is an extremely important disease around the world, especially in developing countries. Its clinical manifestations and severity vary with the patient population studied and the species of Brucella involved. The choice of regimen and duration of antimicrobial therapy should be based on whether focal disease is present or there are underlying conditions that contraindicate certain antibiotics (e.g. pregnant patients or children under 8 years old). Most individuals with acute brucellosis respond well to a combination of doxycycline plus aminoglycosides or rifampicin for 6 weeks...
November 2010: International Journal of Antimicrobial Agents
Stéphane Paulus, Simon Dobson, Shahrad Rassekh, Edith Blondel-Hill
Viridans group Streptococcus (VGS) is a leading cause of bacteremia in pediatric oncology patients, primarily in children with acute myeloid leukemia or after hematopoietic stem cell transplantation. We retrospectively identified all positive blood cultures in oncology patients at the British Columbia Children's Hospital for a period of 54 months. VGS was the second most commonly isolated pathogen, present in 19% of all the positive blood cultures. Susceptibility analysis of 46 VGS isolates from that period was performed using the Etest method for penicillin, cefotaxime, ceftazidime, and piperacillin/tazobactam...
April 2009: Journal of Pediatric Hematology/oncology
Stéphane Paulus, Simon Dobson
There is a need for increased consensus in the definition of fever and neutropenia, the approach to risk stratification (including outpatient therapy and early discharge) and choices of empiric antimicrobial therapy in children. There has been an increased incidence of Gram positive infection in FN patients, in particular with VGS in patient with AML. However, Gram negative bacteria are still responsible for most of the mortality associated with FN. Piperacillin/tazobactam, cefipime, or meropenem are all effective first-choice antimicrobial monotherapy in FN...
2009: Advances in Experimental Medicine and Biology
Benoit Brethon, Karima Yakouben, Caroline Oudot, Patrick Boutard, Bénédicte Bruno, Cécile Jérome, Brigitte Nelken, Lionel de Lumley, Yves Bertrand, Jean-Hugues Dalle, Sylvie Chevret, Thierry Leblanc, André Baruchel
Gemtuzumab ozogamicin (GO) monotherapy is reported to yield a 20-30% response rate in advanced acute myeloid leukaemia (AML). This study examined the efficacy and tolerability of GO combined with cytarabine (GOCYT) in children with refractory/relapsed CD33(+) AML. Seventeen children received GO 3 mg/m(2) on days 1, 4 and 7 plus cytarabine 100 mg/m(2)/d for 7 d on a compassionate-use basis. Seven patients then received GO-based consolidation. At the outset of GOCYT, two patients were refractory; eight patients were in refractory first relapse; six patients had relapsed after stem cell transplantation (SCT); and one patient [del(5q) therapy-related AML (t-AML)] had not yet been treated...
November 2008: British Journal of Haematology
Abhijit Chandra, Puneet Dhar, Satish Dharap, Amitabh Goel, Rajesh Gupta, Jayprakash V Hardikar, Vinay K Kapoor, Ashok K Mathur, Pankaj Modi, Mahendra Narwaria, Mayakonda K Ramesh, Hariharan Ramesh, R A Sastry, Shashank Shah, Satpalsingh Virk, Otivilvayoth V Sudheer, Maddibande R Sreevathsa, Subodh Varshney, Puja Kochhar, Sanjay Somasundaram, Chetan Desai, Manjula Schou
BACKGROUND: Combinations of a third-generation cephalosporin and metronidazole, with or without an aminoglycoside, often are used for the treatment of intra-abdominal infections in surgical settings. Simpler regimens that preserve an adequate spectrum of coverage, but allow easier administration and have fewer side effects, may be a more desirable option. METHODS: This randomized, open-label, active comparator study evaluated the effectiveness (non-inferiority hypothesis) of the beta-lactam/beta-lactamase inhibitor combination cefoperazone-sulbactam (2-8 g/day), compared with ceftazidime (2-6 g/day)-amikacin (15 mg/kg/day)-metronidazole (500 mg three times daily) in 154 and 152 subjects, respectively, having intra-abdominal infections...
June 2008: Surgical Infections
Vicente Pintado, Lucía García San Miguel, Fabio Grill, Blanca Mejía, Javier Cobo, Jesús Fortún, Pilar Martín-Dávila, Santiago Moreno
OBJECTIVE: To assess the efficacy and toxicity of intravenous colistin in the treatment of infections due to multidrug-resistant gram-negative bacteria. METHODS: Retrospective cohort study. RESULTS: Sixty patients received colistin sulphomethate sodium (mean dose, 4.4mg/kg/day; median duration, 20days). The main infections were pneumonia or tracheobronchitis (63.3%), intra-abdominal (10%), urinary tract (8.3%), and surgical site infection (6...
March 2008: Journal of Infection
A Ondrusova, E Grey, J Benca, B Rudinsky, M Huttova, F Bauer, M Kovac, M Sramka
We have been unable to document a benefit of a combination of aminoglycosides with betalactam or carbapenem antibiotics in nosocomial meningitis. This was similar to the cases of sepsis, where survival of patients did not improve with combination therapy. Combination therapy did not increase the chance of appropriateness of the therapy. 30% of those on combination therapy were considered as inappropriately treated in comparison to 2.8% of those on monotherapy (p<0.01).
June 2007: Neuro Endocrinology Letters
Adam B Goldin, Robert S Sawin, Michelle M Garrison, Danielle M Zerr, Dimitri A Christakis
OBJECTIVE: We conducted a retrospective cohort study to compare the use of triple therapy versus monotherapy for children and adolescents with perforated appendicitis and to determine whether there has been a transition to monotherapy within the freestanding children's hospitals that contribute to the Pediatric Health Information System database. METHODS: We used the Pediatric Health Information System database, which includes billing and discharge data for 32 children's hospitals in the United States, to examine the trend in antibiotic usage and whether the postappendectomy antibiotic regimen was associated with differences in complication-related readmissions, length of stay, or charges in a population of children and adolescents with ruptured appendicitis and discharge dates between March 1, 1999, and September 30, 2004...
May 2007: Pediatrics
Hany Ariffin, Chong Lee Ai, Chan Lee Lee, Wan Ariffin Abdullah
AIM: Empirical therapy for children with febrile neutropenia has traditionally consisted of combination antibiotics, usually a beta-lactam and an aminoglycoside. However, recent trends and international guidelines have now made monotherapy a feasible option in the management of this group of patients. We prospectively evaluated the efficacy and safety of cefepime monotherapy in our population of paediatric cancer patients with febrile neutropenia. METHODS: An audit was performed on children aged 16 years and younger presenting with fever and neutropenia who were managed with empirical single-agent cefepime...
December 2006: Journal of Paediatrics and Child Health
Reiko Sato, Yusuke Tanigawara, Mitsuo Kaku, Naoki Aikawa, Kihachiro Shimizu
Arbekacin is widely used in Japan for the treatment of patients infected with methicillin-resistant Staphylococcus aureus (MRSA). In this study, we have determined the optimal concentration targets of arbekacin for both efficacy and safety. A pharmacokinetic-pharmacodynamic analysis was performed to relate exposure to the drug and clinical cure/improvement or nephrotoxicity. Since we have reported the population pharmacokinetic parameters for arbekacin in the preceding paper (Y. Tanigawara, R. Sato, K. Morita, M...
November 2006: Antimicrobial Agents and Chemotherapy
C Viscoli, A Cometta, W V Kern, R Bock, M Paesmans, F Crokaert, M P Glauser, T Calandra
Combination therapy with a beta-lactam plus an aminoglycoside has been the standard approach for treating febrile neutropenia for many years. More recently, beta-lactam monotherapy has also been shown to be a reliable and safe approach. In the present study, 763 eligible patients with fever and neutropenia received piperacillin-tazobactam monotherapy. On day 3, according to the study protocol, 165 patients with persistent fever who fulfilled the study entry criteria were randomised to receive vancomycin or a placebo...
March 2006: Clinical Microbiology and Infection
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