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::An in vitro pharmacodynatnic modeling apparatus (PDMA) generated specific bacterial kill profiles for single-dose regimens of gatifloxacin (GT), gemifloxacin (GM), moxifloxacin (MX) and levofloxacin (LV) against isolates of Streptococcus pneumoniae with specific QRDR profiles: SP-WT (no modifications); SP-C (changes i...
journal_title:Diagnostic microbiology and infectious disease
pub_type: 杂志文章
doi:10.1016/s0732-8893(03)00152-4
更新日期:2003-12-01 00:00:00
abstract::Soft surfaces in the health-care setting harbor potentially pathogenic bacteria and fungi that can be transferred to patients and personnel. We evaluated the in vitro antimicrobial efficacy of two types of innovative copper-coated textiles against a variety of nosocomial multi-drug resistant (MDR) pathogens. Five isol...
journal_title:Diagnostic microbiology and infectious disease
pub_type: 杂志文章
doi:10.1016/j.diagmicrobio.2016.02.015
更新日期:2016-06-01 00:00:00
abstract::The Alere-i™ Influenza A&B (Abbott), a nicking endonuclease amplification reaction test, has recently been improved in order to deliver results in a few minutes. Our field observation highlights two problems with this new version: improper interpretation of a test as valid despite improper reagent hydration and falsel...
journal_title:Diagnostic microbiology and infectious disease
pub_type: 杂志文章
doi:10.1016/j.diagmicrobio.2019.03.002
更新日期:2019-08-01 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 FiltraCheck-UT1 (FC) is a disposable colorimetric urine screen for bacteriuria that requires less than 1 min to perform. The results of the FC and two other urine screens, the Bac-T-Screen (BTS) and the Chemstrip LN test strip (LN), were compared with quantitative culture method. A total of 551 urine specimens wer...
journal_title:Diagnostic microbiology and infectious disease
pub_type: 杂志文章
doi:10.1016/0732-8893(90)90019-r
更新日期:1990-07-01 00:00:00
abstract::Invasive fungal disease has taken a great toll on immunocompromised patients. With the emergence of fluconazole and amphotericin B resistance, the rapid identification of fungi to species level is of clinical relevance in guiding appropriate antifungal therapy. Among these opportunistic fungi, Candida species are the ...
journal_title:Diagnostic microbiology and infectious disease
pub_type: 杂志文章
doi:10.1016/s0732-8893(00)00171-1
更新日期:2000-10-01 00:00:00
abstract::The indirect immunofluorescence assay (IFA) is considered the reference method for diagnosing Q fever, but serology is also performed by complement fixation assay (CFA) or enzyme-linked immunosorbent assay (ELISA). However, comparability between these assays is not clear, and therefore a quality assessment was perform...
journal_title:Diagnostic microbiology and infectious disease
pub_type: 杂志文章
doi:10.1016/j.diagmicrobio.2012.09.001
更新日期:2013-01-01 00:00:00
abstract::Two commercial microtiter cytotoxin assays using a fibroblast cell line (Bartels, Baxter Diagnostics, Inc., Deerfield, IL) and an epithelial cell line (Cytotoxi Test, Advanced Clinical Diagnostics, Toledo, OH) were evaluated for their ability to detect Clostridium difficile toxin B in stool specimens. After 48 hours, ...
journal_title:Diagnostic microbiology and infectious disease
pub_type: 杂志文章
doi:10.1016/s0732-8893(96)00172-1
更新日期:1996-09-01 00:00:00
abstract::During the early stages of the 2009/2010 swine-origin H1N1 influenza A (S-OIV H1N1 FluA) outbreak, the development and validation of sensitive and specific detection methods were a priority for rapid and accurate diagnosis. Between May and June 2009, 2 real-time reverse transcriptase-polymerase chain reaction (rRT-PCR...
journal_title:Diagnostic microbiology and infectious disease
pub_type: 杂志文章
doi:10.1016/j.diagmicrobio.2010.09.020
更新日期:2011-02-01 00:00:00
abstract::Present guidelines recommend culturing only central venous catheter (CVC) tips from patients with suspected catheter-related bloodstream infection (CR-BSI). However, a high proportion of these suspicions are not confirmed. Moreover, CVC tip culture increases laboratory workload, and reports of colonization may be mean...
journal_title:Diagnostic microbiology and infectious disease
pub_type: 杂志文章
doi:10.1016/j.diagmicrobio.2009.02.011
更新日期:2009-07-01 00:00:00
abstract::This study was performed to determine whether elevation of serum transaminases can be used to eliminate unnecessary serological tests to diagnose acute hepatitis A (HAV) and acute hepatitis B (HBV). Serum samples of 1226 patients were tested for HBsAg, anti-HBc (IgM), and anti-HAV (IgM). Acute hepatitis was diagnosed ...
journal_title:Diagnostic microbiology and infectious disease
pub_type: 杂志文章
doi:10.1016/s0732-8893(98)00141-2
更新日期:1999-04-01 00:00:00
abstract::GSK2251052 is a boron-containing antimicrobial agent in clinical development for the treatment of serious Gram-negative bacterial infections. These GSK2251052 quality control (QC) studies were performed to establish ranges for control strains (broth microdilution [BMD] MIC and disk diffusion zones) as follows: Pseudom...
journal_title:Diagnostic microbiology and infectious disease
pub_type: 杂志文章
doi:10.1016/j.diagmicrobio.2013.01.007
更新日期:2013-04-01 00:00:00
abstract::Increased use of colistin in a clinical setting had resulted in the emergence of colistin-resistant (CoR) Acinetobacter baumannii. Combination therapy has been studied as a new approach to treat infections caused by A. baumannii. Here, we investigated the in vitro antimicrobial synergistic activities of several antimi...
journal_title:Diagnostic microbiology and infectious disease
pub_type: 杂志文章
doi:10.1016/j.diagmicrobio.2016.07.017
更新日期:2016-10-01 00:00:00
abstract::Recent reports suggest that false-positive rifampicin resistance may be assigned by the Xpert MTB/RIF assay. We analysed 169 specimens using the MTB/RIF assay. Using culture as the gold standard, we found that the assay had 100% sensitivity and specificity for detecting M. tuberculosis. However, we found that the assa...
journal_title:Diagnostic microbiology and infectious disease
pub_type: 杂志文章
doi:10.1016/j.diagmicrobio.2012.06.013
更新日期:2012-10-01 00:00:00
abstract::A reformulated fluorescein isothiocyanate conjugate-labeled monoclonal antibody typing reagent for herpes simplex virus (HSV) was compared for culture confirmation and typing with a similar commercially available HSV typing stain. There was complete agreement between the two stains in the confirmation of 240 cultures ...
journal_title:Diagnostic microbiology and infectious disease
pub_type: 杂志文章
doi:10.1016/0732-8893(93)90137-v
更新日期:1993-01-01 00:00:00
abstract::Adult pyogenic vertebral osteomyelitis due to Haemophilus influenzae is exceedingly rare. After a search of the literature, we deemed our case to be the seventh case of H. influenzae pyogenic osteomyelitis. Vertebral osteomyelitis in itself is a rarity. The most common organisms associated with vertebral osteomyelitis...
journal_title:Diagnostic microbiology and infectious disease
pub_type: 杂志文章,评审
doi:10.1016/s0732-8893(97)00073-4
更新日期:1997-08-01 00:00:00
abstract::Bartonella quintana, known to cause various clinical symptoms, is increasingly recognized as one important cause of culture-negative endocarditis. We report a case of infectious endocarditis with B. quintana on the prosthetic valve, accompanied by proteinase 3-antineutrophil cytoplasmic antibody-positive collagen vasc...
journal_title:Diagnostic microbiology and infectious disease
pub_type: 杂志文章
doi:10.1016/j.diagmicrobio.2011.03.011
更新日期:2011-07-01 00:00:00
abstract::The pncA gene mutations associated with pyrazinamide (PZA) resistance in Mycobacterium tuberculosis complex were determined in 26 PZA-resistant isolates in Japan. Of the 26 PZA-resistant isolates included, 21 were negative for pyrazinamidase (PZase). Of these, 20 isolates had various pncA mutations, resulting in alter...
journal_title:Diagnostic microbiology and infectious disease
pub_type: 杂志文章
doi:10.1016/j.diagmicrobio.2003.09.013
更新日期:2004-02-01 00:00:00
abstract::We described a carbapenem-resistant Escherichia coli ST8499 strain producing New Delhi metallo-β-lactamase-13 (NDM-13) from patient in Korea. The isolate exhibited multidrug resistance, but remained susceptible to colistin and tigecycline. The blaNDM-13 gene was located on a 130-kb self-transmissible plasmid. This is ...
journal_title:Diagnostic microbiology and infectious disease
pub_type: 杂志文章
doi:10.1016/j.diagmicrobio.2019.02.013
更新日期:2019-08-01 00:00:00
abstract::The in vitro activity of ceftibuten was studied in 572 bacterial strains and was compared with the activity of other orally administered beta-lactams. Ceftibuten displayed high activity against the Enterobacteriaceae, generally being 16-fold more active than cefuroxime, cefaclor, cephalexin, or amoxicillin-clavulanic ...
journal_title:Diagnostic microbiology and infectious disease
pub_type: 杂志文章
doi:10.1016/0732-8893(91)90089-x
更新日期:1991-01-01 00:00:00
abstract::A prospective multicenter study was conducted to assess the epidemiology of antimicrobial resistance among uropathogens causing uncomplicated cystitis. Adult women with clinical diagnosis of uncomplicated cystitis were enrolled from 54 participating centers distributed all over Hong Kong during 2006 to 2008. A positiv...
journal_title:Diagnostic microbiology and infectious disease
pub_type: 杂志文章,多中心研究
doi:10.1016/j.diagmicrobio.2009.03.027
更新日期:2010-01-01 00:00:00
abstract::In a collection of 50 pvl-positive Staphylococcus aureus isolates from 10 Rio de Janeiro hospitals, 18 (36%) were from bloodstream infections, and 31 (62%) carried the SCCmec IV. Among 25 (50%) isolates of the USA1100/ST30/CC30 lineage present in 8 hospitals, 1 isolate was characterized as vancomycin-intermediate S. a...
journal_title:Diagnostic microbiology and infectious disease
pub_type: 杂志文章
doi:10.1016/j.diagmicrobio.2015.09.004
更新日期:2015-12-01 00:00:00
abstract::Ampicillin was generally twice as active as amoxicillin against 2440 consecutive isolates of Enterobacteriaceae from five medical centers. When beta-lactamase inhibitors were added to the penicillins, there was a significant increase in susceptibility. The magnitude of the increased susceptibility to ampicillin-sulbac...
journal_title:Diagnostic microbiology and infectious disease
pub_type: 杂志文章
doi:10.1016/0732-8893(93)90030-b
更新日期:1993-08-01 00:00:00
abstract::The interferon gamma (IFN-γ) release assay (IGRA) is widely used as a diagnostic method for latent tuberculosis infection (LTBI). The QuantiFERON-TB Gold and QuantiFERON-TB Gold In-tube (QFT-IT) tests measure plasma IFN-γ levels using enzyme-linked immunosorbent assay (ELISA), and T-SPOT.TB counts IFN-γ-producing cell...
journal_title:Diagnostic microbiology and infectious disease
pub_type: 杂志文章
doi:10.1016/j.diagmicrobio.2012.09.015
更新日期:2013-01-01 00:00:00
abstract::We previously reported that adenosine 5'-triphosphate (ATP) inhibited the growth of various bacteria, including mycobacteria, Staphylococcus, and Pseudomonas, without damaging bacterial surface structures. Notably, ATP's antibacterial activity was found to be attributable to its iron-chelating ability. ATP exhibited c...
journal_title:Diagnostic microbiology and infectious disease
pub_type: 杂志文章
doi:10.1016/j.diagmicrobio.2017.04.012
更新日期:2017-07-01 00:00:00
abstract::The Verigene Gram-Negative Blood Culture Nucleic Acid Test (BC-GN) is a microarray-based assay that enables rapid detection of 9 common Gram-negative bacteria and 6 resistance determinants directly from positive blood cultures. We compared the performance of BC-GN with currently used automated systems, testing 141 cli...
journal_title:Diagnostic microbiology and infectious disease
pub_type: 杂志文章,多中心研究
doi:10.1016/j.diagmicrobio.2015.08.004
更新日期:2015-12-01 00:00:00
abstract::We conducted a retrospective review of the clinical data on patients with polymicrobial candidemia during a nine-year period (1992-2000) at our tertiary care University Hospital. Also, the clinical features of patients with polymicrobial vs monomicrobial candidemia were compared. There were 16 (5.2%) patients with mul...
journal_title:Diagnostic microbiology and infectious disease
pub_type: 杂志文章,评审
doi:10.1016/s0732-8893(02)00460-1
更新日期:2002-12-01 00:00:00
abstract::Early differentiation of mycobacteria in sputa is crucial. This study was set to evaluate the usefulness of a newly developed duplex polymerase chain reaction (PCR) for hsp65 gene-based method in differentiating mycobacteria in sputum with a positive acid-fast bacilli (AFB) smear before culturing. One hundred forty-se...
journal_title:Diagnostic microbiology and infectious disease
pub_type: 杂志文章
doi:10.1016/j.diagmicrobio.2008.05.013
更新日期:2008-10-01 00:00:00
abstract::To evaluate the diagnostic value of immunochromatographic test (ICT) on pleural fluid in diagnosing pneumococcal empyema in children and to determine pneumococcal serotypes, 62 exudative parapneumonic effusions from Korean children were tested with culture, ICT for S. pneumoniae, pneumococcal autolysin polymerase chai...
journal_title:Diagnostic microbiology and infectious disease
pub_type: 杂志文章
doi:10.1016/j.diagmicrobio.2011.09.025
更新日期:2012-02-01 00:00:00
abstract::bla(OXA-23) and bla(OXA-66) were detected in 49 Acinetobacter baumannii isolates. These isolates were assigned to 7 subtypes by enterobacterial repetitive intergenic consensus polymerase chain reaction and 7 representative isolates were of ST92 or ST75. In most cases, the ISAba1-bla(OXA-23)-ATPaseΔ structure was ident...
journal_title:Diagnostic microbiology and infectious disease
pub_type: 杂志文章
doi:10.1016/j.diagmicrobio.2010.10.018
更新日期:2011-02-01 00:00:00