Moxifloxacin is non-inferior to combination therapy with ceftriaxone plus metronidazole in patients with community-origin complicated intra-abdominal infections

Solomkin, Joseph S.; Zhao, Yupei; Ma, Enlong; Chen, Minjun; Hampel, Barbara

doi:10.1016/j.ijantimicag.2009.06.022

Cited by 45 publications

(57 citation statements)

References 13 publications

(17 reference statements)

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“…In the IAI literature, "combination therapy" consists of agents with significantly different spectra of activity, for example, ticarcillinclavulanate versus clindamycin and gentamicin or imipenem versus clindamycin, metronidazole, and tobramycin, etc. (12,49,76,115,164,188,204,223,231,232,234,251). To our knowledge, there is only one RCT comparing the clinical efficacy of a ␤-lactam to that of a ␤-lactam plus an aminoglycoside for IAIs.…”

Section: Intra-abdominal Infectionsmentioning

confidence: 99%

Combination Therapy for Treatment of Infections with Gram-Negative Bacteria

2012

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SUMMARY Combination antibiotic therapy for invasive infections with Gram-negative bacteria is employed in many health care facilities, especially for certain subgroups of patients, including those with neutropenia, those with infections caused by Pseudomonas aeruginosa , those with ventilator-associated pneumonia, and the severely ill. An argument can be made for empiric combination therapy, as we are witnessing a rise in infections caused by multidrug-resistant Gram-negative organisms. The wisdom of continued combination therapy after an organism is isolated and antimicrobial susceptibility data are known, however, is more controversial. The available evidence suggests that the greatest benefit of combination antibiotic therapy stems from the increased likelihood of choosing an effective agent during empiric therapy, rather than exploitation of in vitro synergy or the prevention of resistance during definitive treatment. In this review, we summarize the available data comparing monotherapy versus combination antimicrobial therapy for the treatment of infections with Gram-negative bacteria.

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Section: Intra-abdominal Infectionsmentioning

confidence: 99%

Combination Therapy for Treatment of Infections with Gram-Negative Bacteria

2012

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“…Sometimes, these agents are used for surgical prophylaxis for abdominal surgery and for the treatment of aspiration pneumonia. Recently, the IDSA has removed cefotetan from the recommended list of therapies for intra-abdominal infections due to poor B. fragilis group activity and resultant clinical failures (89)(90)(91).…”

Section: ␤-Lactam Antibioticsmentioning

confidence: 99%

“…Consequently, they are employed in more serious anaerobic infections, such as intra-abdominal and skin and soft tissue infections (89)(90)(91). Two recent reports have noted the development of some carbapenem resistance among anaerobes (22), ranging from 1.1 to 2.5% in a multicenter U.S. survey but with a higher rate for a small number of isolates from Taiwan (33).…”

Section: ␤-Lactam Antibioticsmentioning

confidence: 99%

Antianaerobic Antimicrobials: Spectrum and Susceptibility Testing

2013

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SUMMARY Susceptibility testing of anaerobic bacteria recovered from selected cases can influence the choice of antimicrobial therapy. The Clinical and Laboratory Standards Institute (CLSI) has standardized many laboratory procedures, including anaerobic susceptibility testing (AST), and has published documents for AST. The standardization of testing methods by the CLSI allows comparisons of resistance trends among various laboratories. Susceptibility testing should be performed on organisms recovered from sterile body sites, those that are isolated in pure culture, or those that are clinically important and have variable or unique susceptibility patterns. Organisms that should be considered for individual isolate testing include highly virulent pathogens for which susceptibility cannot be predicted, such as Bacteroides , Prevotella , Fusobacterium , and Clostridium spp.; Bilophila wadsworthia ; and Sutterella wadsworthensis . This review describes the current methods for AST in research and reference laboratories. These methods include the use of agar dilution, broth microdilution, Etest, and the spiral gradient endpoint system. The antimicrobials potentially effective against anaerobic bacteria include beta-lactams, combinations of beta-lactams and beta-lactamase inhibitors, metronidazole, chloramphenicol, clindamycin, macrolides, tetracyclines, and fluoroquinolones. The spectrum of efficacy, antimicrobial resistance mechanisms, and resistance patterns against these agents are described.

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“…On the other hand, the efficacy of moxifloxacin on the management of complicated intraabdominal infections and sepsis has also been positive 7,13,14 . However, its use inside the abdominal cavity for severe peritonitis has not yet been tested.…”

Section: Introductionmentioning

confidence: 99%

Severe autogenously fecal peritonitis in Wistar rats with permanent bilateral carotid occlusion. Response to intra peritoneal moxifloxacin combined with dexamethasone

Melo

Gadelha²,

Oliveira

et al. 2014

Acta Cir. Bras.

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PURPOSE:To evaluate the treatment outcome of severe peritonitis in rats submitted to permanent bilateral carotid occlusion (PBCO). METHODS:Sixteen Wistar rats (mean age of 8.5 months) with PBCO underwent autogenously fecal peritonitis, and were treated with moxifloxacin combined with dexamethasone, and followed-up for 45 days. Ten rats (mean age five months) without PBCO were used as a control group. The variables were expressed by their mean and standard error of the mean (SEM). p<0.05 was used for rejecting the null hypothesis. The study was approved by the Ethics Committee. RESULTS:There was a significant increase (p=0.0002) in the mortality and morbidity in older rats that underwent PBCO (study group). However, even among the survival rats presenting with severe residual abscesses both in the abdomen and thorax cavities, they present an almost normal life. CONCLUSIONS:The treatment of severe autogenously fecal peritonitis with intraperitoneal moxifloxacin combined with dexamethasone was very effective in young rats without permanent bilateral carotid occlusion. The treatment reached reasonable results in older rats with PBCO, even considering residual abscesses on abdomen and thorax. Older age was the greater risk factor for the outcome of the treatment of severe peritonitis. Sepsis remains a challenging situation, especially in elderly.Key words: Peritonitis. Quinolones. Dexamethasone. Therapy. Rats. Severe autogenously fecal peritonitis in Wistar rats with permanent bilateral carotid occlusion.Response to intra peritoneal moxifloxacin combined with dexamethasone

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Moxifloxacin is non-inferior to combination therapy with ceftriaxone plus metronidazole in patients with community-origin complicated intra-abdominal infections

Cited by 45 publications

References 13 publications

Combination Therapy for Treatment of Infections with Gram-Negative Bacteria

Combination Therapy for Treatment of Infections with Gram-Negative Bacteria

Antianaerobic Antimicrobials: Spectrum and Susceptibility Testing

Severe autogenously fecal peritonitis in Wistar rats with permanent bilateral carotid occlusion. Response to intra peritoneal moxifloxacin combined with dexamethasone

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