Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · May 2002
Review[Antibiotic combinations in Staphylococcus aureus infections: arguments against].
In a case of severe infection due to Staphylococcus aureus, generally accepted practice involves the use of a combination of antibiotics. This article examines the type and quality of the experimental and clinical data which has been collected in this context. Published findings suggest that the arguments in favour of combinations are usually theoretical, and that a demonstration of the superiority of combinations has never been made by comparative, randomised studies.
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Ann Fr Anesth Reanim · May 2002
Review[The management of treatment failures for staphylococcal infections].
Therapeutic failure is a situation to be feared in severe infections due to staphylococci. In this article, we consider the difficulties faced is achieving a positive diagnosis in the context of such failures, and an approach to analysing their causes. The possible reasons for therapeutic failure must be considered systematically. ⋯ The rules for the prescription of antibiotics are followed, target concentrations are achieved and drug failures are a rarity today. This observation may be called into question by the emergence of strains with diminished sensitivity to glycopeptides. These therapeutic failures remain exceptional cases today.
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Research efforts to discover new compounds active against staphylococci are more than ever justified today. The incidence of methicillin-resistant staphylococci remains very high in hospitals, and the solution provided by glycopeptides is far from being satisfactory. ⋯ Finally, strains with diminished sensitivity to these antibiotics are beginning to appear. This article examines the opportunities offered by two new anti-staphylococcal agents: quinupristine-dalfopristine (Synercid) and linezolide (not marketed in France).
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Ann Fr Anesth Reanim · May 2002
Review[Antibiotic combinations in Staphylococcus aureus infections: arguments in favour].
More than 40% of Staphylococcus aureus strains isolated in hospitals are methicillin-resistant, thus posing daily problems regarding therapy. The treatment of these infections is principally based on glycopeptides. The need or not to combine them, first-line or second-line, with another antibiotic, remains a subject for debate. In this article, we have endeavoured to demonstrate the validity of arguments which plead in favour of using glycopeptides in combination, and not as single-drug therapy.