Imipenem ‐Cilastatin‐Relebactam: A Novel β‐Lactam–β‐Lactamase Inhibitor Combination for the Treatment of Multidrug‐Resistant Gram‐Negative Infections

AbstractImipenem ‐cilastatin‐relebactam (IMI‐REL) is a novel β‐lactam–β‐lactamase inhibitor combination recently approved for the treatment of complicated urinary tract infections (cUTIs) and complicated intraabdominal infections (cIAIs). Relebactam is a β‐lactamase inhibitor with the ability to inh ibit a broad spectrum of β‐lactamases such as class A and class C β‐lactamases, including carbapenemases. The addition of relebactam to imipenem restores imipenem activity against several imipenem‐resistant bacteria, including Enterobacteriaceae andPseudomonas aeruginosa. Clinical data demonstrate that IMI ‐REL is well tolerated and effective in the treatment of cUTIs and cIAIs due to imipenem‐resistant bacteria. In a phase III trial comparing IMI‐REL with imipenem plus colistin, favorable clinical response was achieved in 71% and 70% of patients, respectively. Available clinical and pharmacokin etic data support the approved dosage of a 30‐minute infusion of imipenem 500 mg–cilastatin 500 mg–relebactam 250 mg every 6 hours, along with dosage adjustments based on renal function. In this review, we describe the chemistry, mechanism of action, spectrum of activity, pharmacokinetics and pharmacodynamics, and clinical efficacy, and safety and tolerability of this new agent. The approval of IMI‐REL represents another important step in the ongoing fight against multidrug‐resistant gram‐negative pathogens.
Source: Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy - Category: Drugs & Pharmacology Authors: Tags: REVIEW OF THERAPEUTICS Source Type: research

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The aim of the study was to evaluate the impact of a multifaceted antimicrobial stewardship intervention on antibiotic consumption in a primary health care (PHC) area in Spain. Quasi-experimental study conducted in a PHC area with nine PHC centers, a 400-bed acute care teaching hospital, and 18 nursing homes serving a population of 260,561. The intervention was based on the 2016 CDC Core Elements of Outpatient Antibiotic Stewardship publication and targeted 130 PHC physicians, 41 PHC pediatricians, 19 emergency physicians, and 18 nursing home physicians. The components were commitment, actions for improving antibiotic pres...
Source: Frontiers in Pharmacology - Category: Drugs & Pharmacology Source Type: research
AbstractBackgroundWe sought to determine the rate of emergency department (ED) attendance for complications after ureterorenoscopy (URS) for stone disease and to identify risk factors for ED attendance after URS.MethodsAn analysis of all patients undergoing URS over 12  months at a single institution was performed. Patient demographics, preoperative and intraoperative variables associated with postoperative complications and subsequent ED attendance were collected. Logistic regression analyses were performed to determine predictors of URS complications presenting to ED.ResultsIn total, 202 ureteroscopies were performe...
Source: Irish Journal of Medical Science - Category: General Medicine Source Type: research
Source: Infection and Drug Resistance - Category: Infectious Diseases Tags: Infection and Drug Resistance Source Type: research
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Source: TIME: Health - Category: Consumer Health News Authors: Tags: Uncategorized COVID-19 Source Type: news
Conclusion: The study indicates that outpatients with UTI could be at high risk of antibiotic resistance, suggesting regular surveillance and monitoring of antibiotics.
Source: The Journal of Infection in Developing Countries - Category: Infectious Diseases Source Type: research
The antimicrobial susceptibility testing of 284 Enterobacteriaceae isolates responsible for urinary tract infections to ampicillin, ceftazidime, ciprofloxacin, nitrofurantoin, trimethoprin-sulfamethaxole, and fosfomycin was performed by disk diffusion method. Additionally, in fosfomycin-resistant and intermediate susceptible isolates using disk diffusion method, the minimum inhibitory concentration (MIC) of fosfomycin was determined by agar dilution. The presence of fosA and fosA3 genes and ESBL genes was investigated in fosfomycin-resistant isolates and ESBL-producing isolates, respectively. Klebsiella pneumoniae [72.34% ...
Source: Reviews in Medical Microbiology - Category: Microbiology Tags: BACTERIOLOGY Source Type: research
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Source: Techniques in Coloproctology - Category: Surgery Source Type: research
Circulating androgens prime the kidney for fibrosis upon infectious injury (Escherichia coli pyelonephritis) by enhancing local TGF β1 production and myofibroblast activation. AbstractRenal scarring after pyelonephritis is linked to long ‐term health risks for hypertension and chronic kidney disease. Androgen exposure increases susceptibility to, and severity of, uropathogenicEscherichia coli (UPEC) pyelonephritis and resultant scarring in both male and female mice, while anti ‐androgen therapy is protective against severe urinary tract infection (UTI) in these models. This work employed androgenized female C57BL/...
Source: Physiological Reports - Category: Physiology Authors: Tags: ORIGINAL RESEARCH Source Type: research
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Source: Progres en Urologie - Category: Urology & Nephrology Tags: Prog Urol Source Type: research
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Source: International Braz J Urol - Category: Urology & Nephrology Source Type: research
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