Journal of chemotherapy
-
Journal of chemotherapy · Dec 2010
Randomized Controlled TrialSafety and efficacy of intravenous doripenem for the treatment of complicated urinary tract infections and pyelonephritis.
Doripenem was evaluated in adults with complicated urinary tract infections and pyelonephritis in two phase 3 studies. DORI-05, a randomized, double-blind study compared doripenem 500 mg every 8 hours with levofloxacin 250 mg every 24 hours. DORI-06 was a single-arm study designed to confirm the doripenem response in DORI-05. 799 received doripenem, 372 levofloxacin. ⋯ Genotyping data indicate persistent E. coli infections were often due to infection with new strains. Doripenem was generally found to be safe and well tolerated. ClinicalTrials.gov registration numbers: DORI-05 = NCT00229021, DORI-06 = NCT00210990.
-
Journal of chemotherapy · Oct 2010
ReviewAntibiotic therapy for exacerbations of chronic obstructive pulmonary disease (COPD).
Chronic obstructive pulmonary disease (COPD) is already the world's fourth most common cause of mortality and likely to become the third in a few year's time. Because it is an inflammatory airway disease with altered host immune response, infectious complications are frequent. Acute exacerbations of COPD (AECOPD) significantly worsen the patient's general health, accelerating disability. ⋯ If treating with antibiotics, treatment must include coverage for Haemophilus influenzae, Streptococcus pneumoniae and Moraxella catarrhalis in all cases, but other bacteria (such as Gram-negatives) may need to be covered depending on the condition of the patient. Antibiotics, particularly macrolides and fluoroquinolones, when administered under suitable conditions, shorten the clinical course and prevent severe deterioration. possible complications resulting from untreated severe AECOPD surpass the potential risks from the use of antibiotic therapy. Additional anti-inflammatory and immunomodulatory actions of some antibiotics may contribute to their efficacy in AECOPD.
-
Journal of chemotherapy · Oct 2010
Do different susceptibility breakpoints affect the selection of antimicrobials for treatment of uncomplicated cystitis?
Because of increasing antibiotic resistance in Escherichia coli, the main uropathogen of uncomplicated urinary tract infections (UTIs), updated susceptibility data are vital in guiding the selection of first-line treatment agents. interpretation of these data depends on the breakpoints adopted, that may vary among different guidelines. In this study we report the minimum inhibitory concentrations (MICs) of eight antibiotics and compare antimicrobial susceptibility results obtained in 2315 E. coli strains recently collected during the ARESC survey using EUCAST and CLSI breakpoints. We have also evaluated the clinical impact of breakpoint discrepancies on the overall susceptibility patterns. ⋯ In conclusion, fosfomycin, mecillinam, and nitrofurantoin have preserved their in vitro activity in all countries investigated, regardless of the criteria adopted. They continue to represent effective options for the empiric therapy of female patients with uncomplicated cystitis. The use of different interpretative criteria for E. coli responsible for UTIs therefore has no influence on the decision to be taken by the physicians managing the patients.
-
Journal of chemotherapy · Aug 2009
Multicenter StudyAntimicrobial resistance in gram-negative hospital isolates: results of the Turkish HITIT-2 Surveillance Study of 2007.
Resistance rates to amikacin, ciprofloxacin, ceftazidime, cefepime, imipenem, cefoperazone/sulbactam and piperacillin/tazobactam in Escherichia coli (n= 438), Klebsiella pneumoniae (n= 444), Pseudomonas aeruginosa (n= 210) and Acinetobacter baumanni (n=200) were determined with e-test in a multicenter surveillance study (Hitit-2) in 2007. ESBL production in Escherichia coli and K. pneumoniae was investigated following the CLSI guidelines. Overall 42.0% of E.coli and 41.4% of K. pneumoniae were ESBL producers. ⋯ In K. pneumoniae resistance to imipenem, ciprofloxacin and amikacin was 3.1%, 17.8% 12.4% respectively. In P. aeruginosa the lowest rate of resistance was observed with piperacillin/tazobactam (18.1%). A. baumanni isolates were highly resistant to all the antimicrobial agents, the lowest level of resistance was observed against cefoperazone/sulbactam (52.0%) followed by imipenem (55.5%). this study showed that resistance rates to antimicrobials are high in nosocomial isolates and show variations among the centers.
-
Journal of chemotherapy · Jul 2009
ReviewTigecycline for treatment of intra-abdominal infections: a literature update.
This article examines and discusses some of the most pertinent recent literature on the new glycylcycline antibiotic, tigecycline, in relation to its use for treatment of intraabdominal infections.