How to tailor recommendations on the treatment of multi-drug resistant Gram-negative infections at country level integrating antibiotic stewardship principles within the GRADE-ADOLOPMENT framework

Carrara, Elena; Grossi, Paolo Antonio; Gori, Andrea; Lambertenghi, Lorenza; Antonelli, Massimo; Lombardi, Andrea; Bongiovanni, Filippo; Magrini, Nicola; Manfredi, Carlo; Stefani, Stefania; Tumbarello, Mario; Tacconelli, Evelina; Auerbach, Nina; Cassol, Chiara; Rancan, laria; Mangioni, Davide; Ungaro, Riccardo; Postorino, Stefania; Vargas, Joel

doi:10.1016/s1473-3099(23)00435-8

Cited by 3 publications

(1 citation statement)

References 49 publications

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“…They are an older beta-lactam (BL) plus a new beta-lactamase inhibitor (BLI) (CZA, MVB, I-R), a new BL plus an older BLI (C-T), a new siderophore cephalosporin (FDC), and a new tetracycline (ERV). Recently published guidelines from scientific societies regulate the use of these molecules in the general population [19][20][21]. We provide a complete dissection of these new molecules, focusing on their activity spectrum, toxicity profile and pharmacokinetic/pharmacodynamic (PK/ PD) properties, including therapeutic drug monitoring, in LTx.…”

Section: Introductionmentioning

confidence: 99%

New Antibiotics Against Multidrug-Resistant Gram-Negative Bacteria in Liver Transplantation: Clinical Perspectives, Toxicity, and PK/PD Properties

Lombardi,

Alagna,

Palomba

et al. 2024

Transpl Int

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Antimicrobial resistance is a growing global health problem, and it is especially relevant among liver transplant recipients where infections, particularly when caused by microorganisms with a difficult-to-treat profile, are a significant cause of morbidity and mortality. We provide here a complete dissection of the antibiotics active against multidrug-resistant Gram-negative bacteria approved over the last years, focusing on their activity spectrum, toxicity profile and PK/PD properties, including therapeutic drug monitoring, in the setting of liver transplantation. Specifically, the following drugs are presented: ceftolozane/tazobactam, ceftazidime/avibactam, meropenem/vaborbactam, imipenem/relebactam, cefiderocol, and eravacycline. Overall, studies on the safety and optimal employment of these drugs in liver transplant recipients are limited and especially needed. Nevertheless, these pharmaceuticals have undeniably enhanced therapeutic options for infected liver transplant recipients.

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Section: Introductionmentioning

confidence: 99%

New Antibiotics Against Multidrug-Resistant Gram-Negative Bacteria in Liver Transplantation: Clinical Perspectives, Toxicity, and PK/PD Properties

Lombardi,

Alagna,

Palomba

et al. 2024

Transpl Int

Self Cite

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Antimicrobial resistance: Impacts, challenges, and future prospects

Ahmed,

Hussein,

Qurbani

et al. 2024

Journal of Medicine, Surgery, and Public Health

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Evaluation of three protocols for direct susceptibility testing for gram negative-Enterobacteriaceae from patient samples in Uganda with SMS reporting

Aruhomukama,

Magiidu,

Katende

et al. 2024

Sci Rep

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In Uganda, the challenge of generating and timely reporting essential antimicrobial resistance (AMR) data has led to overreliance on empirical antibiotic therapy, exacerbating the AMR crisis. To address this issue, this study aimed to adapt a one-step AMR testing protocol alongside an SMS (Short Message Service) result relay system (SRRS), with the potential to reduce the turnaround time for AMR testing and result communication from 4 days or more to 1 day in Ugandan clinical microbiology laboratories. Out of the 377 samples examined, 54 isolates were obtained. Notably, E. coli (61%) and K. pneumoniae (33%) were the most frequently identified, majority testing positive for ESBL. Evaluation of three AMR testing protocols revealed varying sensitivity and specificity, with Protocol A (ChromID ESBL-based) demonstrating high sensitivity (100%) but no calculable specificity, Protocol B (ceftazidime-based) showing high sensitivity (100%) and relatively low specificity (7.1%), and Protocol C (cefotaxime-based) exhibiting high sensitivity (97.8%) but no calculable specificity. ESBL positivity strongly correlated with resistance to specific antibiotics, including cefotaxime, ampicillin, and aztreonam (100%), cefuroxime (96%), ceftriaxone (93%), and trimethoprim sulfamethoxazole (87%). The potential of integrating an SRRS underscored the crucial role this could have in enabling efficient healthcare communication in AMR management. This study underscores the substantial potential of the tested protocols for accurately detecting ESBL production in clinical samples, potentially, providing a critical foundation for predicting and reporting AMR patterns. Although considerations related to specificity warrant careful assessment before widespread clinical adoption.

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How to tailor recommendations on the treatment of multi-drug resistant Gram-negative infections at country level integrating antibiotic stewardship principles within the GRADE-ADOLOPMENT framework

Cited by 3 publications

References 49 publications

New Antibiotics Against Multidrug-Resistant Gram-Negative Bacteria in Liver Transplantation: Clinical Perspectives, Toxicity, and PK/PD Properties

New Antibiotics Against Multidrug-Resistant Gram-Negative Bacteria in Liver Transplantation: Clinical Perspectives, Toxicity, and PK/PD Properties

Antimicrobial resistance: Impacts, challenges, and future prospects

Evaluation of three protocols for direct susceptibility testing for gram negative-Enterobacteriaceae from patient samples in Uganda with SMS reporting

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