Empirical antibiotic therapy of complicated skin and soft tissue infections in dermatological practice

2011 ◽  
Vol 152 (7) ◽  
pp. 252-258
Author(s):  
Andrea Magyar ◽  
Edina Garaczi ◽  
Edit Hajdú ◽  
Lajos Kemény
Keyword(s):  
Soft Tissue ◽  
Antibiotic Therapy ◽  
Streptococcus Pyogenes ◽  
Anaerobic Bacteria ◽  
Empirical Therapy ◽  
Soft Tissue Infections ◽  
Empirical Antibiotic Therapy ◽  
Gram Negative ◽  
First Choice ◽  
Complicated Skin

Erysipelas is an acute bacterial infection of the skin predominantly caused by Streptococcus pyogenes. According to the international classification complicated erysipelas belongs to the complicated skin and soft tissue infections. Complicated infections are defined as severe skin involvement or when the infection occurs in compromised hosts. These infections frequently involve Gram-negative bacilli and anaerobic bacteria. Aims: The aim of this study was to compare the efficacy of the empirical antibiotic therapy for the patients who were admitted to the Department of Dermatology and Allergology, University of Szeged. Methods: The empirical therapy was started according to a previously determined protocol. The data of 158 patients with complicated skin and soft tissue infections were analyzed and the microbiology culture specimens and the isolates were also examined. Results and conclusions: The results show that penicillin is the first choice for the treatment of erysipelas. However, the complicated skin and soft tissue infections require broad-spectrum antibiotics. Orv. Hetil., 2011, 152, 252–258.

scholarly journals Role of cefditoren in the treatment of community skin and soft tissue infections: revisiting the evidence

2021 ◽  
Author(s):  
Marta Dafne Cabañero-Navalón ◽  
Víctor García-Bustos ◽  
Miguel Salavert Lletí ◽  
Keyword(s):  
Soft Tissue ◽  
Streptococcus Pyogenes ◽  
Oral Antibiotic ◽  
Third Generation ◽  
Soft Tissue Infections ◽  
Oral Cephalosporin ◽  
Gram Negative ◽  
Anaerobic Microorganisms ◽  
Cure Rates

Cefditoren pivoxil is a third-generation oral cephalosporin with extended spectrum against Gram-negative, Gram-positive, and several anaerobic microorganisms, including those frequently implicated in skin and soft tissue infections (SSTI). Despite the fact that there are no approved breakpoint criteria for cefditoren susceptibility, many pharmacokinetic and pharmacodynamic studies reassert cefditoren as a good oral antibiotic for the treatment of SSTI. Regarding patients with SSTI, including those infections caused by Staphylococcus aureus y Streptococcus pyogenes, cefditoren showed high cure rates when compared to other oral cephalosporins.

scholarly journals In Vitro Activity of Ceftaroline against 623 Diverse Strains of Anaerobic Bacteria

2010 ◽  
Vol 54 (4) ◽  
pp. 1627-1632 ◽  
Author(s):  
D. M. Citron ◽  
K. L. Tyrrell ◽  
C. V. Merriam ◽  
E. J. C. Goldstein
Keyword(s):  
Soft Tissue ◽  
Broad Spectrum ◽  
Anaerobic Bacteria ◽  
Soft Tissue Infections ◽  
Good Activity ◽  
In Vitro Activity ◽  
Gram Negative ◽  
Amoxicillin Clavulanate ◽  
Gram Negative Organisms

ABSTRACT The in vitro activities of ceftaroline, a novel, parenteral, broad-spectrum cephalosporin, and four comparator antimicrobials were determined against anaerobic bacteria. Against Gram-positive strains, the activity of ceftaroline was similar to that of amoxicillin-clavulanate and four to eight times greater than that of ceftriaxone. Against Gram-negative organisms, ceftaroline showed good activity against β-lactamase-negative strains but not against the members of the Bacteroides fragilis group. Ceftaroline showed potent activity against a broad spectrum of anaerobes encountered in respiratory, skin, and soft tissue infections.

scholarly journals Extended Spectrum β-Lactamases among Gram-negative bacteria from an Egyptian pediatric hospital: a two-year experience

2007 ◽  
Vol 1 (03) ◽  
pp. 269-274 ◽  
Author(s):  
Maysaa El Sayed Zaki
Keyword(s):  
Antibiotic Therapy ◽  
Burkholderia Cepacia ◽  
Empirical Therapy ◽  
Empirical Antibiotic Therapy ◽  
Pediatric Hospital ◽  
Klebsiella Species ◽  
Antibiotic Resistant ◽  
Gram Negative ◽  
Extended Spectrum ◽  
Resistant Strains

Background Knowledge of the anti-microbial susceptibility pattern of common pathogens in a given area helps to inform the choice of empirical antibiotic therapy. The aim of this study was to determine the existence and to describe the characteristics of extended spectrum β-lactamase (ESBLs) in a pediatric hospital in Mansoura University, Egypt, to aid in the choice of empirical antibiotic therapy. Method: Between January 2005 and December 2006, blood samples were collected from children suspected to have nosocomial infections in a pediatric hospital in Mansoura. The gram negative isolates were identified, tested for antimicrobial susceptibility and analyzed for presence of ESBL. Results: A total of 1,600 children with suspected septicemia were studied. Gram negative septicemia was identified in 816 cases (45%). The commonest isolated gram negative bacilli was Klebsiella species (38.2%) followed by Enterobacter species (32.4), Serratia species (16.2%) and Burkholderia cepacia (10.3%). The highest susceptibility was for imipenem (74.3%) followed by gentamicin (70.8%), cefoperazone (64.5%) and cefotaxime (63.2%). The highest resistant rate was for cefazolin and ampicillin/sulbactam (75.5% for each), followed by cefuroxime 70.3% and ceftriaxone (63.5%). The ESBL was found in 44.5% for cefotaxime and 50% for ceftazidime by double discs method. Conclusion: This study highlights the emergence of antibiotic resistant gram negative bacilli in a pediatric hospital with special emphasis on extended β-lactamase resistant strains. Our results show that the most appropriate antibiotics to be used for empirical therapy are amikacin and gentamicin.

scholarly journals Antibiotics in Necrotizing Soft Tissue Infections

Antibiotics ◽  
2021 ◽  
Vol 10 (9) ◽  
pp. 1104
Author(s):  
Tomas Urbina ◽  
Keyvan Razazi ◽  
Clément Ourghanlian ◽  
Paul-Louis Woerther ◽  
Olivier Chosidow ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Antibiotic Therapy ◽  
Broad Spectrum ◽  
Bacterial Infections ◽  
Group A Streptococcus ◽  
Empirical Therapy ◽  
Antibiotic Use ◽  
Soft Tissue Infections ◽  
Beta Lactam ◽  
Necrotizing Soft Tissue Infections

Necrotizing soft tissue infections (NSTIs) are rare life-threatening bacterial infections characterized by an extensive necrosis of skin and subcutaneous tissues. Initial urgent management of NSTIs relies on broad-spectrum antibiotic therapy, rapid surgical debridement of all infected tissues and, when present, treatment of associated organ failures in the intensive care unit. Antibiotic therapy for NSTI patients faces several challenges and should (1) carry broad-spectrum activity against gram-positive and gram-negative pathogens because of frequent polymicrobial infections, considering extended coverage for multidrug resistance in selected cases. In practice, a broad-spectrum beta-lactam antibiotic (e.g., piperacillin-tazobactam) is the mainstay of empirical therapy; (2) decrease toxin production, typically using a clindamycin combination, mainly in proven or suspected group A streptococcus infections; and (3) achieve the best possible tissue diffusion with regards to impaired regional perfusion, tissue necrosis, and pharmacokinetic and pharmacodynamic alterations. The best duration of antibiotic treatment has not been well established and is generally comprised between 7 and 15 days. This article reviews the currently available knowledge regarding antibiotic use in NSTIs.

scholarly journals Antibiogram of Gram Negative Bacteria isolated from the Skin and Soft Tissue Infections a Guide for Empirical Therapy to the Clinicians

2020 ◽  
Vol 14 (2) ◽  
pp. 1353-1358
Author(s):  
Lakshmi Kakhandki ◽  
Aparna Y Takpere ◽  
Smitha Bagali ◽  
Sanjay Wavare ◽  
Rashmi Karigoudar ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Empirical Therapy ◽  
Gram Negative Bacteria ◽  
Soft Tissue Infections ◽  
Gram Negative

scholarly journals MONITORING OF ANAEROBIC PATHOGENS RESISTANCE IN PATIENTS WITH SURGICAL SKIN AND SOFT TISSUE INFECTIONS

2021 ◽  
Vol 19 (2) ◽  
pp. 166-169
Author(s):  
S. D. Fedzianin ◽  
◽  
V. K. Okulich ◽  
E. L. Lokteva ◽  
◽  
...  
Keyword(s):  
Soft Tissue ◽  
Antibiotic Therapy ◽  
High Activity ◽  
Soft Tissue Infections ◽  
Empirical Antibiotic Therapy ◽  
Anaerobic Infection ◽  
Test Systems ◽  
Anaerobic Infections

Background: The problem of treating anaerobic infections in surgery continues to be relevant. Aim: To develop a protocol for empirical antibiotic therapy of anaerobic infection in patients with surgical skin and soft tissue infections. Material and methods: A total of 191 patients were examined. Identification and assessment of pathogens sensitivity was performed on the АТВ Expression analyzer. In addition, we used the ID-ANA and AB-AN test systems, developed by us. Results: In the structure of anaerobes, bacteroids, peptococci and peptostreptococci continue to occupy the leading positions. No changes in the resistance of anaerobes to most antibiotics were found. There is an increase in the resistance of peptococci and peptostreptococci to clindamycin. Metronidazole, imipenem, meropenem retain high activity. Conclusions: If anaerobic infection is suspected, it is recommended to prescribe metronidazole, and imipenem and meropenem as reserve drugs.

Analysis of 11 Cases of Neonatal Invasive Streptococcus pyogenes Infection

2020 ◽  
Vol 15 (04) ◽  
pp. 212-216
Author(s):  
Yong-Ping Xie ◽  
Chun-Zhen Hua ◽  
Hui Yu ◽  
Hong-Mei Xu ◽  
Wei Gao ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Streptococcus Pyogenes ◽  
Soft Tissue Infections ◽  
Pathogen Identification ◽  
First Choice ◽  
Focal Infection ◽  
Highly Sensitive ◽  
Cerebrospinal Fluid Culture ◽  
Common Manifestation ◽  
Fluid Culture

Abstract Objective This study aimed to improve the understanding of clinical characteristics of neonatal invasive Streptococcus pyogenes infection (iSPI). Methods A retrospective study was performed to analyze the clinical and laboratory aspects of culture-confirmed neonatal iSPI cases during 2010 to 2017. Results Eleven cases of neonatal iSPI were confirmed. The ages ranged from 2 hours to 26 days. Ten cases had positive blood culture results and one had positive cerebrospinal fluid culture for S. pyogenes. Seven patients had fever and seven had identified focal infection, including six skin and soft tissue infections and one case of pneumonia. All of the S. pyogenes strains were sensitive to penicillin, cefotaxime, and vancomycin, and nine were resistant to clindamycin and erythromycin. Six patients received penicillin or cephalosporin monotherapy. Three patients received meropenem plus vancomycin initially, and then two of them were switched to penicillin and one to vancomycin after pathogen identification. Two cases were treated with vancomycin monotherapy. All cases were discharged after being cured or showing improvement. Conclusion Skin and soft tissue infection is a common manifestation of neonatal iSPI. Streptococcus pyogenes strains are highly sensitive to β-lactams, which should be used as the first-choice treatment.

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