scholarly journals A Critical Review of Oxazolidinones: An Alternative or Replacement for Glycopeptides and Streptogramins?

2001 ◽  
Vol 12 (6) ◽  
pp. 379-390 ◽  
Author(s):  
George G Zhanel ◽  
Coleen Schroeder ◽  
Lavern Vercaigne ◽  
Alfred S Gin ◽  
John Embil ◽  
...  
Keyword(s):  
Mechanism Of Action ◽  
Standard Therapy ◽  
Data Extraction ◽  
Gram Positive ◽  
Antibiotic Resistant ◽  
Complicated Skin ◽  
Linezolid Therapy ◽  
Hospital Acquired Pneumonia ◽  
Hospital Acquired ◽  
Unique Mechanism

OBJECTIVE:To review the available data on the oxazolidinones linezolid and eperezolid.DATA SELECTION:Published reports were obtained by searching MEDLINE for articles published between 1992 and 2000, inclusive. References of published papers were also obtained and reviewed. Abstracts from scientific proceedings were reviewed.DATA EXTRACTION:Due to the limited data available regarding these agents, the criteria for study inclusion were not restrictive.DATA SYNTHESIS:The oxazolidinones (eg, linezolid) are a new antimicrobial class with a unique mechanism of action. They are active against resistant Gram-positive cocci including methicillin-susceptible and -resistantStaphylococcus aureus(MRSA), methicillin-susceptible and -resistantStaphylococccus epidermidis, vancomycin-resistant enterococci (VRE) and penicillin-resistantStreptococcus pneumoniae(PRSP). Linezolid is active against anaerobes and displays modest activity against fastidious Gram-negative pathogens such asHaemophilus influenzae, but is not active againstEnterobacteriaceae. Linezolid is available both orally and parenterally, and has a bioavailability of 100%. Clinical trials comparing linezolid with standard therapy have demonstrated similar bacteriological and clinical cures rates to standard therapy in community- and hospital-acquired pneumonia, uncomplicated and complicated skin and soft tissue infections, and infections caused by MRSA and VRE. Adverse effects have been minor and infrequent; however, platelets should be monitored in patients who have received more than two weeks of linezolid therapy. It is expected that these agents will have a bright future due to their excellent spectrum of activity against antibiotic-resistant Gram-positive organisms, such as MRSA, VRE and PRSP, and their excellent bioavailability.CONCLUSION:The oxazolidinones represent a new class of antimicrobials with a unique mechanism of action. They have excellent activity against susceptible and resistant Gram-positive organisms such as MRSA, methicillin-susceptibleS epidermidis, VRE and PRSP, and a good adverse effect profile; they can be administered both intravenously and orally. Their potential use in Canada may be as an intravenous and oral alternative to glycopeptides and streptogramins.

Microbiology of Ventilator–Associated Pneumonia Compared With That of Hospital-Acquired Pneumonia

2007 ◽  
Vol 28 (7) ◽  
pp. 825-831 ◽  
Author(s):  
David J. Weber ◽  
William A. Rutala ◽  
Emily E. Sickbert-Bennett ◽  
Gregory P. Samsa ◽  
Vickie Brown ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Empirical Therapy ◽  
Ventilator Associated Pneumonia ◽  
Gram Positive ◽  
Similar Frequency ◽  
Gram Negative ◽  
Hospital Acquired Pneumonia ◽  
Hospital Acquired ◽  
Gram Positive Cocci ◽  
Ventilated Patients

Objective.Nosocomial pneumonia is the leading cause of mortality attributed to nosocomial infection. Appropriate empirical therapy has been associated with improved survival, but data are limited regarding the etiologic agents of hospital-acquired pneumonia in non-ventilated patients (HAP). This evaluation assessed whether the currently recommended empirical therapy is appropriate for both ventilator-associated pneumonia (VAP) and HAP by evaluating the infecting flora.Design.Prospectively collected hospitalwide surveillance data was obtained by infection control professionals using standard Centers for Disease Control and Prevention definitions.Setting.A tertiary care academic hospital.Patients.All patients admitted from 2000 through 2003.Results.A total of 588 episodes of pneumonia were reported in 556 patients: 327 episodes of VAP in 309 patients, and 261 episodes of HAP in 247 Patients. The infecting flora in ventilated patients included gram-positive cocci (32.0% [oxacillin-susceptible Staphylococcus aureus {OSSA}, 9.25%; oxacillin-resistant Staphylococcus aureus {ORSA}, 17.75%]), gram-negative bacilli (59.0% {Pseudomonas aeruginosa, 17.50%; Stenotrophomonas maltophilia, 6.75%; Acinetobacter species, 7.75%), and miscellaneous pathogens (9.0%). The infecting flora in nonventilated patients included gram-positive cocci (42.59% [OSSA, 13.33%; ORSA, 20.37%]), gram-negative bacilli (39.63% [P. aeruginosa, 9.26%; S. maltophilia, 1.11%; Acinetobacter species, 3.33%), and miscellaneous pathogens (17.78%).Conclusions.Our data demonstrated that patients with HAP, compared with those with VAP, had a similar frequency of infection with ORSA but less commonly had infections due to P. aeruginosa, Acinetobacter species, and S. maltophilia. However, the overall frequency of infection with these pathogens was sufficiently high to warrant the use of empirical therapy likely to be active against them. Our data supports using the currently recommended empirical therapy for both HAP and VAP.

The Use of Moxisaxin for Treatment of a Decompensated Cirrhosis Patient with Severe Pulmonary Infection

2020 ◽  
Vol 13 (9) ◽  
Author(s):  
Junfei Jiang ◽  
Jing Wang ◽  
Zhiwen Yang
Keyword(s):  
Pulmonary Infection ◽  
Clinical Symptoms ◽  
Safety Data ◽  
Poor Response ◽  
Decompensated Cirrhosis ◽  
Clinical Safety ◽  
Case Presentation ◽  
Linezolid Therapy ◽  
Hospital Acquired Pneumonia ◽  
Hospital Acquired

Introduction: Moxifloxacin is recommended for empirical antibiotic treatment of patients with cirrhosis. However, due to a lack of clinical safety data on moxifloxacin in Child-Pugh C patients, it is unknown how to use moxifloxacin in clinical practice. Case Presentation: A 76-year-old female with decompensated cirrhosis developed pneumonia during hospitalization. She had an initial failure to respond to imipenem/cilastatin + linezolid therapy. After three-day therapy with imipenem/cilastatin + moxisaxin, her infection symptoms rapidly improved. At this time, she presented a poor response with suspected hepatic encephalopathy. Given the worsening clinical symptoms caused by drug hepatotoxicity, moxisaxin was discontinued. Then, her body temperature rapidly raised. Conclusions: Moxisaxin may be a potentially useful antibiotic for hospital-acquired pneumonia in patients with decompensated cirrhosis, but further studies are needed to validate its hepatotoxicity.

scholarly journals Telavancin versus Standard Therapy for Treatment of Complicated Skin and Skin Structure Infections Caused by Gram-Positive Bacteria: FAST 2 Study

2006 ◽  
Vol 50 (3) ◽  
pp. 862-867 ◽  
Author(s):  
Martin E. Stryjewski ◽  
Vivian H. Chu ◽  
William D. O'Riordan ◽  
Brian L. Warren ◽  
Lala M. Dunbar ◽  
...  
Keyword(s):  
Standard Therapy ◽  
Clinical Success ◽  
Therapy Group ◽  
Success Rates ◽  
Standard Therapy Group ◽  
Gram Positive ◽  
Double Blind ◽  
Skin Structure ◽  
Complicated Skin ◽  
Cure Rates

ABSTRACT Telavancin is a bactericidal lipoglycopeptide with a multifunctional mechanism of action. We conducted a randomized, double blind, active-control phase II trial. Patients ≥18 years of age with complicated skin and skin structure infections caused by suspected or confirmed gram-positive organisms were randomized to receive either telavancin at 10 mg/kg intravenously every 24 h (q24h) or standard therapy (antistaphylococcal penicillin at 2 g q6h or vancomycin at 1 g q12h). A total of 195 patients were randomized and received at least one dose of study medication. Clinical success rates were similar in all analysis populations at test of cure. In microbiologically evaluable patients with Staphylococcus aureus at baseline (n = 91), 96% of the telavancin group and 90% of the standard-therapy group were cured. Among patients with methicillin-resistant S. aureus (MRSA) at baseline (n = 45), clinical cure rates were also 96% for telavancin and 90% for standard therapy. Microbiologic eradication in patients with S. aureus infection was better with telavancin compared to standard therapy (92% versus 78%, P = 0.07) and significantly better in patients with MRSA (92% versus 68%; P = 0.04). Therapy was discontinued for an adverse event (AE) in 6% and 3% of the patients receiving telavancin and standard therapy, respectively. Except for two cases of rash in the telavancin group, these AEs were similar in type and severity in the two groups. The overall incidences and severities of AEs and laboratory abnormalities were similar between the two groups. These data support the ongoing studies assessing the efficacy and safety of telavancin in the treatment of serious gram-positive infections, particularly involving MRSA.

Telavancin: A Novel Lipoglycopeptide Antibiotic

2009 ◽  
Vol 43 (5) ◽  
pp. 928-938 ◽  
Author(s):  
Lisa Charneski ◽  
Priti N Patel ◽  
Donna Sym
Keyword(s):  
English Language ◽  
Data Extraction ◽  
Anaerobic Bacteria ◽  
Drug Application ◽  
Qtc Interval ◽  
Gram Positive ◽  
Gram Positive Bacteria ◽  
Complicated Skin

Objective To review the pharmacology, antimicrobial activity, pharmacokinetics, clinical applications, and safety of telavancin, a new lipoglycopeptide antibiotic. Data Sources Literature was obtained from MEDLINE (1966–April 2009) and International Pharmaceutical Abstracts (1971–April 2009) using the search terms telavancin and TD-6424, and also from Theravance, Inc., and Astellas Pharma US, Inc. Study Selection And Data Extraction Available English-language articles were reviewed, as well as information obtained from Theravance, Inc., and Astellas Pharma US, Inc. Data Synthesis Telavancin has rapid bactericidal activity against gram-positive aerobic and anaerobic bacteria through multiple mechanisms of action. In vitro and Phase 2 in vivo data support the efficacy of telavancin against antibiotic-resistant gram-positive organisms. On March 4, 2008, the Food and Drug Administration (FDA) accepted as complete for review Theravance's response to the October 19, 2007, New Drug Application approvable letter for telavancin to be used as treatment for complicated skin and skin structure infections (cSSSIs) caused by gram-positive bacteria. QTc interval prolongation has been reported, although the clinical impact of this has not been determined. Drug interactions have not been identified as of yet. Conclusions Telavancin is currently under review by the FDA for the treatment of cSSSIs caused by gram-positive bacteria. The completion of Phase 3 trials will determine whether telavancin will have a role in the treatment of other infections caused by resistant gram-positive bacteria.

scholarly journals Telavancin Versus Standard Therapy for Treatment of Complicated Skin and Soft-Tissue Infections Due to Gram-Positive Bacteria

2005 ◽  
Vol 40 (11) ◽  
pp. 1601-1607 ◽  
Author(s):  
M. E. Stryjewski ◽  
W. D. O'Riordan ◽  
W. K. Lau ◽  
F. D. Pien ◽  
L. M. Dunbar ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Standard Therapy ◽  
Soft Tissue Infections ◽  
Gram Positive ◽  
Gram Positive Bacteria ◽  
Complicated Skin

scholarly journals POLA BAKTERI DAN USIA PASIEN TERHADAP PROKALSITONIN DI PNEUMONIA KOMUNITAS DAN NOSOKOMIAL

2018 ◽  
Vol 21 (2) ◽  
pp. 153
Author(s):  
Coriejati Coriejati ◽  
Mohammad Iqbal ◽  
Emmy Hermyanti Pranggono
Keyword(s):  
Infectious Disease ◽  
Mortality Rate ◽  
Bacterial Infection ◽  
Community Acquired Pneumonia ◽  
Sectional Study ◽  
Gram Positive ◽  
Gram Negative ◽  
Hospital Acquired Pneumonia ◽  
The Difference ◽  
Hospital Acquired

Pneumonia is one of an infectious disease with high mortality rate. In the last decade procalcitonin (PCT) was found as a biomarkerthat can predict a kind of infection. The aim of the study was to know the difference of PCT level between community acquired pneumonia(CAP) and hospital acquired pneumonia (HAP) by analyzing it, and the difference between <60 years old and older age patients. Across-sectional study was conducted on the CAP and HAP patients in RSHS, in August–October 2009. The level difference were analyzedwith Mann-Whitney test, with a significancy of p<0.05. In this study 40 (forty) patients (66%) CAP and 21 patients (34%) HAP wereincluded. The median of PCT levels in CAP was 0.88 ng/dL and HAP 8.32 ng/dL (p=0.002), where as in the in Gram negative bacterialinfection (GNBI) level in CAP was 4.76 ng/dL and in Gram positive was 0.61 ng/dL. The median PCT level in HAP with Gram negativewas 19.02 ng/dL and in the Gram positive was 4.63 ng/dL (p=0.201). The median of PCT level in CAP group <60 yo was 1.42 ng/dLand in ≥60 yo was 0.65 ng/dL (p=0.207). The median of PCT level in HAP <60 yo was 8.32 ng/dL, where as in ≥60 yo was 9.93ng/dL (p=0.178). Based in this study can be concluded that the PCT level in HAP group was higher than in the CAP group. The PCTlevel in HAP with Gram negative bacterial infection was higher than in the CAP, where as in the CAP group was lower in ≥60 yo.

scholarly journals CRISPR-Cas9-mediated genome editing in vancomycin-resistant Enterococcus faecium

2019 ◽  
Vol 366 (22) ◽  
Author(s):  
Vincent de Maat ◽  
Paul B Stege ◽  
Mark Dedden ◽  
Maud Hamer ◽  
Jan-Peter van Pijkeren ◽  
...  
Keyword(s):  
Genome Editing ◽  
Enterococcus Faecium ◽  
Deletion Mutant ◽  
Large Subunit ◽  
Recombination Rates ◽  
Gram Positive ◽  
Antibiotic Resistant ◽  
Green Fluorescent ◽  
Genome Modifications ◽  
Hospital Acquired

ABSTRACT The Gram-positive bacterium Enterococcus faecium is becoming increasingly prevalent as a cause of hospital-acquired, antibiotic-resistant infections. A fundamental part of research into E. faecium biology relies on the ability to generate targeted mutants but this process is currently labour-intensive and time-consuming, taking 4 to 5 weeks per mutant. In this report, we describe a method relying on the high recombination rates of E. faecium and the application of the Clustered Regularly Interspaced Short Palindromic Repeat (CRISPR)-Cas9 genome editing tool to more efficiently generate targeted mutants in the E. faecium chromosome. Using this tool and the multi-drug resistant clinical E. faecium strain E745, we generated a deletion mutant in the lacL gene, which encodes the large subunit of the E. faeciumβ-galactosidase. Blue/white screening using 5-bromo-4-chloro-3-indolyl-β-D-galactopyranoside (X-gal) could be used to distinguish between the wild-type and lacL deletion mutant. We also inserted two copies of gfp into the intrinsic E. faecium macrolide resistance gene msrC to generate stable green fluorescent cells. We conclude that CRISPR-Cas9 can be used to generate targeted genome modifications in E. faecium in 3 weeks, with limited hands-on time. This method can potentially be implemented in other Gram-positive bacteria with high intrinsic recombination rates.

Telavancin for the treatment of serious gram-positive infections, including hospital acquired pneumonia

2011 ◽  
Vol 12 (17) ◽  
pp. 2737-2750 ◽  
Author(s):  
Ethan Rubinstein ◽  
G Ralph Corey ◽  
Martin E Stryjewski ◽  
Zeina A Kanafani
Keyword(s):  
Gram Positive ◽  
Hospital Acquired Pneumonia ◽  
Hospital Acquired
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