PubMed Journals Articles About "Piperacillin Tazobactam Alternative Carbapenems Patients" RSS

13:43 EST 18th November 2018 | BioPortfolio

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Showing "Piperacillin tazobactam alternative carbapenems patients" PubMed Articles 1–25 of 37,000+

Impact of Piperacillin/Tazobactam on Nephrotoxicity in Patients with Gram-negative Bacteremia.

Piperacillin/tazobactam has been associated with nephrotoxicity in patients receiving vancomycin. Its impact on nephrotoxicity in patients with gram-negative bacteremia (GNB) is unclear. This study aims to evaluate piperacillin/tazobactam's impact on nephrotoxicity in patients with GNB. Our retrospective cohort included patients ≥18 years of age who received ≥48 hours of therapy for bacteremia due to Escherichia coli, Pseudomonas aeruginosa, Enterobacter sp., Klebsiella sp., Acinetobacter sp., or Stenot...

Rapid onset severe thrombocytopenia following reexposure to piperacillin-tazobactam: report of two cases and review of the literature.

Pipercillin-tazobactam is a frequently used antibiotic that has a broad spectrum of antibacterial activity. The development of severe thrombocytopenia following the use of piperacillin-tazobactam is unusual. Several mechanisms have been proposed for the pathogenesis of thrombocytopenia in this setting which include immune and non-immune causes. Multiple case reports have shown the ability of piperacillin-tazobactam to cause drug-induced immune thrombocytopenia, likely through formation of antibodies that re...

Effect of Piperacillin-Tazobactam vs Meropenem on 30-Day Mortality for Patients With E coli or Klebsiella pneumoniae Bloodstream Infection and Ceftriaxone Resistance: A Randomized Clinical Trial.

Extended-spectrum β-lactamases mediate resistance to third-generation cephalosporins (eg, ceftriaxone) in Escherichia coli and Klebsiella pneumoniae. Significant infections caused by these strains are usually treated with carbapenems, potentially selecting for carbapenem resistance. Piperacillin-tazobactam may be an effective "carbapenem-sparing" option to treat extended-spectrum β-lactamase producers.

Assessing Antimicrobial Stewardship Initiatives: Clinical Evaluation of Cefepime or Piperacillin-tazobactam in Patients with Bloodstream Infections Secondary to AmpC Producing Organisms.

Management of organisms harboring AmpC beta-lactamases remains challenging. Carbapenems are often considered first-line agents. Due to growing concern for carbapenem resistant Enterobacteriaceae, integrating non-carbapenem strategies is being explored for these pathogens. The primary objective of this study was to evaluate clinical outcomes in patients with bacteremia secondary to AmpC producing organisms treated with cefepime or piperacillin-tazobactam.

After standard dosage of piperacillin plasma concentrations of drug are subtherapeutic in burn patients.

Infections are a major problem in patients with burn diseases. Mortality is high despite antibiotic therapy as studies are controversial concerning drug underdosing. The aims of this prospective, observational study were to monitor plasma concentrations of piperacillin during standard piperacillin/tazobactam treatment in 20 burn patients and 16 controls from the intensive care unit (ICU) and to optimize doses by in silico analyses. Piperacillin/tazobactam (4/0.5 g, tid) was administered over 0.5 h. Blood ...

Comparative incidence and excess risk of acute kidney injury in hospitalized patients receiving vancomycin and piperacillin-tazobactam in combination or as monotherapy.

Combination therapy with vancomycin and piperacillin-tazobactam has been associated with increased risk of acute kidney injury (AKI) as compared to monotherapy. This study was conducted to assess the comparative incidence of AKI due to combination therapy in patients receiving vancomycin and piperacillin-tazobactam in combination or as monotherapy.

Comparison of acute kidney injury risk associated with vancomycin and concomitant piperacillin/tazobactam or cefepime in the intensive care unit.

The objective of this study was to evaluate AKI incidence with concomitant vancomycin and piperacillin/tazobactam (PTZ) compared to vancomycin and cefepime (FEP) in critically ill patients.

Higher than standard dosing regimen are needed to achieve optimal antibiotic exposure in critically ill patients with augmented renal clearance receiving piperacillin-tazobactam administered by continuous infusion.

To determine whether augmented renal clearance (ARC) impacts negatively on piperacillin-tazobactam unbound concentrations in critically ill patients receiving 16 g/2 g/day administered continuously.

Hematologic Adverse Effects of Prolonged Piperacillin-Tazobactam Use in Adults.

Key words: Neutropenia; Leukopenia; Eosinophilia; Piperacillin-tazobactam; Adverse effects.

Efficacy of Antibiotic Prophylaxis against ventilator-associated pneumonia.

Ventilator-associated pneumonia (VAP) is one of the most important problems of intensive care units. 84 neurologic patients with acute stroke (Glasgow Coma Score ≤ 8) were entered into a double-blind clinical trial. Patients in the intervention group received piperacillin-tazobactam 4g/0.5g at the time of intubation and 12 hours later. The incidences of early-onset (within 4 days of intubation) and late-onset VAP were 9.2 and 26.9 episodes/1,000 days of mechanical ventilation in the intervention and contr...

Results of the effectiveness of two piperacillin-tazobactam molecules in the real world.

The objective was to determine the effectiveness of of two piperacillin-tazobactam molecules in terms of all-cause mortality, mortality by infection and hospital stay.

In-vitro detection of Candida and Aspergillus antigen in parenteral nutrition and fixed combinations of piperacillin-tazobactam.

Screening for Aspergillus (Asp-AG) and Candida antigen (Ca-AG) with immunoassays is established for stem cell recipients at high risk for invasive fungal infections (IFI). While parenteral nutrition (PN) will be applied in case of complications leading to insufficient alimentation, piperacillin-tazobactam (TZP) is started at the onset of febrile neutropenia.

Acute kidney injury associated with concomitant vancomycin and piperacillin/tazobactam administration: a systematic review and meta-analysis.

As a tricyclic glycopeptide antibiotic used to treat acute infections, Vancomycin (VAN) is often administered with piperacillin/tazobactam (PT) to treat various infections in clinical practice. However, whether the combination of these two drugs, compared to VAN alone, can cause an increased risk of acute kidney injury (AKI) remains controversial.

Nephrotoxicity of piperacillin-tazobactam combined with vancomycin: Should it be a concern?

The combination of piperacillin-tazobactam (pip-tazo) and vancomycin provides a wide spectrum of activity against many pathogens acquired in the health-care setting. However, there have been reports of increased potential for nephrotoxicity with this combination. The aim of this study was to evaluate the nephrotoxic effect of pip-tazo plus vancomycin and compare it with that of pip-tazo and vancomycin alone, and meropenem plus vancomycin, another broad-spectrum combination. A total of 402 patients receiving...

Potential for More Rational Use of Antibiotics in Hospitalized Children in a Country with Low Resistance - Data From Eight Point Prevalence Surveys.

Antimicrobial resistance (AMR) is low in Norway, but to prevent an increase the Norwegian Government has launched a National Strategy including a 30% reduction of broad-spectrum antibiotics (BSA) in hospitals within 2020. BSA are defined as second- and third-generation cephalosporins, carbapenems, piperacillin/tazobactam and quinolones. There are no recent studies of antibiotic use in Norwegian hospitalized children.

Characterization of a colistin-resistant Salmonella enterica 4,5,12:i:- harbouring mcr-3.2 on a variant IncHI-2 plasmid identified in Canada.

We have identified a Salmonella enterica serotype 4,[5],12:i:- containing a mcr-3.2 in a patient who travelled to Thailand 1 month prior to the identification of it in Canada. The isolate was multidrug resistant, but remained susceptible to the carbapenems, amikacin and piperacillin/tazobactam. The mcr-3.2 was carried on a 261 Kb variant of the IncHI2 pWJ1. This report provides further evidence of the emergence of a ST34 colistin-resistant clone.

Generalized fixed drug eruption to piperacillin/tazobactam and review of literature.

Fixed drug eruption (FDE) is an adverse drug reaction characterized by the development of well-circumscribed, round, dusky erythematous macules and plaques on cutaneous or mucosal surfaces. The reaction occurs on the same mucosal or cutaneous site with subsequent exposures to the offending drug. Although FDE usually manifests as a single lesion, in rare instances, more than one lesion may arise and this is referred to as a generalized eruption. Herein, we present a 31year-old man with history of cystic fibr...

Evaluation of a Risk-guided Strategy for Empiric Carbapenem Use in Febrile Neutropenia.

Febrile neutropenia (FN) is associated with substantial morbidity and necessitate empiric broad spectrum antibiotic treatment. We evaluated a risk-guided FN management strategy using empiric piperacillin-tazobactam and carbapenem in a prospective cohort study. The analysis involved 723 FN episodes in hospitalised adult patients, including those with severe sepsis or prior infection/colonisation with extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae. Propensity score matching analysis was ...

Carbapenems versus alternative β-lactams for the treatment of nosocomial pneumonia: A systematic review and meta-analysis.

Carbapenems have demonstrated efficacy in treating nosocomial pneumonias in clinical trials despite a reported low lung penetration compared to other β-lactams. Preserving the clinical activity of carbapenems through stewardship efforts is essential. This review aims to identify if differences in outcomes exist, potentially as a function of decreased penetration.

Broad-spectrum antibiotic prescriptions are unevenly discontinued throughout the week.

To investigate prescribing patterns of in-hospital broad-spectrum antibiotics (anti-meticillin-resistant Staphylococcus aureus drugs, carbapenems, and piperacillin/tazobactam), we analysed data of the distribution of antibiotic initiations and discontinuations throughout the week at Osaka University Hospital, Japan. There were no statistical differences in the number of initiations among weekdays. However, the broad-spectrum antibiotics were disproportionately discontinued on Tuesday or on the second day af...

Inoculum effect of methicillin-susceptible Staphylococcus aureus against broad-spectrum beta-lactam antibiotics.

Scarce information concerning the inoculum effect (InE) of methicillin-susceptible Staphylococcus aureus (MSSA) against broad-spectrum β-lactam antibiotics is available. We investigated the InE of MSSA against ceftriaxone, cefepime, meropenem, ampicillin/sulbactam and piperacillin/tazobactam. The bacteraemic MSSA isolates were collected at ten Korean general hospitals from Sep 2013 to Mar 2015. The InE was defined if MICs of antibiotics at high inoculum (HI, ~5 × 10 CFU/ml) increased beyond the susce...

Determination of total and free ceftolozane and tazobactam in human plasma and interstitial fluid by HPLC-UV.

Ceftolozane/tazobactam is a new cephalosporin/beta-lactamase inhibitor combination. An HPLC-UV method is described for the determination of total and free ceftolozane and tazobactam in human plasma and in microdialysate of subcutaneous tissue, respectively. Separation was performed using a reversed-phase column with phosphate buffer/acetonitrile as eluent and photometric detection at 260 nm (ceftolozane) or 220 nm (tazobactam). Linearity has been shown down to ceftolozane/tazobactam 0.1/0.05 mg/L in p...

Incidence of acute kidney injury among critically ill patients with brief empiric use of anti-pseudomonal beta-lactams with vancomycin.

Nephrotoxins contribute to 20-40% of acute kidney injury (AKI) cases in the intensive care unit (ICU). The combination of piperacillin/tazobactam and vancomycin (PTZ/VAN) has been identified as nephrotoxic, but existing studies focus on extended durations of therapy rather than the brief empiric courses often used in the ICU.

Extensive Gene Amplification as a Mechanism for Piperacillin-Tazobactam Resistance in Escherichia coli.

Although the TEM-1 β-lactamase (Bla) hydrolyzes penicillins and narrow-spectrum cephalosporins, organisms expressing this enzyme are typically susceptible to β-lactam/β-lactamase inhibitor combinations such as piperacillin-tazobactam (TZP). However, our previous work led to the discovery of 28 clinical isolates of resistant to TZP that contained only One of these isolates, 907355, was investigated further in this study. 907355 exhibited significantly higher β-lactamase activity and Bla protein level...

A Monte Carlo Simulation Approach for Beta-Lactam Dosing in Critically Ill Patients Receiving Prolonged Intermittent Renal Replacement Therapy.

Cefepime, ceftazidime, and piperacillin/tazobactam are commonly used beta-lactam antibiotics in the critical care setting. For critically ill patients receiving prolonged intermittent renal replacement therapy (PIRRT), limited pharmacokinetic data are available to inform clinicians on the dosing of these agents. Monte Carlo simulations (MCS) can be used to guide drug dosing when pharmacokinetic trials are not feasible. For each antibiotic, MCS using previously published pharmacokinetic data derived from cri...

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