Abstract:
:Although the vancomycin minimum inhibitory concentration (VMIC) susceptibility breakpoint for Staphylococcus aureus was recently lowered to ≤2 mg/L, it is argued that isolates in the higher levels of the susceptible range may bear adverse clinical outcomes. Clinical outcomes (all-cause mortality and treatment failure) of patients with S. aureus infections by 'high-VMIC' (conventionally defined as VMIC >1 mg/L but ≤2 mg/L) and 'low-VMIC' (VMIC≤1 mg/L) isolates were compared by performing a systematic review and meta-analysis. The effect of potential confounders was assessed by univariate meta-regression analyses. In total, 33 studies (6210 patients) were included. Most studies were retrospective (28/33), used the Etest (22/33) and referred to meticillin-resistant S. aureus (MRSA) infections (26/33) and bacteraemia (23/33). Irrespective of VMIC testing method, meticillin resistance and site of infection, the high-VMIC group had higher mortality [relative risk (RR)=1.21 (95% confidence interval 1.03-1.43); 4612 patients] and more treatment failures [RR=1.67 (1.26-2.21); 2049 patients] than the low-VMIC group. The results were not affected by the potential confounders and were reproduced in the subset of patients with MRSA infections [mortality, RR=1.19 (1.02-1.40), 2956 patients; treatment failure, RR=1.69 (1.26-2.25), 1793 patients]. In conclusion, infection by vancomycin-susceptible S. aureus with VMIC>1mg/L appears to be associated with higher mortality than VMIC≤1mg/L. Further research is warranted to verify these results and to assess the impact of VMIC on meticillin-susceptible S. aureus infections. Evaluation of alternative antimicrobial agents also appears justified.
journal_name
Int J Antimicrob Agentsjournal_title
International journal of antimicrobial agentsauthors
Mavros MN,Tansarli GS,Vardakas KZ,Rafailidis PI,Karageorgopoulos DE,Falagas MEdoi
10.1016/j.ijantimicag.2012.07.023subject
Has Abstractpub_date
2012-12-01 00:00:00pages
496-509issue
6eissn
0924-8579issn
1872-7913pii
S0924-8579(12)00341-Xjournal_volume
40pub_type
杂志文章,meta分析,评审abstract::As a result of macrolide resistance rates of 25% for pneumococci in the US, the clinical use of this class as empirical therapy has been questioned. However, macrolides continue to be used with clinical success. Using an immunocompromised murine pneumonia model, this study evaluated in vivo efficacy of human simulated...
journal_title:International journal of antimicrobial agents
pub_type: 杂志文章
doi:10.1016/j.ijantimicag.2003.09.028
更新日期:2004-05-01 00:00:00
abstract::Due to the ever-increasing number of immunocompromised patients, both localised and life-threatening systemic fungal infections are on the increase. Conventional treatment is of limited help, not in the least due to a less optimum benefit-to-risk ratio. Moreover, emerging pathogens with reduced antimicrobial susceptib...
journal_title:International journal of antimicrobial agents
pub_type: 杂志文章,评审
doi:10.1016/s0924-8579(00)00323-x
更新日期:2001-02-01 00:00:00
abstract::Ciprofloxacin, levofloxacin, ofloxacin, and trovafloxacin were tested by the E-test against 100 clinical isolates of Pseudomonas aeruginosa. Ciprofloxacin was the most active of the tested agents with 82% of isolates having a MIC =1 mg/l (range: 0.094->8). Levofloxacin and trovafloxacin had nearly identical potency:...
journal_title:International journal of antimicrobial agents
pub_type: 杂志文章
doi:10.1016/s0924-8579(00)00132-1
更新日期:2000-06-01 00:00:00
abstract::We have evaluated the literature to review optimal dosing and monitoring of intravenous vancomycin in adults, in response to evolving understanding of targets associated with efficacy and toxicity. The area under the total concentration-time curve (0-24 h) divided by the minimum inhibitory concentration (AUC24/MIC) is...
journal_title:International journal of antimicrobial agents
pub_type: 杂志文章,评审
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更新日期:2019-04-01 00:00:00
abstract::An important goal of outpatient parenteral antibiotic therapy (OPAT) is to provide a drug and dosing regimen that allows for convenient administration of the antibiotic in the outpatient setting. While once-daily administration or handling of the drug would be ideal, dosing frequencies up to three times a day for intr...
journal_title:International journal of antimicrobial agents
pub_type: 杂志文章
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更新日期:1995-01-01 00:00:00
abstract::Little is known about undergraduate education on antibiotic prescribing in Europe and even less about the antibiotic prescribing skills of nearly-graduated medical students. This study aimed to evaluate the antibiotic prescribing skills of final-year medical students across Europe and the education they received durin...
journal_title:International journal of antimicrobial agents
pub_type: 杂志文章
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abstract::Aspergillus fumigatus is the main causal agent of invasive aspergillosis (IA), however other species of the genus can also cause IA, such as Aspergillus flavus, Aspergillus terreus, Aspergillus niger and related cryptic species. This infectious disease mainly affects immunosuppressed patients and is linked to elevated...
journal_title:International journal of antimicrobial agents
pub_type: 杂志文章,评审
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更新日期:2020-01-01 00:00:00
abstract::Two hundred and twenty-eight episodes of infective endocarditis in adult patients (mean age 36 years) were reviewed retrospectively. There were 183 episodes (80%) of native valve, 15 (7%) early prosthetic valve and 30 (13%) late prosthetic valve endocarditis. The most common predisposing factor was rheumatic valvular ...
journal_title:International journal of antimicrobial agents
pub_type: 杂志文章
doi:10.1016/s0924-8579(01)00344-2
更新日期:2001-07-01 00:00:00
abstract::Globally, antibiotic resistance continues to be an increasing problem. The emergence of methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), and extended spectrum beta-lactamase-producing Enterobacteriaceae has seriously reduced the number of empirical agents suitable for selecte...
journal_title:International journal of antimicrobial agents
pub_type: 杂志文章,评审
doi:10.1016/S0924-8579(09)70003-2
更新日期:2008-12-01 00:00:00
abstract::Many antimicrobial agents including new quinolones (NQs) influence the cellular defense mechanisms such as polymorphonuclear leukocytes (PMNs), macrophages and lymphocytes. We examined the effects of NQs on superoxide (SO) production of PMNs following stimulation of phorbol myristate acetate (PMA). Ofloxacin (OFLX) an...
journal_title:International journal of antimicrobial agents
pub_type: 杂志文章
doi:10.1016/0924-8579(95)00024-0
更新日期:1995-12-01 00:00:00
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journal_title:International journal of antimicrobial agents
pub_type: 杂志文章
doi:10.1016/j.ijantimicag.2006.03.026
更新日期:2006-09-01 00:00:00
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journal_title:International journal of antimicrobial agents
pub_type: 杂志文章
doi:10.1016/s0924-8579(03)00220-6
更新日期:2003-09-01 00:00:00
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journal_title:International journal of antimicrobial agents
pub_type: 杂志文章
doi:10.1016/s0924-8579(99)00026-6
更新日期:1999-05-01 00:00:00
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journal_title:International journal of antimicrobial agents
pub_type: 杂志文章
doi:10.1016/j.ijantimicag.2006.09.010
更新日期:2007-02-01 00:00:00
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journal_title:International journal of antimicrobial agents
pub_type: 杂志文章
doi:10.1016/j.ijantimicag.2004.08.020
更新日期:2005-06-01 00:00:00
abstract::The in vitro activity of moxifloxacin was compared with that of penicillin G, amoxycillin/clavulanate, cefoxitin, erythromycin, clindamycin and metronidazole against 158 isolates associated with periodontal infections. MIC(50)/MIC(90) values of moxifloxacin were respectively 0.06/0.5 mg/l for Porphyromonas gingivalis ...
journal_title:International journal of antimicrobial agents
pub_type: 杂志文章
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更新日期:2002-12-01 00:00:00
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journal_title:International journal of antimicrobial agents
pub_type: 杂志文章
doi:10.1016/j.ijantimicag.2007.12.015
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journal_title:International journal of antimicrobial agents
pub_type: 杂志文章,评审
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journal_title:International journal of antimicrobial agents
pub_type: 杂志文章
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journal_title:International journal of antimicrobial agents
pub_type: 杂志文章
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journal_title:International journal of antimicrobial agents
pub_type: 杂志文章,评审
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更新日期:2001-01-01 00:00:00
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journal_title:International journal of antimicrobial agents
pub_type: 临床试验,杂志文章,随机对照试验
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journal_title:International journal of antimicrobial agents
pub_type: 杂志文章,多中心研究
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更新日期:2005-12-01 00:00:00
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journal_title:International journal of antimicrobial agents
pub_type: 杂志文章
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journal_title:International journal of antimicrobial agents
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更新日期:2017-04-01 00:00:00
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journal_title:International journal of antimicrobial agents
pub_type: 杂志文章,评审
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journal_title:International journal of antimicrobial agents
pub_type: 杂志文章
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更新日期:2004-04-01 00:00:00
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journal_title:International journal of antimicrobial agents
pub_type: 杂志文章
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更新日期:1997-05-01 00:00:00
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journal_title:International journal of antimicrobial agents
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更新日期:2019-11-01 00:00:00
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journal_title:International journal of antimicrobial agents
pub_type: 杂志文章
doi:10.1016/j.ijantimicag.2017.12.026
更新日期:2018-05-01 00:00:00