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Biapenem, Ritipenem, Panipenem, and Sulopenem
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
Panipenem is a parenteral carbapenem with a broad spectrum of in vitro activity against both Gram-positive and Gram-negative bacteria (Miyadera et al., 1991; Shimada and Kawahara, 1994; Goa and Noble, 2003). Because it is not stable to hydrolysis by renal DHP-1 (Hikida et al., 1992b), panipenem requires concomitant administration of a DHP-1 inhibitor such as betamipron. Betamipron is an organic anion tubular transport inhibitor with very low toxicity that inhibits the active transport of panipenem in the renal cortex (Hirouchi et al., 1994; Enomoto et al., 2002).
A plethora of carbapenem resistance in Acinetobacter baumannii: no end to a long insidious genetic journey
Published in Journal of Chemotherapy, 2021
Abolfazl Vahhabi, Alka Hasani, Mohammad Ahangarzadeh Rezaee, Behzad Baradaran, Akbar Hasani, Hossein Samadi Kafil, Faeze Abbaszadeh, Leila Dehghani
Carbapenem resistance is an on-going concern as carbapenems, including imipenem and meropenem, had a potent activity against A. baumannii and were often used as the last resort for the treatment of infections caused by MDR A. baumannii. Carbapenems have a good bactericidal activity, are stable towards a range of β-lactamases, possess broad-spectrum activity and a good safety profile.20,21 The first carbapenem discovered was olivanic acid produced by Streptomyces olivaceus. This was followed by the discovery of thienamycin in 1976. Years later, a more stable thienamycin derivative known as imipenem was synthesized and approved for use in 1984. Other carbapenems for parenteral administration were discovered later and included biapenem, panipenem, lenapenem and ertapenem. Carbapenems are recommended for the empirical treatment of a variety of severe infections and they are generally well tolerated in the human body except certain treatable allergic reactions.21,22 In parallel with the increase in carbapenem use and increase in A. baumannii infections there has been an increase in the rise of not only carbapenem resistance, but also resistance towards majority of other antibiotics (except the polymyxins or tigecycline). Imipenem resistance was first described in 1985 and since then carbapenem resistance in A. baumannii became increasingly common.20–22
Assessing an alpha-defensin lateral flow device for diagnosing septic arthritis: reporting on a false-negative case and a false-positive case
Published in Modern Rheumatology Case Reports, 2020
Atsushi Narita, Akemi Suzuki, Taku Nakajima, Yuya Takakubo, Juji Ito, Akiko Sasaki, Michiaki Takagi
Four months before her current presentation, a 67-year-old woman visited the hospital for pain in her right lower limb. In that visit, she exhibited a high fever and laboratory tests showed a white blood cell (WBC) count of 5,150/μL and C-reactive protein (CRP) level of 39.4 mg/dL. She was diagnosed with sepsis and was admitted. Her blood culture was negative, and she was administered panipenem/betamipron 500 mg twice a day intravenously. Plain radiographs revealed advanced hip osteoarthritis (Figure 1). A contrast-enhanced MRI of the right hip showed slight fluid in the joint and high signals of soft tissue around the femoral head and proximal femur (Figure 2). No infection focus was found in any organs other than in the right hip joint. A hip joint aspiration was performed, but synovial fluid culture was negative. The patient was diagnosed with thigh cellulitis, and her antibiotic treatment was switched to ceftriaxone and then tazobactam/piperacillin. However, her symptoms did not improve, and she was scheduled to be transferred to our hospital. Our hospital’s doctor ordered her previous doctor to discontinue antibiotics to make it easier to detect bacteria in culture tests. Therefore, the patient had not used antibiotics for four weeks before the transfer.
Meningitis caused by Campylobacter jejuni: a case presentation and literature review
Published in Acta Clinica Belgica, 2021
Marija Kusulja, Marija Santini, Karla Margetić, Marija Guzvinec, Silvija Šoprek, Iva Butić, Arjana Tambić Andrašević
Prior to our case, three articles described individual adult patients with C. jejuni meningitis, the patients aged between 34 and 51 [10–12]. All described adults were male. One patient had no comorbidities [12], one had ventriculoperitoneal shunt after neuroblastoma surgery in childhood [10] and one had severe alcohol misuse [11]. Only one adult patient presented with diarrhea [11]. The first described adult patient had fever with worsening of the preexisting ataxia and dysarthria [10], the second patient suffered a severe traumatic brain injury requiring surgical intervention, with C. jejuni meningitis evolving during the recovery [11], and the third patient had fever with headache [12]. CSF analysis revealed pleocytosis in all three cases, with white blood cell number in CSF ranging from 340 to 12,800/mm3, with PMN proportion from 7% to 93% and protein levels 6.5 to 6.72 g/L. No bacteria were found on CSF gram stain in any of the cases. C. jejuni was detected in two cases by CSF culture [10,12], in one by CSF and blood culture and additionally identified by PCR in both samples [11]. The patients from 1980 [10], 1999 [11] and 2010 [12] were treated with chloramphenicol for 25 days, meropenem for 14 days and panipenem for 21 days, respectively. The patient from 1980 had a relapse after initial treatment with chloramphenicol lasting 11 days, which is why he received another 14 days of chloramphenicol therapy, resulting in complete recovery [10]. The patient from 2010 had treatment failure with cefotaxime but, was successfully treated with panipenem [12]. In all adult cases of C. jejuni meningitis the treatment was successful.