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Antibiotic Resistance and Molecular Typing of Pseudomonas Aeruginosa: Focus on Imipenem
BJID 2002; 6 (February) 1 Antibiotic Resistance and Molecular Typing of Pseudomonas aeruginosa: Focus on Imipenem Ana Lúcia Peixoto de Freitas and Afonso Luis Barth Federal University of Rio Grande do Sul, Pharmacy School, Clinical Hospital of Porto Alegre, Cardiology Institute, Porto Alegre, RS; Catholic University of Pelotas, Pharmacy School, Pelotas, RS, Brazil Susceptibility tests by disk diffusion and by E-test and molecular typing by macrorestriction analysis were performed to determine the relatedness of Pseudomonas aeruginosa isolates from three distinct hospitals. The resistance profile of 124 isolates to 8 antimicrobial agents was determined in three different hospitals, in Porto Alegre, Brazil. Frequencies of susceptibility ranged from 43.9% for carbenicillin to 87.7% for ceftazidime. Cross-resistance data of imipenem-resistant isolates indicated that most (70%) were also resistant to carbenicillin, although 30% remained susceptible to ceftazidime and cefepime. In general, susceptibility profiles were not able to determine relatedness among isolates of P. aeruginosa. On the other hand, molecular typing by macrorestriction analysis demonstrated high discriminatory power and identified 66 strains among 72 isolates of P. aeruginosa. Imipenem-susceptible isolates were all different. However, identical clones of imipenem-resistant isolates were found in two of the hospitals, despite variable response to other antibiotics. No clustering of infection among the different medical centers was observed. In conclusion, clones of P. aeruginosa did not spread among the different hospitals in our city even though related isolates of imipenem- resistant P. aeruginosa were found. Key Words: Pseudomonas aeruginosa, antibiotic resistance, imipenem. Despite improvements in antibiotic therapy, However, nosocomial isolates may easily develop Pseudomonas aeruginosa remains as one of the most resistance to carbapenens due to reduced uptake of prominent Gram-negative bacteria causing hospital- the drug, which leads to outbreaks of multiresistant/ associated infections. -
Prevalence of Urinary Tract Infection and Antibiotic Resistance Pattern in Pregnant Women, Najran Region, Saudi Arabia
Vol. 13(26), pp. 407-413, August, 2019 DOI: 10.5897/AJMR2019.9084 Article Number: E3F64FA61643 ISSN: 1996-0808 Copyright ©2019 Author(s) retain the copyright of this article African Journal of Microbiology Research http://www.academicjournals.org/AJMR Full Length Research Paper Prevalence of urinary tract infection and antibiotic resistance pattern in pregnant women, Najran region, Saudi Arabia Ali Mohamed Alshabi1*, Majed Saeed Alshahrani2, Saad Ahmed Alkahtani1 and Mohammad Shabib Akhtar1 1Department of Clinical Pharmacy, College of Pharmacy, Najran University, Najran, Saudi Arabia. 2Department of Obstetics and Gyneocology, Faculty of Medicine, Najran University, Najran, Saudi Arabia. Received 25 February, 2019; Accepted August 5, 2019 Urinary Tract Infection (UTI) is one of the commonest infectious disease in pregnancy, and in pregnancy we have very limited number of antibiotics to treat the UTI. This study was conducted on 151 patients who attended the gynecology clinic during the study period. Nineteen UTI proven cases of UTI were studied for prevalence of microorganism and sensitivity pattern against different antibiotics. Among the bacteria isolated, Escherichia coli (73.68%) and Staphylococcus aureus (10.52%) were the most prevalent Gram negative and Gram positive bacteria respectively. To know the resistance pattern of microorganism we used commercially available discs of different antibiotics. Gram negative bacteria showed more resistance as compared to Gram positive one. It is observed that the most effective antibiotic for Gram negative isolates is Ceftriaxone (87.5%), followed by Amoxicillin + Clavulanic acid (81.25%), Amikacin (75%), Cefuroxime (75%), Cefixime (68.75%) and Mezlocillin (62.5%). For the Gram positive bacteria, Ceftriaxone, Amikacin and Amoxicillin + Clavulanic acid were the most effective antimicrobials (100%). -
12. What's Really New in Antibiotic Therapy Print
What’s really new in antibiotic therapy? Martin J. Hug Freiburg University Medical Center EAHP Academy Seminars 20-21 September 2019 Newsweek, May 24-31 2019 Disclosures There are no conflicts of interest to declare EAHP Academy Seminars 20-21 September 2019 Antiinfectives and Resistance EAHP Academy Seminars 20-21 September 2019 Resistance of Klebsiella pneumoniae to Pip.-Taz. olates) EAHP Academy Seminars 20-21 September 2019 https://resistancemap.cddep.org/AntibioticResistance.php Multiresistant Pseudomonas Aeruginosa Combined resistance against at least three different types of antibiotics, 2017 EAHP Academy Seminars 20-21 September 2019 https://atlas.ecdc.europa.eu/public/index.aspx Distribution of ESBL producing Enterobacteriaceae EAHP Academy Seminars 20-21 September 2019 Rossolini GM. Global threat of Gram-negative antimicrobial resistance. 27th ECCMID, Vienna, 2017, IS07 Priority Pathogens Defined by the World Health Organisation Critical Priority High Priority Medium Priority Acinetobacter baumanii Enterococcus faecium Streptococcus pneumoniae carbapenem-resistant vancomycin-resistant penicillin-non-susceptible Pseudomonas aeruginosa Helicobacter pylori Haemophilus influenzae carbapenem-resistant clarithromycin-resistant ampicillin-resistant Enterobacteriaceae Salmonella species Shigella species carbapenem-resistant fluoroquinolone-resistant fluoroquinolone-resistant Staphylococcus aureus vancomycin or methicillin -resistant Campylobacter species fluoroquinolone-resistant Neisseria gonorrhoae 3rd gen. cephalosporin-resistant -
595 PART 441—PENEM ANTIBIOTIC DRUGS Subpart A—Bulk Drugs
Food and Drug Administration, HHS § 441.20a (6) pH. Proceed as directed in § 436.202 imipenem per milliliter at 25 °C is ¶85° of this chapter, using an aqueous solu- to ¶95° on an anhydrous basis. tion containing 60 milligrams per mil- (vi) It gives a positive identity test. liliter. (vii) It is crystalline. (7) Penicillin G content. Proceed as di- (2) Labeling. It shall be labeled in ac- rected in § 436.316 of this chapter. cordance with the requirements of (8) Crystallinity. Proceed as directed § 432.5 of this chapter. in § 436.203(a) of this chapter. (3) Requests for certification; samples. (9) Heat stability. Proceed as directed In addition to complying with the re- in § 436.214 of this chapter. quirements of § 431.1 of this chapter, [42 FR 59873, Nov. 22, 1977; 43 FR 2393, Jan. 17, each such request shall contain: 1978, as amended at 45 FR 22922, Apr. 4, 1980; (i) Results of tests and assays on the 50 FR 19918, 19919, May 13, 1985] batch for potency, sterility, pyrogens, loss on drying, specific rotation, iden- PART 441ÐPENEM ANTIBIOTIC tity, and crystallinity. DRUGS (ii) Samples, if required by the Direc- tor, Center for Drug Evaluation and Subpart AÐBulk Drugs Research: (a) For all tests except sterility: 10 Sec. 441.20a Sterile imipenem monohydrate. packages, each containing approxi- mately 500 milligrams. Subpart BÐ[Reserved] (b) For sterility testing: 20 packages, each containing equal portions of ap- Subpart CÐInjectable Dosage Forms proximately 300 milligrams. 441.220 Imipenem monohydrate-cilastatin (b) Tests and methods of assayÐ(1) Po- sodium injectable dosage forms. -
Antibacterial Drug Usage Analysis
Department of Health and Human Services Public Health Service Food and Drug Administration Center for Drug Evaluation and Research Office of Surveillance and Epidemiology Drug Use Review Date: April 5, 2012 To: Edward Cox, M.D. Director Office of Antimicrobial Products Through: Gerald Dal Pan, M.D., MHS Director Office of Surveillance and Epidemiology Laura Governale, Pharm.D., MBA Deputy Director for Drug Use Division of Epidemiology II Office of Surveillance and Epidemiology Hina Mehta, Pharm.D. Drug Use Data Analysis Team Leader Division of Epidemiology II Office of Surveillance and Epidemiology From: Tracy Pham, Pharm.D. Drug Use Data Analyst Division of Epidemiology II Office of Surveillance and Epidemiology Drug Name(s): Systemic Antibacterial Drug Products Application Type/Number: Multiple Applicant/sponsor: Multiple OSE RCM #: 2012-544 **This document contains proprietary drug use data obtained by FDA under contract. The drug use data/information in this document has been cleared for public release.** 1 EXECUTIVE SUMMARY The Division of Epidemiology II is providing an update of the drug utilization data in terms of number of kilograms or international units of selected systemic antibacterial drug products sold from manufacturers to various retail and non-retail channels of distribution for years 2010-2011 as a surrogate for nationwide antibacterial drug use in humans. Propriety drug use databases licensed by the FDA were used to conduct this analysis. Data findings are as follows: During years 2010 and 2011, the majority of kilograms of selected systemic antibacterial drug products sold were to outpatient retail pharmacy settings. Approximately 3.28 million kilograms of selected systemic antibacterial drug products were sold during year 2010, and around 3.29 million kilograms were sold during year 2011. -
Consideration of Antibacterial Medicines As Part Of
Consideration of antibacterial medicines as part of the revisions to 2019 WHO Model List of Essential Medicines for adults (EML) and Model List of Essential Medicines for children (EMLc) Section 6.2 Antibacterials including Access, Watch and Reserve Lists of antibiotics This summary has been prepared by the Health Technologies and Pharmaceuticals (HTP) programme at the WHO Regional Office for Europe. It is intended to communicate changes to the 2019 WHO Model List of Essential Medicines for adults (EML) and Model List of Essential Medicines for children (EMLc) to national counterparts involved in the evidence-based selection of medicines for inclusion in national essential medicines lists (NEMLs), lists of medicines for inclusion in reimbursement programs, and medicine formularies for use in primary, secondary and tertiary care. This document does not replace the full report of the WHO Expert Committee on Selection and Use of Essential Medicines (see The selection and use of essential medicines: report of the WHO Expert Committee on Selection and Use of Essential Medicines, 2019 (including the 21st WHO Model List of Essential Medicines and the 7th WHO Model List of Essential Medicines for Children). Geneva: World Health Organization; 2019 (WHO Technical Report Series, No. 1021). Licence: CC BY-NC-SA 3.0 IGO: https://apps.who.int/iris/bitstream/handle/10665/330668/9789241210300-eng.pdf?ua=1) and Corrigenda (March 2020) – TRS1021 (https://www.who.int/medicines/publications/essentialmedicines/TRS1021_corrigenda_March2020. pdf?ua=1). Executive summary of the report: https://apps.who.int/iris/bitstream/handle/10665/325773/WHO- MVP-EMP-IAU-2019.05-eng.pdf?ua=1. -
Use of Long Half-Life Parenteral Cephalosporins in Ambulatory Practice
Use of Long Half-Life Parenteral Cephalosporins in Ambulatory Practice Mark Sauerwein, MD, Robert L. Deamer, PharmD, and John G. Prichard, MD Ventura, California, and Houston, Texas Cefonicid (Monocid) and ceftriaxone (Rocephin) are long half-life cephalos porins that may be used for serious infections in the outpatient setting. They may be used as an extension of initial hospital treatment, or therapy can be initiated and completed in many cases with the patient remaining at home. Sufficient clinical experience exists with both ceftriaxone and cefonicid to recommend these agents for selected patients having pyelonephritis, os teomyelitis, or soft tissue infections. Cefonicid, perhaps in combination with erythromycin, will provide excellent coverage for complicated community- acquired pneumonias. Ceftriaxone is effective as single-dose therapy for even complicated gonococcal infections. The use of long half-life cephalo sporins in ambulatory practice may result in substantial cost savings for certain patients. linicians are at times frustrated by prolonged management of selected infections are herein re C hospitalizations of those who are not acutely ill viewed. simply to provide parenteral antibiotic therapy. Pa Cefonicid (Monocid, Smith Kline & French) is a tients and their families may be equally disconcerted broad-spectrum cephalosporin that because of its because of the high cost and disruption consequent to spectrum of activity is typically grouped as a second- hospitalization. Nevertheless, the physician may wish generation agent. Cefonicid is usually administered in to initiate parenteral antibiotic therapy for a particular travenously or intramuscularly in doses of 1 to 2 g, and illness, such as pyelonephritis or pneumonia, as the because of its extended four-hour half-life, it can be clinical circumstances can create apprehension about given once every 24 hours (Table 1). -
WO 2010/025328 Al
(12) INTERNATIONAL APPLICATION PUBLISHED UNDER THE PATENT COOPERATION TREATY (PCT) (19) World Intellectual Property Organization International Bureau (10) International Publication Number (43) International Publication Date 4 March 2010 (04.03.2010) WO 2010/025328 Al (51) International Patent Classification: (81) Designated States (unless otherwise indicated, for every A61K 31/00 (2006.01) kind of national protection available): AE, AG, AL, AM, AO, AT, AU, AZ, BA, BB, BG, BH, BR, BW, BY, BZ, (21) International Application Number: CA, CH, CL, CN, CO, CR, CU, CZ, DE, DK, DM, DO, PCT/US2009/055306 DZ, EC, EE, EG, ES, FI, GB, GD, GE, GH, GM, GT, (22) International Filing Date: HN, HR, HU, ID, IL, IN, IS, JP, KE, KG, KM, KN, KP, 28 August 2009 (28.08.2009) KR, KZ, LA, LC, LK, LR, LS, LT, LU, LY, MA, MD, ME, MG, MK, MN, MW, MX, MY, MZ, NA, NG, NI, (25) Filing Language: English NO, NZ, OM, PE, PG, PH, PL, PT, RO, RS, RU, SC, SD, (26) Publication Language: English SE, SG, SK, SL, SM, ST, SV, SY, TJ, TM, TN, TR, TT, TZ, UA, UG, US, UZ, VC, VN, ZA, ZM, ZW. (30) Priority Data: 61/092,497 28 August 2008 (28.08.2008) US (84) Designated States (unless otherwise indicated, for every kind of regional protection available): ARIPO (BW, GH, (71) Applicant (for all designated States except US): FOR¬ GM, KE, LS, MW, MZ, NA, SD, SL, SZ, TZ, UG, ZM, EST LABORATORIES HOLDINGS LIMITED [IE/ ZW), Eurasian (AM, AZ, BY, KG, KZ, MD, RU, TJ, —]; 18 Parliament Street, Milner House, Hamilton, TM), European (AT, BE, BG, CH, CY, CZ, DE, DK, EE, Bermuda HM12 (BM). -
Comparative Activity of Newer Antibiotics Against Gram-Negative Bacilli
CONTRIBUTION • Comparative activity of newer antibiotics against gram-negative bacilli CYNTHIA C. KNAPP, MS AND JOHN A. WASHINGTON, MD • The in vitro activities of cefoperazone, cefotaxime, ceftriaxone, ceftazidime, azlocillin, mezlocillin, piperacillin, ticarcillin/clavulanate, aztreonam, imipenem, and ciprofloxacin were concurrently deter- mined against over 1,000 isolates of gram-negative bacilli from clinical specimens of patients at the Cleve- land Clinic. Cephalosporins, penicillins, and aztreonam were active against species of Enterobacteriaceae other than Citrobacter freundii, Enterobacter aerogenes, and Enterobacter cloacae. Ceftazidime was the most active cephalosporin against Pseudomonas aeruginosa. Against the Enterobacteriaceae, the rank order of activity of penicillins was ticarcillin/clavulanate > piperacillin > mezlocillin > azlocillin. Against P. aer- uginosa, the rank order of activity of penicillins was piperacillin > ticarcillin/clavulanate > azlocillin > mezlocillin. Aztreonam was less active v P. aeruginosa than ceftazidime, cefoperazone, or piperacillin. The most active antimicrobials against all isolates tested were imipenem and ciprofloxacin. • INDEX TERMS: ANTIBIOTICS, LACTAM; GRAM-NEGATIVE BACTERIA • CLEVE CLIN J MED 1989; 56:161-166 HE RECENT introduction of ciprofloxacin for and penicillins, as well as the monobactam, aztreonam, clinical use follows closely a period of active re- and the carbapenem, imipenem.1-3 search in and development of expanded spec- We compared the susceptibility of more than 1,000 trum p-lactam antibiotics, including cephalo- clinical bacterial isolates to four expanded spectrum Tsporins, penicillins, monobactams, and carbapenems. cephalosporins (cefoperazone, cefotaxime, ceftriaxone, Although numerous published studies compare the ac- and ceftazidime), four expanded spectrum penicillins tivity of ciprofloxacin with other quinolones, only a (azlocillin, mezlocillin, piperacillin, and ticarcil- limited number of studies compare the activity of ci- lin/clavulanate), aztreonam, imipenem, and ciproflox- acin. -
Antimicrobial Stewardship Antimicrobial Stewardship: Systems and Processes for Effective Antimicrobial Medicine Use
NICE Medicines and prescribing centre DRAFT for consultation Antimicrobial stewardship Antimicrobial stewardship: systems and processes for effective antimicrobial medicine use Medicines practice guideline Appendices August 2015 National Institute for Health and Care Excellence Disclaimer This guideline represents the views of NICE and was arrived at after careful consideration of the evidence available. Those working in the NHS, local authorities, the wider public, voluntary and community sectors and the private sector should take it into account when carrying out their professional, managerial or voluntary duties. Implementation of this guidance is the responsibility of local commissioners and/or providers. Commissioners and providers are reminded that it is their responsibility to implement the guidance, in their local context, in light of their duties to have due regard to the need to eliminate unlawful discrimination, advance equality of opportunity and foster good relations. Nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties. Copyright National Institute for Health and Care Excellence 2015 Declarations of interest Contents Appendices .......................................................................................................................... 5 Appendix A: Declarations of interest ............................................................................ 5 A.1 Guideline development group (GDG) members .............................................. 5 A.2 -
Antibiotic Resistance: Bioinformatics-Based Understanding As a Functional Strategy for Drug Cite This: RSC Adv., 2020, 10, 18451 Design
RSC Advances View Article Online REVIEW View Journal | View Issue Antibiotic resistance: bioinformatics-based understanding as a functional strategy for drug Cite this: RSC Adv., 2020, 10, 18451 design Umar Ndagi, *a Abubakar A. Falaki,b Maryam Abdullahi,c Monsurat M. Lawald and Mahmoud E. Soliman e The use of antibiotics to manage infectious diseases dates back to ancient civilization, but the lack of a clear distinction between the therapeutic and toxic dose has been a major challenge. This precipitates the notion that antibiotic resistance was from time immemorial, principally because of a lack of adequate knowledge of therapeutic doses and continuous exposure of these bacteria to suboptimal plasma concentration of antibiotics. With the discovery of penicillin by Alexander Fleming in 1924, a milestone in bacterial infections' treatment was achieved. This forms the foundation for the modern era of antibiotic drugs. Antibiotics such as penicillins, cephalosporins, quinolones, tetracycline, macrolides, sulphonamides, Creative Commons Attribution-NonCommercial 3.0 Unported Licence. aminoglycosides and glycopeptides are the mainstay in managing severe bacterial infections, but resistant strains of bacteria have emerged and hampered the progress of research in this field. Recently, new approaches to research involving bacteria resistance to antibiotics have appeared; these involve combining the molecular understanding of bacteria systems with the knowledge of bioinformatics. Consequently, many molecules have been developed to curb resistance associated with different bacterial infections. However, because of increased emphasis on the clinical relevance of antibiotics, the Received 15th February 2020 synergy between in silico study and in vivo study is well cemented and this facilitates the discovery of Accepted 1st May 2020 potent antibiotics. -
E3 Appendix 1 (Part 1 of 2): Search Strategy Used in MEDLINE
This single copy is for your personal, non-commercial use only. For permission to reprint multiple copies or to order presentation-ready copies for distribution, contact CJHP at [email protected] Appendix 1 (part 1 of 2): Search strategy used in MEDLINE # Searches 1 exp *anti-bacterial agents/ or (antimicrobial* or antibacterial* or antibiotic* or antiinfective* or anti-microbial* or anti-bacterial* or anti-biotic* or anti- infective* or “ß-lactam*” or b-Lactam* or beta-Lactam* or ampicillin* or carbapenem* or cephalosporin* or clindamycin or erythromycin or fluconazole* or methicillin or multidrug or multi-drug or penicillin* or tetracycline* or vancomycin).kf,kw,ti. or (antimicrobial or antibacterial or antiinfective or anti-microbial or anti-bacterial or anti-infective or “ß-lactam*” or b-Lactam* or beta-Lactam* or ampicillin* or carbapenem* or cephalosporin* or c lindamycin or erythromycin or fluconazole* or methicillin or multidrug or multi-drug or penicillin* or tetracycline* or vancomycin).ab. /freq=2 2 alamethicin/ or amdinocillin/ or amdinocillin pivoxil/ or amikacin/ or amoxicillin/ or amphotericin b/ or ampicillin/ or anisomycin/ or antimycin a/ or aurodox/ or azithromycin/ or azlocillin/ or aztreonam/ or bacitracin/ or bacteriocins/ or bambermycins/ or bongkrekic acid/ or brefeldin a/ or butirosin sulfate/ or calcimycin/ or candicidin/ or capreomycin/ or carbenicillin/ or carfecillin/ or cefaclor/ or cefadroxil/ or cefamandole/ or cefatrizine/ or cefazolin/ or cefixime/ or cefmenoxime/ or cefmetazole/ or cefonicid/ or cefoperazone/