Antimicrobial Use Prior to the Acquisition of Multiresistant Bacteria

2002 ◽  
Vol 23 (3) ◽  
pp. 155-158 ◽  
Author(s):  
Matthieu Eveillard ◽  
Jean-Luc Schmit ◽  
François Eb
Keyword(s):  
Staphylococcus Aureus ◽  
Prospective Study ◽  
Clavulanic Acid ◽  
Antimicrobial Therapy ◽  
Antimicrobial Agents ◽  
Antimicrobial Use ◽  
Third Generation ◽  
Multiresistant Bacteria ◽  
Amoxicillin Clavulanic Acid ◽  
Third Generation Cephalosporins

AbstractWe assessed whether patients who acquired methicillin-resistantStaphylococcus aureus(MRSA) had less exposure to antimicrobial agents than did those who acquired Enterobacteriaceae that produced extended-spectrum β-lactamase (ESβL). In a 6-month, prospective study, ESβL carriers had received antimicrobial therapy more often than had MRSA carriers. Amoxicillin-clavulanic acid, fluoroquinolones, and third-generation cephalosporins, especially ceftazidime, had been prescribed more often for ESβL carriers than for MRSA carriers.

scholarly journals Novel Antibiotic Combinations of Diverse Subclasses for Effective Suppression of Extensively Drug-Resistant Methicillin-Resistant Staphylococcus aureus (MRSA)

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Shumyila Nasir ◽  
Muhammad Sufyan Vohra ◽  
Danish Gul ◽  
Umm E Swaiba ◽  
Maira Aleem ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Clavulanic Acid ◽  
Antimicrobial Agents ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Multidrug Resistant ◽  
Methicillin Resistant ◽  
Development Of Resistance ◽  
Amoxicillin Clavulanic Acid ◽  
Combination Antibiotics ◽  
Time Kill

The emergence of multidrug-resistant pathogens such as methicillin-resistant Staphylococcus aureus (MRSA), the chief etiological agent for a range of refractory infections, has rendered all β-lactams ineffective against it. The treatment process is further complicated with the development of resistance to glycopeptides, primary antibiotics for treatment of MRSA. Antibiotic combination therapy with existing antimicrobial agents may provide an immediate treatment option. Minimum inhibitory concentrations (MICs) of 18 different commercially available antibiotics were determined along with their 90 possible pairwise combinations and 64 triple combinations to filter out 5 best combinations. Time-Kill kinetics of these combinations were then analyzed to find collateral bactericidal combinations which were then tested on other randomly selected MRSA isolates. Among the top 5 combinations including levofloxacin-ceftazidime; amoxicillin/clavulanic acid-tobramycin; amoxicillin/clavulanic acid-cephradine; amoxicillin/clavulanic acid-ofloxacin; and piperacillin/tazobactam-tobramycin, three combinations were found to be collaterally effective. Levofloxacin-ceftazidime acted synergistically in 80% of the tested clinical MRSA isolates. First-line β-lactams of lower generations can be used effectively against MRSA infection when used in combination. Antibiotics other than glycopeptides may still work in combination.

Impact of simplified therapeutic guidelines on antibiotic prescriptions: a prospective multicentre comparative study

2019 ◽  
Vol 75 (3) ◽  
pp. 747-755
Author(s):  
Pierre-Marie Roger ◽  
Ingrid Peyraud ◽  
Michel Vitris ◽  
Valérie Romain ◽  
Laura Bestman ◽  
...  
Keyword(s):  
Clavulanic Acid ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Antibiotic Use ◽  
Antibiotic Consumption ◽  
Third Generation ◽  
Therapeutic Guidelines ◽  
Amoxicillin Clavulanic Acid ◽  
The Impact ◽  
Third Generation Cephalosporins

Abstract Objectives We studied the impact of simplified therapeutic guidelines (STGs) associated with accompanied self-antibiotic reassessment (ASAR) on antibiotic use. Methods Prospective antibiotic audits and feedback took place at 15 hospitals for 12 months, allowing STGs with ≤15 drugs to be devised. STGs were explained to prescribers through sessions referred to as ASAR. Optimal therapy was defined by the conjunction of a diagnosis and the drug specified in the STGs. Analysis of consumption focused on critical drugs: amoxicillin/clavulanic acid, third-generation cephalosporins and fluoroquinolones. Results We compared prescriptions in five hospitals before (n = 179) and after (n = 168) the implementation of STGs + ASAR. These tools were associated with optimal therapies and amoxicillin/clavulanic acid prescriptions [adjusted odds ratio (AOR) 3.28, 95% CI 1.82–5.92 and 2.18, 95% CI 1.38–3.44, respectively] and fewer prescriptions for urine colonization [AOR 0.20 (95% CI 0.06–0.61)]. Comparison of prescriptions (n = 1221) from 10 departments of three clinics with STGs + ASAR for the first quarters of 2018 and 2019 revealed that the prescriptions by 23 ASAR participants more often complied with STGs than those by 28 other doctors (71% versus 60%, P = 0.003). STGs alone were adopted by 10 clinics; comparing the prescriptions (n = 311) with the 5 clinics with both tools, we observed fewer unnecessary therapies in the latter [AOR 0.52 (95% CI 0.34–0.80)]. The variation in critical antibiotic consumption between 2017 and 2018 was −16% for the 5 clinics with both tools and +20% for the other 10 (P = 0.020). Conclusions STGs + ASAR promote optimal antibiotic therapy and reduce antibiotic use.

scholarly journals Evaluation of Bacterial Infections in Bahraini Pediatric Patients From A Tertiary Care Hospital – A Prospective Study

2021 ◽  
Vol 33 (2) ◽  
Keyword(s):  
Staphylococcus Aureus ◽  
Prospective Study ◽  
Clavulanic Acid ◽  
Pediatric Patients ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Care Hospital ◽  
Methicillin Resistant ◽  
E Coli ◽  
Amoxicillin Clavulanic Acid ◽  
Susceptibility Patterns

Background & Objective: Children are prone to a plethora of infections. This study aimed to evaluate the prevalence of most common microorganisms isolated from the bacterial cultures infecting pediatric patients and their resistance to antibiotics in Bahrain. Methods: This prospective study included 1146 isolates collected from pediatric patients of Bahrain. Demographic details such as age, gender, and nationality were recorded for each of the patients. Samples were cultured using different nutrient media (MacConkey agar, Sheep blood agar etc.), and analysis was done using standard microbiological techniques and Vitex automated analyzer. Application of Kirby- Bauer procedure and Vitex aided in the assessment of antibiotic resistance of the isolates. Proportion test was used to calculate the study outcomes. P value < 0.05 was considered statistically significant. Results: Streptococcus group A (52.98%) and E. coli (35.97%) were the two most common microorganisms observed in pediatric patients. A high prevalence of Extended-spectrum beta-lactamases (ESBL), Campylobacter sp., and Methicillin-resistant Staphylococcus aureus (MRSA) were also observed (P<0.001). A majority of the organisms were identified from urine (27.66%) and throat cultures (25.22%). E-coli showed significant resistance towards trimethoprim /sulfamethoxazole (22.97%) and amoxicillin/ clavulanic acid (20.19%). Susceptibility patterns of gentamicin, amoxicillin, trimethoprim, ciprofloxacin showed significant association with the isolates. Odds of susceptibility of amoxicillin/ clavulanic acid (2.89 times), trimethoprim/sulfamethoxazole (2.29 times) was more for gram-positive isolates but for ciprofloxacin (2.08 times), which was more for gram-negative isolates. Conclusion: Antimicrobial susceptibility patterns were unique among the pediatric patients of Bahrain. Keywords: Anti-bacterial Agents, Antimicrobial Stewardship, Escherichia coli, Child, Methicillin- Resistant Staphylococcus aureus.

Antimicrobial Susceptibility of Subgingival Bacterial Flora in Cats with Gingivitis

1995 ◽  
Vol 12 (4) ◽  
pp. 157-160 ◽  
Author(s):  
C.E. Harvey ◽  
C. Thornsberry ◽  
B.R. Miller ◽  
F. S. Shofer
Keyword(s):  
Clavulanic Acid ◽  
Antimicrobial Susceptibility ◽  
Antimicrobial Agents ◽  
Bacterial Flora ◽  
In Vitro Susceptibility ◽  
Amoxicillin Clavulanic Acid ◽  
Aerobic And Anaerobic

The aerobic and anaerobic flora from gingival pockets of 40 cats with established gingivitis were cultured. The susceptibility of each isolate to four antimicrobial agents currently approved for use in cats (amoxicillin-clavulanic acid; clindamycin; cefadroxil; enrofloxacin) was determined. Amoxicillin-clavulanic acid (Clavamox®) had the highest in-vitro susceptibility against all isolates (92%) and all anaerobes (99% [co-equal with clindamycin]) tested; enrofloxacin (Baytril®) had the highest in-vitro susceptibility against all aerobes (90%) tested.

scholarly journals Quinolone Resistance in EnterotoxigenicEscherichia coli Causing Diarrhea in Travelers to India in Comparison with Other Geographical Areas

2000 ◽  
Vol 44 (6) ◽  
pp. 1731-1733 ◽  
Author(s):  
Jordi Vila ◽  
Martha Vargas ◽  
Joaquim Ruiz ◽  
Manuel Corachan ◽  
M. Teresa Jimenez de Anta ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Clavulanic Acid ◽  
Nalidixic Acid ◽  
Antimicrobial Therapy ◽  
Antimicrobial Agents ◽  
Quinolone Resistance ◽  
Moderate Activity ◽  
Good Activity ◽  
Resistant Strains ◽  
Traveler's Diarrhea

ABSTRACT Enterotoxigenic Escherichia coli isolates were identified as a cause of traveler's diarrhea in 82 of 520 (16%) patients and tested for resistance to seven antimicrobial agents. Thirty patients (36%) needed antimicrobial therapy: 17 (56%) for persistence of symptoms and 13 (44%) for severity of symptoms. Ampicillin, tetracycline, and trimethoprim-sulfamethoxazole resistance was high. Chloramphenicol showed moderate activity, and amoxicillin plus clavulanic acid, nalidixic acid, and ciprofloxacin showed very good activity. Five nalidixic acid-resistant strains were isolated, four from patients visiting India.

Norfloxacin: A Quinoline Antibiotic

1986 ◽  
Vol 20 (4) ◽  
pp. 261-266 ◽  
Author(s):  
Dwight A. Marble ◽  
John A. Bosso
Keyword(s):  
Side Effects ◽  
Nalidixic Acid ◽  
Antimicrobial Agents ◽  
Bitter Taste ◽  
Gram Negative Bacteria ◽  
Third Generation ◽  
Gram Negative ◽  
Intravenous Antibiotics ◽  
Third Generation Cephalosporins ◽  
Quinolinecarboxylic Acid

Norfloxacin is a quinoline (quinolinecarboxylic acid) that should prove successful in treating infections that currently require hospitalization and intravenous antibiotics. Although a nalidixic acid derivative, it possesses greater antibacterial activity against gram-positive and gram-negative bacteria. Compared with other antimicrobial agents, norfloxacin is more potent than the aminoglycosides, first-, second-, and third-generation cephalosporins, tetracycline, trimethoprim-sulfamethoxazole, carbenicillin, piperacillin, nalidixic acid, oxolinic acid, cinoxacin, and enoxacin. In the clinical studies to date, the side effects of norfloxacin have been minimal, but include nausea, vomiting, anorexia, dizziness, headache, drowsiness, depression, and a bitter taste in the mouth. In studies with more than 4000 patients, the incidence of side effects ranged from 3.9 to 4.7 percent, with most appearing by the second day of therapy.

Motile Aeromonas as agent of infections of the foot

1995 ◽  
Vol 85 (9) ◽  
pp. 505-508 ◽  
Author(s):  
M Wakabongo
Keyword(s):  
Second Generation ◽  
Antimicrobial Agents ◽  
Third Generation ◽  
Beta Lactam ◽  
Beta Lactam Antibiotics ◽  
Taxonomic Uncertainty ◽  
Post Traumatic ◽  
Third Generation Cephalosporins

Motile Aeromonas infections of the foot are caused mostly by post-traumatic incidence, occurring mostly during summer months. Serious complications such as osteomyelitis and amputation can result if the infections go untreated or are inadequately treated. The role of each species of motile Aeromonas in pathogenesis and response to antimicrobial agents is not well understood because of taxonomic uncertainty. As a group, motile Aeromonas respond well to aminoglycosides, second-generation and third-generation cephalosporins, quinolones, and some beta-lactam antibiotics.

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