Trimetoprim-sulfametoxazole in ventilator-associated pneumonia: a cohort study

AbstractTo evaluate the effectiveness of trimetoprim-sulfametoxazole (TMP-SMX) for treatment of ventilator-associated pneumonia (VAP). A retrospective cohort study including patients with VAP from 2011 to 2017. Two groups were analysed: TMP-SMX group, including patients who had received TMP-SMX (as first-line and as de-escalation), and No-TMP-SMX group, including patients who had not received TMP-SMX treatment. Primary clinical outcome was mortality at 30  days from starting the antibiotic treatment (T30). Secondary outcomes were mortality at end of treatment (EoT), day survival at T30, and acquisition of multidrug-resistant bacteria during hospitalization in intensive care unit. Eighty cases of VAP were included and devised into two groups: No-TMP- SMX (31/80; 39%) and TMP-SMX (49/80; 61%). Univariate analysis showed no significant differences were found when the TMP-SMX group was compared with the No-TMP-SMX group, except for frequency of male gender (p = 0.025). No significant statistical correlations between mortality at T30 and individual factors were detected by the multivariate model. No cases of either severe allergy orClostridium difficile disease were reported in the TMP-SMX and No-TMP-SMX groups. TMP-SMX treatment was not associated with higher mortality at EoT and T30 in comparison with the No-TMP-SMX group. TMP-SMX had a good safety profile, in terms of ecology (acquisition of MDR bacteria andClostridium difficile disease) and clinical manageme...
Source: European Journal of Clinical Microbiology and Infectious Diseases - Category: Microbiology Source Type: research

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Authors: Rombauts A, Abelenda-Alonso G, Cuervo G, Gudiol C, Carratalà J Abstract INTRODUCTION: Despite adequate antibiotic coverage, community-acquired pneumonia (CAP) remains a leading cause of hospitalization and mortality worldwide. It induces both a local pulmonary and a systemic inflammatory response, particularly significant in severe cases. The intensity of the dysregulated host response varies from patient to patient and has a negative impact on survival and other outcomes. AREAS COVERED: This comprehensive review summarizes the pathophysiological aspects of the inflammatory response in CAP, brie...
Source: Expert Review of Anti-Infective Therapy - Category: Infectious Diseases Tags: Expert Rev Anti Infect Ther Source Type: research
Authors: Reissier S, Cattoir V Abstract INTRODUCTION: Streptogramins (pristinamycin and quinupristin-dalfopristin) can be interesting options for the treatment of infections due to Gram-positive cocci, especially multidrug-resistant isolates. AREAS COVERED: This review provides an updated overview on structural and activity characteristics, mechanisms of action and resistance, pharmacokinetic/pharmacodynamic and clinical use of streptogramins. EXPERT OPINION: The streptogramin antibiotics act by inhibition of the bacterial protein synthesis. They are composed of two chemically distinct compounds, namely typ...
Source: Expert Review of Anti-Infective Therapy - Category: Infectious Diseases Tags: Expert Rev Anti Infect Ther Source Type: research
Boosting the sensitivity of in vitroβ-lactam allergy diagnostic tests. Chem Commun (Camb). 2020 Oct 14;56(80):11973-11976 Authors: Peña-Mendizabal E, Morais S, Maquieira Á Abstract The synthesis of structurally new haptens and the development of suitable antigens are essential for boosting the sensitivity of drug allergy diagnostic testing. Unprecedented structural antigens for benzylpenicillin and amoxicillin are characterised and evaluated in a cohort of 70 subjects with a turnkey solution based on consumer electronics. PMID: 33033809 [PubMed - in process]
Source: Chemical Communications - Category: Chemistry Authors: Tags: Chem Commun (Camb) Source Type: research
Abstract To date, there has been little experience in using fosfomycin in children. However, its broad spectrum of action and excellent safety profile have renewed interest in this antibiotic, especially for treating infections by multidrug-resistant bacteria. The main indication for fosfomycin in pediatrics is currently community-acquired lower urinary tract infection. Given its good activity against bacteria, fosfomycin can also be useful in urinary infections caused by extended-spectrum beta-lactamase-producing enterobacteria. Fosfomycin presents very good dissemination to tissues including bone and is therefor...
Source: Revista Espanola de Quimioterapia - Category: Drugs & Pharmacology Authors: Tags: Rev Esp Quimioter Source Type: research
Conclusion: New carbapenem/βLI combinations may be viable alternatives to antimicrobial combination therapy as they displayed high efficacy in vitro and in vivo. Meropenem/Avibactam and Meropenem/Relebactam should be tested on larger sample sizes with different carbapenemases before progressing further in its preclinical development. Introduction Carbapenem resistant Gram-negative bacteria have been gradually increasing in prevalence in recent years. In the United States, the latest CDC Antibiotic Resistance Threat Report indicates that Carbapenem-Resistant Enterobacteriaceae (CREs) are responsible for 9,000 a...
Source: Frontiers in Microbiology - Category: Microbiology Source Type: research
In conclusion, we unraveled a mechanism of immune evasion of Kpn KPC ST258, which may contribute to design more effective strategies for the treatment of these multi-resistant bacterial infections. Introduction Klebsiella pneumoniae (Kpn) is a Gram-negative pathogen causing a wide range of infections from urinary tract infections to pneumonia. Kpn is a member of the so-called ESKAPE group of microorganisms, a term that emphasizes the fact that they effectively “escape” the effects of antibacterial drugs (1). Antimicrobial resistance is a significant problem for the treatment of infectious diseases caused ...
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research
François Chassagne1†, Xinyi Huang1†, James T. Lyles1 and Cassandra L. Quave1,2* 1Center for the Study of Human Health, Emory University, Atlanta, GA, United States 2Department of Dermatology, Emory University, Atlanta, GA, United States In the search for new therapeutic solutions to address an increasing number of multidrug-resistant bacterial pathogens, secondary metabolites from plants have proven to be a rich source of antimicrobial compounds. Ginkgo biloba, a tree native to China, has been spread around the world as an ornamental tree. Its seeds have been used as snacks and medical mater...
Source: Frontiers in Microbiology - Category: Microbiology Source Type: research
Cerebral palsy patients are at high risk for developing recurrent pneumonia with increased morbidity and mortality. Frequent requirements of antibiotics have resulted in multidrug resistant (MDR) pathogens. Newer antibiotics can help treat these infections, but many contain beta lactam rings and less information is known about tolerability. This abstract describes a penicillin tolerant cerebral palsy patient who developed a type I hypersensitivity reaction to ceftazidime/avibactam, and his successful treatment with this antibiotic after rapid induction of temporary tolerance.
Source: Annals of Allergy, Asthma and Immunology - Category: Allergy & Immunology Authors: Tags: M012 Source Type: research
Conclusions: Residential proximity to road traffic volumes and traffic density were associated with increased all-cause mortality in patients undergoing treatment for active tuberculosis even after adjusting for multiple demographic, socioeconomic, and clinical factors, suggesting that TB patients are susceptible to the adverse health effects of traffic-related air pollution. https://doi.org/10.1289/EHP1699 Received: 31 January 2017 Revised: 18 August 2017 Accepted: 23 August 2017 Published: 29 September 2017 Address correspondence to R.J. Blount, Divisions of Pulmonary and Critical Care Medicine and Pediatric Pulmon...
Source: EHP Research - Category: Environmental Health Authors: Tags: Research Source Type: research
WASHINGTON ― When Baltimore resident Arjun kisses his 6-year-old daughter’s forehead, it’s not always just a sign of affection. His daughter, Sujata, is onto him. “Is that a temperature kiss?” she asks. Arjun compulsively checks his little girl’s temperature for a reason. Sujata is the survivor of the “first well-described case” of extensively drug-resistant tuberculosis in a young child in the U.S., according to her physicians. Tuberculosis is the world’s biggest killer among infectious diseases, and extensively drug-resistant tuberculosis ― or XDR-TB, which is re...
Source: Science - The Huffington Post - Category: Science Source Type: news
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