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Nosocomial Pneumonia in the Critical Care Unit
Published in Cheston B. Cunha, Burke A. Cunha, Infectious Diseases and Antimicrobial Stewardship in Critical Care Medicine, 2020
The antibiotics that best fulfill the criteria cited earlier include cefepime and meropenem. Cefepime is a fourth-generation cephalosporin and is given less often than ceftazidime, i.e., 2 g (IV) q12h and has not been associated with the emergence of resistant P. aeruginosa, as has ceftazidime. High-dose cefepime is also useful against ceftazidime-resistant P. aeruginosa. Furthermore, unlike ceftazidime, cefepime does not result in an increase in MRSA colonization. For all these reasons, when a cephalosporin is selected, cefepime is preferred over ceftazidime for empiric monotherapy of NP/VAP [1,2,6,31].
Surgical infection
Published in Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie, Bailey & Love's Short Practice of Surgery, 2018
Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie
There are several b-lactamase-susceptible cephalosporins that are of value in surgical practice: cefuroxime, cefotaxime and ceftazidime are widely used. The first two are most effective in intra-abdominal skin and soft-tissue infections, being active against Staphylococcus aureus and most Enterobacteriaceae. As a group, the enterococci (Streptococcus faecalis) are not sensitive to the cephalosporins. Ceftazidime, although active against the gram-negative organisms and Staphylococcus aureus, is also effective against Pseudomonas aeruginosa. These cephalosporins may be combined with an aminoglycoside, such as gentamicin, and an imidazole, such as metronidazole, if anaerobic cover is needed.
Ceftazidime and Ceftazidime–Avibactam
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
The pharmacodynamics of ceftazidime have been described in detail elsewhere. Similar to other cephalosporins, time that the free drug concentration is in excess of the MIC of the organism is the best predictor of antimicrobial activity. With ceftazidime, the time over a MIC of > 50% has been shown to be a predictor of bactericidal activity and correlates with successful microbiological outcome in the treatment of nosocomial pneumonia (MacVane et al., 2014).
Ceftobiprole medocaril for the treatment of pneumonia
Published in Expert Review of Anti-infective Therapy, 2023
Wan-Hsuan Hsu, Chi-Kuei Hsu, Chih-Cheng Lai
The emergence of MDROs, including PRSP and MRSA, has become a major threat in the treatment of patients with CAP. In addition, both CAP and HAP can be caused by polymicrobial infections including both Gram-positive cocci (S. pneumoniae and S. aureus) and Gram-negative bacillus (susceptible P. aeruginosa and non-ESBL Enterobacterales). Therefore, combination treatment of an anti-MRSA agent, such as vancomycin and linezolid, along with an anti-Pseudomonas agent, such as ceftazidime and cefepime, is usually the recommended regimen when encountering these clinical entities. However, with ceftobiprole, we are now able to overcome the challenge by using one single agent against these MDROs pathogens. Even for MSSA pneumonia, ceftobiprole use was associated with a significantly lower clinical failure rate than ceftriaxone [57].
Unusual disseminated Talaromyces marneffei infection presenting with fever and diarrhea in an AIDS patient: a case report and literature review
Published in Acta Clinica Belgica, 2023
Yuting Tan, Zhihan Zhang, Mengmeng Wu, Shi Zou, Wei Guo, Ke Liang
A 41-year-old female was admitted to our hospital for intermittent fever for 5 months and abdominal pain and diarrhea for half a month. Five months ago, she developed fever and the highest temperature was over 39°C. Half a month ago, she developed persistent abdominal pain and diarrhea. A colonoscopy performed at the local hospital revealed multiple colon ulcers and further histopathological examination suggested autolysis of epithelial cells in the colonic mucous membrane. The patient was treated with ceftazidime for 10 days, followed by cefepime and gatifloxacin for 11 days in the local hospital. After treatment, her symptoms relieved. However, high fever, abdominal pain and diarrhea reoccurred after the drug withdrawal. Four months ago, she had been confirmed as HIV infection, and her CD4 + T lymphocyte count was 6 cells/μl. Three months before, she accepted an antiretroviral therapy (ART) regimen of lamivudine, stavudine and efavirenz. Her CD4 + T lymphocyte count was 36 cells/μl after 3 months’ ART. Being born in the middle China, she was used to work in Guangdong province, Southern China for 6–7 years. Physical examination at admission revealed scattered old skin lesions on her back and both lower extremities; some of these lesions were scabbed. Several enlarged lymph nodes were found in the cervical and right inguinal region. Tenderness throughout the abdomen was found, without rebound pain.
Evaluation of the post-antibiotic effect in vivo for the combination of a β-lactam antibiotic and a β-lactamase inhibitor: ceftazidime-avibactam in neutropenic mouse thigh and lung infections
Published in Journal of Chemotherapy, 2021
Johanna Berkhout, Maria J. Melchers, Anita C. van Mil, Claudia M. Lagarde, Wright W. Nichols, Johan W. Mouton
Treatment with a single 0.1-mL dose of ceftazidime and avibactam or saline (control) was administered subcutaneously at t = 0 h (2 h after inoculation). Doses were calculated using previously-described, systematically-determined, PK data16 using MicLab 2.36 (Medimatics, Maastricht, The Netherlands). Free drug concentrations were used in all calculations (protein binding of avibactam and ceftazidime being 8% and 10%, respectively). Avibactam doses were chosen in such a way that 1 h after the single dose of ceftazidime-avibactam, a target concentration of avibactam of 4 or 1 mg/L would be reached in plasma (thigh- and lung-infections) or epithelial lining fluid (ELF) (lung infections). Concomitant ceftazidime doses were chosen with a target concentration in plasma of the (in vitro) MIC of ceftazidime measured in the presence of the matching target of 4 or 1 mg/L avibactam. In the thigh model, the experiments were also performed with the target of ceftazidime at 0.25 × MIC of the drug combination. In the pulmonary model, experiments were also performed using target concentrations of both ceftazidime and avibactam in ELF. Avibactam-negative control experiments were performed in which ceftazidime monotherapy was administered such that target plasma concentrations 1 h after dosing replicated the ones above calculated for combinations. CFU in lungs and thighs were also monitored in untreated control animals.