Terapia delle infezioni da Pseudomonas aeruginosa MDR
|
|
- Martina Hancock
- 5 years ago
- Views:
Transcription
1 Verona 23 ottobre 2010 Terapia delle infezioni da Pseudomonas aeruginosa MDR Pierluigi Viale Clinica di Malattie Infettive Policlinico S. Orsola Malpighi
2 Global resistance surveillance of Pseudomonas aeruginosa isolated in the Mystic programme Genta Tobra Pip/tazo Cefta Cefe Imi Mer Cipro Nort Eur South Eur East Eur
3 Imipenem resistance of Pseudomonas in pneumonia: a systematic literature review Zilberberg et al. BMC Pulmonary Medicine 2010, 10:45 Of the 46 studies identified, 20 included patients with pneumonia (imipenem 1,667, comparator 1,661). Pooled clinical success rates for PA were 45.2% (range %) for imipenem and 74.9% (range %) for comparator regimens. Microbiologic eradication was achieved in 47.6% (range 0.0% %) of isolates in the imipenem and 52.8% (range 0.0%-100.0%) in the comparator groups
4 COLISTINA
5 COLISTIN PRATICAL USE Predictions from modelling indicate that without a loading dose, it takes 2 3 days before the steady-state concentration of colistin is obtained. A loading dose of 9 million IU CMS and a maintenance dose of 4.5 million IU CMS every 12 hours would result in a right steady-state concentration of colistin but would achieve the target faster. The intrathecal and intraventricular doses of CMS are equal to IU/day. By the inhalation route, the recommended dosage ranges from IU every 12 hours to 2 million IU every 8 hours In renal dysfunction, the CMS dosage adjustment recommended by the manufacturers is as follows: for serum creatinine levels of mg/dl, 2 million IU every 12 h for serum creatinine levels of mg/dl, 2 million IU every 24 h for serum creatinine levels > 2.6 mg/dl, 2 million IU every 36 h During hemodialysis the recommended dose is 2 million IU after each session During CVVH the same dosage schedule as for normal renal function
6 COLISTIN PRATICAL USE In contrast to older information, recent data indicate that nephrotoxicity in ICU patients after CMS administration ranges from 0% to 36%. Safety data from 19 courses of prolonged intravenous CMS administration (mean duration 43.4 days and mean daily dose 4.4 million IU) showed that the median creatinine value increased only by 0.25 mg/dl, which returned to close to baseline at the end of therapy. The reported discrepancies could be attributed to the improvement in supportive care offered to seriously ill patients, the possible avoidance of coadministering other nephrotoxic drugs, different formulations of colistin lacking sulfate impurities and the different definitions of nephrotoxicity. On the other hand nephrotoxicity in the recently reported studies ranged from 0% to 14%. The incidence of neurotoxicity in earlier studies of colistin reached approximately 7%.
7 COLISTIN CLINICAL EXPERIENCE In total, from 1999 until August 2005, in 7 retrospective studies involving almost 300 patients without CF, among whom most represented ICU patients with VAP, intravenous CMS was given at a dose of 1 3 million IU every 8 hours for days. In almost all patients, at a rate close to 50%, either MDR P. aeruginosa or MDR A. baumannii were isolated in relevant cultures. Irrespective of the susceptibility patterns of the isolated pathogens, as a rule, CMS was given in combination with other antibacterials (mostly with a carbapenem). Clinical cure rates ranged between 57% and 73%, with mortality rates of %.
8 COLISTIN CLINICAL EXPERIENCE In 2007, two retrospective monotherapy studies with CMS were published. In the first study, no difference in mortality rates (51.6% vs 45.1%) was observed between 31 patients with VAP caused by isolates susceptible only to colistin who were treated with CMS monotherapy and 30 patients with VAP caused by carbapenem-susceptible strains who were treated with imipenem/ cilastatin or meropenem as monotherapy. Patients who received appropriate empirical therapy had significantly better outcome compared to those who received inappropriate empirical therapy (mortality 36.6% vs 70%, respectively; p = 0.014). Rios FG et al. VAP due to susceptible only to colistin microorganisms. Eur Respir 2007; 30: In the largest retrospective matched case-control study thus far to assess the efficacy of monotherapy with CMS, the latter was compared with imipenem in VAP caused by isolates susceptible only to colistin (n = 60) and carbapenem susceptible A. baumannii or P. aeruginosa. A favourable clinical response was observed in 75% of patients without difference in the time to resolution of infectious parameters between the two groups. Kallel H, et al. Safety and efficacy of colistin compared with imipenem in the treatment of VAP: a matched case-control study. Intensive Care Med 2007; 33 :
9 Colistin therapy for microbiologically documented multidrug-resistant Gramnegative bacterial infections: a retrospective cohort study of 258 patients Falagas ME et al, Intern J Antimicrob Ag 2010; 35: Over a 7-year period (October 2000 to October 2007), 258 patients received intravenous colistin for at least 72 h for microbiologically documented multidrug-resistant Gramnegative bacterial infections, comprising 170 (65.9%) Acinetobacter baumannii, 68 (26.4%) Pseudomonas aeruginosa, 18 (7.0%) Klebsiella pneumoniae, 1 (0.4%) Stenotrophomonas maltophilia and 1 (0.4%) Enterobacter cloacae. Cure of infection occurred in 79.1% of patients, nephrotoxicity in 10% and hospital survival in 65.1%.
10 Colistin therapy for microbiologically documented multidrug-resistant Gramnegative bacterial infections: a retrospective cohort study of 258 patients Falagas ME et al, Intern J Antimicrob Ag 2010; 35:
11 Colistin therapy for microbiologically documented multidrug-resistant Gramnegative bacterial infections: a retrospective cohort study of 258 patients Falagas ME et al, Intern J Antimicrob Ag 2010; 35:
12 Polymyxin B versus other antimicrobials for the treatment of P. aeruginosa bacteraemia Kvitko CH et al J Antimicrob Chemoter Advance Access published October 20, 2010 Retrospective cohort study. Patients 18 years of age and who received appropriate therapy for 48 h for P. aeruginosa bacteraemia were analysed. Clinical covariates were assessed and compared between patients treated with polymyxin B and other drugs (comparators). Data were retrieved from medical records. A total of 133 patients were included: 45 (33.8%) treated with polymyxin B and 88 (66.2%) with comparators.
13 Nebulized and intravenous colistin in experimental pneumonia caused by P. aeruginosa Lu Q et al Intensive Care Med (2010) 36: Lung bacterial burden after 24 h of colistin administration In the aerosol group, median peak lung tissue concentration of colistin was 2.8 mcg g-1 (25 75% IQR: ) In the intravenous group, colistin could not be detected in any of the analyzed lung segments.
14 Nebulized and intravenous colistin in experimental pneumonia caused by P. aeruginosa Lu Q et al Intensive Care Med (2010) 36: Colistin peak lung tissue concentrations according to histological severity of pneumonia following 24-h treatment by nebulized colistin.
15 Nebulized and intravenous colistin in experimental pneumonia caused by P. aeruginosa Lu Q et al Intensive Care Med (2010) 36: Regional distribution of colistin peak lung tissue concentrations measured 1 h after the third aerosol of colistin on lung specimens obtained in different lung segments representative of each lobe S2 S3 S6 S8 S10 upper lobe middle lobe lower lobe
16 Randomized controlled trial of nebulized colistimethate sodium as adjunctive therapy of ventilator-associated pneumonian caused by Gram-negative bacteria. Rattanaumpawan P et al, J Antimicrob ChemotherAdvance Access published September 28, 2010 One hundred adult patients who developed Gram-negative VAP received systemic antibiotics according to the decisions of their responsible physicians. The patients were randomized to receive an additional 4 ml of nebulized sterile normal saline (NSS) (n¼49) or nebulized CMS equivalent to 75 mg of colistin base in 4 ml of NSS every 12 h until systemic antibiotic therapy of VAP was ended.
17 Randomized controlled trial of nebulized colistimethate sodium as adjunctive therapy of ventilator-associated pneumonian caused by Gram-negative bacteria. Rattanaumpawan P et al, J Antimicrob ChemotherAdvance Access published September 28, 2010
18 COLISTIN PRATICAL USE future studies with colistin necessitate large prospective, possibly comparative, trials in MDRinfections of ICU patients under well-designed protocols and reliable susceptibility testing; further pharmacokinetic/ pharmacodynamic exploitation; Clarification in vivo of the possible benefits of coadministering colistin with other antimicrobials, such as the carbapenems and rifampicin; evaluation of nebulized colistin as single VAP therapy versus combination with parenteral colistin; better monitoring and elucidation of resistance mechanisms; larger experience in specific populations, for example the febrile neutropenic host.
19 DORIPENEM
20 DORIPENEM Doripenem, the most recently FDA-approved carbapenem, possesses an antimicrobial spectrum similar to meropenem against Gram-negative pathogens and similar to imipenem against Gram-positive pathogens, while retaining 2- to 4-fold lower MICs against P. aeruginosa compared with meropenem A potential advantage of this new carbapenem over the existing members of the class is its lower potential for the selection of resistance in vitro Fluoroquinolone Enhances the Mutation Frequency for Meropenem-Selected Carbapenem Resistance in P.aeruginosa, but Use of the High-Potency Drug Doripenem Inhibits Mutant Formation Tanimoto K et al, Antimicrob Ag Chemother 2009; 52: Preliminary data indicate that PK/PD applications, by means of prolonged infusion and supported by the relative stability of the infusate in ambient conditions, may help in the treatment of strains with borderline MICs, thus overcoming low-level resistance
21 Susceptibility of Pseudomonas aeruginosa clinical isolates in Japan to doripenem and other antipseudomonal agents Fujimura T Intern J Antimicrob Ag 2009; 34: the susceptibility of 694 Pseudomonas aeruginosa clinical isolates to nine antipseudomonal agents including doripenem was investigated The MIC90 of doripenem was 2-fold lower than that of meropenem, imipenem and amikacin and was 4-fold lower than that of piperacillin, ceftazidime, cefepime, ciprofloxacin and tobramycin
22 EFFICACY AND SAFETY OF INTRAVENOUS INFUSION OF DORIPENEM VERSUS IMIPENEM IN VAP: A MULTICENTER,RANDOMIZED STUDY Chastre J et al. Crit Care Med 2008; 67: PER-PATHOGEN CLINICAL AND MICROBIOLOGICAL CURE RATES
23 EFFICACY AND SAFETY OF INTRAVENOUS INFUSION OF DORIPENEM VERSUS IMIPENEM IN VAP: A MULTICENTER,RANDOMIZED STUDY Chastre J et al. Crit Care Med 2008; 67: PER-PATHOGEN CLINICAL AND MICROBIOLOGICAL CURE RATES
24 Lucasti C et al. Clin Ther 2008;30:
25 FOSFOMICINA
26 FOSFOMYCIN Since penetration of fosfomycin is reported to be sufficient in various body compartments, particularly during inflammation, peak plasma concentrations are anticipated to exceed the MICs of the tested MDR pathogens after a maximum dosage of 8 g intravenously every 8 hours. Clinical data with fosfomycin for MDR infections are very scarce.
27 Fosfomycin for the treatment of infections caused by multidrug-resistant nonfermenting Gram-negative bacilli: a systematic review of microbiological, animal and clinical studies Falagas ME et al. Int J Antimicr Agents 2009; 34: Microbiological studies 23 microbiological studies 1859 MDR non-fermenting Gram neg isolates Susceptibility rate to fosfomycin of MDR P aeruginosa isolates was >=90%, and 50-90% in 7/19 and 4/19 relevant studies, respectively. Only 3/85 (3.5%) MDR A baumannii and 0/31 MDR Burkholderia spp isolates were susceptible to fosfomycin. Fosfomycin was synergistic in combination with a beta-lactam, aminoglycoside or ciprofloxacin in 46/86 (53.5%) MDR P aeruginosa isolates
28 Fosfomycin for the treatment of infections caused by multidrug-resistant nonfermenting Gram-negative bacilli: a systematic review of microbiological, animal and clinical studies Falagas ME et al. Int J Antimicr Agents 2009; 34: One animal study found a good therapeutic effect of the combination fosfomycin/gentamicin against MDR P. aeruginosa endocarditis. In six clinical studies, 33 patients with MDR P. aeruginosa infections (mainly pulmonary exacerbations of cystic fibrosis) received fosfomycin (25/33 in combination with other antibiotics); 91% of the patients clinically improved.
29 COMBINAZIONI
30 In Vitro Double and Triple Bactericidal Activities of Doripenem, Polymyxin B, and Rifampin against MDR A. baumannii, P. aeruginosa, K. pneumoniae, and E. coli Urban C et al, Antimicrob Ag Chemother 2010;54:
31 Colistin-Tobramycin Combinations Are Superior to Monotherapy Concerning the Killing of Biofilm P. aeruginosa Herrmann G et al, J Infect Dis 2010; 202: Colistin Tobramycin Combo
32 Colistin-Tobramycin Combinations Are Superior to Monotherapy Concerning the Killing of Biofilm P. aeruginosa Herrmann G et al, J Infect Dis 2010; 202: Five CF patients consecutively inhaled 1 million IU (3 ml) of colistin and 300 mg (5 ml) of tobramycin twice daily for 28 days. The change in the number of P. aeruginosa colony-forming units in sputum at day 30, compared with day 1, was used as the primary end point inhaled colistin-tobramycin resulted in a mean decrease in P. aeruginosa of log cfu/ml of sputum (P=.027)
33 The Combination of Meropenem and Levofloxacin Is Synergistic with Respect to both Pseudomonas aeruginosa Kill Rate and Resistance Suppression Louie A et al, Antimicrob Agents Chemother Jun;54(6): Effect of combination therapy versus that of monotherapy on WT P. aeruginosa PAO1 Monotherapy Combo
34 The Combination of Meropenem and Levofloxacin Is Synergistic with Respect to both Pseudomonas aeruginosa Kill Rate and Resistance Suppression Louie A et al, Antimicrob Agents Chemother Jun;54(6):
35 The Combination of Meropenem and Levofloxacin Is Synergistic with Respect to both Pseudomonas aeruginosa Kill Rate and Resistance Suppression Louie A et al, Antimicrob Agents Chemother Jun;54(6):
36 OTTIMIZZAZIONE DELL USO DEI FARMACI DISPONIBILI
37 Suboptimal Aminoglycoside Dosing in Critically Ill Patients Rea RS et al, Ther Drug Monit 2008;30: probability (%) of simulated patients with optimal PD target (C MAX /MIC > 10) with gentamicin N = 102 TDM = JAN 2004 DEC
38 Suboptimal Aminoglycoside Dosing in Critically Ill Patients Rea RS et al, Ther Drug Monit 2008;30: Probability (%) of Cmax >10³ MIC by Different MIC and AG Dose
39
40 Ceftazidime plasma concentration (mg/l) Intravenous continuous infusion of ceftazidime in febrile neutropenic patients with acute myeloid leukemia: a helpful tool for maximizing drug exposure Pea F, Viale P et al., Antimicrob Agents Chemother, 2005; 49: N = 20 CL CR = 1.64 ± 0.35 ml/min/kg CEFTAZIDIME: LD 1G 6G/24h CI Time after stopping continuous infusion (h)
41 High-Dose Continuous Infusion b-lactam Antibiotics for the Treatment of Resistant Pseudomonas aeruginosa Infections in Immunocompromised Patients Moriyama B et al, Ann Pharmacother 2010;44:929-35
42 REASSESSMENT OF RECOMMENDED IMIPENEM DOSES IN FEBRILE NEUTROPENIC PATIENTS WITH HAEMATOLOGICAL MALIGNANCIES Lamoth F et al. Antimicrob Agents Chemother 2009 Feb, 59: CHARACTERISTICS OF PATIENTS
43 REASSESSMENT OF RECOMMENDED IMIPENEM DOSES IN FEBRILE NEUTROPENIC PATIENTS WITH HAEMATOLOGICAL MALIGNANCIES Lamoth F et al. Antimicrob Agents Chemother 2009 Feb, 59: CHARACTERISTICS OF PATIENTS
44 REASSESSMENT OF RECOMMENDED IMIPENEM DOSES IN FEBRILE NEUTROPENIC PATIENTS WITH HAEMATOLOGICAL MALIGNANCIES Lamoth F et al. Antimicrob Agents Chemother 2009 Feb, 59: PERCENTAGE OF SIMULATED PATIENTS WITH C MIN > 1 MG/L 500 Q4H over 30 min 1000 Q8H over 30 min
45 MEROPENEM DOSING IN CRITICALLY ILL PATIENTS WITH SEPSIS AND WITHOUT RENAL DYSFUNCTION: INTERMITTENT BOLUS vs CONTINUOUS ADMINISTRATION? Roberts JA et al. J Antimicrob Chemother 2009 July; 64: PROBABILITY OF PD TARGET ATTAINMENT (50% free T>MIC) Alma Mater Studiorum Università di Bologna
46 Meropenem by continuous versus intermittent infusion in VAP due to gramnegative bacilli Lorente L et al. Ann Pharmacother 2006;40: Alma Mater Studiorum Università di Bologna
47 Outcomes of Bacteremia due to Pseudomonas aeruginosa with Reduced Susceptibility to Piperacillin-Tazobactam: Implications on the Appropriateness of the Resistance Breakpoint Tam VH et al Clin Infect Dis 2008; 46:862 7 Thirty-day mortality rate according to piperacillin-tazobactam MIC.
48 Piperacillin-Tazobactam for P. aeruginosa Infection: Clinical Implications of an Extended- Infusion Dosing Strategy Lodise TP et al, Clin Infect Dis 2007; 44: Results of the probability of target attainment analysis for pip-taz therapy Monte Carlo simulation study
49 Piperacillin-Tazobactam for P. aeruginosa Infection: Clinical Implications of an Extended- Infusion Dosing Strategy Lodise TP et al, Clin Infect Dis 2007; 44:357 63
50 Alveolar concentrations of piperacillin/tazobactam administered in continuous infusion to patients with VAP. Boselli E et al, Crit Care Med 2008; 36: Relationship between serum piperacillin concentrations and creatinine clearance.
51 WHAT DOES IT MEAN CORRECT ANTIBIOTIC THERAPY? The microorganism point of view - A GOOD MICROBIOLOGICAL / EPIDEMIOLOGICAL CHOICE The drug point of view - A CORRECT PHARMACOKINETICAL CHOICE and ADMINISTRATION liphophilic vs hydrophilic drugs Viale P & Pea F Crit Care Med 2006 time dependent vs concentration dependent drugs MIC value DRUG CHOICE DAILY SCHEDULA The patient point of view - A TARGETED PHYSIOPHATOLOGICAL DAILY SCHEDULA illness severity grading physio-pathological conditions affecting distribution Clinical condition
52 Impact of time to antibiotics on survival in patients with severe sepsis or septic shock in whom early goal-directed therapy was initiated in the emergency department Gaieski DF et al, Crit Care Med 2010; 38: Design: Single-center cohort study. Setting: The emergency department of an academic tertiary care center from 2005 through Patients: Two hundred sixty-one patients undergoing early goal-directed therapy. Interventions: None. Measurements: Effects of different time cutoffs from triage to antibiotic administration, qualification for early goal-directed therapy to antibiotic administration, triage to appropriate antibiotic administration, and qualification for early goal-directed therapy to appropriate antibiotic administration on inhospital mortality were examined. The mean age of the 261 patients was yrs; 41% were female. In-hospital mortality was 31% for the cohort as a whole; it was 35.1% for culture-positive patients vs. 25.7% (p.11) for culture-negative patients.
53 Impact of time to antibiotics on survival in patients with severe sepsis or septic shock in whom early goal-directed therapy was initiated in the emergency department Gaieski DF et al, Crit Care Med 2010; 38:
54 Impact of time to antibiotics on survival in patients with severe sepsis or septic shock in whom early goal-directed therapy was initiated in the emergency department Gaieski DF et al, Crit Care Med 2010; 38:
A Snapshot of Colistin Use in South-East Europe and Particularly in Greece
A Snapshot of Colistin Use in South-East Europe and Particularly in Greece Helen Giamarellou 02.05.2013 When Greek Physicians Prescribe Colistin? It is mainly prescribed in the ICU for VAP, bacteremia
More informationContinuous Infusion of Antibiotics In The ICU: What Is Proven? Professor of Medicine Vice-Chairman, Department of Medicine SUNY at Stony Brook
Continuous Infusion of Antibiotics In The ICU: What Is Proven? Michael S. Niederman, M.D. Chairman, Department of Medicine Winthrop-University Hospital Mineola, NY Professor of Medicine Vice-Chairman,
More informationICU Volume 11 - Issue 3 - Autumn Series
ICU Volume 11 - Issue 3 - Autumn 2011 - Series Impact of Pharmacokinetics of Antibiotics in ICU Clinical Practice Introduction The efficacy of a drug is mainly dependent on its ability to achieve an effective
More informationLa farmacologia in aiuto
Ferrara, 15 giugno 2018 La farmacologia in aiuto Pier Giorgio Cojutti, Federico Pea Istituto di Farmacologia Clinica Azienda Sanitaria Universitaria Integrata di Udine Therapeutic Drug Monitoring of Beta-Lactams
More informationwithout the permission of the author Not to be copied and distributed to others
Emperor s Castle interior-prato What is the Role of Inhaled Polymyxins for Treatment of Respiratory Tract Infections? Helen Giamarellou CONCLUSIONS: Patients with Pseudomonas and Acinetobacter VAP may
More informationPharmacologyonline 1: (2010) ewsletter Singh and Kochbar. Optimizing Pharmacokinetic/Pharmacodynamics Principles & Role of
Optimizing Pharmacokinetic/Pharmacodynamics Principles & Role of Cefoperazone Sulbactam Singh M*, Kochhar P* Medical & Research Division, Pfizer India. Summary Antimicrobial resistance is associated with
More informationPHARMACOKINETIC & PHARMACODYNAMIC OF ANTIBIOTICS
PHARMACOKINETIC & PHARMACODYNAMIC OF ANTIBIOTICS SITI HIR HURAIZAH MD TAHIR Bpharm (UKM), MSc (Clinical Microbiology) (UoN) CLINICAL PHARMACIST HOSPITAL MELAKA WHY STUDY PHARMACOKINETICS (PK) AND PHARMACODYNAMICS
More informationLessons from recent studies. João Gonçalves Pereira UCIP DALI
Lessons from recent studies João Gonçalves Pereira UCIP DALI 1 Patterns of Antimicrobial Activity Concentration C max Aminoglycosides Cmax/MIC>10 Metronidazol Area under the concentration curve Azithromycin
More informationESCMID Online Lecture Library. by author
Novel PK/PD data on the optimisation of colistin and the carbapenems Diamantis Plachouras Athens, Greece Hot Topics on Infections in the Critically Ill Patient, ESCMID Postgraduate Education Course, 31
More informationExpert rules. for Gram-negatives
Academic Perspective in Expert rules Emerging Issues of Resistance in Gram-ve Bacteria for Gram-negatives Trevor Winstanley Sheffield Teaching Hospitals Presented on behalf of David Livermore University
More informationLa batteriocidia sierica: passato e presente
Genova, 23 settembre 2016 La batteriocidia sierica: passato e presente Dott.ssa Maddalena Giannella Clinica di Malattie Infettive AOU Policlinico Sant Orsola Malpighi Case 1 Case 2 Summary: Cured of cancer
More informationTreatment Strategies for Infections due to MDR-GNR
Treatment Strategies for Infections due to MDR-GNR Michael Satlin, MD Instructor in Medicine Division of Infectious Diseases Weill Cornell Medical College, New York, NY October 16, 2012 1 2 Faculty Disclosure
More informationUse of imipenem. with the support of Wallonie-Bruxelles International. Magali Dodémont Microbiology Hospital Erasme Université Libre de Bruxelles
with the support of Wallonie-Bruxelles International Use of imipenem Magali Dodémont Microbiology Hospital Erasme Université Libre de Bruxelles 1 Β-lactams classification 2 Β-lactams: mode of action Inhibition
More informationGiving the Proper Dose: How Can The Clinical and Laboratory Standards Institute(CLSI)Help?
Giving the Proper Dose: How Can The Clinical and Laboratory Standards Institute(CLSI)Help? Pranita D. Tamma, M.D., M.H.S. Director, Pediatric Antimicrobial Stewardship Johns Hopkins University School of
More informationPHARMACOKINETICS OF COLISTIN IN
PHARMACOKINETICS OF COLISTIN IN CRITICALLY ILL PATIENTS WITH MULTIDRUG-RESISTANT GRAM- NEGATIVE BACILLI INFECTION JOURNAL CLUB PRESENTATION Amal M. Al-Anizi, PharmD Candidate KSU, Infectious disease rotation
More informationMarcos I. Restrepo, MD, MSc, FCCP
Thank you for viewing this presentation. We would like to remind you that this material is the property of the author. It is provided to you by the ERS for your personal use only, as submitted by the author.
More informationIs the package insert correct? PK considerations
Is the package insert correct? PK considerations Jason A Roberts B Pharm (Hons), PhD, FSHP Professor of Medicine and Pharmacy The University of Queensland, Australia Royal Brisbane and Women s Hospital,
More informationThe CLSI Approach to Setting Breakpoints
The CLSI Approach to Setting Breakpoints Jean B. Patel, PhD, D(ABMM) Deputy Director, Office of Antimicrobial Resistance Division of Healthcare Quality Promotion National Center for Emerging and Zoonotic
More informationIntracheal antibiotics administration
Intracheal antibiotics administration Jean Chastre, M.D. www.reamedpitie.com Disclosure Conflicts of interest: Consulting or Lecture fees: Bayer, Pfizer, Cubist/Merck, Basilea, Kenta/Aridis, Roche, AstraZeneca/Medimmune
More informationOptimizing Polymyxin Combinations Against Resistant Gram-Negative Bacteria
Infect Dis Ther (2015) 4:391 415 DOI 10.1007/s40121-015-0093-7 REVIEW Optimizing Polymyxin Combinations Against Resistant Gram-Negative Bacteria Phillip J. Bergen Zackery P. Bulman Cornelia B. Landersdorfer
More informationAntibiotic Usage Related to Microorganisms Pattern and MIC
Antibiotic Usage Related to Microorganisms Pattern and MIC DR. Dr. Latre Buntaran Sp.MK(K) Secretary General PERDALIN Head of Compartment of Infection Control PERSI Doripenem: Potent
More informationP. aeruginosa: Present therapeutic options in Intensive Care. Y. Van Laethem (CHU St-Pierre & Université libre de Bruxelles, Brussels, Belgium)
P. aeruginosa: Present therapeutic options in Intensive Care Y. Van Laethem (CHU St-Pierre & Université libre de Bruxelles, Brussels, Belgium) Activity vs Pseudomonas aeruginosa Pseudomonas aeruginosa
More informationNadira Durakovic, Vedran Radojcic, Ana Boban, Mirando Mrsic, Dubravka Sertic, Ranka Serventi-Seiwerth, Damir Nemet and Boris Labar.
ORIGINAL ARTICLE Efficacy and Safety of Colistin in the Treatment of Infections Caused by Multidrug-resistant Pseudomonas aeruginosa in Patients with Hematologic Malignancy: A Matched Pair Analysis Nadira
More informationDiane M. Gomes, Pharm.D. Outcomes in Antimicrobial Stewardship Post-Doctoral Pharmacy Fellow Providence Veterans Affairs Medical Center
Diane M. Gomes, Pharm.D. Outcomes in Antimicrobial Stewardship Post-Doctoral Pharmacy Fellow Providence Veterans Affairs Medical Center The information disseminated in this lecture is given in my personal
More informationALERT. Clinical microbiology considerations related to the emergence of. New Delhi metallo beta lactamases (NDM 1) and Klebsiella
ALERT Clinical microbiology considerations related to the emergence of New Delhi metallo beta lactamases (NDM 1) and Klebsiella pneumoniae carbapenemases (KPC) amongst hospitalized patients in South Africa
More informationGuess or get it right?
Guess or get it right? Antimicrobial prescribing in the 21 st century Robert Masterton Traditional Treatment Paradigm Conservative start with workhorse antibiotics Reserve more potent drugs for non-responders
More informationProfessor of Chemotherapy Department of Preclinical and Clinical Pharmacology University of Florence
Professor of Chemotherapy Department of Preclinical and Clinical Pharmacology University of Florence Researching field Pharmacokinetics, Pharmacodynamics of antimicrobial, antifungal and antitumoral drugs
More informationAnnual Surveillance Summary: Pseudomonas aeruginosa Infections in the Military Health System (MHS), 2016
Annual Surveillance Summary: Pseudomonas aeruginosa Infections in the Military Health System (MHS), 2016 Sarah Gierhart and Uzo Chukwuma Approved for public release. Distribution is unlimited. The views
More informationContinuous vs Intermittent Dosing of Antibiotics in Critically-Ill Patients
Continuous vs Intermittent Dosing of Antibiotics in Critically-Ill Patients Jan O Friedrich, MD DPhil Associate Professor of Medicine, University of Toronto Medical Director, MSICU St. Michael s Hospital,
More information%T MIC MIC. Pharmacokinetics PK: Cmax AUC T1/2 Pharmacodynamics PD: MIC: minimum inhibitory concentration time-killing-curve 1990.
THE JAPANESE JOURNAL OF ANTIBIOTICS 58 2 159( 55 ) ( 2 15 ) %T MIC MIC 2002 30%T MIC 50%T MIC 1000 mg 3 3 /day Pharmacokinetics PK: Cmax AUC T1/2 Pharmacodynamics PD: MIC: minimum inhibitory concentration
More informationLa neutropenia febbrile
XII Corso Avanzato di Terapia Antibiotica Pisa, 15-16 novembre 2017 La neutropenia febbrile Alessandra Micozzi Dipartimento di Biotecnologie Cellulari ed Ematologia Sapienza Università di Roma Fever developing
More informationTRANSPARENCY COMMITTEE OPINION. 15 October Date of Marketing Authorisation (national procedure): 16 April 1997, variation of 18 February 2008
The legally binding text is the original French version TRANSPARENCY COMMITTEE OPINION 15 October 2008 MERONEM 1 g, powder for solution for IV Injection Box of 10 vials (CIP: 387 830-6) Applicant: ASTRAZENECA
More informationTRANSPARENCY COMMITTEE. Opinion. 07 January 2009
The legally binding text is the original French version TRANSPARENCY COMMITTEE Opinion 07 January 2009 500 mg, powder for solution for perfusion B/10 bottles (CIP: 387 355-6) Applicant: JANSSEN-CILAG doripenem
More informationShould we be performing TDM in seriously ill patients with Gram negative infections?
Should we be performing TDM in seriously ill patients with Gram negative infections? Jason A Roberts B Pharm (Hons), PhD, FSHP Royal Brisbane and Women s Hospital, Australia. The University of Queensland,
More informationTherapeutic drug monitoring of β-lactams
CORATA Belgique Reims 1-2/10/2014 Therapeutic drug monitoring of β-lactams Frédéric Cotton Clinical Chemistry Erasme Hospital Faculty of Pharmacy ULB TDM of β-lactams β-lactams pharmacokinetics pharmacodynamics
More informationDisclosures. Efficacy of the drug. Optimizing Dosing Based on PKPD- An overview. Dose Finding - The Past
Disclosures Optimizing Dosing Based on PKPD- An overview Johan W. Mouton MD PhD FIDSA FAAM Professor pharmacokinetics and pharmacodynamics Research grants advisory boards speaker This Patient Needs Antibiotics.
More informationAntibiotic Treatment of GNR MDR Infections. Stan Deresinski
Antibiotic Treatment of GNR MDR Infections Stan Deresinski Kucers: The Use of Antibiotics 1st Edition 1972 392 pages Kucers: The Use of Antibiotics 7 th Edition 2017 5338 pages Carbapenem Susceptibility
More informationConsultation on the Revision of Carbapenem Breakpoints
Consultation on the Revision of Carbapenem Breakpoints July 2018 Please send comments to the EUCAST Scientific Secretary at jturnidge@gmail.com by September 15. EUCAST revision of carbapenem breakpoints
More informationAnnex III. Amendments to relevant sections of the summary of product characteristics and the package leaflets
Annex III Amendments to relevant sections of the summary of product characteristics and the package leaflets 22 Changes agreed by the CHMP to the product information of CMS-containing products for injection
More informationPharmacokinetics pharmacodynamics issues relevant for the clinical use of betalactam antibiotics in critically ill patients
Veiga and Paiva Critical Care (2018) 22:233 https://doi.org/10.1186/s13054-018-2155-1 REVIEW Pharmacokinetics pharmacodynamics issues relevant for the clinical use of betalactam antibiotics in critically
More information(See the editorial commentary by Paterson and Rogers, on pages )
MAJOR ARTICLE Aerosolized plus Intravenous Colistin versus Intravenous Colistin Alone for the Treatment of Ventilator-Associated Pneumonia: A Matched Case-Control Study Diamantis P. Kofteridis, 1 Christina
More informationPK/PD degli antibiotici utilizzati nella sepsi
PK/PD degli antibiotici utilizzati nella sepsi Dario Cattaneo, U.O. Farmacologia Clinica ASST Fatebenefratelli Sacco, Milano Bergamo, città alta Variability of antibiotic concentrations in critically ill
More informationStanford Health Care Last Review Date: 8/2016 Pharmacy Department Policies and Procedures
Medication Administration: Extended-Infusion Piperacillin/Tazobactam (Zosyn ) Protocol Related Documents: Patient Care Manual Guide: Medication Administration IV Infusion Guidelines I. PURPOSE Dose optimization
More information/01/$ DOI: /JCM Copyright 2001, American Society for Microbiology. All Rights Reserved.
JOURNAL OF CLINICAL MICROBIOLOGY, Jan. 2001, p. 183 190 Vol. 39, No. 1 0095-1137/01/$04.00 0 DOI: 10.1128/JCM.39.1.183 190.2001 Copyright 2001, American Society for Microbiology. All Rights Reserved. Contemporary
More informationAchieving pharmacokinetic/pharmacodynamic (PK/PD) targets of β-lactams in critically ill patients at first dose: Can we do it with standard dosing?
Oral session: PK/PD-based optimized broad-spectrum beta-lactam therapy (Sunday 10 April, 11:30) Achieving pharmacokinetic/pharmacodynamic (PK/PD) targets of β-lactams in critically ill patients at first
More informationCefotaxime Rationale for the EUCAST clinical breakpoints, version th September 2010
Cefotaxime Rationale for the EUCAST clinical breakpoints, version 1.0 26 th September 2010 Foreword EUCAST The European Committee on Antimicrobial Susceptibility Testing (EUCAST) is organised by the European
More informationAminoglycosides John A. Bosso, Pharm.D.
AMINOGLYCOSIDES Therapeutics/PHRMP-73 Aminoglycoside Mechanism of Action Aminoglycosides bind to 30s ribosomal subunit resulting in mistranslation of mrna thus disrupting protein synthesis. They are rapidly
More informationColistin therapy for microbiologically documented multidrug-resistant Gram-negative bacterial infections: a retrospective cohort study of 258 patients
Colistin therapy for microbiologically documented multidrug-resistant Gram-negative bacterial infections: a retrospective cohort study of 258 patients Matthew E. Falagas, Petros I. Rafailidis, Elda Ioannidou,
More informationNightmare Bacteria. Disclosures. Technician Objectives. Pharmacist Objectives. Carbapenem Resistance in Carbapenem Resistance in 2017
Nightmare Bacteria How to Deal with the Reality of Carbapenem-resistant Organisms Disclosures I have no conflicts of interest relative to the content of this presentation Matthew L. Brown, Pharm.D., BCPS
More informationAnnual Surveillance Summary: Pseudomonas aeruginosa Infections in the Military Health System (MHS), 2017
i Annual Surveillance Summary: Pseudomonas aeruginosa Infections in the Military Health System (MHS), 2017 Jessica R. Spencer and Uzo Chukwuma Approved for public release. Distribution is unlimited. The
More informationSuccessful treatment of pan - resistant pseudomonas Aerugınosa menıngıtıs wıth ıntrathecal polymyxın b therapy
ISPUB.COM The Internet Journal of Infectious Diseases Volume 7 Number 2 Successful treatment of pan - resistant pseudomonas Aerugınosa menıngıtıs wıth ıntrathecal polymyxın b F Simsek, T Yildirmak, G Cetmeli,
More informationOvercoming the PosESBLities of Enterobacteriaceae Resistance
Overcoming the PosESBLities of Enterobacteriaceae Resistance Review of current treatment options Jamie Reed, PharmD Pharmacy Grand Rounds August 28, 2018 Rochester, MN 2018 MFMER slide-1 Disclosure No
More informationPharmacokinetic-Pharmacodynamic (PKPD) Modeling Characterizing Resistance for Predictions of Bacterial Kill in vivo
Pharmacokinetic-Pharmacodynamic (PKPD) Modeling Characterizing Resistance for Predictions of Bacterial Kill in vivo Anders Kristoffersson Pascale David- Pierson, Neil John Parrott, Olaf Kuhlmann, Thierry
More informationThe promise of nebulized antibiotic therapy
1 st ATHENA International Conference Athens, 19-20 November 2015 Let s Talk About Inhaled Antibiotics Inhaled Antibiotics: The Story Stijn BLOT Dept. of Internal Medicine Faculty of Medicine & Health Science
More informationAdenium Biotech. Management: - Peter Nordkild, MD, CEO, ex Novo Nordisk, Ferring, Egalet - Søren Neve, PhD, project director, ex Lundbeck, Novozymes
Adenium Biotech Management: - Peter Nordkild, MD, CEO, ex Novo Nordisk, Ferring, Egalet - Søren Neve, PhD, project director, ex Lundbeck, Novozymes Board of Directors: - Stephan Christgau, PhD, chairman,
More informationOptimizing Antibiotic Therapy in the ICU For Pneumonia Current and Future Approaches
Optimizing Antibiotic Therapy in the ICU For Pneumonia Current and Future Approaches Andrew F. Shorr, MD, MPH Washington Hospital Center Georgetown Univ. Disclosures I have served as a consultant to, researcher/investigator
More informationMedication Dosing in CRRT
Medication Dosing in CRRT Linda Awdishu, PharmD, MAS Associate Clinical Professor of Pharmacy and Medicine Learning Objectives 1. List the pharmacokinetic changes associated with AKI. 2. Determine the
More informationZIN EN ONZIN VAN ANTIBIOTICASPIEGELS BIJ NEONATEN
ZIN EN ONZIN VAN ANTIBIOTICASPIEGELS BIJ NEONATEN Anne Smits Fellow neonatologie UZ Leuven Use of antibiotics in neonates 50 European hospitals 23 non-european hospitals Countries n = 14 n = 9 Pediatric
More informationSepsis new definitions of sepsis and septic shock and Novelities in sepsis treatment
Sepsis new definitions of sepsis and septic shock and Novelities in sepsis treatment What is sepsis? Life-threatening organ dysfunction caused by a dysregulated host response to infection A 1991 consensus
More informationWhy we need inhaled antibiotics?
Athens 19-20 November 2015 Why we need inhaled antibiotics? Garyfallia Poulakou Consultant, Infectious Diseases 4 th Dept of Internal Medicine, Attikon University Hospital of Athens TRANSPARENCY DECLARATION
More informationXYLISTIN 4.5 MIU Injection (Colistimethate sodium)
Published on: 28 Jun 2016 XYLISTIN 4.5 MIU Injection (Colistimethate sodium) Composition XYLISTIN 4.5 MIU Injection Each vial contains: Colistimethate Sodium IP.45,00,000 IU (IU: International Units) As
More informationReassessment of Recommended Imipenem Doses in Febrile Neutropenic Patients with. Haematological Malignancies ACCEPTED
AAC Accepts, published online ahead of print on 1 December 2008 Antimicrob. Agents Chemother. doi:10.1128/aac.00891-08 Copyright 2008, American Society for Microbiology and/or the Listed Authors/Institutions.
More informationThe clinical implication and prognostic predictors of Tigecycline treatment for pneumonia involving multidrug-resistant Acinetobacter baumannii
Journal of Infection (2011) 63, 351e361 The clinical implication and prognostic predictors of Tigecycline treatment for pneumonia involving multidrug-resistant Acinetobacter baumannii R 陳南丞 VS 余文良醫師 本檔僅供內部教學使用檔案內所使用之照片之版權仍屬於原期刊公開使用時,
More informationCLINICAL USE OF GLYCOPEPTIDES. Herbert Spapen Intensive Care Department University Hospital Vrije Universiteit Brussel
CLINICAL USE OF GLYCOPEPTIDES Herbert Spapen Intensive Care Department University Hospital Vrije Universiteit Brussel Glycopeptides Natural Vancomycin introduced in 1958 Teicoplanin introduced in Europe
More informationDilemmas in Septic Shock
Dilemmas in Septic Shock William Janssen, M.D. Assistant Professor of Medicine National Jewish Health University of Colorado Denver Health Sciences Center A 62 year-old female presents to the ED with fever,
More informationDosing of Colistin in Special Patient Populations: CNS, Bone, UTIs, Sepsis
Akropolis Dosing of Colistin in Special Patient Populations: CNS, Bone, UTIs, Sepsis Helen Giamarellou 02.05.2013 The Erechtheion Temple Colistin in CNS Infections The presence of multi-resistant bacteria
More informationICU Case Presentation: Double antimicrobial coverage for gram negative infections. Christine Rizkalla, RPh, BScPhm Pharmacy Resident May 16, 2007
ICU Case Presentation: Double antimicrobial coverage for gram negative infections Christine Rizkalla, RPh, BScPhm Pharmacy Resident May 16, 2007 Objectives Understand the theoretical advantages and disadvantages
More informationUpdate on CLSI and EUCAST
Update on CLSI and EUCAST 1 Completed work» Cephalosporin breakpoints for Enterobacteriaceae ESBL screens MIC versus resistance mechanism» Carbapenem breakpoints for Enterobacteriaceae Modified Hodge Test»
More informationPlazomicin for complicated urinary tract infection
October 2016 Horizon Scanning Research & Intelligence Centre Plazomicin for complicated urinary tract infection NIHR HSRIC ID: 9787 Lay summary Serious infections caused by Gram-negative bacteria are becoming
More informationCefuroxime iv Rationale for the EUCAST clinical breakpoints, version th September 2010
Cefuroxime iv Rationale for the EUCAST clinical breakpoints, version 1.0 26 th September 2010 Foreword EUCAST The European Committee on Antimicrobial Susceptibility Testing (EUCAST) is organised by the
More informationConflicts of Interest. Learning Objectives VAP. Common Organisms. Risk Factors for VAP. Gram Positive 10/13/2017
Conflicts of Interest The author has no conflicts of interest to disclose Nebulized Antibiotics in VAP: Don t Hold Your Breath Luis M. Ramirez, Pharm.D. PGY1 Pharmacy Practice Resident University of Texas
More informationBasic Concepts of PK/PD -pharmacodynamic indices- Johan W. Mouton MD PhD FIDSA Professor pharmacokinetics and pharmacodymamics
Basic Concepts of PK/PD -pharmacodynamic indices- Johan W. Mouton MD PhD FIDSA Professor pharmacokinetics and pharmacodymamics This patient needs antibiotics. But which ones? Intensive care patient Ceftazidime,
More informationColistimethate sodium for injection and inhalation COLISTIN COMPOSITION
Colistin, Colistimethate sodium, injection, cyclic polypeptide antibiotic, manufacturers, India, infusion, inhalation, Taj Products Pharmaceuticals, Allopathic Products Manufacturer,exporter,Supplier,india,formulations,medicines,injections,insulin,free
More informationAntibiotic Resistance Pattern of Blood and CSF Culture Isolates At NHLS Academic Laboratories (2005)
Antibiotic Resistance Pattern of Blood and CSF Culture Isolates At NHLS Academic Laboratories (2005) Streptococcus pneumoniae (SP) Blood Culture Isolates Penicillin intermediate Penicillin Cefotaxime 336
More informationAdult Dose. Adults Day 1: 1mg/kg daily Day 2: 2mg/kg daily Day 3 onwards: 3mg/kg daily. Where appropriate consider rounding dose to nearest 50mg.
AMIKACIN All ages>1month: 30mg/kg daily 1.5g once daily IV infusion over 30-60 Monitor renal function before treatment and weekly. Caution if used with other nephrotoxic drugs. Levels required. Trough
More informationInhalational antibacterial regimens in non-cystic fibrosis patients. Jeff Alder Bayer HealthCare
Inhalational antibacterial regimens in non-cystic fibrosis patients Jeff Alder Bayer HealthCare Alder - Inhaled therapy for non-cf - EMA 25-26 Oct 2012 1 Inhalational antibacterials: two approaches 1.
More informationAcademic Perspective in. David Livermore Prof of Medical Microbiology, UEA Lead on Antibiotic resistance PHE
Academic Perspective in Emerging No, we can t Issues treat of carbapenemase Resistance and ESBL in Gram-ve producers Bacteria based on MIC David Livermore Prof of Medical Microbiology, UEA Lead on Antibiotic
More informationColistin Is Effective in Treatment of Infections Caused by Multidrug-Resistant Pseudomonas aeruginosa in Cancer Patients
ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, June 2007, p. 1905 1911 Vol. 51, No. 6 0066-4804/07/$08.00 0 doi:10.1128/aac.01015-06 Copyright 2007, American Society for Microbiology. All Rights Reserved. Colistin
More informationPD Targets for Various Infection Types: Stasis vs. 1-Log Kill vs. 2 Log Kill
PD Targets for Various Infection Types: Stasis vs. 1-Log Kill vs. 2 Log Kill G.L. Drusano, M.D. Professor and Director Institute for Therapeutic Innovation University of Florida To have insight into appropriate
More informationIn Vitro Susceptibility Pattern of Cephalosporin- Resistant Gram-Negative Bacteria
In Vitro Susceptibility Pattern of Cephalosporin- Resistant Gram-Negative Bacteria Warunee Punpanich MD*, Worraporn Tantichattanon MD**, Siriporn Wongwatcharapaiboon MD**, Vipa Treeratweeraphong BSc, MSc***
More informationReporting blood culture results to clinicians: MIC, resistance mechanisms, both?
Reporting blood culture results to clinicians: MIC, resistance mechanisms, both? Christian G. Giske, MD, PhD Senior Consultant Physician/Associate Professor Department of Clinical Microbiology Karolinska
More informationTherapy of MDR/XDR Gram-negative bacteria: dealing with the devil. CRE: high dosing, how much? by author
Therapy of MDR/XDR Gram-negative bacteria: dealing with the devil CRE: high dosing, how much? George L. Daikos, MD National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece
More informationPharmacodynamic indices in targeting therapy of critical infections
Pharmacodynamic indices in targeting therapy of critical infections P.M. Tulkens Cellular and Molecular Pharmacology, Catholic University of Louvain, Brussels, Belgium & International Society of Anti-infective
More informationInhaled Antibiotic Therapy for Ventilator-Associated Tracheobronchitis and Ventilator-Associated Pneumonia: an Update
Adv Ther (2011) 28(9):728-747. DOI 10.1007/s12325-011-0051-z REVIEW Inhaled Antibiotic Therapy for Ventilator-Associated Tracheobronchitis and Ventilator-Associated Pneumonia: an Update Tareq Abu-Salah
More informationOutline. Pharmacists Improving Outcomes in the Management of. of Infectious Diseases. Threats Against Desired Outcomes 7/11/2010
Pharmacists Improving Outcomes in the Management of Infectious Diseases Christine Teng, MSc(Clin Pharm) BCPS Assistant Professor Dept of Pharmacy, National University of Singapore Principal Pharmacist
More informationSBUH Aminoglycoside Dosing Protocol
Adult Aminoglycoside Dosing for Gram negative infections prior to available serum levels (Excludes patients with cystic fibrosis, OB GYN patients and surgical prophylaxis) Cr Cl 40 ml/min 5 7 mg/kg INT
More informationPREVENTION AND TREATMENT OF BACTERIAL INFECTIONS IN CIRRHOSIS
PREVENTION AND TREATMENT OF BACTERIAL INFECTIONS IN CIRRHOSIS Dr. J. Fernández. Head of the Liver Unit Hospital Clinic Barcelona, Spain AEEH Postgraduate Course, Madrid, February 15 2017 Prevalence of
More informationCommunity Acquired & Nosocomial Pneumonias
Community Acquired & Nosocomial Pneumonias IDSA/ATS 2007 & 2016 Guidelines José Luis González, MD Clinical Assistant Professor of Medicine Outline Intro - Definitions & Diagnosing CAP treatment VAP & HAP
More informationMDR AGENTS: RISK FACTORS AND THERAPEUTIC STRATEGIES
MDR AGENTS: RISK FACTORS AND THERAPEUTIC STRATEGIES 1 Marin H. Kollef, MD Professor of Medicine Virginia E. and Sam J. Golman Chair in Respiratory Intensive Care Medicine Washington University School of
More informationAffinity of Doripenem and Comparators to Penicillin-Binding Proteins in Escherichia coli and ACCEPTED
AAC Accepts, published online ahead of print on February 00 Antimicrob. Agents Chemother. doi:./aac.01-0 Copyright 00, American Society for Microbiology and/or the Listed Authors/Institutions. All Rights
More informationAdult Inpatient Antibiogram. Antimicrobial Susceptibilities of Frequently Recovered Clinical Isolates. January to December 2016
Adult Inpatient Antibiogram Antimicrobial Susceptibilities of Frequently Recovered Clinical Isolates January to December 2016 Department of Pathology Camille Hamula, PhD Director, Clinical Microbiology
More informationThe antibiotic dose and the obese ICU patient
The antibiotic dose and the obese ICU patient Philippe Montravers, M.D., Ph.D. Anaesthesia and Surgical ICU CHU Bichat Claude Bernard Assistance Publique-Hôpitaux de Paris INSERM UMR 1152 University Paris
More informationTreatment Options for Urinary Tract Infections Caused by Extended-Spectrum Β-Lactamase-Producing Escherichia coli and Klebsiella pneumoniae
Treatment Options for Urinary Tract Infections Caused by Extended-Spectrum Β-Lactamase-Producing Escherichia coli and Klebsiella pneumoniae medicine.missouri.edu/jahm/treatment-options-urinary-tract-infections-caused-extended-spectrum-β-lactamase-producingescherichia-coli-klebsiella-pneumoniae/
More informationBack to the Future: Using Aminoglycosides Again and How to Dose Them Optimally
INVITED ARTICLE ANTIMICROBIAL RESISTANCE George M. Eliopoulos, Section Editor Back to the Future: Using Aminoglycosides Again and How to Dose Them Optimally George L. Drusano, Paul G. Ambrose, Sujata M.
More informationASHP Therapeutic Position Statements 623
ASHP Therapeutic Position Statements 623 Therapeutic Monitoring of Vancomycin in Adult Patients: A Consensus Review of the American Society of Health-System Pharmacists, the Infectious Diseases Society
More informationChoc septique. Frédéric Pène
Choc septique Frédéric Pène Réanimation Médicale, Hôpital Cochin, AP-HP Université Paris Descartes Institut Cochin, Inserm U1016, CNRS UMR-8104, Département 3i No conflict of interest A 54 y.o. male patient
More informationReceived 13 December 2010/Returned for modification 13 March 2011/Accepted 28 April 2011
ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, July 2011, p. 3284 3294 Vol. 55, No. 7 0066-4804/11/$12.00 doi:10.1128/aac.01733-10 Copyright 2011, American Society for Microbiology. All Rights Reserved. Population
More informationDoripenem: pharmacokinetics and pharmacodynamics. Paul M. Tulkens, MD, PhD Françoise Van Bambeke, PharmD, PhD
16/04/2009 1 Doripenem: pharmacokinetics and pharmacodynamics Paul M. Tulkens, MD, PhD Françoise Van Bambeke, PharmD, PhD Unité de Pharmacologie cellulaire et moléculaire Louvain Drug Research Institute
More informationCURRENT GUIDELINES FOR SEPSIS MANAGEMENT
HELLENIC SEPSIS STUDY GROUP www.sepsis.gr CURRENT GUIDELINES FOR SEPSIS MANAGEMENT Evangelos J. Giamarellos-Bourboulis, MD, PhD Associate Professor of Medicine 4 th Department of Internal Medicine, National
More informationPharmacodynamics: the methods
Pharmacodynamics: the methods In vitro models Animal models Clinical studies Population studies With the support of Wallonie-Bruxelles-International 3B-1 Pharmacodynamics: the methods "un peu de tout "
More information