Inappropriate Continued Empirical Vancomycin Use in a Hospital with a High Prevalence of Methicillin-Resistant Staphylococcus aureus

Kim, Nak Hyun; Koo, Hei Lim; Choe, Pyeong Gyun; Cheon, Shinhye; Kim, Moon Suk; Lee, Myung Jin; Jung, Young Hee; Park, Sang-Won; Kim, Eu Suk; Bang, Ji Hwan; Kim, Hong Bin; Oh, Myoung Don

doi:10.1128/aac.04523-14

Cited by 23 publications

(21 citation statements)

References 33 publications

(38 reference statements)

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“…The search for new anti- S. aureus agents is extremely important, since infections caused by multidrug resistant strains have been growing worldwide and are one of the most serious problems within health care facilities (Stryjewski and Corey, 2014 ). Such issues have been accounted to the excessive use of drugs (Kim et al, 2015 ), which results in development of new resistance mechanisms (Dordel et al, 2014 ). Our data shows that the chloroform extracts were able to inhibit and kill with good efficiency against different clinical strains, the most active was CL, with MIC 50 values ranging from 4- to 8-fold lower than other extracts.…”

Section: Discussionmentioning

confidence: 99%

Antimicrobial Activity and Phytochemical Analysis of Organic Extracts from Cleome spinosa Jaqc.

Silva

Silva²,

Fonseca

et al. 2016

Front. Microbiol.

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Due to the use of Cleome spinosa Jacq. (Cleomaceae) in traditional medicine against inflammatory and infectious processes, this study evaluated the in vitro antimicrobial potential and phytochemical composition of extracts from its roots and leaves. From leaves (L) and roots (R) of C. spinosa different extracts were obtained (cyclohexane: ChL and ChR; chloroform: CL and CR; ethyl acetate: EAL and EAR, methanol: ML and MR). The antimicrobial activity was evaluated by the broth microdilution method to obtain the minimum inhibitory (MIC) and microbicidal (MMC) concentrations against 17 species, including bacteria and yeasts. Additionally, antimicrobial and combinatory effects with oxacillin were assessed against eight clinical isolates of Staphylococcus aureus. All C. spinosa extracts showed a broad spectrum of antimicrobial activity, as they have inhibited all tested bacteria and yeasts. This activity seems to be related to the phytochemicals (flavonoid, terpenoids and saponins) detected into the extracts of C. spinosa. ChL and CL extracts were the most actives, with MIC less than 1 mg/mL against S. aureus, Bacillus subtilis, and Micrococcus luteus. It is important to note that these concentrations are much lower than their 50% hemolysis concentration (HC50) values. Strong correlations were found between the average MIC against S. aureus and their phenolic (r = −0.89) and flavonoid content (r = −0.87), reinforcing the possible role of these metabolite classes on the antimicrobial activity of C. spinosa derived extracts. Moreover, CL and CR showed the best inhibitory activity against S. aureus clinical isolates, they also showed synergistic action with oxacillin against all these strains (at least at one combined proportion). These results encourage the identification of active substances which could be used as lead(s) molecules in the development of new antimicrobial drugs.

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Section: Discussionmentioning

confidence: 99%

Antimicrobial Activity and Phytochemical Analysis of Organic Extracts from Cleome spinosa Jaqc.

Silva

Silva²,

Fonseca

et al. 2016

Front. Microbiol.

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“…Empirical vancomycin treatment should be stopped when available culture results fail to reveal β-lactamresistant Gram-positive bacterial infections. So, it is regarded as inappropriate that the empirical vancomycin use is continued for a proportion of patients [22]. Misan et al reported that 97% of the patients receiving vancomycin for prophylaxis purposes were classi ed as inappropriate use [23].…”

Section: Discussionmentioning

confidence: 99%

The treatment and prophylaxis usage profile of intravenous vancomycin medication in orthopedics

Wang

Jiang

2020

Preprint

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Background Despite vancomycin has been widely used in orthopedics, the details of vancomycin usage in orthopedics remains unknown. The purpose of the study was to evaluate the usage profile of intravenous vancomycin medication in orthopedics. Methods The medical records of inpatients receiving intravenous vancomycin medication from January 2015 to December 2019 in a single center of orthopedics department were retrospectively reviewed. The gender, age, diagnosis, surgical information, microbiological data, duration of vancomycin medication were collected. The related data were analyzed and compared between subgroups. Results A total of 258 cases receiving intravenous vancomycin medication (≥ 3 days) were enrolled. The mean age was 57.3 years. There were 141 cases in treatment and 117 in Prophylaxis group. The mean duration of vancomycin medication was 11.2 days. The duration was longer in Treatment than Prophylaxis group (14.8 versus 6.9 days, P < 0.05). The main reasons for treatment were PJI after TKA (46.7%) and THA (18.2%) in Joint subgroup and SSI after spine surgery (51.5%) for Spine subgroup. For prophylaxis usage, the main reasons were postoperative clinical suspicious infection. The bacteria responsible for infections in Treatment group were S. epidermidis (34.6%), S. aureus (31.8%), other Staphylococcus (12.1%), MRSA (7.5%), Streptococcus (7.5%), Enterococcus faecalis (3.7%) and Bacillus (2.8%). Conclusion Taken together, our research firstly revealed the treatment and prophylaxis usage profile of intravenous vancomycin medication in orthopedics. It provides the different purposes, main causes, bacteriological data and medication duration for treatment and prophylaxis vancomycin usage in orthopedics.

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“…So, it is regarded as inappropriate that the empirical vancomycin use is continued for a proportion of patients [22]. Misan et al reported that 97% of the patients receiving vancomycin for prophylaxis purposes were classi ed as inappropriate use [23].…”

Section: Discussionmentioning

confidence: 99%

The Treatment and Prophylaxis Usage Profile of Intravenous Vancomycin Medication in Orthopedics

Wang

Jiang

2020

Preprint

View full text Add to dashboard Cite

Background: Despite vancomycin has been widely used in orthopedics, the details of vancomycin usage in orthopedics remains unknown. The purpose of the study was to evaluate the usage profile of intravenous vancomycin medication in orthopedics.Methods: The medical records of inpatients receiving intravenous vancomycin medication from January 2015 to December 2019 in a single center of orthopedics department were retrospectively reviewed. The gender, age, diagnosis, surgical information, microbiological data, duration of vancomycin medication were collected. The related data were analyzed and compared between subgroups.Results: A total of 258 cases receiving intravenous vancomycin medication (≥3 days) were enrolled. The mean age was 57.3 years. There were 141 cases in treatment and 117 in Prophylaxis group. The mean duration of vancomycin medication was 11.2 days. The duration was longer in Treatment than Prophylaxis group (14.8 versus 6.9 days, P<0.05). The main reasons for treatment were PJI after TKA (46.7%) and THA (18.2%) in Joint subgroup and SSI after spine surgery (51.5%) for Spine subgroup. For prophylaxis usage, the main reasons were postoperative clinical suspicious infection. The bacteria responsible for infections in Treatment group were S. epidermidis (34.6%), S. aureus (31.8%), other Staphylococcus (12.1%), MRSA (7.5%), Streptococcus (7.5%), Enterococcus faecalis (3.7%) and Bacillus (2.8%).Conclusion: Taken together, our research firstly revealed the treatment and prophylaxis usage profile of intravenous vancomycin medication in orthopedics. It provides the different purposes, main causes, bacteriological data and medication duration for treatment and prophylaxis vancomycin usage in orthopedics.

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Inappropriate Continued Empirical Vancomycin Use in a Hospital with a High Prevalence of Methicillin-Resistant Staphylococcus aureus

Cited by 23 publications

References 33 publications

Antimicrobial Activity and Phytochemical Analysis of Organic Extracts from Cleome spinosa Jaqc.

Antimicrobial Activity and Phytochemical Analysis of Organic Extracts from Cleome spinosa Jaqc.

The treatment and prophylaxis usage profile of intravenous vancomycin medication in orthopedics

The Treatment and Prophylaxis Usage Profile of Intravenous Vancomycin Medication in Orthopedics

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