The Journal of antimicrobial chemotherapy
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The degree of penetration of an antibiotic into the infected site is an important criterion for therapeutic success. Ertapenem is a new carbapenem, exhibiting activity against most Gram-positive and Gram-negative aerobic and anaerobic bacteria commonly recovered from community-acquired infections. However, no studies concerning its diffusion into bone and synovial tissue are available. Our objective was to quantify ertapenem bone and synovial tissue penetration and to compare our data with the MIC(90)s for causative pathogens. ⋯ The concentrations after an ertapenem 1 g dose achieved in cancellous and cortical bone tissue and in synovial tissue were greater than the MIC(90)s for most aerobic organisms for 24 h, and for 12 to 24 h for anaerobic bacteria in healthy volunteers undergoing total hip replacement.
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J. Antimicrob. Chemother. · Oct 2007
ReviewSex issues in HIV-1-infected persons during highly active antiretroviral therapy: a systematic review.
Since the introduction of highly active antiretroviral therapy (HAART), morbidity and mortality rates have sharply decreased among HIV-infected patients. Studies of possible differences between men and women in the course of HIV infection give conflicting results. The objective of this study was to assess sex differences during HAART. ⋯ We found little evidence of sex differences during antiretroviral treatment. Nevertheless, most of these studies were underpowered to detect sex differences and had limited follow-up at 6 or 12 months. Design of new gender-sensitive clinical trials with both prolonged follow-up and sample size representative of the current HIV prevalence among women are strongly needed to detect the likely sex differences of antiretroviral agents during HIV infection.
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J. Antimicrob. Chemother. · Oct 2007
Vancomycin MIC creep in non-vancomycin-intermediate Staphylococcus aureus (VISA), vancomycin-susceptible clinical methicillin-resistant S. aureus (MRSA) blood isolates from 2001-05.
To assess whether methicillin-resistant Staphylococcus aureus (MRSA) vancomycin MIC shifts (MIC creep) at a tertiary care institution occurred that may have gone undetected using traditional susceptibility markers (percentage susceptible, MIC(50), MIC(90)) over a 5 year period. Additionally, MIC trends were evaluated for oxacillin, linezolid and daptomycin. ⋯ Oxacillin, vancomycin and linezolid MICs increased over time. For vancomycin and linezolid, these MIC increases were not reliably detected by percentage susceptibility as they occurred below the susceptibility breakpoint. Although the MICs of all agents appeared to be associated with increasing oxacillin MICs, the strongest associations were noted for vancomycin and linezolid.
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J. Antimicrob. Chemother. · Sep 2007
Adequacy of empirical antifungal therapy and effect on outcome among patients with invasive Candida species infections.
Although inadequate antimicrobial therapy has been demonstrated in multiple studies to increase the risk for death in bacterial infections, few data investigating the effect of antifungal therapy on outcome of serious fungal disease are available. We sought to assess the adequacy of empirical therapy and its effect on mortality in invasive Candida species infections. ⋯ Adequate empirical therapy is used in a minority of patients with invasive Candida spp. infections but is associated with improved survival.
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J. Antimicrob. Chemother. · Sep 2007
Invasive Candida species infection: the importance of adequate empirical antifungal therapy.
Candida species are a common cause of bloodstream and invasive infection in critically ill and immunosuppressed patients. Furthermore, invasive Candida infection carries a poor prognosis and may initially be mistaken for bacterial infection. ⋯ This study shows that adequate empirical therapy is received by only a quarter of patients, and that inappropriate therapy is associated with increased mortality. These findings highlight the importance of appropriate empirical therapy in invasive Candida infection.