Ceftriaxone: a Third-generation Cephalosporin with Advantages?

InPharma ◽  
1985 ◽  
Vol 499 (1) ◽  
pp. 2-3
Keyword(s):  
Generation Cephalosporin ◽  
Third Generation

scholarly journals Ceftolozane-tazobactam versus meropenem for definitive treatment of bloodstream infection due to extended-spectrum beta-lactamase (ESBL) and AmpC-producing Enterobacterales (“MERINO-3”): study protocol for a multicentre, open-label randomised non-inferiority trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Adam G. Stewart ◽  
Patrick N. A. Harris ◽  
Mark D. Chatfield ◽  
Roberta Littleford ◽  
David L. Paterson
Keyword(s):  
Bloodstream Infection ◽  
Generation Cephalosporin ◽  
Multidrug Resistant ◽  
Definitive Treatment ◽  
Resistant Organism ◽  
Third Generation ◽  
Beta Lactamase ◽  
Open Label ◽  
Extended Spectrum Beta Lactamase ◽  
Extended Spectrum

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.

Acute gastroenteritis due to Blastocystis hominis in an adolescent boy

2020 ◽  
Vol 13 (12) ◽  
pp. e237810
Author(s):  
Ramesh Bhat Yellanthoor
Keyword(s):  
Acute Gastroenteritis ◽  
Diarrhoeal Disease ◽  
Generation Cephalosporin ◽  
Watery Diarrhoea ◽  
Stool Examination ◽  
Third Generation ◽  
Blastocystis Hominis ◽  
Persistent Vomiting ◽  
Bacterial Aetiology ◽  
High Degree

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.

First countrywide survey of third-generation cephalosporin-resistant Escherichia coli from broilers, swine, and cattle in Switzerland

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

scholarly journals Third-Generation Cephalosporin-Resistant Non-Typhoidal Salmonella Isolated from Human Feces in Japan

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

scholarly journals Characteristics of third-generation cephalosporin-resistant Salmonella from retail chicken meat produced by integrated broiler operations

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

scholarly journals Oral Microbiota of the Snake Bothrops lanceolatus in Martinique

2018 ◽  
Vol 15 (10) ◽  
pp. 2122 ◽  
Author(s):  
Dabor Résière ◽  
Claude Olive ◽  
Hatem Kallel ◽  
André Cabié ◽  
Rémi Névière ◽  
...  
Keyword(s):  
Oral Cavity ◽  
Generation Cephalosporin ◽  
Oral Microbiota ◽  
Third Generation ◽  
Beta Lactams ◽  
Morganella Morganii ◽  
Enterococcus Spp ◽  
Bacillus Spp ◽  
Amoxicillin Clavulanate ◽  
Third Generation Cephalosporins

In Martinique, Bothrops lanceolatus snakebite, although relatively uncommon (~30 cases/year), may result in serious complications such as systemic thrombosis and local infections. Infections have been hypothesized to be related to bacteria present in the snake’s oral cavity. In this investigation, we isolated, identified, and studied the susceptibility to beta-lactams of bacteria sampled from the oral cavity of twenty-six B. lanceolatus specimens collected from various areas in Martinique. Microbiota from B. lanceolatus oral cavity was polymicrobial. Isolated bacteria belonged to fifteen different taxa; the most frequent being Aeromonas hydrophyla (present in 50% of the samples), Morganella morganii, Klebsiella pneumoniae, Bacillus spp., and Enterococcus spp. Analysis of antibiotic susceptibility revealed that 66.7% of the isolated bacteria were resistant to amoxicillin/clavulanate. In contrast, the majority of isolated bacteria were susceptible to the third-generation cephalosporins (i.e., 73.3% with cefotaxime and 80.0% with ceftazidime). Microbiota from B. lanceolatus oral cavity is polymicrobial with bacteria mostly susceptible to third-generation cephalosporins but rarely to amoxicillin/clavulanate. In conclusion, our findings clearly support that first-line antibiotic therapy in the B. lanceolatus-bitten patients, when there is evidence of infection, should include a third-generation cephalosporin rather than amoxicillin/clavulanate.

scholarly journals Socioeconomic Factors Contributing to Antibiotic Resistance in China: A Panel Data Analysis

Antibiotics ◽  
2021 ◽  
Vol 10 (8) ◽  
pp. 994
Author(s):  
Xuemei Zhen ◽  
Jingchunyu Chen ◽  
Xueshan Sun ◽  
Qiang Sun ◽  
Shasha Guo ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Socioeconomic Factors ◽  
Health Expenditure ◽  
Mainland China ◽  
Generation Cephalosporin ◽  
Gdp Per Capita ◽  
Third Generation ◽  
Physician Density ◽  
Per Capita ◽  
Economic Zones

The relationship between socioeconomic factors and antibiotic resistance (ABR) prevalence remains a knowledge gap in China. In this study, our aim was to examine the association between ABR prevalence and socioeconomic factors across 30 provinces in mainland China. We used two measures of level of ABR: the proportion of methicillin-resistant Staphylococcus aureus (MRSA), third-generation cephalosporin-resistant Escherichia coli (3GCREC), and third-generation cephalosporin-resistant Klebsiella pneumoniae (3GCRKP), and the aggregate resistance. The data of ABR prevalence, education, gross domestic product (GDP) per capita, out-of-pocket (OOP) health expenditure, physician density, hospital bed density, and public toilet density during 2014 and 2018 in 30 provinces in mainland China were included. We examined the association between ABR prevalence and potential contributing socioeconomic factors using panel data modeling. In addition, we explored this relationship in the eastern, central, and western economic zones. Our results indicated that GDP per capita was significantly positively correlated with ABR in mainland China and the eastern economic zone; however, significantly positive associations did not exist in the central and western economic zones. Surprisingly, both higher GDP per capita and higher OOP health expenditure were associated with a higher level of MRSA, but a lower level of 3GCREC; higher physician density was associated with a lower level of MRSA, but a higher level of 3GCREC. In addition, ABR prevalence presented a decline trend during 2014 and 2018. Our study highlights that intervention measures tackling the development and spread of ABR in mainland China must better recognize and address the importance of social and economic determinants.

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