scholarly journals Outpatient Parenteral Antimicrobial Therapy With Ceftolozane/Tazobactam via Continuous Infusion for Multidrug-Resistant Pseudomonas aeruginosa Osteomyelitis

2020 ◽  
Vol 7 (11) ◽  
Author(s):  
Judith Álvarez Otero ◽  
Jose Luis Lamas Ferreiro ◽  
Ana Sanjurjo Rivo ◽  
Javier de la Fuente Aguado
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Antibiotic Therapy ◽  
Continuous Infusion ◽  
Antimicrobial Therapy ◽  
Multidrug Resistant ◽  
Effective Alternative ◽  
Outpatient Parenteral Antimicrobial Therapy ◽  
At Home

Abstract We present a case of Pseudomonas aeruginosa osteomyelitis treated with surgery and antibiotic therapy with ceftolozane-tazobactam in continuous infusion at home using an elastomeric pump. We discuss the use of ceftolozane-tazobactam in continuous infusion administered at home as an effective alternative for the treatment of multidrug-resistant Pseudomonas aeruginosa osteomyelitis.

scholarly journals Colour Me Blue: The History and the Biotechnological Potential of Pyocyanin

Molecules ◽  
2021 ◽  
Vol 26 (4) ◽  
pp. 927
Author(s):  
Thiago Gonçalves ◽  
Ulrich Vasconcelos
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Antibiotic Therapy ◽  
Electric Current ◽  
Antimicrobial Therapy ◽  
Blue Colour ◽  
Current Generation ◽  
Biotechnological Potential ◽  
Avant Garde ◽  
New Horizons ◽  
The Subject

Pyocyanin was the first natural phenazine described. The molecule is synthesized by about 95% of the strains of Pseudomonas aeruginosa. From discovery up to now, pyocyanin has been characterised by a very rich and avant-garde history, which includes its use in antimicrobial therapy, even before the discovery of penicillin opened the era of antibiotic therapy, as well as its use in electric current generation. Exhibiting an exuberant blue colour and being easy to obtain, this pigment is the subject of the present review, aiming to narrate its history as well as to unveil its mechanisms and suggest new horizons for applications in different areas of engineering, biology and biotechnology.

Effectiveness and safety of ertapenem used in hospital-at-home units: data from Spanish Outpatient Parenteral Antimicrobial Therapy Registry

2018 ◽  
Vol 13 (12) ◽  
pp. 1363-1373 ◽  
Author(s):  
Pedro Sanroma ◽  
Pedro Muñoz ◽  
Manuel Mirón-Rubio ◽  
Ana Aguilera ◽  
Oriol Estrada ◽  
...  
Keyword(s):  
Antimicrobial Therapy ◽  
Outpatient Parenteral Antimicrobial Therapy ◽  
Hospital At Home ◽  
At Home

scholarly journals P64 Implementation of a paediatric outpatient parenteral antibiotic therapy (p-OPAT) service at a specialist children’s hospital

2020 ◽  
Vol 105 (9) ◽  
pp. e39.2-e40
Author(s):  
Hannah Porter ◽  
Kate Stock
Keyword(s):  
Data Collection ◽  
Antibiotic Therapy ◽  
Antimicrobial Stewardship ◽  
Antimicrobial Therapy ◽  
List Type ◽  
Parenteral Antibiotic ◽  
Outpatient Parenteral Antimicrobial Therapy ◽  
Paediatric Outpatient ◽  
Bed Days ◽  
One Year

AimThe aim of this project is to optimise patient care, enhance patient experience, improve antimicrobial stewardship and assist patient flow through the hospital.MethodData collection was conducted one day a week over five consecutive weeks. All eligible wards were visited. Patient medication charts were inspected to see if intravenous antimicrobials were prescribed and a patient - specific data collection form was then completed. All the patients that met the eligibility criteria to be put forward for OPAT referral were then considered from a clinical perspective by a paediatric consultant as to their suitability for OPAT or IVOST and discharge. If the patient was deemed suitable for an OPAT discharge or IVOST and discharge a decision was made as to what antimicrobials they would theoretically have been on when discharged home. The number of potential bed days saved was calculated as the number of days between the patients review by the consultant (ie the day of data collection) and the date of their discharge prescription from that episode of care.The following was examinedpercentage of patients with identified pathogenspercentage of patients that had received input from the ID teampercentage of patients that had received input from microbiologythe prevalence of antimicrobials prescribedthe location of the patient’s home residencepatient/parent willingness to go home on OPAT.The data for patient numbers and bed day savings was then extrapolated to 52 weeks in order to be indicative of one year.ResultsOver the five days, 66 patients were identified that met the exclusion criteria to be referred for OPAT or IVOST. After clinical consideration the consultant deemed 4 patients to be suitable for OPAT and 19 for IVOST and discharge which generated a potential bed day saving of 38 bed days. This was comprised of 17 days through providing IVAs via OPAT and 21 days from timelier IVOST and discharge of patients. Extrapolated to be representative of one year, this would be a bed saving to the Trust of 1, 976 bed days.ConclusionThe potential has been identified for the hospital to make considerable bed day savings through the investment in an extended antimicrobial stewardship programme and establishment of a paediatric OPAT service. A business case has been submitted to the hospital board for consideration, with the hope that the service will be funded for a six month probationary period in order to assess its impact over the winter months, when demand for beds and pressures on PICU and theatres are highest.ReferencesPatel S, et al. 2015. Good practice recommendations for paediatric outpatient parenteral antibiotic therapy (p-OPAT) in the UK: a consensus statement. Journal of Antimicrobial Chemotherapy2015;702:360–373.Carter B, et al. Delivery, setting and outcomes of paediatric outpatient parenteral antimicrobial therapy (OPAT): a scoping review. BMJ Open, 2018;8:e021603.Hodgson KA, et al. The use, appropriateness and outcomes of outpatient parenteral antimicrobial therapy. Archives of Disease in Childhood, 2016:10:886–893.Knackstedt ED, et al. Outpatient parenteral antimicrobial therapy in pediatrics: an opportunity to expand antimicrobial stewardship. Infection Control & Hospital „Epidemiology 2015:36:222–224.

scholarly journals Use of Ceftolozane-Tazobactam in Patient with Severe Medium Chronic Purulent Otitis by XDR Pseudomonas aeruginosa

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
L. M. Saraca ◽  
C. Di Giuli ◽  
F. Sicari ◽  
G. Priante ◽  
F. Lavagna ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Antibiotic Therapy ◽  
Poor Response ◽  
Late Recurrence ◽  
Generation Cephalosporin ◽  
Multidrug Resistant ◽  
Complete Healing ◽  
Severe Neutropenia ◽  
Surgical Drainage ◽  
Tract Infections

We present a case of a male Italian patient of 66 years with a history of kidney transplantation in treatment with cyclosporine and methylprednisolone. He visited an ENT clinic and was diagnosed as chronic left purulent otitis media. He began at-home antibiotic therapy with poor benefit. On 09/13/18, he was admitted to the hospital “S. Maria ”of Terni for persistence of left ear pain and complete hearing loss. Magnetic resonance imaging (MRI) of the brain showed “in correspondence of the petrous rock and the mastoid…presence of flogistic tissue.” Auricular swabs and later surgical drainage of the purulent material were performed and both were positive for extensively drug-resistant (XDR) Pseudomonas aeruginosa sensitive only to colistin in absence of synergism with rifampin. The patient underwent antibiotic therapy with ceftolozane-tazobactam, a new generation cephalosporin with anti-Pseudomonas activity and a β-lactamase inhibitor, that currently is indicated for the treatment of complicated urinary tract infections and complicated intra-abdominal infections, with complete healing. In literature, it is described a series of 12 patients with severe MDR (multidrug-resistant) Pseudomonas aeruginosa infections (6 pneumonia) who received salvage therapy with ceftolozane-tazobactam after inappropriate empirical and/or suboptimal treatment. This study included a case of a male patient of 45 years, affected by Burkitt lymphoma and severe neutropenia, who presented with otitis and mastoiditis, and isolation of Pseudomonas aeruginosa in surgical drainage of the purulent material of the ear (blood cultures were negative). He underwent antibiotic therapy with ceftolozane–tazobactam at a dosage of 3 g/8 h for 21.3 days. The patient was healed, but a late recurrence was described because of isolation of ceftolozane-tazobactam-resistant Pseudomonas after therapy. The possibility of acquiring resistance to ceftolozane-tazobactam should be considered in patients with previous exposure to beta-lactams and with poor response to these antibiotics.

scholarly journals 1926. Evaluation of Safety and Effectiveness of Continuous Infusion Ceftolozane/Tazobactam as Outpatient Parenteral Antimicrobial Therapy

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S554-S555
Author(s):  
Bruce M Jones ◽  
Kathryn Huelfer ◽  
Melissa Wynn ◽  
Henry N Young ◽  
Christopher Bland
Keyword(s):  
Continuous Infusion ◽  
Antimicrobial Therapy ◽  
Outpatient Parenteral Antimicrobial Therapy

scholarly journals 2082. Evaluation of Outpatient Parenteral Antimicrobial Therapy (OPAT) Processes and Outcomes Among Patients Within an Integrated Health System

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S702-S702
Author(s):  
Brittany Brown ◽  
Thomas J Dilworth ◽  
Margaret Cook ◽  
Charles F Brummitt
Keyword(s):  
Antibiotic Therapy ◽  
Health System ◽  
Antimicrobial Therapy ◽  
High Volume ◽  
Treatment Level ◽  
Once Daily ◽  
Outpatient Parenteral Antimicrobial Therapy ◽  
Patient Demographics ◽  
Level Data ◽  
Access Complications

Abstract Background Successful management of outpatient parenteral antimicrobial therapy (OPAT) optimizes outcomes and reduces cost. We examined (i) local OPAT processes and outcomes, (ii) whether OPAT constraints favoring once daily antibiotics promoted suboptimal therapeutic choices, and (iii) whether these data could drive OPAT improvements. Methods Patients ≥ 18 years of age who received > 48 hours of OPAT at five infusion centers within a single health-system from January 1, 2018 to March 1, 2018 were eligible for review. The following patient- and treatment-level data were collected: age, gender, drug allergies, laboratory studies and frequency, OPAT indication, infection source, pathogen(s), antibiotic sensitivities, antibiotic therapy and duration, electronic order set used, prescriber specialty, evidence of failed prior oral or intravenous (IV) therapy and IV access type. The primary outcome was OPAT success: the clinical resolution of the infection without relapse within 30 days of antibiotic therapy completion. Secondary outcomes included change in antibiotic therapy due to lack of clinical improvement, adverse drug reactions and IV access complications. A sub-analysis of patients who received daptomycin and/or ertapenem was also performed. OPAT practice was compared with 2018 Infectious Diseases Society of America OPAT guidelines (Norris et al. Clin Infect Dis. 2019;68(1):e1-e35). Results A total of 108 patients were evaluated. Patient demographics, treatment and outcomes are shown in Table 1. The most common OPAT indications were bone/joint, bacteremia and skin infection. Third-generation cephalosporins, carbapenems and daptomycin were most commonly prescribed. In 34.3% and 24.2% of daptomycin and ertapenem cases, respectively, β-lactam therapy could have been utilized. Assessment of prior failed antibiotic therapy, patient allergies and pathogen-site pairing found 28.7% of patients were eligible for oral therapy upon OPAT initiation. Conclusion Several components of our local OPAT aligned with current guidelines. Initial OPAT patient selection may benefit from added scrutiny. Given the high volume of once daily antibiotics administered for convenience there is an internal opportunity to facilitate multi-daily infusions. Disclosures All authors: No reported disclosures.

scholarly journals 756Emergency Department Visits During Outpatient Parenteral Antimicrobial Therapy (OPAT) Administered at Home

2014 ◽  
Vol 1 (suppl_1) ◽  
pp. S213-S214
Author(s):  
Nabin Shrestha ◽  
Jugnu Shrestha ◽  
Angela Everett ◽  
Don Carroll ◽  
Steven Gordon ◽  
...  
Keyword(s):  
Antimicrobial Therapy ◽  
Outpatient Parenteral Antimicrobial Therapy ◽  
At Home
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