Gram-positive cocci infections in intensive care: guide to antibacterial selection.

Abstract:

:The incidence of multiresistance in Gram-positive cocci causing infections in critically ill patients admitted to the intensive care unit (ICU) has increased notably in recent years. Thus, therapeutic proposals have been modified according to the emergence of multiresistant cocci and adapted to epidemiological markers of individual infectious processes, geographical variations of these markers, the availability of new antibacterials, and advances in the knowledge of pharmacokinetic and pharmacodynamic aspects of their use. The current management of critically ill patients should consider new therapeutic approaches, such as the "de-escalating strategy", which includes the administration of empirical antibacterials active against multiresistant pathogens followed by directed treatment based on unequivocal data from antibacterial-susceptibility testing. Optimisation of antibacterial treatment should be viewed in the context of the need to determine plasma drug concentrations, pharmacoeconomic considerations and control of drug-related adverse events. Therapeutic proposals should be developed within the framework of the antibacterial policy of each hospital. The present review is focused on the description of the therapeutic strategies for the main infectious processes caused by Gram-positive cocci in severely ill patients admitted to the ICU according to a review of the pertinent literature and the clinical experience of the authors.

journal_name

Drugs

journal_title

Drugs

authors

Alvarez-Lerma F,Grau S,Gracia-Arnillas MP

doi

10.2165/00003495-200666060-00003

subject

Has Abstract

pub_date

2006-01-01 00:00:00

pages

751-68

issue

6

eissn

0012-6667

issn

1179-1950

pii

6663

journal_volume

66

pub_type

杂志文章

相关文献

DRUGS文献大全
  • Myocardial infarction. Secondary prevention with nifedipine.

    abstract::The rationale for the use of nifedipine in patients with acute myocardial infarction (MI) is based on the various cardiovascular actions of the compound: reduction of myocardial oxygen consumption by attenuation of cardiac and vascular smooth muscle tension; augmentation of oxygen and substrate supply after increased ...

    journal_title:Drugs

    pub_type: 临床试验,杂志文章,随机对照试验,评审

    doi:10.2165/00003495-199100422-00007

    authors: Rafflenbeul W,Ebner F

    更新日期:1991-01-01 00:00:00

  • Lemborexant: First Approval.

    abstract::Lemborexant (DAYVIGO™) is an orally administered, dual orexin receptor (OXR) antagonist that exhibits reversible competitive antagonism at OXR1 and OXR2 (> affinity at OXR2) that was discovered and developed by Eisai Inc. for the treatment of adult patients with insomnia. In December 2019, lemborexant received its fir...

    journal_title:Drugs

    pub_type: 杂志文章,评审

    doi:10.1007/s40265-020-01276-1

    authors: Scott LJ

    更新日期:2020-03-01 00:00:00

  • Long term management of oesophageal varices.

    abstract::Effective control of variceal rebleeding (secondary prophylaxis) or prevention of the initial bleeding (primary prophylaxis) are the main objectives of the treatment of portal hypertension. Endoscopic sclerotherapy is the treatment of choice for secondary prophylaxis, since it significantly decreases rebleeding and, t...

    journal_title:Drugs

    pub_type: 杂志文章,评审

    doi:10.2165/00003495-199200442-00007

    authors: Sarin SK

    更新日期:1992-01-01 00:00:00

  • The role of proton pump inhibitors in gastro-oesophageal reflux disease.

    abstract::The proton pump inhibitors (PPIs) are the most successful class of drugs that have been introduced for the treatment of gastro-oesophageal reflux disease (GORD) because of their profound and consistent effect on gastric acid secretion. The PPIs have demonstrated an excellent adverse effect profile after approximately ...

    journal_title:Drugs

    pub_type: 杂志文章,评审

    doi:10.2165/00003495-200464030-00004

    authors: Dekel R,Morse C,Fass R

    更新日期:2004-01-01 00:00:00

  • Rheumatoid arthritis: strategies in the management of patients showing an inadequate response to TNFalpha antagonists.

    abstract::The introduction of medications that target specific proinflammatory cytokines has revolutionized the management of patients with rheumatoid arthritis. The agents that antagonize the effects of tumour necrosis factor (TNF)-alpha -- infliximab, etanercept and adalimumab -- have consistently shown very good efficacy for...

    journal_title:Drugs

    pub_type: 杂志文章,评审

    doi:10.2165/00003495-200868050-00003

    authors: Lutt JR,Deodhar A

    更新日期:2008-01-01 00:00:00

  • The Expanding Role of Ketamine in the Emergency Department.

    abstract::Patients frequently come to the emergency department for pain. For decades, ketamine has been used in the emergency department for procedural sedation but is now receiving attention as a potential alternative to opioids because of its unique analgesic effects. Additionally, ketamine's dissociative properties have made...

    journal_title:Drugs

    pub_type: 杂志文章,评审

    doi:10.1007/s40265-018-0904-8

    authors: Sheikh S,Hendry P

    更新日期:2018-05-01 00:00:00

  • Entecavir: a review of its use in the treatment of chronic hepatitis B in patients with decompensated liver disease.

    abstract::The oral deoxyguanosine nucleoside analogue entecavir (Baraclude®) has potent activity against hepatitis B virus (HBV) and a high genetic barrier to resistance. This article reviews the clinical efficacy and tolerability of entecavir in the treatment of chronic hepatitis B in patients with decompensated liver disease,...

    journal_title:Drugs

    pub_type: 杂志文章,评审

    doi:10.2165/11208510-000000000-00000

    authors: Keating GM

    更新日期:2011-12-24 00:00:00

  • Antiepileptic drug development in children: considerations for a revisited strategy.

    abstract::The European Commission and the European Parliament have acknowledged the specific need for a proper evaluation of new drugs in children. The evaluation of the antiepileptic drugs (AEDs) available on the market illustrates the deficit in therapeutic trials for childhood epilepsy syndromes. Currently, the development o...

    journal_title:Drugs

    pub_type: 杂志文章,评审

    doi:10.2165/00003495-200868010-00002

    authors: Chiron C,Dulac O,Pons G

    更新日期:2008-01-01 00:00:00

  • Simple analgesics.

    abstract::A number of drugs are available that act fairly specifically as "mild" analgesics, although this description by no means implies that their clinical effectiveness is limited to the relief of slight pain and trivial disability. They are effective by mouth and their action is mediated peripherally. Among the possible me...

    journal_title:Drugs

    pub_type: 杂志文章,评审

    doi:10.2165/00003495-197510050-00007

    authors: Parkhouse J

    更新日期:1975-01-01 00:00:00

  • Pharmacological management of first-episode schizophrenia and related nonaffective psychoses.

    abstract::Schizophrenia is a severe mental illness characterised by abnormalities of thought and perception that affects 1-2% of the population. Patients who experience a first episode of schizophrenia should be treated early and optimally with antipsychotic agents to lessen the morbidity of the initial episode and possibly imp...

    journal_title:Drugs

    pub_type: 杂志文章,评审

    doi:10.2165/00003495-200363210-00001

    authors: Bradford DW,Perkins DO,Lieberman JA

    更新日期:2003-01-01 00:00:00

  • Effect of nedocromil sodium on the bronchoconstrictor effect of neurokinin A in asthmatics.

    abstract::In a double-blind, crossover study we have investigated the effect of nedocromil sodium on neurokinin A (NKA)-induced bronchoconstriction in asthmatics. 12 patients with mild asthma inhaled either nedocromil sodium 4mg or placebo, on 2 separate days, as 2 puffs from a metered-dose aerosol 30 minutes before challenge w...

    journal_title:Drugs

    pub_type: 临床试验,杂志文章

    doi:10.2165/00003495-198900371-00019

    authors: Joos GF,Pauwels RA,Van der Straeten ME

    更新日期:1989-01-01 00:00:00

  • Effects of treatment with verapamil SR and captopril on the lipid profile of hypertensive patients.

    abstract::The potential beneficial effects of antihypertensive drugs on cardiovascular morbidity and mortality may be compromised by their adverse effects on serum lipid levels. In our study we compared verapamil and captopril and evaluated their effects on blood pressure and on serum lipid and lipoprotein levels, with particul...

    journal_title:Drugs

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.2165/00003495-199200441-00016

    authors: Catalano M,Cislaghi C,Carzaniga G,Aronica A,Seregni R,Libretti A

    更新日期:1992-01-01 00:00:00

  • Quinolone activity against anaerobes: microbiological aspects.

    abstract::Currently available quinolones are either inactive or marginally active against anaerobic bacteria. This review summarises the in vitro activity of currently available as well as experimental quinolones against clinically significant anaerobic bacteria. Quinolones with low activity against anaerobes include ciprofloxa...

    journal_title:Drugs

    pub_type: 杂志文章,评审

    doi:10.2165/00003495-199500492-00012

    authors: Appelbaum PC

    更新日期:1995-01-01 00:00:00

  • Prescribing oral contraceptives.

    abstract::The combined oral contraceptive pill is the most popular method of contraception worldwide, with modern low-dose formulations significantly improving tolerability. Breakthrough bleeding is the most significant adverse event associated with the low-dose combined oral contraceptives. Monophasic, biphasic, triphasic and ...

    journal_title:Drugs

    pub_type: 杂志文章,评审

    doi:10.2165/00003495-199549020-00007

    authors: Weisberg E

    更新日期:1995-02-01 00:00:00

  • Glipizide: a review of its pharmacological properties and therapeutic use.

    abstract::Glipizide is a 'second generation' oral hypoglycaemic agent similar in potency to glibenclamide. It is completely absorbed after oral administration and has a rapid onset of action, but the duration of its hypoglycaemic effect is shorter than that of glibenclamide. It is rapidly metabolised to inactive metabolites whi...

    journal_title:Drugs

    pub_type: 杂志文章,评审

    doi:10.2165/00003495-197918050-00001

    authors: Brogden RN,Heel RC,Pakes GE,Speight TM,Avery GS

    更新日期:1979-11-01 00:00:00

  • Optimal therapeutic strategies for resectable oesophageal or oesophagogastric junction cancer.

    abstract::Oesophageal cancer is the eighth most common cancer diagnosed worldwide, with almost half a million new cases diagnosed each year. Despite improvements in surgical and radiotherapy techniques and refinements of chemotherapeutic regimens, long-term survival, even from localized oesophageal cancer, remains poor. Surgica...

    journal_title:Drugs

    pub_type: 杂志文章,评审

    doi:10.2165/11585460-000000000-00000

    authors: Bystricky B,Okines AF,Cunningham D

    更新日期:2011-03-26 00:00:00

  • Nizatidine. A preliminary review of its pharmacodynamic and pharmacokinetic properties, and its therapeutic use in peptic ulcer disease.

    abstract::Nizatidine is an H2-receptor antagonist which in animal studies was more active on a weight-for-weight basis than cimetidine in inhibiting basal and stimulated gastric acid secretion. Similarly, studies in humans have confirmed that nizatidine is a potent inhibitor of basal, nocturnal and stimulated gastric acid secre...

    journal_title:Drugs

    pub_type: 杂志文章,评审

    doi:10.2165/00003495-198836050-00002

    authors: Price AH,Brogden RN

    更新日期:1988-11-01 00:00:00

  • Current status of dopamine agonists in Parkinson's disease management.

    abstract::The occurrence of late side effects of long term levodopa therapy (fluctuations in motor performance, abnormal movements, and symptoms unresponsive to dihydroxyphenylalanine) led to the search for novel anti-Parkinsonian drugs. Dopamine agonists are one of the newer families of anti-Parkinsonian agents, and they inclu...

    journal_title:Drugs

    pub_type: 杂志文章,评审

    doi:10.2165/00003495-199346030-00005

    authors: Montastruc JL,Rascol O,Senard JM

    更新日期:1993-09-01 00:00:00

  • Gatifloxacin: a review of its use in the management of bacterial infections.

    abstract:UNLABELLED:Gatifloxacin is an 8-methoxy fluoroquinolone antibacterial agent. The drug has a broader spectrum of antibacterial activity than the older fluoroquinolones (e.g. ciprofloxacin) and shows good activity against many Gram-positive and Gram-negative pathogens, atypical organisms and some anaerobes. Notably, gati...

    journal_title:Drugs

    pub_type: 杂志文章,评审

    doi:10.2165/00003495-200262010-00007

    authors: Perry CM,Ormrod D,Hurst M,Onrust SV

    更新日期:2002-01-01 00:00:00

  • Treatment options for carbapenem-resistant and extensively drug-resistant Acinetobacter baumannii infections.

    abstract::Acinetobacter baumannii is a leading cause of healthcare-associated infections worldwide. Because of various intrinsic and acquired mechanisms of resistance, most β-lactam agents are not effective against many strains, and carbapenems have played an important role in therapy. Recent trends show many infections are cau...

    journal_title:Drugs

    pub_type: 杂志文章,评审

    doi:10.1007/s40265-014-0267-8

    authors: Viehman JA,Nguyen MH,Doi Y

    更新日期:2014-08-01 00:00:00

  • The optimal management of hairy cell leukaemia.

    abstract::Hairy cell leukaemia is an uncommon B cell chronic lymphoproliferative disorder characterised by circulating lymphocytes displaying prominent cytoplasmic projections. Therapy is initiated for severe cytopenias or recurrent infections. Splenectomy, the first standard treatment, is now less commonly used as primary trea...

    journal_title:Drugs

    pub_type: 杂志文章,评审

    doi:10.2165/00003495-199549060-00006

    authors: Gollard R,Lee TC,Piro LD,Saven A

    更新日期:1995-06-01 00:00:00

  • Pharmacology and therapeutic use of calcitonin.

    abstract::Calcitonin is a peptide hormone secreted by the C-cells of the thyroid gland. A major physiological function of the hormone appears to be the protection of the skeleton against resorption in humans. It thus opposes the resorptive actions of parathyroid hormone and 1,25 dihydroxyvitamin D. This action is utilised pharm...

    journal_title:Drugs

    pub_type: 杂志文章,评审

    doi:10.2165/00003495-198121040-00002

    authors: Stevenson JC,Evans IM

    更新日期:1981-04-01 00:00:00

  • Antibacterials as adjuncts to incision and drainage for adults with purulent methicillin-resistant Staphylococcus aureus (MRSA) skin infections.

    abstract::The annual incidence of skin and soft tissue infections (SSTIs) has nearly tripled in the US since the early 1990s. Many purulent SSTIs in the community setting are caused by methicillin-resistant Staphylococcus aureus (MRSA). Incision and drainage (I&D) are indicated for most purulent MRSA infections; however, the us...

    journal_title:Drugs

    pub_type: 杂志文章,评审

    doi:10.2165/11599510-000000000-00000

    authors: Forcade NA,Wiederhold NP,Ryan L,Talbert RL,Frei CR

    更新日期:2012-02-12 00:00:00

  • Acyclovir. An updated review of its antiviral activity, pharmacokinetic properties and therapeutic efficacy.

    abstract::Acyclovir (aciclovir) is a nucleoside antiviral drug with antiviral activity in vitro against members of the herpes group of DNA viruses. As an established treatment of herpes simplex infection, intravenous, oral and to a lesser extent topical formulations of acyclovir provide significant therapeutic benefit in genita...

    journal_title:Drugs

    pub_type: 杂志文章,评审

    doi:10.2165/00003495-198937030-00002

    authors: O'Brien JJ,Campoli-Richards DM

    更新日期:1989-03-01 00:00:00

  • Parenteral cephalosporin therapy in ambulatory care: advantages and disadvantages.

    abstract::Outpatient parenteral antibiotic therapy (OPAT) programmes are effective, well tolerated and economically advantageous in carefully selected patient populations. Inclusion criteria for patient selection for OPAT include good clinical appearance and uncomplicated infection. By virtue of their favourable microbiological...

    journal_title:Drugs

    pub_type: 杂志文章,评审

    doi:10.2165/00003495-200059003-00003

    authors: Esposito S

    更新日期:2000-01-01 00:00:00

  • Brodalumab: First Global Approval.

    abstract::Brodalumab (Lumicef(®)) is a human monoclonal immunoglobulin G antibody that is being developed by Kyowa Hakko Kirin in Japan, where it has been approved for the treatment of psoriasis vulgaris, psoriatic arthritis, pustular psoriasis and psoriatic erythroderma. Brodalumab binds with high affinity to interleukin (IL)-...

    journal_title:Drugs

    pub_type: 杂志文章

    doi:10.1007/s40265-016-0634-8

    authors: Greig SL

    更新日期:2016-09-01 00:00:00

  • Antihistamines: pharmacology and clinical use.

    abstract::Antihistamines are a diverse group of drugs which possess the ability to inhibit various histaminic actions. By and large, they bear a certain structural resemblance to histamine, and act principally to prevent histamine-receptor interaction through competition with histamine for histamine receptors. Consequently, the...

    journal_title:Drugs

    pub_type: 杂志文章,评审

    doi:10.2165/00003495-197612040-00002

    authors: Pearlman DS

    更新日期:1976-01-01 00:00:00

  • Valsartan/hydrochlorothiazide: a review of its use in the management of hypertension.

    abstract::Valsartan/hydrochlorothiazide is a fixed-dose (valsartan 80, 160 or 320mg plus hydrochlorothiazide 12.5 or 25mg) angiotensin II receptor blocker/diuretic drug combination indicated for the treatment of patients with essential hypertension not adequately controlled by monotherapy.There is ample evidence that valsartan/...

    journal_title:Drugs

    pub_type: 杂志文章,meta分析,评审

    doi:10.2165/00003495-200666140-00011

    authors: Wagstaff AJ

    更新日期:2006-01-01 00:00:00

  • The Multifactor Primary Prevention Trial in Göteborg, Sweden. Comparison with a previously untreated population sample.

    abstract::All male inhabitants of the city of Göteborg, who were born between 1915-1922 and 1924-1925 were included in the trial, and were 47 to 55 years of age on entry to the study in 1970 to 1973. One-third of these men were randomly allocated to an intervention group, whilst the other two-thirds acted as controls. Men of al...

    journal_title:Drugs

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.2165/00003495-198600311-00009

    authors: Wilhelmsen L,Berglund G,Elmfeldt D,Samuelsson O,Svardsudd K

    更新日期:1986-01-01 00:00:00

  • Cenegermin: A Review in Neurotrophic Keratitis.

    abstract::Cenegermin (Oxervate™), an ophthalmic solution containing 20 µg/mL of recombinant human nerve growth factor (rhNGF), is the first drug to be approved for the treatment of neurotrophic keratitis (NK; also referred to as neurotrophic keratopathy). In the registration trials, the majority of adults with moderate or sever...

    journal_title:Drugs

    pub_type: 杂志文章,评审

    doi:10.1007/s40265-020-01289-w

    authors: Deeks ED,Lamb YN

    更新日期:2020-04-01 00:00:00