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Fosfomycin
Published in M. Lindsay Grayson, Sara E. Cosgrove, Suzanne M. Crowe, M. Lindsay Grayson, William Hope, James S. McCarthy, John Mills, Johan W. Mouton, David L. Paterson, Kucers’ The Use of Antibiotics, 2017
Fosfomycin was synergistic with ampicillin against various Enterobacteriaceae, even reducing MICs for P. vulgaris and Providencia rettgeri to within achievable clinical ranges (Chin et al., 1986). A number of studies have tested fosfomycin in combination with meropenem, colistin, aztreonam, and various aminoglycosides against carbapenemase-producing Enterobacteriaceae (Albur et al., 2015; Rodríguez-Avial et al., 2015; Souli et al., 2011; Tängdén et al., 2014). Synergy with fosfomycin and meropenem, colistin, gentamicin, or plazomicin was demonstrated against some but not all tested New Delhi metallo-beta-lactamase 1 (NDM-1)–producing E. coli and VIM or NDM-producing Klebsiella pneumoniae. Prevention of mutational resistance has also been demonstrated for combinations with fosfomycin (Albur et al., 2015; Tängdén et al., 2014; Souli et al., 2011).
Infection control
Published in Philip Woodrow, Nursing Acutely Ill Adults, 2015
Antibiotic resistance rapidly followed introduction of antibiotics: meticillin was marketed in 1960, and six months later resistance was reported (Grundmann, 2006). However, recent exponential increase in microbial resistance (‘superbugs’) (Larson et al., 2010) raises spectres of antibiotic-resistance epidemics (Cars et al., 2008), prompting promotion of antibiotic stewardship – avoiding unnecessary usage. Emergence of extended spectrum beta-lactamase (ESBL) enables organisms to develop cross-resistance to many antibiotics, making them even more difficult to eliminate. Carbapenems are the ‘last resort’ antibiotic (WHO, 2014), so carbapenem-resistant Enterobactericeae (CRE, previously called New Delhi Metallo Beta-Lactamase – NDM-1) pose a major threat, which is increasing (CDC, 2013; WHO, 2014).
Developing a latent class analysis model to identify at-risk populations among people using medicine without prescription
Published in Expert Review of Clinical Pharmacology, 2020
Praveen Kumar-M, Rahul Mahajan, S Kathirvel, Naveen Hegde, Ashish Kumar Kakkar, Amol N. Patil
Topical steroids are commonly available as fixed-dose combinations (FDC) commonly with antibacterial, antifungals, and psoriasis medications besides steroid alone preparations. The mis-use of topical steroids is well known in many countries[1]]. Some of the reasons identified for such behavior include chemist shop consultation and consultation from non-practitioners. Topical medication sale and use need to be checked especially for low to middle income countries where frequency and the duration of topical medication may go unattended[2]]. In addition, the lack of dermatokinetic research and regulatory laxity in approving the topical combination medications is also a factor [3]]. The felt need can also be justified with the rise of skin infections resistant to almost all antimicrobials and the birth of New Delhi metallo beta lactamase (NDM-1) [4]].
Proteomics approach to understand bacterial antibiotic resistance strategies
Published in Expert Review of Proteomics, 2019
Bo Peng, Hui Li, Xuanxian Peng
β-lactams are a class of broad-spectrum antibiotics that contain a beta-lactam ring, including penicillins, cephalosporins, cephamycins, carbapenems, and monobactam as well as β-lactamase inhibitors. β-Lactam antibiotics are currently the most used class of antibacterial agents in the treatment of bacterial infection [19]. β-Lactams target penicillin-binding proteins to inhibit bacterial cell wall synthesis and are one of the most commonly prescribed drugs. Thus, β-lactam-resistant bacteria are predominant in the clinic and environment. There are three common mechanisms of resistance to β-lactams: inactivating β-lactams by β-lactamases such as NDM-1 (New Delhi Metallo-beta-lactamase 1), failing to bind to penicillin-binding proteins, and altering binding affinity to penicillin-binding proteins [20,21]. Additionally, these mechanisms are always accompanied with decreased uptake and increased efflux of β-lactams by bacteria, which is the major cause of high-level resistance in clinical settings [19].
Hypervirulence and carbapenem resistance: two distinct evolutionary directions that led high-risk Klebsiella pneumoniae clones to epidemic success
Published in Expert Review of Molecular Diagnostics, 2019
Yi-Chyi Lai, Min-Chi Lu, Po-Ren Hsueh
The New-Delhi metallo beta-lactamase, NDM-1, was discovered in 2008 in a 59-year-old man who returned to Sweden after hospitalization in New Delhi, India [93]. Since then, infections associated with NDM-1-producing Enterobacteriaceae, have been continually reported worldwide [94]. The global spread is mostly related to international travel and medical tourism in India, the Balkans region, and the Middle East, which are considered the main reservoirs of NDM-producing K. pneumoniae. Among a total of 27 variants of NDM carbapenemases (National Database of Antibiotic Resistant Organisms, NDARO), NDM-1 is still the predominant subtype, especially in the Indian subcontinent. NDM1 does not hydrolyze aztreonam. However, due to the co-production of ESBLs (mostly CTX-M types) and AmpC, over 80% of NDM-1 producing K. pneumoniae are resistant to aztreonam. The combined use of colistin and rifampin is an option for treatment.