Prosthetic Joint Infection Caused by Gram-Negative Organisms

2011 ◽  
Vol 26 (6) ◽  
pp. 104-108 ◽  
Author(s):  
Benjamin Zmistowski ◽  
Catherine J. Fedorka ◽  
Eoin Sheehan ◽  
Gregory Deirmengian ◽  
Matthew S. Austin ◽  
...  
Keyword(s):  
Prosthetic Joint Infection ◽  
Joint Infection ◽  
Gram Negative ◽  
Prosthetic Joint ◽  
Gram Negative Organisms

scholarly journals Prosthetic Joint Infection from Carbapenemase-Resistant Klebsiella pneumoniae Successfully Treated with Ceftazidime-Avibactam

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
A. Schimmenti ◽  
E. Brunetti ◽  
E. Seminari ◽  
B. Mariani ◽  
P. Cambieri ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Prosthetic Joint Infection ◽  
Joint Infection ◽  
Significant Proportion ◽  
Health Concern ◽  
Gram Negative Bacteria ◽  
Gram Negative ◽  
Extended Spectrum Beta Lactamase ◽  
First Case ◽  
Prosthetic Joint

Antimicrobial resistance in Gram-negative bacteria, particularly Enterobacteriaceae, has become a leading cause of morbidity and mortality and a serious public health concern. Gram-negative bacteria carrying extended-spectrum beta-lactamase (ESBL) enzymes now represent a significant proportion of all bacteria isolated from different countries worldwide. Furthermore, the increasing number of isolates carrying carbapenemases in recent years includes multidrug-resistant (MDR), extensively drug-resistant (XDR), and pandrug-resistant (PDR) bacteria. Here, we describe what, to our knowledge, is the first case of a patient with a prosthetic joint infection from carbapenemase-resistant Klebsiella pneumoniae (CRKP) successfully treated with ceftazidime-avibactam in Italy.

scholarly journals Mouse model of Gram-negative prosthetic joint infection reveals therapeutic targets

JCI Insight ◽  
2018 ◽  
Vol 3 (17) ◽  
Author(s):  
John M. Thompson ◽  
Robert J. Miller ◽  
Alyssa G. Ashbaugh ◽  
Carly A. Dillen ◽  
Julie E. Pickett ◽  
...  
Keyword(s):  
Mouse Model ◽  
Prosthetic Joint Infection ◽  
Joint Infection ◽  
Therapeutic Targets ◽  
Gram Negative ◽  
Prosthetic Joint

scholarly journals Pharmacokinetic/Pharmacodynamic Dosage Individualization of Suppressive Beta-Lactam Therapy Administered by Subcutaneous Route in Patients With Prosthetic Joint Infection

2021 ◽  
Vol 8 ◽  
Author(s):  
Sylvain Goutelle ◽  
Anne Conrad ◽  
Cécile Pouderoux ◽  
Evelyne Braun ◽  
Frédéric Laurent ◽  
...  
Keyword(s):  
Antibiotic Therapy ◽  
Prosthetic Joint Infection ◽  
Joint Infection ◽  
Case Series ◽  
Therapeutic Drug ◽  
Beta Lactam ◽  
Beta Lactams ◽  
Gram Negative ◽  
Prosthetic Joint

Suppressive parenteral antibiotic therapy with beta-lactams may be necessary in patients with Gram-negative bone and joint infection (BJI). Subcutaneous drug administration can facilitate this therapy in outpatient setting, but there is limited information about this practice. We have developed an original approach for drug dosing in this context, based on therapeutic drug monitoring (TDM) and pharmacokinetic/pharmacodynamic (PK/PD) principles. The objective of this study was to describe our approach and its first results in a case series. We analyzed data from patients who received suppressive antibiotic therapy by subcutaneous (SC) route with beta-lactams as salvage therapy for prosthetic joint infection (PJI) and had TDM with PK/PD-based dose adjustment. Ten patients (six women and four men with a mean age of 77 years) were included from January 2017 to May 2020. The drugs administered by SC route were ceftazidime (n = 4), ertapenem (n = 4), and ceftriaxone (n = 2). In each patient, PK/PD-guided dosage individualization was performed based on TDM and minimum inhibitory concentration (MIC) measurements. The dose interval could be prolonged from twice daily to thrice weekly in some patients, while preserving the achievement of PK/PD targets. The infection was totally controlled by the strategy in nine out the 10 patients during a median follow-up of 1,035 days (~3 years). No patient acquired carbapenem-resistant Gram-negative bacteria during the follow-up. One patient presented treatment failure with acquired drug resistance under therapy, which could be explained by late MIC determination and insufficient exposure, retrospectively. To conclude, our innovative approach, based on model-based TDM, MIC determination, and individualized PK/PD goals, facilitates, and optimizes suppressive outpatient beta-lactam therapy administered by SC route for PJI. These encouraging results advocate for larger clinical evaluation.

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