Acute kidney injury in patients using amikacin in an era of carbapenem-resistant bacteria

Tuon, Felipe Francisco; Aragao, Bruna Zanette de; Santos, Thiago Almeida; Gasparetto, Juliano; Cordova, Kassia; Abujamra, Marcela

doi:10.1080/23744235.2016.1205215

Cited by 12 publications

(8 citation statements)

References 8 publications

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“…Furthermore, previous studies have corroborated the safety of these drugs when used in adjusted doses and with serum monitoring. 36 , 37 In addition, a new meta-analysis highlighted the association of acute renal injury with patients receiving concomitant piperacillin-tazobactam and vancomycin, which reinforced our exchange strategy. 38 …”

Section: Discussionmentioning

confidence: 84%

A broad-spectrum beta-lactam-sparing stewardship program in a middle-income country public hospital: antibiotic use and expenditure outcomes and antimicrobial susceptibility profiles

Zequinão

Gasparetto

Oliveira

et al. 2020

The Brazilian Journal of Infectious Diseases

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Section: Discussionmentioning

confidence: 84%

A broad-spectrum beta-lactam-sparing stewardship program in a middle-income country public hospital: antibiotic use and expenditure outcomes and antimicrobial susceptibility profiles

Zequinão

Gasparetto

Oliveira

et al. 2020

The Brazilian Journal of Infectious Diseases

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“…The most important β-lactamases in P. aeruginosa are cephalosporinases, ampC hyper-expression, extended-spectrum β-lactamases, and carbapenemases. Currently, carbapenemases has been the major challenge, reducing therapeutic options to just a few, including old and toxic drugs (polymyxins and aminoglycosides) [ 97 , 98 , 99 , 100 , 101 , 102 ].…”

Section: Motility (Flagella and Type IV Pili)mentioning

confidence: 99%

Pathogenesis of the Pseudomonas aeruginosa Biofilm: A Review

et al. 2022

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Pseudomonas aeruginosa is associated with several human infections, mainly related to healthcare services. In the hospital, it is associated with resistance to several antibiotics, which poses a great challenge to therapy. However, one of the biggest challenges in treating P. aeruginosa infections is that related to biofilms. The complex structure of the P. aeruginosa biofilm contributes an additional factor to the pathogenicity of this microorganism, leading to therapeutic failure, in addition to escape from the immune system, and generating chronic infections that are difficult to eradicate. In this review, we address several molecular aspects of the pathogenicity of P. aeruginosa biofilms.

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“… 4 , 5 Currently, the treatment options for CRPA infection are limited, usually based on polymyxin (including colistin or polymyxin B), aminoglycosides, carbapenems or combination therapy, as well as novel antibiotic therapies including ceftazidime/avibactam (CAZ/AVI). 6 However, polymyxin B and aminoglycoside drugs have been associated with nephrotoxic side effects, 7 with increasing number of reports of Pseudomonas aeruginosa resistance to these antibiotics worldwide. 8 Accordingly, it is imperative to find effective treatment approaches against CRPA infection.…”

Section: Introductionmentioning

confidence: 99%

Ceftazidime/Avibactam versus Polymyxin B in the Challenge of Carbapenem-Resistant Pseudomonas aeruginosa Infection

Chen¹,

Liang²,

Chen³

et al. 2022

IDR

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Purpose Ceftazidime/avibactam (CAZ/AVI) monotherapy and polymyxin B-based combination therapy are currently two treatment options for patients with carbapenem-resistant Pseudomonas aeruginosa (CRPA) infection; however, few studies have contrasted the relative efficacy of the two antibiotic regimens. The purpose of this study was to compare the effectiveness of CAZ/AVI and polymyxin B against CRPA infection and analyze the independent predictors of 30-day mortality or survival. Patients and Methods This single-center retrospective observational study included patients with CRPA infection treated with CAZ/AVI or polymyxin B between January 2018 and December 2020. The primary outcomes were the 14-day and 30-day mortality. The secondary outcomes were in-hospital mortality and bacterial clearance. Baseline characteristics and outcomes were compared between the two groups, and COX regression analysis was used to identify predictors of 30-day mortality. Results A total of 136 patients with CRPA infection were enrolled, including 51 patients in the CAZ/AVI group and 85 patients in the polymyxin B group. The 14-day mortality (5.9% vs 27.1%, p=0.002), 30-day mortality (13.7% vs 47.1%, p<0.001) and in-hospital mortality (29.4% vs 60.0%, p=0.001) in the CAZ/AVI group were significantly lower than the polymyxin B group. The bacterial clearance rate (45.1% vs 12.9%, p<0.001) in the CAZ/AVI group were higher than in the polymyxin B group. After adjustment by propensity score matching, the CAV/AVI group still had lower 30-day mortality (14.3% vs 42.9%, p=0.018) and higher bacterial clearance rate (42.9% vs 14.3%, p=0.018) than the polymyxin B group. The multivariate COX analysis showed that the age was identified as independent predictor of 30-day mortality while CAZ/AVI therapy and central venous catheterization emerged as independent predictors of 30-day survival. Conclusion CAZ/AVI therapy was superior to polymyxin B therapy for patients with CRPA infection, and provided significant survival benefits, but further larger studies were needed to substantiate our findings.

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Acute kidney injury in patients using amikacin in an era of carbapenem-resistant bacteria

Cited by 12 publications

References 8 publications

A broad-spectrum beta-lactam-sparing stewardship program in a middle-income country public hospital: antibiotic use and expenditure outcomes and antimicrobial susceptibility profiles

A broad-spectrum beta-lactam-sparing stewardship program in a middle-income country public hospital: antibiotic use and expenditure outcomes and antimicrobial susceptibility profiles

Pathogenesis of the Pseudomonas aeruginosa Biofilm: A Review

Ceftazidime/Avibactam versus Polymyxin B in the Challenge of Carbapenem-Resistant Pseudomonas aeruginosa Infection

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