Comparison of short-term antibiotic cover with a third-generation cephalosporin against conventional five-day therapy using metronidazole with an aminoglycoside in emergency and complicated colorectal surgery

1988 ◽  
Vol 31 (1) ◽  
pp. 28-32 ◽  
Author(s):  
R. G. Tudor ◽  
I. Haynes ◽  
Denise J. Youngs ◽  
D. W. Burdon ◽  
M. R.B. Keighley
Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Adam G. Stewart ◽  
Patrick N. A. Harris ◽  
Mark D. Chatfield ◽  
Roberta Littleford ◽  
David L. Paterson

Abstract Background Extended-spectrum beta-lactamase (ESBL) and AmpC-producing Enterobacterales are common causes of bloodstream infection. ESBL-producing bacteria are typically resistant to third-generation cephalosporins and result in a sizeable economic and public health burden. AmpC-producing Enterobacterales may develop third-generation cephalosporin resistance through enzyme hyper-expression. In no observational study has the outcome of treatment of these infections been surpassed by carbapenems. Widespread use of carbapenems may drive the development of carbapenem-resistant Gram-negative bacilli. Methods This study will use a multicentre, parallel group open-label non-inferiority trial design comparing ceftolozane-tazobactam and meropenem in adult patients with bloodstream infection caused by ESBL or AmpC-producing Enterobacterales. Trial recruitment will occur in up to 40 sites in six countries (Australia, Singapore, Italy, Spain, Saudi Arabia and Lebanon). The sample size is determined by a predefined quantity of ceftolozane-tazobactam to be supplied by Merck, Sharpe and Dohme (MSD). We anticipate that a trial with 600 patients contributing to the primary outcome analysis would have 80% power to declare non-inferiority with a 5% non-inferiority margin, assuming a 30-day mortality of 5% in both randomised groups. Once randomised, definitive treatment will be for a minimum of 5 days and a maximum of 14 days with the total duration determined by treating clinicians. Data describing demographic information, risk factors, concomitant antibiotics, illness scores, microbiology, multidrug-resistant organism screening, discharge and mortality will be collected. Discussion Participants will have bloodstream infection due to third-generation cephalosporin non-susceptible E. coli and Klebsiella spp. or Enterobacter spp., Citrobacter freundii, Morganella morganii, Providencia spp. or Serratia marcescens. They will be randomised 1:1 to ceftolozane-tazobactam 3 g versus meropenem 1 g, both every 8 h. Secondary outcomes will be a comparison of 14-day all-cause mortality, clinical and microbiological success at day 5, functional bacteraemia score, microbiological relapse, new bloodstream infection, length of hospital stay, serious adverse events, C. difficile infection, multidrug-resistant organism colonisation. The estimated trial completion date is December 2024. Trial registration The MERINO-3 trial is registered under the US National Institute of Health ClinicalTrials.gov register, reference number: NCT04238390. Registered on 23 January 2020.


2020 ◽  
Vol 13 (12) ◽  
pp. e237810
Author(s):  
Ramesh Bhat Yellanthoor

Acute gastroenteritis with persistent vomiting, high degree fever and blood streaking stools often suggests bacterial aetiology in children. Authors report a 13-year-old boy presenting with acute watery diarrhoea with persistent vomiting, fever of 103°F, abdominal cramps and blood streaking stools who failed to show any response to parenteral third-generation cephalosporin for 72 hours. The stool examination revealed numerous cystic and amoeboid forms of Blastocystis hominis. Metronidazole was started and the boy promptly responded within 24 hours. There was no recurrence of symptoms then onwards. The case highlights the crucial stool examination in case of acute diarrhoeal disease for rare aetiology.


2012 ◽  
Vol 73 (1) ◽  
pp. 31-38 ◽  
Author(s):  
Andrea Endimiani ◽  
Alexandra Rossano ◽  
Daniel Kunz ◽  
Gudrun Overesch ◽  
Vincent Perreten

2017 ◽  
Vol 70 (3) ◽  
pp. 301-304 ◽  
Author(s):  
Satomi Saito ◽  
Yoshio Koori ◽  
Yusuke Ohsaki ◽  
Shunsuke Osaka ◽  
Kozue Oana ◽  
...  

2019 ◽  
Vol 98 (4) ◽  
pp. 1766-1774 ◽  
Author(s):  
Hye Young Jeon ◽  
Kwang Won Seo ◽  
Yeong Bin Kim ◽  
Dong Kyu Kim ◽  
Shin Woo Kim ◽  
...  

2013 ◽  
Vol 15 (8) ◽  
pp. e483-e487 ◽  
Author(s):  
A. Krishna ◽  
M. Russell ◽  
G. L. Richardson ◽  
M. J. F. X. Rickard ◽  
A. Keshava

2013 ◽  
Vol 217 (6) ◽  
pp. 1063-1069.e1 ◽  
Author(s):  
Deborah S. Keller ◽  
Lobat Hashemi ◽  
Minyi Lu ◽  
Conor P. Delaney

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