New antimicrobial options for the management of complicated intra-abdominal infections

Leone, Sebastiano; Damiani, Giovanni; Pezone, Ilaria; Kelly, Molly E; Cascella, Marco; Alfieri, Aniello; Pace, Maria Caterina; Fiore, Marco

doi:10.1007/s10096-019-03533-y

Cited by 37 publications

(25 citation statements)

References 43 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A stark difference was seen in treating P. aeruginosa with 81% of imipenem-relebactam patients having a favorable response versus only 63% of imipenem-colistatin patients. Additionally, all-cause mortality was 20% lower in patients receiving imipenem-relebactam, and there were significantly less nephrotoxic events compared to imipenem-colistatin [22,48].…”

Section: Imipenem-colistatin Plus Relebactammentioning

confidence: 92%

“…Intra-abdominal infections (IAI) are infections of the peritoneal space, which can be defined by abscess formation or diffuse peritonitis. They can vary greatly in severity, but are universally associated with high rates of morbidity and mortality given that the most vulnerable population are critically ill patients [22]. There are three categories of IAI: primary, secondary, and tertiary.…”

Section: Intra-abdominal Infectionsmentioning

confidence: 99%

“…Aztreonam is a monobactam with activity against metallo-β-lactamase, which has recently been paired with a novel diazabicyclooctane (DBO) β-lactamase inhibitor, avibactam. The combination provides adequate coverage of Ambler Classes A, B, C, and some D with limited coverage of A. baumannii and P. aeruginosa [22].…”

Section: Aztreonammentioning

confidence: 99%

“…It functions as a trojan horse, gaining entrance to bacterial periplasm bound to iron needed for cell survival. The development was inspired by the siderophore machinery of the bacteria itself, which extends into the host environment to obtain iron and transports it back inside the cell beyond the protective outer membrane [22,40,49]. This is an exciting development as there is potential to use antibiotics that previously could not penetrate the outer membrane of Gram-negative bacteria.…”

Section: Cefiderocolmentioning

confidence: 99%

See 3 more Smart Citations

Trends, Epidemiology, and Management of Multi-Drug Resistant Gram-Negative Bacterial Infections in the Hospitalized Setting

2020

View full text Add to dashboard Cite

The increasing prevalence of antibiotic resistance is a threat to human health, particularly within vulnerable populations in the hospital and acute care settings. This leads to increasing healthcare costs, morbidity, and mortality. Bacteria rapidly evolve novel mechanisms of resistance and methods of antimicrobial evasion. Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae, and Acinetobacter baumannii have all been identified as pathogens with particularly high rates of resistance to antibiotics, resulting in a reducing pool of available treatments for these organisms. Effectively combating this issue requires both preventative and reactive measures. Reducing the spread of resistant pathogens, as well as reducing the rate of evolution of resistance is complex. Such a task requires a more judicious use of antibiotics through a better understanding of infection epidemiology, resistance patterns, and guidelines for treatment. These goals can best be achieved through the implementation of antimicrobial stewardship programs and the development and introduction of new drugs capable of eradicating multi-drug resistant Gram-negative pathogens (MDR GNB). The purpose of this article is to review current trends in MDR Gram-negative bacterial infections in the hospitalized setting, as well as current guidelines for management. Finally, new and emerging antimicrobials, as well as future considerations for combating antibiotic resistance on a global scale are discussed.

show abstract

Section: Imipenem-colistatin Plus Relebactammentioning

confidence: 92%

Section: Intra-abdominal Infectionsmentioning

confidence: 99%

Section: Aztreonammentioning

confidence: 99%

Section: Cefiderocolmentioning

confidence: 99%

See 2 more Smart Citations

Trends, Epidemiology, and Management of Multi-Drug Resistant Gram-Negative Bacterial Infections in the Hospitalized Setting

2020

View full text Add to dashboard Cite

show abstract

“…This omission from the current SS guidelines might potentially deprive our less severe SS patients with a GNB infection from one of the effective SS approaches, in critical care medicine, with is an evidence-based, at worst, of grade 2B, which goes back 10 years [7][8][9]15]. In an era of multi-resistance, where the antibiotic option for the treatment of severe infections due to GNB in intensive care patients, especially of abdominal origin, is very limited, the research into different strategies seems to be inalienable [16].…”

Section: Expert Opinionmentioning

confidence: 99%

Should endotoxin be a research priority in Gram-negative sepsis and septic shock?

Mallat

Leone

Cascella

et al. 2019

Expert Review of Clinical Pharmacology

Self Cite

View full text Add to dashboard Cite

A descriptive pharmacokinetic/pharmacodynamic analysis of ceftazidime‐avibactam in a case series of critically ill patients with augmented renal clearance

Xu,

Tang,

Yuan

et al. 2023

Pharmacology Res & Perspec

View full text Add to dashboard Cite

To describe the pharmacokinetics/pharmacodynamics (PK/PD) of a 2 h infusion of ceftazidime‐avibactam (CAZ‐AVI) in critically ill patients with augmented renal clearance (ARC). A retrospective review of all critically ill patients with ARC who were treated with CAZ‐AVI between August 2020 and May 2023 was conducted. Patients whose 12‐h creatinine clearance prior to CAZ‐AVI treatment and steady‐state concentration (Css) of CAZ‐AVI were both monitored were enrolled. The free fraction (fCss) of CAZ‐AVI was calculated from Css. The joint PK/PD targets of CAZ‐AVI were considered optimal when a Css/minimum inhibitory concentration (MIC) ratio for CAZ ≥4 (equivalent to 100% fT > 4 MIC) and a Css/CT ratio of AVI >1 (equivalent to 100% fT > CT 4.0 mg/L) were reached simultaneously, quasioptimal when only one of the two targets was reached, and suboptimal when neither target was reached. The relationship between PK/PD goal achievement, microbial eradication and the clinical efficacy of CAZ‐AVI was evaluated. Four patients were included. Only one patient achieved optimal joint PK/PD targets, while the other three reached suboptimal targets. The patient with optimal PK/PD targets achieved microbiological eradication, while the other three patients did not, but all four patients achieved good clinical efficacy. Standard dosages may not enable most critically ill patients with ARC to reach the optimal joint PK/PD targets of CAZ‐AVI. Optimal drug dose adjustment of CAZ‐AVI in ARC patients requires dynamic drug concentration monitoring.

show abstract

New antimicrobial options for the management of complicated intra-abdominal infections

Cited by 37 publications

References 43 publications

Trends, Epidemiology, and Management of Multi-Drug Resistant Gram-Negative Bacterial Infections in the Hospitalized Setting

Trends, Epidemiology, and Management of Multi-Drug Resistant Gram-Negative Bacterial Infections in the Hospitalized Setting

Should endotoxin be a research priority in Gram-negative sepsis and septic shock?

A descriptive pharmacokinetic/pharmacodynamic analysis of ceftazidime‐avibactam in a case series of critically ill patients with augmented renal clearance

Contact Info

Product

Resources

About