Abstract:
:With the introduction of piperacillin/tazobactam to the North American market, hospitals have been faced with the task of making a decision regarding its formulary role. In view of its broad spectrum of activity, piperacillin/tazobactam could be considered as a formulary alternative to imipenem. To evaluate the formulary feasibility of substituting piperacillin/tazobactam for imipenem, a comparative assessment of these agents in the empiric treatment of serious bacterial infections was undertaken at this tertiary care hospital. This trial was conducted as a randomized, double-blind, single-center study. Consenting adult patients (>16 years of age) who were prescribed imipenem were randomized to receive either 4 g of i.v. piperacillin/tazobactam or imipenem 500 mg of i.v. Q6H with or without concurrent antibiotics. Doses were adjusted according to renal function. There were no restrictions regarding the use of nonstudy antibiotics before and during the study period. Patients with beta-lactam allergies or meningitis or who had received greater than 72 h of previous imipenem therapy were excluded. Patients were evaluated at the end of treatment, at discharge, and at 30 days postdischarge. Endpoints included both clinical and microbiologic efficacy as well as drug toxicity. Over the 433-day study period, 360 imipenem treatment courses were initiated. Of these, 150 treatment courses (75 piperacillin/tazobactam courses and 75 imipenem courses) met study criteria and were subsequently randomized. The distribution of prescriber services for enrolled patients was similar to that for all patients receiving imipenem during the study period (p = 0.15). Also, there were no statistically significant differences in demographic parameters between enrolled and excluded patients. For those patients enrolled in the study, demographic characteristics, treatment course indication(s), and accompanying antibiotics were similar across treatment arms. The mean duration of study drug therapy was 7.7 days (SD, 6.2) for imipenem and 7.5 days (SD, 6.7)for piperacillin/tazobactam (p = 0.84). In the majority of cases, treatment discontinuation occurred as a result of a favorable treatment course outcome, stepdown to a narrower spectrum parenteral agent, or stepdown to an oral agent and did not differ between study drugs (p = 0.73). Clinical and microbiologic treatment course outcomes were also similar across treatment arms. Clinical outcome was deemed successful or improved for 68% of imipenem and 70% of the piperacillin/tazobactam treatment courses (p = 0.54). Fifty-three percent of treatment courses were microbiologically confirmed. Of the 58 courses that were assessed for microbiological outcome, 93% demonstrated successful eradication of the causative pathogens. There was no difference between study drugs (96% imipenem; 90% piperacillin/tazobactam; p = 0.61). The proportion of treatment courses with at least one adverse event was similar between the study drugs (p = 1.0). Nausea and/or vomiting were/was observed more commonly in the imipenem arm (p = 0.03). Discontinuation of therapy due to drug toxicity occurred in 16% of imipenem and 5% of piperacillin/tazobactam treatment courses (p = 0.06). There was no statistically significant difference between the mean treatment course cost for imipenem ($762; range, $55-$3192) versus piperacillin/tazobactam ($696; range, $79-$2967; p = 0.59). In summary, piperacillin/tazobactam seems to represent a suitable alternative to imipenem for several clinical indications including intraabdominal infections, pneumonia, febrile neutropenia, and skin/soft tissue infections in which the causative pathogens are susceptible. However, in view of the prevalence of multiresistant Gram-negative aerobic pathogens at this institution, we do not believe that imipenem can be removed from the drug formulary. In addition, at the currently studied dosing regimen, there seems to be no evidence of a direct cost advantage associated with
journal_name
Diagn Microbiol Infect Disjournal_title
Diagnostic microbiology and infectious diseaseauthors
Marra F,Reynolds R,Stiver G,Bryce E,Sleigh K,Frighetto L,MacDougall C,Jewesson Pdoi
10.1016/s0732-8893(97)00239-3subject
Has Abstractpub_date
1998-06-01 00:00:00pages
355-68issue
2eissn
0732-8893issn
1879-0070pii
S0732-8893(97)00239-3journal_volume
31pub_type
临床试验,杂志文章,随机对照试验abstract::We described 27 polyclonal colistin-resistant Enterobacteriaceae (MIC 4-16 μg/mL) infections (12 pneumonia, 12 urinary tract infection (UTI), two Bacteremia, and one skin/soft tissue infection) in which 74% harbored KPC. The isolates were polyclonal, 6 STs were identified and the colistin resistance was due to chromos...
journal_title:Diagnostic microbiology and infectious disease
pub_type: 杂志文章
doi:10.1016/j.diagmicrobio.2016.11.007
更新日期:2017-03-01 00:00:00
abstract::The objective of the study is to compare the performance of conventional fluorescence microscopy (CFM) and light-emitting diode (LED) fluorescence microscopy (FM) for detection of acid-fast bacilli (AFB) in clinical samples. We included AFB smears, stained using the auramine O method and blindly examined with both CFM...
journal_title:Diagnostic microbiology and infectious disease
pub_type: 杂志文章
doi:10.1016/j.diagmicrobio.2013.03.023
更新日期:2013-07-01 00:00:00
abstract::Four cases of Salmonella prosthetic valve endocarditis have been reported previously in the English medical literature (Fraser et al. 1967; Yamamoto et al., 1974; Shanson et al., 1977; Bassa et al., 1989). This report describes a fifth case in a 62-year-old woman who developed tricuspid valve endocarditis after an epi...
journal_title:Diagnostic microbiology and infectious disease
pub_type: 杂志文章,评审
doi:10.1016/0732-8893(92)90124-c
更新日期:1992-03-01 00:00:00
abstract::A shift to Candida non-albicans infections has been noted during the last years, and the emergence of multi-resistant Candida auris has complicated their management. The aim of this study was first to compare the performance of the novel chromogenic medium CHROMagar™ Candida Plus (CHROMagar, France) with CHROMagar™ Ca...
journal_title:Diagnostic microbiology and infectious disease
pub_type: 杂志文章
doi:10.1016/j.diagmicrobio.2020.115168
更新日期:2020-12-01 00:00:00
abstract::Methods currently used for susceptibility testing of Mycobacterium, including agar dilution and the Bactec radiometric method, are based on the proportion technique using a single critical concentration of antibiotic. Preliminary studies were conducted with Mycobacterium species by using the Etest method, a gradient m...
journal_title:Diagnostic microbiology and infectious disease
pub_type: 杂志文章
doi:10.1016/0732-8893(94)90064-7
更新日期:1994-07-01 00:00:00
abstract::We determined the frequency of isolation of non-aureus staphylococcal small colony variants (SCVs) from 31 patients with staphylococcal prosthetic joint infection (PJI) and described the antimicrobial susceptibility, auxotrophy, and biofilm-forming capacity of these SCVs. Eleven non-aureus SCVs were recovered, all of ...
journal_title:Diagnostic microbiology and infectious disease
pub_type: 杂志文章
doi:10.1016/j.diagmicrobio.2012.06.029
更新日期:2012-11-01 00:00:00
abstract::The frequency of isolation and antifungal susceptibility patterns to fluconazole and itraconazole were determined for 166 Candida glabrata isolates causing bloodstream infection at a single institution from 1995-2000. Findings demonstrated a trend of increasing resistance to itraconazole among the isolates, but no tre...
journal_title:Diagnostic microbiology and infectious disease
pub_type: 杂志文章
doi:10.1016/s0732-8893(01)00214-0
更新日期:2001-03-01 00:00:00
abstract::Two standardized susceptibility test methods, a broth microdilution (BMD) and agar dilution (AD) method were performed on a total of 441 clinical isolates of anaerobes with ceftizoxime, cefotaxime, ceftriaxone, cefoxitin, piperacillin, and metronidazole. Against the 339 strains of the Bacteroides fragilis group BMD mi...
journal_title:Diagnostic microbiology and infectious disease
pub_type: 杂志文章
doi:10.1016/0732-8893(94)90107-4
更新日期:1994-11-01 00:00:00
abstract::The aim of the study was to evaluate the influence of dietary and demographic factors and some habits on the prevalence of Helicobacter pylori infection in 150 dyspeptic patients examined endoscopically and by the urea breath test. Positivity rate was lower (50.6%) in patients consuming honey ≥1 day weekly compared wi...
journal_title:Diagnostic microbiology and infectious disease
pub_type: 杂志文章
doi:10.1016/j.diagmicrobio.2015.03.001
更新日期:2015-05-01 00:00:00
abstract::Serologic methods are well established for the diagnosis of Mycoplasma pneumoniae infections in humans, but they are less sensitive than polymerase chain reaction (PCR). To improve their sensitivity, a new panel of antigens was tested. Compared with PCR results, up to 92% of PCR-positive patients were confirmed by our...
journal_title:Diagnostic microbiology and infectious disease
pub_type: 杂志文章
doi:10.1016/j.diagmicrobio.2012.02.014
更新日期:2012-06-01 00:00:00
abstract::Resistance to linezolid among Enterococcus faecium and Enterococcus faecalis isolates has been reported in patients who receive a prolonged course of the drug. We report two cases of linezolid-resistant Enterococcus faecalis that occurred in patients who previously received linezolid for infections with vancomycin-res...
journal_title:Diagnostic microbiology and infectious disease
pub_type: 杂志文章
doi:10.1016/s0732-8893(03)00153-6
更新日期:2003-11-01 00:00:00
abstract::Though the FilmArray GI Panel has a reported aggregate specificity and reproducibility of >97% and > 99%, respectively, the reproducibility is less understood in clinical practice. We measured the reproducibility of positive results for low-prevalence pathogens. Samples with positive results for selected targets were ...
journal_title:Diagnostic microbiology and infectious disease
pub_type: 杂志文章
doi:10.1016/j.diagmicrobio.2019.03.013
更新日期:2019-09-01 00:00:00
abstract::Therapy of vancomycin-resistant enterococcal infections is an increasing problem for many large medical centers. One promising agent for use against Enterococcus faecium is RP 59500 (Quinupristin/Dalfopristin). To assess the potential for emergence of resistant strains during clinical trials with this new compound, we...
journal_title:Diagnostic microbiology and infectious disease
pub_type: 杂志文章
doi:10.1016/0732-8893(96)00067-3
更新日期:1996-05-01 00:00:00
abstract::The antimicrobial susceptibilities of 49 Clostridium difficile isolates obtained from patients with C. difficile-associated diarrhea to metronidazole, vancomycin, rifampicin, fusidic acid, doxycycline, and linezolid were determined by the disc diffusion and Etest (Biodisk, Solna, Sweden). Random amplification of polym...
journal_title:Diagnostic microbiology and infectious disease
pub_type: 杂志文章
doi:10.1016/j.diagmicrobio.2005.09.008
更新日期:2006-02-01 00:00:00
abstract::We used 4 different bioinformatics algorithms to evaluate the application of a metagenomic shot-gun sequencing method in detection of Enterovirus D68 and other respiratory viruses in clinical specimens. Our data supported that next-generation sequencing, combined with improved bioinformatics tools, is practically feas...
journal_title:Diagnostic microbiology and infectious disease
pub_type: 杂志文章
doi:10.1016/j.diagmicrobio.2016.01.013
更新日期:2016-05-01 00:00:00
abstract::Norepinephrine is secreted under conditions of stress in humans. The ability of bacteria to sense mammalian hormone may have a role in propagation of infection. The present study investigated the effect of norepinephrine on in vitro growth of uropathogenic E. coli (UPEC) and the effect of silodosin on norepinephrine-i...
journal_title:Diagnostic microbiology and infectious disease
pub_type: 杂志文章
doi:10.1016/j.diagmicrobio.2018.05.005
更新日期:2018-10-01 00:00:00
abstract::A prospective study on the susceptibility of Clostridium difficile to metronidazole and vancomycin using the Etest and disk diffusion test was performed over a 6-month period. One hundred strains were tested; one strain was highly resistant to metronidazole (MIC = 64 micrograms/mL). The zone size of inhibition by the ...
journal_title:Diagnostic microbiology and infectious disease
pub_type: 杂志文章
doi:10.1016/s0732-8893(98)00139-4
更新日期:1999-05-01 00:00:00
abstract::The emergence and sustained prevalence of Gram-positive organisms resistant to antimicrobials has been of interest for over a decade. Quinupristin/dalfopristin (formerly RP 59500 or Synercid) is a new injectable streptogramin combination that has been reported to have activity against Gram-positive organisms, even tho...
journal_title:Diagnostic microbiology and infectious disease
pub_type: 杂志文章
doi:10.1016/s0732-8893(00)00111-5
更新日期:2000-04-01 00:00:00
abstract::Since being recognized in 1976 and 1983, respectively, penicillinase-producing strains of Neisseria gonorrhoeae (PPNG) and chromosomally mediated resistance (CMRNG) have attained a worldwide distribution. The high endemicity of both types of resistance in some regions precludes the continued routine use of procaine pe...
journal_title:Diagnostic microbiology and infectious disease
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0732-8893(87)90041-1
更新日期:1987-09-01 00:00:00
abstract::The Gen-probe group A Streptococcus direct test (GASD), a nucleic acid probe assay for detecting GAS from throat swabs, has recently been developed. The test uses an acridium ester-labeled DNA probe which is complementary to the rRNA of Streptococcus pyogenes. In this study, 318 single culturette throat swabs were tes...
journal_title:Diagnostic microbiology and infectious disease
pub_type: 杂志文章
doi:10.1016/0732-8893(95)00275-8
更新日期:1996-02-01 00:00:00
abstract::We evaluated the performance of the 3 automated systems (Cepheid Xpert, BD MAX, and IMDx C. difficile for Abbott m2000) detecting Clostridium difficile toxin gene compared to toxigenic culture. Of the 254 stool specimens tested, 87 (48 slight, 35 moderate, and 4 heavy growth) were toxigenic culture positive. The overa...
journal_title:Diagnostic microbiology and infectious disease
pub_type: 杂志文章
doi:10.1016/j.diagmicrobio.2015.05.005
更新日期:2015-09-01 00:00:00
abstract::Haemophilus influenzae rarely causes acute endometritis and the few published cases have always been associated with intrauterine devices (IUD). A 48-year-old female presented to the emergency department with a 3-day history of lower abdominal pain and fever. On physical examination she was tachycardic, hypotensive an...
journal_title:Diagnostic microbiology and infectious disease
pub_type: 杂志文章,评审
doi:10.1016/j.diagmicrobio.2013.02.010
更新日期:2013-06-01 00:00:00
abstract:BACKGROUND:The Clostridium difficile rate in symptomatic patients represents both those with C. difficile infection (CDI) and those with colonization. To predict the extent of CDI overdiagnosis, we compared the asymptomatic colonization rate to the symptomatic positivity rate in hospitalized patients using nucleic acid...
journal_title:Diagnostic microbiology and infectious disease
pub_type: 杂志文章
doi:10.1016/j.diagmicrobio.2016.12.014
更新日期:2017-04-01 00:00:00
abstract::A 14-year longitudinal survey of Streptococcus pneumoniae (18,911) strains by the SENTRY Antimicrobial Surveillance Program shows significant increases in resistance to amoxicillin/clavulanate (18.9%), penicillin at a MIC of ≥ 4 μg/mL (14.8%), and ceftriaxone (11.7%) among 2011 isolates. Fluoroquinolones (levofloxacin...
journal_title:Diagnostic microbiology and infectious disease
pub_type: 杂志文章
doi:10.1016/j.diagmicrobio.2012.08.024
更新日期:2013-01-01 00:00:00
abstract::Turbid saline suspensions (0.35 ml, approximately 10(9) organisms) of a strain of beta-lactamase-producing Bacteroides intermedius were injected subcutaneously into the right groin of ICR male mice. Therapeutic intraperitoneal doses of clindamycin, metronidazole, or penicillin were administered 4 hr later, and thereaf...
journal_title:Diagnostic microbiology and infectious disease
pub_type: 杂志文章
doi:10.1016/0732-8893(86)90088-x
更新日期:1986-05-01 00:00:00
abstract::Ceftaroline fosamil was approved in 2010 by the United States Food and Drug Administration (USA-FDA) for the treatment of patients with acute bacterial skin and skin structure infections (ABSSSIs) and community-acquired bacterial pneumonia (CABP). After approval, several studies and case reports have described the pos...
journal_title:Diagnostic microbiology and infectious disease
pub_type: 杂志文章,评审
doi:10.1016/j.diagmicrobio.2014.11.016
更新日期:2015-03-01 00:00:00
abstract::Escherichia coli ST131, with its multidrug-resistance-associated H30R1 and H30Rx clonal subsets within the H30R subclone, causes most antimicrobial-resistant E. coli infections. The activity of ceftazidime-avibactam (CZA) against ST131 strains is undefined. We determined CZA MICs for 595 E. coli clinical isolates from...
journal_title:Diagnostic microbiology and infectious disease
pub_type: 杂志文章
doi:10.1016/j.diagmicrobio.2020.115034
更新日期:2020-07-01 00:00:00
abstract::We assessed the performance of the ARCHITECT Toxo IgG, IgM, and IgG Avidity assays against corresponding assays on AxSYM and Vidas using 730 sera from pregnant women. The ARCHITECT Toxo IgG and IgM assays showed a relative sensitivity of 97.5% and 89.9% and a relative specificity of 99.1% and 99.8%, respectively. If I...
journal_title:Diagnostic microbiology and infectious disease
pub_type: 杂志文章
doi:10.1016/j.diagmicrobio.2009.07.013
更新日期:2009-11-01 00:00:00
abstract::A single 15 mg/kg i.v. dose of cefotaxime (CTX) and ceftizoxime (CTZ) were given to six adult volunteers on two separate occasions in a cross-over experiment to determine the pharmacokinetics of each drug and the desacetyl metabolite of cefotaxime, desacetylcefotaxime (des-CTX). From these data, mock serum samples wer...
journal_title:Diagnostic microbiology and infectious disease
pub_type: 杂志文章
doi:
更新日期:1984-06-01 00:00:00
abstract::Sulbactam inhibits the hydrolytic activity of several, clinically important beta-lactamases including those produced by anaerobic bacteria. This study was undertaken to determine the effect of sulbactam on the activity of cefoperazone against 250 anaerobic bacteria including 174 isolates belonging to the Bacteroides f...
journal_title:Diagnostic microbiology and infectious disease
pub_type: 杂志文章
doi:10.1016/0732-8893(90)90054-y
更新日期:1990-01-01 00:00:00