Activities of doripenem against nosocomial bacteremic drug-resistant Gram-negative bacteria in a medical center in Taiwan

Dong, Shao-Xing; Wang, Jann-Tay; Chang, Shan-Chwen

doi:10.1016/j.jmii.2012.08.022

Cited by 3 publications

(4 citation statements)

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“…In a previous study that investigated the in vitro activity of doripenem in antibiotic-resistant clinical isolates collected from 2001-2002, doripenem was more potent than imipenem or meropenem even against non-fermentative GNB [ 19 ]. However, more recent studies of blood GNB isolates reported that doripenem and other carbapenems had similar in vitro activity against non-fermentative GNB, similar to the results of our study [ 11 12 ]. Thus, doripenem should not be considered a treatment option against imipenem-or meropenem-resistant non-fermentative GNB blood isolates, or against hospital-acquired infections or pneumonia in which these GNB isolates are suggested as likely pathogens.…”

Section: Discussionsupporting

confidence: 92%

“…In this context, doripenem, the latest introduced agent of the carbapenem class, may be a useful alternative treatment option as it shows potent in vitro antimicrobial activity against MDR-GNB and clinical effectiveness comparable with other carbapenems [ 5 6 7 8 9 ]. However, clinicians are usually reluctant to prescribe doripenem, because data regarding doripenem susceptibility are rarely available from widely used automated susceptibility testing panels [ 10 ] and the in vitro activity of doripenem against clinically significant isolates such as blood isolates has not been reported separately in the context of recent increases in carbapenem resistance, except for a few studies [ 11 12 ]. One included only blood isolates from bacteremic urinary tract infections, and the other did not include distinct clinical information on bacteremia cases.…”

Section: Introductionmentioning

confidence: 99%

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In vitro Antibacterial Activity of Doripenem against Gram-Negative Blood Isolates in a Korean Tertiary Care Center

et al. 2015

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BackgroundDoripenem is the most recently introduced antimicrobial agent of the carbapenem class. It is a valuable therapeutic option in the context of increasing antimicrobial resistance to imipenem and meropenem among gram-negative bacilli (GNB) clinical isolates. However, clinicians are usually reluctant to prescribe doripenem, because susceptibility to doripenem is not automatically reported by most clinical laboratories and the in vitro activity of doripenem against clinically significant GNB isolates remains uncertain.Materials and MethodsWe investigated the in vitro antibacterial activity of doripenem in GNB blood isolates in a tertiary care center. Over a period of 10 months, 212 adult bacteremia cases were treated at the study hospital. Doripenem susceptibility testing was performed for the 212 blood isolates by the disk diffusion method, and clinical data were collected.ResultsAmong the blood isolates, the rate of doripenem resistance (7.5%) was lower than that of imipenem (12.9%) or other anti-GNB antimicrobial agents, except amikacin (2.1%). Almost all imipenem-susceptible GNB blood isolates (181/182, 99.5%) were susceptible to doripenem. Whereas doripenem resistance was rarely observed in Enterobacteriaceae (2/181, 1.1%), it was frequently observed in patients with non-fermentatative GNB (12/27, 44.4%), hospital-acquired infections (7/27, 25.9%), and pneumonia (11/49, 22.4%).ConclusionDoripenem exhibited more potent in vitro activity against GNB blood isolates than other anti-GNB antimicrobial agents in a tertiary care center where it was infrequently prescribed compared with other carbapenems. However, its clinical utility may be limited due to the increasing number of carbapenem-resistant non-fermentative GNB infections.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

In vitro Antibacterial Activity of Doripenem against Gram-Negative Blood Isolates in a Korean Tertiary Care Center

et al. 2015

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“…Because most automated susceptibility testing panels [10] do not include doripenem, and knowledge about the in vitro activity of doripenem against clinically isolated pathogens in the context of increasing carbapenem resistance is limited [11,12], clinicians usually more frequently prescribe imipenem or meropenem rather than doripenem in clinical practice. Thus, data regarding the clinical experience of patients receiving doripenem are limited.…”

Section: Introductionmentioning

confidence: 99%

Clinical Experience of Patients Receiving Doripenem-Containing Regimens for the Treatment of Healthcare-Associated Infections

et al. 2016

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In this study, we retrospectively reviewed the clinical experience of patients receiving doripenem-containing regimens for the treatment of healthcare-associated infections (HCAIs) in a tertiary care center and assessed the clinical usefulness of doripenem therapy in this clinical setting. In this retrospective study, the medical records of all adult patients who had ever received doripenem-containing therapy for the treatment of HCAIs were reviewed between September 1, 2012 and August 31, 2014, and the following data were extracted: age, gender, type of infection, disease severity, underlying comorbidities or conditions, and laboratory results. Additionally, we also extracted data regarding the rates of mortality and clinical and microbiological response. A total of 184 adult patients with HCAIs who had received doripenem-containing therapy were included in this study. Respiratory tract infections (n = 91, 49.5%) were the most common type of infection, followed by urinary tract infections, intra-abdominal infections and skin and soft tissue infections. The mean APACHE II score was 14.5. The rate of clinical success was 78.2%, and the overall in-hospital mortality rate was only 13.0%. Among patients, in-hospital mortality was independently and significantly associated with APACHE II score (odds ratio (OR), 1.2825; 95% CI, 1.1123–1.4788) and achieving clinical success (OR, 0.003; 95% CI, 0.0003–0.409). In conclusion, the overall in-hospital mortality rate was low and the clinical success rate was high among HCAI patients receiving doripenem treatment. These results suggest that doripenem may be judiciously used for the treatment of patients with HCAIs.

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“…В то же время в исследовании in vitro, проведенном S.X. Dong et al, активность этих трех карбапенемов была одинаковой: чувствительны к дорипенему, имипенему и меропенему были 56, 60 и 60% штаммов соответственно при МИК 50 меньше 0,5 мкг/мл [21].…”

Section: антимикробная активность дорипенема In Vitro в отношении оснunclassified

Antimicrobial Therapy of Patients With Fan-Associated Pneumonia: Focus on Dopirenem

Fesenko¹

2016

Med. sov.

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Activities of doripenem against nosocomial bacteremic drug-resistant Gram-negative bacteria in a medical center in Taiwan

Abstract: Doripenem was as effective as imipenem and meropenem in our study. However, there was a significant proportion of carbapenem resistance among the tested isolates. Hence, longitudinal surveillance is necessary to monitor the resistance trend.

Cited by 3 publications

References 24 publications

In vitro Antibacterial Activity of Doripenem against Gram-Negative Blood Isolates in a Korean Tertiary Care Center

In vitro Antibacterial Activity of Doripenem against Gram-Negative Blood Isolates in a Korean Tertiary Care Center

Clinical Experience of Patients Receiving Doripenem-Containing Regimens for the Treatment of Healthcare-Associated Infections

Antimicrobial Therapy of Patients With Fan-Associated Pneumonia: Focus on Dopirenem

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