7 results on '"Beta-lactam/beta-lactamase inhibitors"'
Search Results
2. Novel pharmacotherapy for the treatment of hospital-acquired and ventilator-associated pneumonia caused by resistant gram-negative bacteria.
- Author
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Kidd JM, Kuti JL, and Nicolau DP
- Subjects
- Administration, Inhalation, Amikacin pharmacology, Amikacin therapeutic use, Ceftazidime pharmacology, Ceftazidime therapeutic use, Cephalosporins pharmacology, Cephalosporins therapeutic use, Clinical Trials as Topic, Drug Resistance, Multiple, Bacterial drug effects, Gram-Negative Bacteria drug effects, Gram-Negative Bacteria isolation & purification, Humans, Pneumonia, Ventilator-Associated microbiology, Sisomicin analogs & derivatives, Sisomicin pharmacology, Sisomicin therapeutic use, Anti-Bacterial Agents therapeutic use, Pneumonia, Ventilator-Associated drug therapy
- Abstract
Introduction: Hospital-acquired and ventilator-associated bacterial pneumonia (HABP/VABP) are among the most prevalent infections in hospitalized patients, particularly those in the intensive care unit. Importantly, the frequency of multidrug resistant (MDR) Gram-negative (GN) bacteria as the bacteriologic cause of HABP/VABP is increasing. These include MDR Pseudomonas aeruginosa, Acinetobacter baumannii, and carbapenem resistant Enterobacteriaceae (CRE). Few antibiotics are currently available when such MDR Gram-negatives are encountered and older agents such as polymyxin B, colistin (polymyxin E), and tigecycline have typically performed poorly in HABP/VABP., Areas Covered: In this review, the authors summarize novel antibiotics which have reached phase 3 clinical trials including patients with HABP/VABP. For each agent, the spectrum of activity, pertinent pharmacological characteristics, clinical trial data, and potential utility in the treatment of MDR-GN HABP/VABP is discussed., Expert Opinion: Novel antibiotics currently available, and those soon to be, will expand opportunities to treat HABP/VABP caused by MDR-GN organisms and minimize the use of more toxic, less effective drugs. However, with sparse clinical data available, defining the appropriate role for each of the new agents is challenging. In order to maximize the utility of these antibiotics, combination therapy and the role of therapeutic drug monitoring should be investigated.
- Published
- 2018
- Full Text
- View/download PDF
3. Using β-lactam/β-lactamase inhibitors for infections due to extended-spectrum β-lactamase-producing Enterobacteriaceae to slow the emergence of carbapenem-resistant Enterobacteriaceae.
- Author
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Watkins RR and Deresinski S
- Subjects
- Anti-Bacterial Agents pharmacology, Carbapenem-Resistant Enterobacteriaceae drug effects, Carbapenem-Resistant Enterobacteriaceae isolation & purification, Enterobacteriaceae drug effects, Enterobacteriaceae isolation & purification, Enterobacteriaceae Infections microbiology, Humans, beta-Lactam Resistance drug effects, beta-Lactamase Inhibitors pharmacology, beta-Lactamases metabolism, beta-Lactams pharmacology, Anti-Bacterial Agents administration & dosage, Enterobacteriaceae Infections drug therapy, beta-Lactamase Inhibitors administration & dosage
- Published
- 2017
- Full Text
- View/download PDF
4. Efficacy of β-Lactam/β-Lactamase Inhibitor Combinations for the Treatment of Bloodstream Infection Due to Extended-Spectrum-β-Lactamase-Producing Enterobacteriaceae in Hematological Patients with Neutropenia.
- Author
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Gudiol C, Royo-Cebrecos C, Abdala E, Akova M, Álvarez R, Maestro-de la Calle G, Cano A, Cervera C, Clemente WT, Martín-Dávila P, Freifeld A, Gómez L, Gottlieb T, Gurguí M, Herrera F, Manzur A, Maschmeyer G, Meije Y, Montejo M, Peghin M, Rodríguez-Baño J, Ruiz-Camps I, Sukiennik TC, Tebe C, and Carratalà J
- Subjects
- Adult, Bacteremia complications, Bacteremia microbiology, Bacteremia mortality, Carbapenems therapeutic use, Cohort Studies, Enterobacteriaceae enzymology, Enterobacteriaceae Infections complications, Enterobacteriaceae Infections microbiology, Enterobacteriaceae Infections mortality, Female, Humans, Male, Middle Aged, beta-Lactamases metabolism, beta-Lactams therapeutic use, Anti-Bacterial Agents therapeutic use, Bacteremia drug therapy, Enterobacteriaceae drug effects, Enterobacteriaceae Infections drug therapy, Neutropenia complications, beta-Lactamase Inhibitors therapeutic use
- Abstract
β-Lactam/β-lactamase inhibitors (BLBLIs) were compared to carbapenems in two cohorts of hematological neutropenic patients with extended-spectrum-β-lactamase (ESBL) bloodstream infection (BSI): the empirical therapy cohort (174 patients) and the definitive therapy cohort (251 patients). The 30-day case fatality rates and other secondary outcomes were similar in the two therapy groups of the two cohorts and also in the propensity-matched cohorts. BLBLIs might be carbapenem-sparing alternatives for the treatment of BSI due to ESBLs in these patients., (Copyright © 2017 American Society for Microbiology.)
- Published
- 2017
- Full Text
- View/download PDF
5. Clinical efficacy of β-lactam/β-lactamase inhibitor combinations for the treatment of bloodstream infection due to extended-spectrum β-lactamase-producing Enterobacteriaceae in haematological patients with neutropaenia: a study protocol for a retrospective observational study (BICAR).
- Author
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Gudiol C, Royo-Cebrecos C, Tebe C, Abdala E, Akova M, Álvarez R, Maestro-de la Calle G, Cano A, Cervera C, Clemente WT, Martín-Dávila P, Freifeld A, Gómez L, Gottlieb T, Gurguí M, Herrera F, Manzur A, Maschmeyer G, Meije Y, Montejo M, Peghin M, Rodríguez-Baño J, Ruiz-Camps I, Sukiennik TC, and Carratalà J
- Subjects
- Adolescent, Adult, Aged, Bacteremia drug therapy, Drug Therapy, Combination, Female, Hematologic Neoplasms therapy, Hematopoietic Stem Cell Transplantation, Humans, Male, Middle Aged, Retrospective Studies, Superinfection prevention & control, Anti-Bacterial Agents therapeutic use, Enterobacteriaceae Infections drug therapy, Neutropenia complications, beta-Lactamase Inhibitors therapeutic use, beta-Lactams therapeutic use
- Abstract
Introduction: Bloodstream infection (BSI) due to extended-spectrum β-lactamase-producing Gram-negative bacilli (ESBL-GNB) is increasing at an alarming pace worldwide. Although β-lactam/β-lactamase inhibitor (BLBLI) combinations have been suggested as an alternative to carbapenems for the treatment of BSI due to these resistant organisms in the general population, their usefulness for the treatment of BSI due to ESBL-GNB in haematological patients with neutropaenia is yet to be elucidated. The aim of the BICAR study is to compare the efficacy of BLBLI combinations with that of carbapenems for the treatment of BSI due to an ESBL-GNB in this population., Methods and Analysis: A multinational, multicentre, observational retrospective study. Episodes of BSI due to ESBL-GNB occurring in haematological patients and haematopoietic stem cell transplant recipients with neutropaenia from 1 January 2006 to 31 March 2015 will be analysed. The primary end point will be case-fatality rate within 30 days of onset of BSI. The secondary end points will be 7-day and 14-day case-fatality rates, microbiological failure, colonisation/infection by resistant bacteria, superinfection, intensive care unit admission and development of adverse events., Sample Size: The number of expected episodes of BSI due to ESBL-GNB in the participant centres will be 260 with a ratio of control to experimental participants of 2., Ethics and Dissemination: The protocol of the study was approved at the first site by the Research Ethics Committee (REC) of Hospital Universitari de Bellvitge. Approval will be also sought from all relevant RECs. Any formal presentation or publication of data from this study will be considered as a joint publication by the participating investigators and will follow the recommendations of the International Committee of Medical Journal Editors (ICMJE). The study has been endorsed by the European Study Group for Bloodstream Infection and Sepsis (ESGBIS) and the European Study Group for Infections in Compromised Hosts (ESGICH)., Competing Interests: JR-B has been a scientific consultant for Merck, AstraZeneca, Achaogen and InfectoPharm, a speaker in accredited educational activities for Merck and AstraZeneca, a recipient of research grants from COMBACTE-NET, COMBACTE-CARE and COMBACTE-MAGNET, funded by the Innovative Medicines Initiative (European Union and EFPIA in kind). AF has received research fees from Merck, and from Astellas for data and safety monitoring. JC has received lecture fees from Novartis, Astellas, Pfizer, MSD, Janssen and Astra-Zeneca., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.)
- Published
- 2017
- Full Text
- View/download PDF
6. Efficacy of β-Lactam/β-Lactamase Inhibitor Combinations for the Treatment of Bloodstream Infection Due to Extended-Spectrum-β-Lactamase-Producing Enterobacteriaceae in Hematological Patients with Neutropenia
- Author
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F. Herrera, Jordi Carratalà, Guillermo Maestro de la Calle, Cristina Royo-Cebrecos, Carlos Cervera, Murat Akova, Maddalena Peghin, Georg Maschmeyer, Pilar Martín-Dávila, Mercè Gurguí, Jesús Rodríguez-Baño, Isabel Ruiz-Camps, Angela Cano, Yolanda Meije, Adriana Manzur, Teresa C. Sukiennik, Edson Abdala, Wanessa Trindade Clemente, Alison G. Freifeld, Cristian Tebe, Miguel Montejo, Thomas Gottlieb, Lucía Gómez, Carlota Gudiol, R. Alvarez, European Society of Clinical Microbiology and Infectious Diseases, Ministerio de Economía y Competitividad (España), Instituto de Salud Carlos III, European Commission, Red Española de Investigación en Patología Infecciosa, [Gudiol, Carlota] Univ Barcelona, Bellvitge Univ Hosp, IDIBELL, Infect Dis Dept, Barcelona, Spain, [Royo-Cebrecos, Cristina] Univ Barcelona, Bellvitge Univ Hosp, IDIBELL, Infect Dis Dept, Barcelona, Spain, [Carratala, Jordi] Univ Barcelona, Bellvitge Univ Hosp, IDIBELL, Infect Dis Dept, Barcelona, Spain, [Gudiol, Carlota] Duran & Reynals Hosp, ICO, Barcelona, Spain, [Abdala, Edson] Univ Sao Paulo, Fac Med, Inst Canc Estado Sao Paulo, Sao Paulo, Brazil, [Akova, Murat] Hacettepe Univ, Sch Med, Ankara, Turkey, [Alvarez, Rocio] Univ Seville, CSIC, Univ Hosp Virgen Rocio & Virgen Macarena, Inst Biomed Seville IBiS,Infect Dis Res Grp,Clin, Seville, Spain, [Maestro-de la Calle, Guillermo] Univ Complutense, Sch Med, Octubre Univ Hosp 12, Inst Invest Hosp Octubre 12 i 12,Infect Dis Unit, Madrid, Spain, [Cano, Angela] UCO, Reina Sofia Univ Hosp, IMIBIC, Cordoba, Spain, [Cervera, Carlos] Univ Alberta Hosp, Edmonton, AB, Canada, [Clemente, Wanessa T.] Univ Fed Minas Gerais, Hosp Clin, Digest Transplant Serv, Belo Horizonte, MG, Brazil, [Martin-Davila, Pilar] Hosp Ramon & Cajal, Infect Dis Dept, Madrid, Spain, [Freifeld, Alison] Univ Nebraska, Med Ctr, Internal Med Infect Dis Sect, Omaha, NE 68182 USA, [Gomez, Lucia] Univ Hosp Mutua Terrassa, Internal Med, Barcelona, Spain, [Gottlieb, Thomas] Concord Hosp, Dept Microbiol & Infect Dis, Concord, NSW, Australia, [Gurgui, Merce] Univ Autonoma Barcelona, Hosp Santa Creu & Sant Pau, Infect Dis Unit, Barcelona, Spain, [Gurgui, Merce] Univ Autonoma Barcelona, Inst Invest Biomed Sant Pau, Barcelona, Spain, [Herrera, Fabian] CEMIC, Dept Med, Infect Dis Sect, Buenos Aires, DF, Argentina, [Manzur, Adriana] Hosp Rawson, Infect Dis, San Juan, Argentina, [Maschmeyer, Georg] Charite, Med Sch, Acad Teaching Hosp, Dept Hematol Oncol & Palliat Care,Klinikum Ernst, Berlin, Germany, [Meije, Yolanda] Barcelona Hosp, SCIAS, Internal Med Dept, Infect Dis Unit, Barcelona, Spain, [Montejo, Miguel] Cruces Univ Hosp, Infect Dis Unit, Bilbao, Spain, [Peghin, Maddalena] Santa Maria Misericordia Univ Hosp, Infect Dis Div, Udine, Italy, [Rodriguez-Bano, Jesus] Univ Seville, Univ Hosp Virgen Macarena & Virgen Rocio IBiS, Dept Med, Clin Unit Infect Dis Microbiol & Prevent Med, Seville, Spain, [Ruiz-Camps, Isabel] Vall Hebron Univ Hosp, Infect Dis Dept, Barcelona, Spain, [Sukiennik, Teresa C.] Hosp Santa Casa Misericordia Porto Alegre, Porto Alegre, RS, Brazil, [Tebe, Cristian] Rovira & Virgili Univ, Inst Biomed Res Bellvitge, Stat Advisory Serv, Tarragona, Spain, [Gudiol, Carlota] Inst Salud Carlos III, REIPI Spanish Network Res Infect Dis, Madrid, Spain, [Royo-Cebrecos, Cristina] Inst Salud Carlos III, REIPI Spanish Network Res Infect Dis, Madrid, Spain, [Meije, Yolanda] Inst Salud Carlos III, REIPI Spanish Network Res Infect Dis, Madrid, Spain, [Montejo, Miguel] Inst Salud Carlos III, REIPI Spanish Network Res Infect Dis, Madrid, Spain, [Rodriguez-Bano, Jesus] Inst Salud Carlos III, REIPI Spanish Network Res Infect Dis, Madrid, Spain, [Ruiz-Camps, Isabel] Inst Salud Carlos III, REIPI Spanish Network Res Infect Dis, Madrid, Spain, [Carratala, Jordi] Inst Salud Carlos III, REIPI Spanish Network Res Infect Dis, Madrid, Spain, ESGBIS, ESGICH, Ministerio de Economia y Competitividad, Instituto de Salud Carlos III - European Development Regional Fund 'A way to achieve Europe' EDRF, Spanish Network for the Research in Infectious Diseases, COMBACTE-NET, COMBACTE-CARE, COMBACTE-MAGNET, Innovative Medicines Initiative (European Union), Innovative Medicines Initiative (EFPIA), Merck, Astellas, Novartis, Pfizer, MSD, Janssen, Astra-Zeneca, and İç Hastalıkları
- Subjects
0301 basic medicine ,Male ,Definitive Therapy ,Bacteremia ,Escherichia-coli ,Cohort Studies ,chemistry.chemical_compound ,Bloodstream infection ,Case fatality rate ,polycyclic compounds ,beta-lactam/beta-lactamase inhibitors ,Pharmacology (medical) ,Pharmacology & Pharmacy ,Cancer ,biology ,Klebsiella-pneumoniae ,Enterobacteriaceae Infections ,Middle Aged ,Enterobacteriaceae ,Anti-Bacterial Agents ,Risk-factors ,Infectious Diseases ,Beta-lactam/beta-lactamase inhibitors ,Cohort ,Lactam ,Female ,beta-Lactamase Inhibitors ,Adult ,medicine.medical_specialty ,Neutropenia ,030106 microbiology ,bloodstream infection ,Outcomes ,Clinical Therapeutics ,beta-Lactams ,Microbiology ,beta-Lactamases ,03 medical and health sciences ,β lactamase inhibitor ,Piperacillin-tazobactam ,Internal medicine ,medicine ,Humans ,Mortality ,Intensive care medicine ,Pharmacology ,business.industry ,biochemical phenomena, metabolism, and nutrition ,medicine.disease ,biology.organism_classification ,bacterial infections and mycoses ,mortality ,chemistry ,ESBLs ,Carbapenems ,bacteria ,Therapy ,Bloodstream infections ,business - Abstract
β-Lactam/β-lactamase inhibitors (BLBLIs) were compared to carbapenems in two cohorts of hematological neutropenic patients with extended-spectrum-β-lactamase (ESBL) bloodstream infection (BSI): the empirical therapy cohort (174 patients) and the definitive therapy cohort (251 patients). The 30-day case fatality rates and other secondary outcomes were similar in the two therapy groups of the two cohorts and also in the propensity-matched cohorts. BLBLIs might be carbapenem-sparing alternatives for the treatment of BSI due to ESBLs in these patients., We thank the ESGBIS and the ESGICH study groups for supporting the study. This study was supported by Ministerio de Economía y Competitividad, Instituto de Salud Carlos III—cofinanced by European Development Regional Fund “A way to achieve Europe” EDRF, Spanish Network for the Research in Infectious Diseases (REIPI RD12/0015).
- Published
- 2017
7. Clinical efficacy of β-lactam/β-lactamase inhibitor combinations for the treatment of bloodstream infection due to extended-spectrum β-lactamase-producing Enterobacteriaceae in haematological patients with neutropaenia: a study protocol for a retrospective observational study (BICAR)
- Author
-
Gudiol, C., Royo-Cebrecos, C., Tebe, C., Abdala, E., Akova, Murat, Álvarez, R., Maestro-de la Calle, G., Cano, A., Cervera, C., Clemente, W. T., Martín-Dávila, P., Freifeld, A., Gómez, L., Gottlieb, T., Gurguí, Mercè, Herrera, F., Manzur, A., Maschmeyer, G., Meije, Y, Montejo, M., Peghin, M., Rodríguez-Baño, Jesús, Ruiz-Camps, I, Sukiennik, T. C., Carratalà, Jordi, Universitat Autònoma de Barcelona, and Universitat de Barcelona
- Subjects
Adult ,Male ,Neutropenia ,Adolescent ,Lactams ,Bacteremia ,beta-Lactams ,Infections ,haematologic stem cell transplant ,beta-lactam/beta-lactamase inhibitors ,Humans ,Hematologia ,Aged ,Retrospective Studies ,Medicine (all) ,Enterobacteriaceae Infections ,Hematopoietic Stem Cell Transplantation ,Haematologic stem cell transplant ,Hematology ,Middle Aged ,biochemical phenomena, metabolism, and nutrition ,bacterial infections and mycoses ,Lactames ,Infeccions ,Bacteraemia ,ESBLs ,Anti-Bacterial Agents ,Hematologic Neoplasms ,Superinfection ,Beta-lactam/beta-lactamase inhibitors ,Drug Therapy, Combination ,Female ,beta-Lactamase Inhibitors - Abstract
Introduction: Bloodstream infection (BSI) due to extended-spectrum β-lactamase-producing Gram-negative bacilli (ESBL-GNB) is increasing at an alarming pace worldwide. Although β-lactam/β-lactamase inhibitor (BLBLI) combinations have been suggested as an alternative to carbapenems for the treatment of BSI due to these resistant organisms in the general population, their usefulness for the treatment of BSI due to ESBL-GNB in haematological patients with neutropaenia is yet to be elucidated. The aim of the BICAR study is to compare the efficacy of BLBLI combinations with that of carbapenems for the treatment of BSI due to an ESBL-GNB in this population. Methods and analysis: A multinational, multicentre, observational retrospective study. Episodes of BSI due to ESBL-GNB occurring in haematological patients and haematopoietic stem cell transplant recipients with neutropaenia from 1 January 2006 to 31 March 2015 will be analysed. The primary end point will be case-fatality rate within 30 days of onset of BSI. The secondary end points will be 7-day and 14-day case-fatality rates, microbiological failure, colonisation/infection by resistant bacteria, superinfection, intensive care unit admission and development of adverse events. Sample size: The number of expected episodes of BSI due to ESBL-GNB in the participant centres will be 260 with a ratio of control to experimental participants of 2. Ethics and dissemination: The protocol of the study was approved at the first site by the Research Ethics Committee (REC) of Hospital Universitari de Bellvitge. Approval will be also sought from all relevant RECs. Any formal presentation or publication of data from this study will be considered as a joint publication by the participating investigators and will follow the recommendations of the International Committee of Medical Journal Editors (ICMJE). The study has been endorsed by the European Study Group for Bloodstream Infection and Sepsis (ESGBIS) and the European Study Group for Infections in Compromised Hosts (ESGICH).
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