Abstract:
:Piperacillin plasma concentrations are known to vary between critically ill patients. However, there are no comprehensive data on the variability of antibiotic concentrations within the same patient. The purpose of this study was to investigate the adequacy of dosing during an entire 7-day antibiotic course and to investigate the variability in antibiotic trough concentrations both between patients and within the same patient. Piperacillin trough concentrations were measured daily in critically ill patients with normal renal function. The drug assay was performed using UPLC-MS/MS. The pharmacokinetic/pharmacodynamic target was 100% fT>MIC of the Pseudomonas aeruginosa EUCAST breakpoint. Within- and between-patient variability were calculated as percent coefficient of variation (CV). Eleven patients treated for pneumonia were included in this nested prospective observational cohort study. The median (range) age was 67 (18-79) years, weight was 75 (57-90)kg and BMI was 23.5 (22.3-26.4). The median (range) creatinine clearance on Day 1 of antibiotic treatment was 102 (62-154)mL/min. Trough concentrations were variable, ranging from 4.9 mg/L to 98.0 mg/L. A median CV of 40% for within-patient variability and 57% for between-patient variability was found. Within-patient variability was inversely correlated with SOFA score (R = 0.65, P = 0.027) and APACHE II score on admission (R = 0.73, P = 0.009). In conclusion, piperacillin concentrations varied widely both between patients and within the same patient. Within-patient variability was inversely correlated with disease severity. Consistent dosing of piperacillin/tazobactam does not result in consistent piperacillin concentrations throughout the entire treatment period.
journal_name
Int J Antimicrob Agentsjournal_title
International journal of antimicrobial agentsauthors
Carlier M,Carrette S,Stove V,Verstraete AG,De Waele JJdoi
10.1016/j.ijantimicag.2014.01.028subject
Has Abstractpub_date
2014-05-01 00:00:00pages
470-3issue
5eissn
0924-8579issn
1872-7913pii
S0924-8579(14)00057-0journal_volume
43pub_type
杂志文章abstract::Three pharmacokinetic/pharmacodynamic parameters--(i) the peak concentration to the minimum inhibitory concentration ratio (C(max)/MIC); (ii) the area under the concentration-time curve to MIC ratio (AUC(24h)/MIC); and (iii) the time the concentration exceeds the MIC (T>MIC)--are important predictors of the clinical e...
journal_title:International journal of antimicrobial agents
pub_type: 杂志文章,评审
doi:10.1016/s0924-8579(01)00406-x
更新日期:2001-01-01 00:00:00
abstract::A point prevalence survey of antimicrobial prescribing was performed in 10 Scottish hospitals using the Glasgow Antimicrobial Audit Tool (GAAT). Appropriateness of the intravenous (IV) route was determined by an infectious diseases physician (IDP) and by a computerised algorithm. The IDP also estimated IV agent approp...
journal_title:International journal of antimicrobial agents
pub_type: 杂志文章
doi:10.1016/j.ijantimicag.2006.10.020
更新日期:2007-06-01 00:00:00
abstract::Toxin-producing gram-positive bacteria are responsible for emerging and life-threatening infections in humans worldwide. Both rapid toxin detection and adapted therapy are essential to limit the morbidity due to such toxins, especially staphylococcal Panton-Valentine leukocidin (PVL). Here we describe the use of a mas...
journal_title:International journal of antimicrobial agents
pub_type: 杂志文章
doi:10.1016/j.ijantimicag.2009.03.017
更新日期:2009-11-01 00:00:00
abstract::Herpes simplex virus (HSV) infections in immunocompromised patients are more severe and invasive than in non-immunocompromised patients. They are characterised by prolonged viral shedding and a tendency to heal more slowly. In addition, resistant viruses are exclusively isolated in immunocompromised patients, requirin...
journal_title:International journal of antimicrobial agents
pub_type: 杂志文章,评审
doi:10.1016/s0924-8579(00)00233-8
更新日期:2000-10-01 00:00:00
abstract::Due to limited therapeutic options, combination therapy has been used empirically to treat carbapenem-resistant Acinetobacter baumannii (CRAB). Polymyxin-based combinations have been widely studied and used in the clinical setting. However, the use of polymyxins is often limited due to nephrotoxicity and neurotoxicity...
journal_title:International journal of antimicrobial agents
pub_type: 杂志文章
doi:10.1016/j.ijantimicag.2020.106115
更新日期:2020-10-01 00:00:00
abstract::The antifungal activity of posaconazole (SCH56592), a new triazole antifungal, against stock cultures and fresh clinical isolates of a wide range of pathogenic fungi was compared with that of itraconazole, fluconazole and amphotericin B. Posaconazole inhibited growth of all the fungal species tested except Fusarium sp...
journal_title:International journal of antimicrobial agents
pub_type: 杂志文章
doi:10.1016/s0924-8579(01)00363-6
更新日期:2001-08-01 00:00:00
abstract::The effect of high-level efflux activity on the MICs of fluoroquinolones against Streptococcus pneumoniae in the absence of topoisomerase mutations leading to fluoroquinolones resistance was investigated. A S. pneumoniae ATCC 46619-derived strain with high-level efflux activity was obtained (SP-25A). Both the parent a...
journal_title:International journal of antimicrobial agents
pub_type: 杂志文章
doi:10.1016/j.ijantimicag.2004.01.012
更新日期:2004-08-01 00:00:00
abstract::The prominence of staphylococci as the causative agent in bone and joint infections suggests that fusidic acid (FA) has a potentially important role in their treatment. FA has been studied in a broad range of orthopaedic infections, mostly in combination with other antimicrobials. For susceptible organisms, particular...
journal_title:International journal of antimicrobial agents
pub_type: 杂志文章,评审
doi:10.1016/s0924-8579(98)00077-6
更新日期:1999-08-01 00:00:00
abstract::The extracts from the starfish Asterina pectinifera obtained using various organic solvents and distilled water were tested for their antimicrobial activities against fungi and yeasts. The methanol and water extracts were found to be the most active and Aspergillus spp. and Cryptococcus neoformans proved to be sensiti...
journal_title:International journal of antimicrobial agents
pub_type: 杂志文章
doi:10.1016/s0924-8579(98)00079-x
更新日期:1999-01-01 00:00:00
abstract::In this study, 2275 clinical isolates of 49 species of non-tuberculous mycobacteria isolated in The Netherlands were subjected to standardised drug susceptibility testing using the Middlebrook 7H10 agar dilution method. Clarithromycin and rifabutin were most active, with 87% and 83% of all isolates, respectively, bein...
journal_title:International journal of antimicrobial agents
pub_type: 杂志文章
doi:10.1016/j.ijantimicag.2009.09.023
更新日期:2010-02-01 00:00:00
abstract::Clinafloxacin, levofloxacin, sparfloxacin and trovafloxacin were tested by Etest against 188 Streptococcus pneumoniae isolates. Clinafloxacin and trovafloxacin were 2-4-fold more potent than sparfloxacin and 8-fold more than levofloxacin. Two isolates, both serotype 6, with high-level quinolone resistance (> or = 8 mi...
journal_title:International journal of antimicrobial agents
pub_type: 杂志文章
doi:10.1016/s0924-8579(97)00053-8
更新日期:1998-02-01 00:00:00
abstract::The objective of this study was to obtain data on the susceptibility of pathogens responsible for acute uncomplicated cystitis in South Korea to currently used antimicrobial agents. A total of 239 isolates were obtained from female outpatients with acute uncomplicated cystitis. The most prevalent causative organism wa...
journal_title:International journal of antimicrobial agents
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ijantimicag.2004.02.012
更新日期:2004-09-01 00:00:00
abstract::The novel ketolide telithromycin (formerly HMR-3647) was tested against a collection of pneumococci of varying sensitivity to erythromycin and clindamycin, isolated in geographically diverse UK hospitals. Telithromycin was highly active against erythromycin-susceptible pneumococci, the MIC(90) being 0.015 mg/l. Erythr...
journal_title:International journal of antimicrobial agents
pub_type: 杂志文章
doi:10.1016/s0924-8579(01)00346-6
更新日期:2001-07-01 00:00:00
abstract::Colistin has been used in veterinary medicine for decades, mainly for the prevention and treatment of Enterobacteriaceae infections. However, data regarding colistin resistance in bacteria from animals and food of animal origin are relatively scarce, partly because there are methodological difficulties hampering the a...
journal_title:International journal of antimicrobial agents
pub_type: 杂志文章,评审
doi:10.1016/j.ijantimicag.2016.09.016
更新日期:2016-12-01 00:00:00
abstract::Growth of Staphylococcus aureus in the presence of salicylate leads to reduced ciprofloxacin and ethidium accumulation and increased resistance to ethidium. Salicylate induced reduction in ciprofloxacin accumulation is energy-independent while salicylate induced alterations in ethidium accumulation and efflux is proto...
journal_title:International journal of antimicrobial agents
pub_type: 杂志文章
doi:10.1016/s0924-8579(02)00162-0
更新日期:2002-09-01 00:00:00
abstract::S fimbrial adhesins (Sfa) represent virulence factors of E. coli wild-type strains causing urinary tract infections and meningitis of the new born. In order to determine the influence of subinhibitory concentration of antibiotics on the expression of the sfa gene cluster, a wild-type strain carrying the lacZ gene, cod...
journal_title:International journal of antimicrobial agents
pub_type: 杂志文章
doi:10.1016/0924-8579(93)90060-i
更新日期:1993-01-01 00:00:00
abstract::The occurrence of antibiotic-resistant bacteria in food animals is a major public health threat. Information on the prevalence of resistance to specific drugs in both bacterial and animal species together with changes occurring over time, are necessary to understand the magnitude of the problem and to establish baseli...
journal_title:International journal of antimicrobial agents
pub_type: 杂志文章
doi:10.1016/s0924-8579(00)00140-0
更新日期:2000-05-01 00:00:00
abstract:BACKGROUND:Fluoroquinolones (FQs) are second-line antimicrobial agents. Once the decision to prescribe an antimicrobial is made, the choice of antimicrobial should be based on both the benefits and adverse effects. This systematic review quantifies the occurrence of common adverse events (AEs) related to FQs in relatio...
journal_title:International journal of antimicrobial agents
pub_type: 杂志文章,meta分析
doi:10.1016/j.ijantimicag.2018.04.014
更新日期:2018-11-01 00:00:00
abstract::Two general strategies have been adopted to develop catheter materials that resist encrustaion by bacterial biofilms: (a) the incorporation of antimicrobial agents into the polymers and (b) the production of materials with surface properties which prevent the adherence of bacterial cells. Our experience to develop non...
journal_title:International journal of antimicrobial agents
pub_type: 杂志文章
doi:10.1016/s0924-8579(02)00091-2
更新日期:2002-06-01 00:00:00
abstract::Resistant mutants of Ureaplasma parvum were selected by serial passages of a susceptible strain in subinhibitory concentrations of different macrolides and related antibiotics (erythromycin, azithromycin, josamycin, quinupristin, quinupristin/dalfopristin, pristinamycin and telithromycin). Mechanisms of resistance wer...
journal_title:International journal of antimicrobial agents
pub_type: 杂志文章
doi:10.1016/j.ijantimicag.2006.09.008
更新日期:2007-02-01 00:00:00
abstract::Neurological complications of antibiotics are relatively common in renal failure. Central nervous system neurotoxicity due to penicillin and beta-lactam antibiotics is best documented with fewer accounts of ototoxicity, peripheral nerve toxicity and neuromuscular blockade. In the context of risk stratification, the go...
journal_title:International journal of antimicrobial agents
pub_type: 杂志文章,评审
doi:10.1016/j.ijantimicag.2003.11.004
更新日期:2004-03-01 00:00:00
abstract:OBJECTIVES:We hypothesised that treatment with a tigecycline-based antimicrobial regimen for intra-abdominal infection (IAI) could be associated with lower rates of subsequent carbapenem-resistant Enterobacteriaceae (CRE) colonisation or Clostridium difficile infection (CDI) compared with a meropenem-based regimen. ME...
journal_title:International journal of antimicrobial agents
pub_type: 杂志文章
doi:10.1016/j.ijantimicag.2018.01.010
更新日期:2018-03-01 00:00:00
abstract::A strong antistaphylococcal peptide (ASP-1) from Bacillus subtilis URID 12.1 strain that is active against cefoxitin- and methicillin-resistant Staphylococcus aureus clinical isolates was purified to homogeneity by solvent extraction, silica gel-based adsorption chromatography and reversed-phase high-performance liqui...
journal_title:International journal of antimicrobial agents
pub_type: 杂志文章
doi:10.1016/j.ijantimicag.2017.08.030
更新日期:2018-01-01 00:00:00
abstract::The main objectives in childhood urinary tract infections are rapid recovery from complaints, prevention of urosepsis and infection-related complications as well as the prevention of renal parenchymal damage. Calculated antibiotic therapy should take the local resistance rates of uropathogens into consideration. The c...
journal_title:International journal of antimicrobial agents
pub_type: 杂志文章,评审
doi:10.1016/j.ijantimicag.2011.09.006
更新日期:2011-12-01 00:00:00
abstract::Quinolone and macrolide resistance of Campylobacter jejuni and Campylobacter coli mainly depend on a mutation in gyrA and in 23S rDNA, respectively. In order to detect quinolone and/or macrolide resistant C. jejuni and C. coli strains, a macrolide and quinolone line probe assay (MQ-LiPA) was developed and 42 C. jejuni...
journal_title:International journal of antimicrobial agents
pub_type: 杂志文章
doi:10.1016/s0924-8579(03)00178-x
更新日期:2003-10-01 00:00:00
abstract::Infections caused by multidrug-resistant bacteria, including Pseudomonas aeruginosa, are threatening public health worldwide. Therefore, a novel antibacterial agent is needed to treat these infections. Here, we investigated the in vitro and in vivo activities of a novel siderophore-conjugated cephalosporin, LCB10-0200...
journal_title:International journal of antimicrobial agents
pub_type: 杂志文章
doi:10.1016/j.ijantimicag.2017.06.001
更新日期:2017-12-01 00:00:00
abstract::Antibiotic treatment represents a mainstay of therapy for clinical sepsis. Distinct from their antimicrobial effects, antibiotics may impact the inflammatory process in sepsis, e.g. within the intestinal microcirculation. The impact of seven antibiotics relevant to clinical sepsis on intestinal leukocyte recruitment a...
journal_title:International journal of antimicrobial agents
pub_type: 杂志文章
doi:10.1016/j.ijantimicag.2013.02.024
更新日期:2013-06-01 00:00:00
abstract::This study was designed to evaluate the potential role of fosfomycin as a therapeutic agent in human listeriosis. The in vitro activity of fosfomycin against 154 Listeria monocytogenes clinical isolates under conditions that mimic the induction of prfA expression was determined and was correlated with fosfomycin intra...
journal_title:International journal of antimicrobial agents
pub_type: 杂志文章
doi:10.1016/j.ijantimicag.2013.10.018
更新日期:2014-02-01 00:00:00
abstract::Demonstration of efflux of ethidium bromide (EtBr) has been made for over 30 bacterial species, usually by showing enhanced efflux in multidrug-resistant strains that was then abolished by inactivating efflux pumps. Here we present a relatively simple automated method that employs EtBr as an efflux pump substrate for ...
journal_title:International journal of antimicrobial agents
pub_type: 杂志文章
doi:10.1016/j.ijantimicag.2007.12.015
更新日期:2008-05-01 00:00:00
abstract::Modifications of the immune response have been reported for a number of antimicrobial agents following both in vivo and in vitro experiments. Present results were obtained from in vitro incubated human polymorphonuclear cells (PMN) and monocytes treated with meropenem, a novel carbapenem antibiotic. Only the highest c...
journal_title:International journal of antimicrobial agents
pub_type: 杂志文章
doi:10.1016/0924-8579(94)00042-s
更新日期:1995-04-01 00:00:00