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Antipseudomonal

The Experts below are selected from a list of 264 Experts worldwide ranked by ideXlab platform

Geoffrey E Playford – 1st expert on this subject based on the ideXlab platform

  • association of ertapenem and Antipseudomonal carbapenem usage and carbapenem resistance in pseudomonas aeruginosa among 12 hospitals in queensland australia
    Journal of Antimicrobial Chemotherapy, 2013
    Co-Authors: David Mcdougall, Geoffrey E Playford, Anthony Morton

    Abstract:

    Objectives: The objective of this study was to determine the association between ertapenem and Antipseudomonal carbapenem use and carbapenem resistance in Pseudomonas aeruginosa in 12 hospitals in Queensland, Australia. Methods: Data on usage of ertapenem and other Antipseudomonal carbapenems, measured in defined daily doses per 1000 occupied bed-days, were collated using statewide pharmacy dispensing and distribution software from January 2007 until June 2011. The prevalence of unique carbapenem-resistant P. aeruginosa isolates derived from statewide laboratory information systems was collected for the same time period. Mixed-effects models were used to determine any relationship between ertapenem and Antipseudomonal carbapenem usage and carbapenem resistance among P. aeruginosa isolates in the 12 hospitals analysed. Results: No relationship between ertapenem usage and P. aeruginosa carbapenem resistance was observed. The introduction of ertapenem did not replace Antipseudomonal carbapenem prescribing to any significant extent. However, an association between greater usage of Antipseudomonal carbapenems and greater P. aeruginosa carbapenem resistance was demonstrated. Conclusions: It is likely that the only mechanism by which ertapenem can improve P. aeruginosa resistance patterns is by being used as a substitute for, rather than in addition to, Antipseudomonal carbapenems.

David P Nicolau – 2nd expert on this subject based on the ideXlab platform

  • 2175. In vitro Potency of Ceftolozane/Tazobactam and Other Antipseudomonal β-Lactams Against P. aeruginosa.
    Open Forum Infectious Diseases, 2020
    Co-Authors: Safa Almarzoky Abuhussain, Christina A Sutherland, David P Nicolau

    Abstract:

    AbstractBackgroundChallenges due to multidrug resistant Gram-negative bacterial pathogens such as P. aeruginosa (PSA) are increasing globally. Suboptimal antimicrobial therapy of infections caused by PSA is associated with increased morbidity and mortality. As a result, antimicrobial susceptibility (%S) studies are pivotal to identifying trends in antimicrobial resistance that inform decisions regarding choice of antimicrobial therapy. This study assessed the in vitro potency of 7 Antipseudomonal agents including ceftolozane/tazobactam against PSA collected from numerous sites across the United States.MethodsMultiple U.S. hospitals provided nonduplicate respiratory and blood isolates of PSA for potency testing. MICs against PSA were determined using broth microdilution methods according to CLSI for seven antimicrobials with Antipseudomonal activity: aztreonam, cefepime, ceftazidime, ceftolozane/tazobactam, imipenem, meropenem and piperacillin/tazobactam. Susceptibility (%S) was defined per CLSI or FDA breakpoint criteria.ResultsFourteen hospitals geographically spread across the United States provided total of 560 PSA isolates. Of the antibiotics assessed, %S to C/T was the highest at 95% with an MIC50 of 1 µg/mL and MIC90 of 2 µg/mL. In comparison, other %S (MIC50/MIC90) were as follows: ceftazidime 76% (4/64); cefepime 75% (4/32); piperacillin/tazobactam 73% (8/128), meropenem 72% (0.5/16); aztreonam 65% (8/32) and imipenem 65% (2/16).ConclusionFor this geographically diverse PSA population, ceftolozane/tazobactam demonstrated the highest overall susceptibility (95%). Other Antipseudomonal agents inclusive of the carbapenems displayed susceptibilities of 65–76%. In the era of escalating PSA resistance to the β-lactams, the potency of ceftolozane/tazobactam may represent an important clinical option.Disclosures D. P. Nicolau, Merck: Consultant, Grant Investigator and Speaker’s Bureau, Consulting fee, Research grant and Speaker honorarium.

  • in vitro potency of Antipseudomonal β lactams against blood and respiratory isolates of p aeruginosa collected from us hospitals
    Journal of Thoracic Disease, 2019
    Co-Authors: Safa Almarzoky Abuhussain, Christina A Sutherland, David P Nicolau

    Abstract:

    Background: Challenges due to multidrug resistant (MDR) Gram-negative bacterial pathogens such as P. aeruginosa (PSA) are increasing globally. Suboptimal antimicrobial therapy of infections caused by PSA is associated with increased morbidity and mortality. As a result, antimicrobial susceptibility (%S) studies are pivotal to identifying trends in antimicrobial resistance that inform decisions regarding choice of antimicrobial therapy. This study assessed the in vitro potency of 7 Antipseudomonal agents including ceftolozane/tazobactam (C/T) against PSA collected from numerous sites across the US.
    Methods: Multiple US hospitals provided non-duplicate respiratory and blood isolates of PSA for potency testing. MICs against PSA were determined using broth microdilution methods according to CLSI for 7 antimicrobials with Antipseudomonal activity: aztreonam (ATM), cefepime (FEP), ceftazidime (CAZ), C/T, imipenem (IPM), meropenem (MEM) and piperacillin/tazobactam (TZP). %S was defined per CLSI or FDA breakpoint criteria.
    Results: Thirty-five hospitals geographically spread across the US provided a total of 1,209 PSA isolates. Of the antibiotics assessed, %S to C/T was the highest at 95% with an MIC 50 of 0.5 mg/L and MIC 90 of 2 mg/L. In comparison, other %S (MIC 50 /MIC 90 ) was as follows: ATM 66% (8/32); FEP 76% (4/32); CAZ 78% (4/64); IPM 68% (2/16); MEM 74% (0.5/16); and TZP 73% (8/128).
    Conclusions: For this geographically diverse PSA population, C/T demonstrated the highest overall susceptibility (95%). Other Antipseudomonal agents inclusive of the carbapenems displayed susceptibilities of 66–78%. In the era of escalating PSA resistance to the β-lactams, the potency of C/T may represent an important clinical option.

  • 2175 in vitro potency of ceftolozane tazobactam and other Antipseudomonal β lactams against p aeruginosa
    Open Forum Infectious Diseases, 2018
    Co-Authors: Safa Almarzoky Abuhussain, Christina A Sutherland, David P Nicolau

    Abstract:

    AbstractBackgroundChallenges due to multidrug resistant Gram-negative bacterial pathogens such as P. aeruginosa (PSA) are increasing globally. Suboptimal antimicrobial therapy of infections caused by PSA is associated with increased morbidity and mortality. As a result, antimicrobial susceptibility (%S) studies are pivotal to identifying trends in antimicrobial resistance that inform decisions regarding choice of antimicrobial therapy. This study assessed the in vitro potency of 7 Antipseudomonal agents including ceftolozane/tazobactam against PSA collected from numerous sites across the United States.MethodsMultiple U.S. hospitals provided nonduplicate respiratory and blood isolates of PSA for potency testing. MICs against PSA were determined using broth microdilution methods according to CLSI for seven antimicrobials with Antipseudomonal activity: aztreonam, cefepime, ceftazidime, ceftolozane/tazobactam, imipenem, meropenem and piperacillin/tazobactam. Susceptibility (%S) was defined per CLSI or FDA breakpoint criteria.ResultsFourteen hospitals geographically spread across the United States provided total of 560 PSA isolates. Of the antibiotics assessed, %S to C/T was the highest at 95% with an MIC50 of 1 µg/mL and MIC90 of 2 µg/mL. In comparison, other %S (MIC50/MIC90) were as follows: ceftazidime 76% (4/64); cefepime 75% (4/32); piperacillin/tazobactam 73% (8/128), meropenem 72% (0.5/16); aztreonam 65% (8/32) and imipenem 65% (2/16).ConclusionFor this geographically diverse PSA population, ceftolozane/tazobactam demonstrated the highest overall susceptibility (95%). Other Antipseudomonal agents inclusive of the carbapenems displayed susceptibilities of 65–76%. In the era of escalating PSA resistance to the β-lactams, the potency of ceftolozane/tazobactam may represent an important clinical option.Disclosures D. P. Nicolau, Merck: Consultant, Grant Investigator and Speaker’s Bureau, Consulting fee, Research grant and Speaker honorarium.

Despina Perrea – 3rd expert on this subject based on the ideXlab platform

  • acute kidney injury following the concurrent administration of Antipseudomonal beta lactams and vancomycin a network meta analysis
    Clinical Microbiology and Infection, 2020
    Co-Authors: Ioannis Bellos, Vasilios Karageorgiou, Vasilios Pergialiotis, Despina Perrea

    Abstract:

    Abstract Background and objectives Acute kidney injury represents a major complication of vancomycin treatment, especially when it is co-administered with other nephrotoxins. This meta-analysis aims to comparatively assess the nephrotoxicity of Antipseudomonal beta-lactams when combined with vancomycin. Data Sources Medline, Scopus, CENTRAL and Clinicaltrials.gov databases were systematically searched from inception through 20 August 2019. Study eligibility criteria Studies evaluating acute kidney injury risk following the concurrent use of Antipseudomonal beta-lactams and vancomycin were selected. Participants Adult and pediatric patients treated in hospital or intensive care unit. Intervention Administration of vancomycin combined with any Antipseudomonal beta-lactam. Methods Acute kidney injury incidence was defined as the primary outcome. Secondary outcomes included severity, onset, duration, need of renal replacement therapy, length of hospitalization and mortality. Quality of evidence was assessed using the ROBINS-I tool and the Confidence In Network Meta-Analysis approach. Results Forty-seven cohort studies were included, with a total of 56,984 patients. In the adult population, the combination of piperacillin-tazobactam and vancomycin resulted in significantly higher nephrotoxicity rates compared to vancomycin monotherapy (Odds ratio-OR: 2.05, 95% confidence intervals-CI [1.17-3.46]) and its concurrent use with meropenem (OR: 1.84, 95% CI [1.02-3.10]) or cefepime (OR: 1.80, 95% CI [1.13-2.77]). In pediatric patients, acute kidney injury was significantly higher with vancomycin plus piperacillin-tazobactam than vancomycin alone (OR: 4.18, 95% CI [1.01-17.29]) or vancomycin plus cefepime OR: 3.71, 95% CI [1.08-11.24]). No significant differences were estimated for the secondary outcomes. Credibility of outcomes was judged as moderate, mainly due to imprecision and inter-study heterogeneity. Conclusions The combination of vancomycin and piperacillin-tazobactam is associated with higher acute kidney injury rates compared to its parallel use with meropenem or cefepime. Current evidence is exclusively observational and is limited by inter-study heterogeneity. Randomized controlled trials are needed to verify these results and define preventive strategies to minimize nephrotoxicity risk.

  • Acute kidney injury following the concurrent administration of Antipseudomonal beta-lactams and vancomycin: a network meta-analysis.
    Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases, 2020
    Co-Authors: Ioannis Bellos, Vasilios Karageorgiou, Vasilios Pergialiotis, Despina Perrea

    Abstract:

    Acute kidney injury represents a major complication of vancomycin treatment, especially when it is co-administered with other nephrotoxins. This meta-analysis aims to comparatively assess the nephrotoxicity of Antipseudomonal beta-lactams when combined with vancomycin.
    Medline, Scopus, CENTRAL and Clinicaltrials.gov databases were systematically searched from inception through 20 August 2019.
    Studies evaluating acute kidney injury risk following the concurrent use of Antipseudomonal beta-lactams and vancomycin were selected.
    Adult and pediatric patients treated in hospital or intensive care unit.
    Administration of vancomycin combined with any Antipseudomonal beta-lactam.
    Acute kidney injury incidence was defined as the primary outcome. Secondary outcomes included severity, onset, duration, need of renal replacement therapy, length of hospitalization and mortality. Quality of evidence was assessed using the ROBINS-I tool and the Confidence In Network Meta-Analysis approach.
    Forty-seven cohort studies were included, with a total of 56,984 patients. In the adult population, the combination of piperacillin-tazobactam and vancomycin resulted in significantly higher nephrotoxicity rates compared to vancomycin monotherapy (Odds ratio-OR: 2.05, 95% confidence intervals-CI [1.17-3.46]) and its concurrent use with meropenem (OR: 1.84, 95% CI [1.02-3.10]) or cefepime (OR: 1.80, 95% CI [1.13-2.77]). In pediatric patients, acute kidney injury was significantly higher with vancomycin plus piperacillin-tazobactam than vancomycin alone (OR: 4.18, 95% CI [1.01-17.29]) or vancomycin plus cefepime OR: 3.71, 95% CI [1.08-11.24]). No significant differences were estimated for the secondary outcomes. Credibility of outcomes was judged as moderate, mainly due to imprecision and inter-study heterogeneity.
    The combination of vancomycin and piperacillin-tazobactam is associated with higher acute kidney injury rates compared to its parallel use with meropenem or cefepime. Current evidence is exclusively observational and is limited by inter-study heterogeneity. Randomized controlled trials are needed to verify these results and define preventive strategies to minimize nephrotoxicity risk.
    Copyright © 2020 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.