Impact of Aminoglycoside Cycling in Six Tertiary Intensive Care Units – Prospective Longitudinal Interventional Study

Francetić, Igor; Kalenić, Smilja; Huić, Mirjana; Merćep, Iveta; Makar-Aušperger, Ksenija; Likić, Robert; Erdeljić, Viktorija; Tripković, Vesna; Šimić, Petra

doi:10.3325/cmj.2008.2.207

Cited by 9 publications

(11 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A flow diagram detailing the reasons for exclusion is shown in Figure 1. The studies meeting our inclusion criteria included ten randomised controlled trials [14][15][16][17][18][19][20][21][22][23] and three comparative observational studies [24][25][26] . Of note, the study by Oudhuis et al 17 was terminated early after the publication of an association between the use of probiotics and increased mortality in patients with acute pancreatitis 27 .…”

Section: Search Resultsmentioning

confidence: 99%

“…Sample sizes varied from a total of 78 subjects 19 to 1172 patients 24 . The study by Francetic et al 28 did not report patient baseline characteristics. Ethnic background was only reported by Warren et al 24 .…”

Section: Characteristics Of Patients Across Studiesmentioning

confidence: 99%

“…The studies by Saidel-Odis et al 23 , Heyland et al 16 and de Jonge et al 14 only reported colonisation. The study by Francetic et al 28 only reported infection as the study endpoint. The other studies reported both colonisation and infections, including VAP, urinary tract infection, catheter-related infection and bloodstream infections.…”

Section: Patient-level Interventionsmentioning

confidence: 99%

See 2 more Smart Citations

Patient-Level Interventions to Prevent the Acquisition of Resistant Gram-Negative Bacteria in Critically Ill Patients: A Systematic Review

Zaky

Zeliadt

2015

Anaesth Intensive Care

View full text Add to dashboard Cite

The rising incidence of multidrug-resistant Gram-negative bacterial (MDR-GNB) infections acquired in intensive care units has prompted a variety of patient-level infection control efforts. However, it is not known whether these measures are effective in reducing colonisation and infection. The purpose of this systematic review was to assess the efficacy of patientlevel interventions for the prevention of colonisation with MDR-GNB and whether these interventions are associated with a reduction in the rate of infection due to MDR-GNB in the intensive care unit. Searches were conducted on PubMed, Cochrane, EMBASE and World of Science databases to identify comparative interventional studies on patient-level interventions implemented in the intensive care unit. Literature published in English, Spanish or French from January 1, 2000, until April 30, 2013, was searched. A total of 631 reports were found and we included and analysed 13 comparative studies that reported outcomes for an intervention compared with a control group. There were ten randomised and three observational interventional trials evaluating seven interventions. Overall, there was a reduction in colonisation (odds ratio [OR] 0.75; 95% confidence interval [CI] 0.66 to 0.85) and infection (OR 0.66; 95% CI 0.59 to 0.75) with MDR-GNB. This trend persisted after restricting pooled analysis to randomised controlled trials (pooled OR 0.66; 95% CI 0.57 to 0.76 and pooled OR 0.62; 95% CI 0.54 to 0.72, respectively). We identified a significant reduction in MDR-GNB colonisation and infection through the use of patient-level interventions. This effect was mostly accounted for by selective digestive decontamination. However, given the limitations of the analysed trials, adequately powered controlled studies are needed to further explore the effects of patientlevel interventions on colonisation and infection with MDR-GNB.

show abstract

Section: Search Resultsmentioning

confidence: 99%

Section: Characteristics Of Patients Across Studiesmentioning

confidence: 99%

Section: Patient-level Interventionsmentioning

confidence: 99%

See 1 more Smart Citation

Patient-Level Interventions to Prevent the Acquisition of Resistant Gram-Negative Bacteria in Critically Ill Patients: A Systematic Review

Zaky

Zeliadt

2015

Anaesth Intensive Care

View full text Add to dashboard Cite

show abstract

“…En el presente estudio se observó una disminución significativa de consumo de gentamicina así como una disminución de costos no significativa, además de un aumento en el consumo de amikacina. En Croacia 19 reportaron que el uso exclusivo de amikacina (frente a gentamicina) redujo significativamente la resistencia de las cepas de bacilos gramnegativos, el número de bacteriemias nosocomiales atribuidas a bacilos gramnegativos y el costo total del uso de antimicrobianos en la UCI.…”

Section: Discussionunclassified

Impacto de un programa de optimización de uso de antimicrobianos en un hospital pediátrico de tercer nivel en Panamá

Rojas-Bonilla

Luciani

Jara

et al. 2020

Rev. chil. infectol.

View full text Add to dashboard Cite

Introducción: Los programas de optimización de uso de antimicrobianos (PROA) se enfocan en el uso apropiado de antimicrobianos para ofrecer mejores resultados clínicos y menores riesgos de eventos adversos. Objetivos: Comparar consumo y costos de antimicrobianos antes y después de instauración de un programa de regulación de antimicrobianos y describir la proporción de resistencia de bacterias prioritarias. Métodos: Estudio cuasi-experimental, retrospectivo y prospectivo, descriptivo y analítico, que comparó el consumo y costo de antimicrobianos en un período pre-intervención (2007-2010) y un período post-intervención (2011-2017). Se realizó análisis descriptivo de resistencias bacterianas prioritarias. Resultados: El consumo de gentamicina, vancomicina, meropenem, cefotaxima, ceftazidima e imipenem disminuyó significativamente en el período postintervención comparado con el período pre-intervención (p < 0,05), mientras que el consumo de amikacina, piperacilina/tazobactam, cefepime y levofloxacina en el período post-intervención mostró un aumento significativo. La reducción de costos no fue significativa para gentamicina, vancomicina, meropenem, cefotaxima, ceftazidima e imipenem. Para amikacina, cefepime, piperacilina/tazobactam y levofloxacina el aumento de costos no fue significativo. Los aislamientos de Acinetobacter baumannii, Klebsiella pneumoniae, Staphylococcus aureus y Enterococcus faecalis disminuyeron durante el período post-intervención. Conclusión: el PROA demostró disminución en consumo y costos de algunos antimicrobianos.

show abstract

“…4 Gentamicin is extremely useful in the treatment of gram- negative infections. 6-10 Hauschild et al 11 highlight the importance of gentamicin in the treatment of serious staphylococcal infections. Therapeutic drug monitoring of gentamicin is recommended since it exhibits a narrow therapeutic index and the relationship between the dose taken and the serum level is unpredictable.…”

mentioning

confidence: 99%

Factors Affecting Gentamicin Penetration in Lower Extremity Ischemic Tissues With Ulcers

Zammit

Fiorentino

Cassar

et al. 2011

The International Journal of Lower Extremity Wounds

View full text Add to dashboard Cite

The aims of the study were to analyze the penetration of gentamicin in foot ulcers in patients with different severities of peripheral arterial disease (PAD) and to determine significant parameters affecting lower limb tissue concentrations. Patients undergoing debridement of a wound or an amputation procedure were included. All patients received a 120 mg or 240 mg intravenous dose of gentamicin prior to the procedure. Patients were classified according to the degree of PAD. Tissue and serum samples were collected at the time of intervention, and gentamicin concentrations were determined by fluorescence polarization immunoassay. Blood and tissue samples were taken from 61 patients, 41 males and 20 females with a mean age of 66 years. Nineteen patients had nil or borderline PAD, 9 patients had mild or moderate PAD, and 26 patients had severe PAD. Forty-eight patients had type 2 diabetes, 8 patients had type 1 diabetes, and 5 patients were nondiabetic. The concentration of gentamicin in peripheral skeletal muscle tissue was dependent on the serum concentration, degree of PAD, gender, and age. For patients with ischemic lower extremity wounds (patients with mild, moderate, and severe PAD), the concentration of gentamicin was significantly lower (P = .010) than the concentration in nonischemic wounds, and the concentration in female patients was also significantly lower than in male patients (P = .047). The concentration in peripheral subcutaneous tissue was 0.663 times the concentration in skeletal muscle tissue (P < .00001). Gentamicin showed greatest penetration in male patients without PAD. For patients with severe PAD, higher doses of gentamicin may be required to achieve the same effect.

show abstract

Impact of Aminoglycoside Cycling in Six Tertiary Intensive Care Units – Prospective Longitudinal Interventional Study

Abstract: Exclusive use of amikacin significantly reduced the resistance of GNB isolates to gentamicin and netilmicin, the number of GNB nosocomial bacteremias, and the cost of total antibiotic usage in ICUs.

Cited by 9 publications

References 24 publications

Patient-Level Interventions to Prevent the Acquisition of Resistant Gram-Negative Bacteria in Critically Ill Patients: A Systematic Review

Patient-Level Interventions to Prevent the Acquisition of Resistant Gram-Negative Bacteria in Critically Ill Patients: A Systematic Review

Impacto de un programa de optimización de uso de antimicrobianos en un hospital pediátrico de tercer nivel en Panamá

Factors Affecting Gentamicin Penetration in Lower Extremity Ischemic Tissues With Ulcers

Contact Info

Product

Resources

About