European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology
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Eur. J. Clin. Microbiol. Infect. Dis. · Aug 2019
Multicenter Study Comparative StudyContinuous infusion of ceftolozane/tazobactam is associated with a higher probability of target attainment in patients infected with Pseudomonas aeruginosa.
Ceftolozane/tazobactam (CTZ/TZ) exhibits time-dependent antimicrobial activity, and prolonged infusion can better achieve the pharmacodynamic target than an intermittent bolus. We aimed to compare the use of prolonged or continuous infusion with intermittent administration of CTZ/TZ for the treatment of infections caused by multidrug-resistant Pseudomonas aeruginosa. We performed a multicentric prospective cohort study to evaluate continuous, prolonged, or intermittent infusion of CTZ/TZ. ⋯ In contrast, intermittent bolus administration and prolonged infusion did not achieve the PK/PD objectives when the CTZ/TZ MICs were ≥ 4 mg/L. However, the PK/PD objectives (100% ƒT>4 MIC) were achieved for strains with MICs up to 8 mg/L in patients receiving continuous infusion of CTZ/TZ. A dosing regimen of 2 g/1 g CTZ/TZ administered every 8 h as a 1-h intravenous infusion, as currently recommended, did not provided adequate coverage to achieve a sufficient probability of target attainment for P. aeruginosa strains with MICs ≥ 4 mg/L.
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Eur. J. Clin. Microbiol. Infect. Dis. · Aug 2019
Cefazolin versus fluoroquinolones for the treatment of community-acquired urinary tract infections in hospitalized patients.
Literature for the treatment of hospitalized patients with community-acquired urinary tract infections (UTI) is limited. Previous outpatient studies do not support the use of oral beta-lactams compared with oral fluoroquinolones (FQ) due to poor clinical cure rates. However, recent studies evaluating intravenous (IV) beta-lactams in more complicated cases demonstrate promising cure rates. ⋯ The clinical failure rates were 2% and 7% in the cefazolin and FQ groups, respectively (p = 0.56). Additionally, there were no significant differences between the secondary endpoints. Treatment with cefazolin, a more narrow-spectrum agent with a potential for less "collateral damage," was non-inferior to FQ for community-acquired UTI in an inpatient setting.