Urinary concentrations and bactericidal activities of newer fluoroquinolones in healthy volunteers

Stein, Gary E.; Schooley, Sharon

doi:10.1016/j.ijantimicag.2004.01.013

Cited by 10 publications

(4 citation statements)

References 24 publications

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“…Nitrofurantoin is another active oral antimicrobial option, although activity is largely limited to E. faecalis isolates (38)(39)(40). Other oral options, albeit with limitations, include linezolid (toxicity risk), quinupristin-dalfopristin (E. faecium only), nitroxoline (not widely available), newer fluoroquinolones (moxifloxacin, gatifloxacin, gemifloxacin; toxicity risk) and doxycycline (effective in the setting of high urinary concentrations; synergy reported in combination with fosfomycin) (19,39,(41)(42)(43)(44)(45)(46)(47).…”

Section: Discussionmentioning

confidence: 99%

Oral Fosfomycin Treatment for Enterococcal Urinary Tract Infections in a Dynamic In Vitro Model

Abbott

Gorp

Meijden

et al. 2020

Antimicrob Agents Chemother

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There are limited treatment options for enterococcal urinary tract infections, especially vancomycin-resistant Enterococcus (VRE). Oral fosfomycin is a potential option, although limited data are available guiding dosing and susceptibility. We undertook pharmacodynamic profiling of fosfomycin against E. faecalis and E. faecium isolates using a dynamic in vitro bladder infection model. Eighty-four isolates underwent fosfomycin agar dilution susceptibility testing (E. faecalis MIC50/90 32/64 μg/ml; E. faecium MIC50/90 64/128 μg/ml). Sixteen isolates (including E. faecalis ATCC 29212 and E. faecium ATCC 35667) were chosen to reflect the MIC range and tested in the bladder infection model with synthetic human urine (SHU). Under drug-free conditions, E. faecium demonstrated greater growth restriction in SHU compared to E. faecalis (E. faecium maximal growth 5.8 ± 0.6 log10 CFU/ml; E. faecalis 8.0 ± 1.0 log10 CFU/ml). Isolates were exposed to high and low fosfomycin urinary concentrations after a single dose, and after two doses given over two days with low urinary concentration exposure. Simulated concentrations closely matched the target (bias 2.3%). E. faecalis isolates required greater fosfomycin exposure for 3 log10 kill from the starting inoculum compared with E. faecium. The ƒAUC0-72/MIC and ƒ%T > MIC0-72 for E. faecalis were 672 and 70%, compared to 216 and 51% for E. faecium, respectively. There was no rise in fosfomycin MIC postexposure. Two doses of fosfomycin with low urinary concentrations resulted in equivalent growth inhibition to a single dose with high urinary concentrations. With this urinary exposure, fosfomycin was effective in promoting suppression of regrowth (>3 log10 kill) in the majority of isolates.

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Section: Discussionmentioning

confidence: 99%

Oral Fosfomycin Treatment for Enterococcal Urinary Tract Infections in a Dynamic In Vitro Model

Abbott

Gorp

Meijden

et al. 2020

Antimicrob Agents Chemother

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“…Fluoroquinolones exhibit concentration dependent bactericidal effects, and urine excretion of moxifloxacin is half that of the next closest fluroquinolone used in our healthcare system (ciprofloxacin at 43% [ 3 ]). Urine concentrations after a single dose of moxifloxacin in healthy volunteers have previously been found to be effective in vitro against levofloxacin susceptible and moderately susceptible strains of E. Coli, E. faecalis, and K. pneumoniae but not P. aeruginosa [ 10 ]. However, the relatively low excretion of moxifloxacin into the urine is particularly important due to the rising North American MIC 90 of moxifloxacin against E. Coli .…”

Section: Discussionmentioning

confidence: 99%

“…In addition, in vivo urine bactericidal concentrations may be much higher then in vitro due to biofilm [ 3 ] and pH effects [ 10 ]. Biofilms have been demonstrated to markedly increase needed minimum inhibitory concentrations (MICs) and a recent study by Rosen et al found filamentous bacteria were common even in healthy women with uncomplicated cystitis [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

Fluoroquinolone resistance during 2000–2005 : An observational study

2008

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“…Niektóre antybiotyki nie osiągają stężeń terapeutycznych we wszystkich narządach. I tak na przykład spośród chinolonów nowej generacji moksyfloksacyna, w przeciwieństwie do lewofloksacyny, nie osiąga stężeń terapeutycznych w moczu [23].…”

Section: Antybiotykoterapia Celowanaunclassified

Wybrane zagadnienia antybiotykoterapii zakażeń bakteryjnych u chorych na nowotwory złośliwe

Nowak¹

2016

Nowotwory. Journal of Oncology

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Zakażenia stanowią jeden z najważniejszych problemów współczesnej onkologii. Nie tylko są one jedną z najważniejszych przyczyn zgonów chorych na nowotwory złośliwe, ale również jednym z najczęstszych powikłań leczenia onkologicznego. Upośledzenie odporności związane najczęściej z chemioterapią oraz sama choroba nowotworowa predysponują pacjentów onkologicznych do zakażeń zarówno typowymi bakteriami, jak też i drobnoustrojami oportunistycznymi. Sprawia to, że leki przeciwdrobnoustrojowe są stosowane w dużych ilościach na oddziałach onkologicznych, a lekarze onkolodzy zmuszeni są nabyć biegłość w posługiwaniu się nimi. Niestety, w ostatnich latach daje się zaobserwować zjawisko narastania wśród bakterii antybiotykooporności, co bardzo utrudnia skuteczne leczenie zakażeń. Wielokrotnie donoszono o występowaniu szczepów bakterii opornych na wszystkie lub prawie wszystkie znane antybiotyki. Ponadto istotnym problemem stają się powikłania związane ze stosowaniem leków przeciwdrobnoustrojowych, w tym zakażenia Clostridium difficile. Wyniki badań pokazują, że prawidłowe prowadzenie antybiotykoterapii skutkuje nie tylko poprawą wyników leczenia chorych, ale również przekłada się na zmniejszenie zużycia tych leków i w konsekwencji może hamować narastanie antybiotykooporności wśród bakterii. Celem artykułu jest przybliżenie zasad prawidłowej antybiotykoterapii, ze szczególnym zwróceniem uwagi na informacje przydatne w praktyce onkologicznej oraz najnowsze osiągnięcia w tej dziedzinie. Zaprezentowano również informacje na temat zasad profilaktyki i leczenia gorączki neutropenicznej. Antibiotic therapy of bacterial infections in oncology Infections are among the most important problems of contemporary oncology. Not only are they responsible for a significant part of cancer mortality, but they are also frequent complications of cancer treatment. Immunosuppression, predominantly due to chemotherapy, predisposes oncological patients to infections, caused not only by the typical bacteria, but also by opportunistic microorganisms. This leads to widespread use of antimicrobial agents in oncological practice, and forces physicians taking care of patients with cancer to become experts in antibiotic therapy. Unfortunately, the efforts to combat infections have been hampered by the phenomenon of increasing antibiotic resistance among bacterial species. Multiple cases of infections with bacteria resistant to all, or almost all, known antibiotics have been described. Complications of antibiotic therapy, especially Clostridium difficile infections are also a growing concern. The results of studies confirm that proper antibiotic therapy not only improves cure rates of infections but also helps diminish antibiotic usage and therefore may contribute to a reduction of antibiotic resistance among bacteria. The aim of this paper is to disseminate knowledge about proper antimicrobial treatment with special emphasis on topics related to oncology and recent discoveries in this field.

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Urinary concentrations and bactericidal activities of newer fluoroquinolones in healthy volunteers

Cited by 10 publications

References 24 publications

Oral Fosfomycin Treatment for Enterococcal Urinary Tract Infections in a Dynamic In Vitro Model

Oral Fosfomycin Treatment for Enterococcal Urinary Tract Infections in a Dynamic In Vitro Model

Fluoroquinolone resistance during 2000–2005 : An observational study

Wybrane zagadnienia antybiotykoterapii zakażeń bakteryjnych u chorych na nowotwory złośliwe

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