Prolonged infusion of beta-lactam antibiotics for Gram-negative infections: rationale and evidence base.

Abstract:

PURPOSE OF REVIEW:The aim of this review is to discuss the rationale of and current evidence for prolonged beta-lactam infusion in the management of Gram-negative infections. RECENT FINDINGS:Pharmacokinetic/pharmacodynamic (PK/PD) data from various in-vitro and in-vivo experimental studies conclusively support prolonged infusion over intermittent infusion in terms of achieving effective beta-lactam exposure for maximal bacterial killing. Superior PK/PD target attainment has been demonstrated with prolonged beta-lactam infusion in patient populations that are more likely to have less susceptible Gram-negative infections. These populations include critically ill patients, cystic fibrosis patients and patients with malignant diseases. The clinical impact of prolonged beta-lactam infusion is likely to be the greatest in these patient groups: critically ill patients with a high level of illness severity who are not receiving renal replacement therapy; patients with nonfermenting Gram-negative bacilli infection and patients with respiratory infection. Critically ill patients with augmented renal clearance may not achieve effective beta-lactam exposure even with the use of prolonged infusion. Maximizing the effectiveness of prolonged beta-lactam infusion via therapeutic drug monitoring is becoming a more common strategy in the management of critically ill patients with Gram-negative infection. SUMMARY:Prolonged beta-lactam infusion may not benefit all patients but only for those who are critically ill and/or immunocompromised, who are also more likely to have less susceptible Gram-negative infections.

journal_name

Curr Opin Infect Dis

authors

Abdul-Aziz MH,Portunato F,Roberts JA

doi

10.1097/QCO.0000000000000681

subject

Has Abstract

pub_date

2020-12-01 00:00:00

pages

501-510

issue

6

eissn

0951-7375

issn

1473-6527

journal_volume

33

pub_type

杂志文章
  • Fungal endocarditis.

    abstract:PURPOSE OF REVIEW:Fungal endocarditis remains a rare disease occurring mostly in patients with predisposing host conditions. Regarding its poor prognosis because of severe complications, there is an urgent need for properly established treatment guidelines and prophylaxis for patients at risk. In this review we provide...

    journal_title:Current opinion in infectious diseases

    pub_type: 杂志文章,评审

    doi:10.1097/QCO.0000000000000009

    authors: Tacke D,Koehler P,Cornely OA

    更新日期:2013-12-01 00:00:00

  • Recent advances in development of amphotericin B formulations for the treatment of visceral leishmaniasis.

    abstract:PURPOSE OF REVIEW:Amphotericin B (AmpB) is considered the first-line treatment for visceral leishmaniasis in areas in which resistance to antimony is prevalent. This review describes recent advances in clinically available and novel drug delivery systems of AmpB to treat visceral leishmaniasis. RECENT FINDINGS:Over th...

    journal_title:Current opinion in infectious diseases

    pub_type: 杂志文章,评审

    doi:10.1097/QCO.0b013e328359eff2

    authors: Mohamed-Ahmed AH,Brocchini S,Croft SL

    更新日期:2012-12-01 00:00:00

  • The range of molecular methods for typing Malassezia.

    abstract:PURPOSE OF REVIEW:The recent sequencing of the whole genome of Malassezia globosa and M. restricta forms the basis for molecular epidemiology studies and instigates investigations into their respective virulence factors. Thus, reviewing current knowledge on Malassezia molecular typing methods would reveal the pros and ...

    journal_title:Current opinion in infectious diseases

    pub_type: 杂志文章,评审

    doi:10.1097/qco.0b013e328324ed19

    authors: Gaitanis G,Bassukas ID,Velegraki A

    更新日期:2009-04-01 00:00:00

  • Current thinking on genital herpes.

    abstract:PURPOSE OF REVIEW:Genital herpes has a high global prevalence and burden of disease. This manuscript highlights recent advances in our understanding of genital herpes simplex virus (HSV) infections. RECENT FINDINGS:Studies demonstrate a changing epidemiological landscape with an increasing proportion of genital herpes...

    journal_title:Current opinion in infectious diseases

    pub_type: 杂志文章,评审

    doi:10.1097/QCO.0000000000000029

    authors: Hofstetter AM,Rosenthal SL,Stanberry LR

    更新日期:2014-02-01 00:00:00

  • Low-level viraemia on HAART: significance and management.

    abstract:PURPOSE OF REVIEW:The source, significance and optimal management of low-level viraemia during highly active antiretroviral therapy (HAART) are poorly defined. This review highlights recent observations that have implications for clinical practice. RECENT FINDINGS:The definition of low-level viraemia remains elusive. ...

    journal_title:Current opinion in infectious diseases

    pub_type: 杂志文章,评审

    doi:10.1097/QCO.0b013e32834ef5d9

    authors: Doyle T,Geretti AM

    更新日期:2012-02-01 00:00:00

  • Control of influenza in healthcare settings: early lessons from the 2009 pandemic.

    abstract:PURPOSE OF REVIEW:The emergence of 2009 pandemic H1N1 influenza A (pH1N1) has provided a unique challenge to influenza control in healthcare settings. We provide an overview of the early lessons from the 2009 pandemic. RECENT FINDINGS:The modes of influenza transmission and their contributions to the development of in...

    journal_title:Current opinion in infectious diseases

    pub_type: 杂志文章,评审

    doi:10.1097/QCO.0b013e32833bb804

    authors: Carlson AL,Budd AP,Perl TM

    更新日期:2010-08-01 00:00:00

  • Rapid diagnostic tests for defining the cause of community-acquired pneumonia.

    abstract:PURPOSE OF REVIEW:We review the potential new diagnostic tools for determining the cause of pneumonia in the setting of community-acquired infection after outlining the limitation of currently available tests. RECENT FINDINGS:A number of new tools are on the horizon with the potential to overcome the problems of exist...

    journal_title:Current opinion in infectious diseases

    pub_type: 杂志文章,评审

    doi:10.1097/QCO.0000000000000148

    authors: Basnayake TL,Waterer GW

    更新日期:2015-04-01 00:00:00

  • In pursuit of a human chlamydial vaccine.

    abstract::The best way to control chlamydial diseases is with an effective vaccine. Although previous studies suggest that a vaccine is an achievable goal, progress has been limited even though many vaccination strategies have been tested. A clearer understanding of the immunobiological basis of chlamydial protection and pathol...

    journal_title:Current opinion in infectious diseases

    pub_type: 杂志文章

    doi:10.1097/00001432-199902000-00009

    authors: Yang X,Brunham RC

    更新日期:1999-02-01 00:00:00

  • The pathogenesis and clinical management of cytomegalovirus infection in the organ transplant recipient: the end of the 'silo hypothesis'.

    abstract:PURPOSE OF REVIEW:Cytomegalovirus infection is initiated when tumor necrosis factor binds to the cytomegalovirus receptors of latently infected cells, resulting in the reactivation of the virus and the production of clinical disease of two types: direct infection causing pneumonia, mononucleosis, colitis and other vira...

    journal_title:Current opinion in infectious diseases

    pub_type: 杂志文章,评审

    doi:10.1097/QCO.0b013e328285a358

    authors: Rubin RH

    更新日期:2007-08-01 00:00:00

  • Autoimmunity and HIV.

    abstract:PURPOSE OF REVIEW:This review focuses on some of the recent advances in the understanding of HIV immunopathogenesis and the diagnosis and treatment of several autoimmune conditions associated with HIV in the era of potent antiretroviral therapy. RECENT FINDINGS:Chronic immune activation with progressive immune exhaust...

    journal_title:Current opinion in infectious diseases

    pub_type: 杂志文章,评审

    doi:10.1097/QCO.0b013e3283210006

    authors: Stratton R,Slapak G,Mahungu T,Kinloch-de Loes S

    更新日期:2009-02-01 00:00:00

  • Placental transfer of antibody and its relationship to vaccination in pregnancy.

    abstract:PURPOSE OF REVIEW:Vaccination in pregnancy boosts maternal vaccine-specific antibody concentration and therefore increases transplacental transfer of antibody to optimize protection of the infant. The purpose of this review is to describe what is known about placental transfer of antibody in the context of vaccination ...

    journal_title:Current opinion in infectious diseases

    pub_type: 杂志文章,评审

    doi:10.1097/QCO.0000000000000372

    authors: Calvert A,Jones CE

    更新日期:2017-06-01 00:00:00

  • Update on treatment of cytomegalovirus infection in pregnancy and of the newborn with congenital cytomegalovirus.

    abstract:PURPOSE OF REVIEW:The purpose of this review is to assess the recent studies of therapy of pregnant women and neonates, aimed at preventing the consequences of congenital cytomegalovirus (CMV) infection. RECENT FINDINGS:A recent randomized controlled trial of treatment of CMV during pregnancy with hyperimmune globulin...

    journal_title:Current opinion in infectious diseases

    pub_type: 杂志文章,评审

    doi:10.1097/QCO.0000000000000317

    authors: Rawlinson WD,Hamilton ST,van Zuylen WJ

    更新日期:2016-12-01 00:00:00

  • HIV outcomes among migrants from low-income and middle-income countries living in high-income countries: a review of recent evidence.

    abstract:PURPOSE OF REVIEW:Migrants living in high-income countries are disproportionately affected by HIV infection and frequently have characteristics associated with poor HIV clinical outcomes. HIV epidemiology among migrants is influenced by changes in migration patterns and variations in transmission risk behaviors. Here w...

    journal_title:Current opinion in infectious diseases

    pub_type: 杂志文章,评审

    doi:10.1097/QCO.0000000000000415

    authors: Ross J,Cunningham CO,Hanna DB

    更新日期:2018-02-01 00:00:00

  • Cardiac diseases complicating community-acquired pneumonia.

    abstract:PURPOSE OF REVIEW:The aim is to evaluate basic mechanisms, prevalence, risk factors, outcomes, and potential treatments of cardiovascular events (CVEs) in patients with community-acquired pneumonia (CAP). RECENT FINDINGS:In this review, we present a new model to evaluate the pathophysiology of cardiac disease in patie...

    journal_title:Current opinion in infectious diseases

    pub_type: 杂志文章,评审

    doi:10.1097/QCO.0000000000000055

    authors: Aliberti S,Ramirez JA

    更新日期:2014-06-01 00:00:00

  • Therapy for pneumococcal bacteremia: monotherapy or combination therapy?

    abstract:PURPOSE OF REVIEW:The issue of whether the outcome of bacteremic pneumococcal infections is improved with the use of combination antibiotic therapy versus monotherapy is still not resolved. This review highlights recent studies that have addressed this issue. RECENT FINDINGS:Some studies have indicated benefit of comb...

    journal_title:Current opinion in infectious diseases

    pub_type: 杂志文章,评审

    doi:10.1097/QCO.0b013e3283232a30

    authors: Feldman C,Anderson R

    更新日期:2009-04-01 00:00:00

  • Recent developments in leishmaniasis.

    abstract:PURPOSE OF REVIEW:The leishmaniases, caused by protozoan parasites of the genus Leishmania, are a significant health problem in many regions of the world. This review highlights the recent advances in the study of leishmaniasis related to parasite biology, disease pathogenesis, clinical evaluation and treatment, and pr...

    journal_title:Current opinion in infectious diseases

    pub_type: 杂志文章,评审

    doi:10.1097/00001432-200210000-00005

    authors: Melby PC

    更新日期:2002-10-01 00:00:00

  • Detecting latent tuberculosis in compromised patients.

    abstract:PURPOSE OF REVIEW:The detection of latent tuberculosis infection (LTBI) in different categories of compromised patients is reviewed with focus on the role of strategies incorporating immunodiagnostic tests and analysis of epidemiological and clinical risk factors. RECENT FINDINGS:The development of active tuberculosis...

    journal_title:Current opinion in infectious diseases

    pub_type: 杂志文章,评审

    doi:10.1097/QCO.0000000000000158

    authors: Sauzullo I,Vullo V,Mastroianni CM

    更新日期:2015-06-01 00:00:00

  • The HIV epidemic in Italy.

    abstract::The implementation of surveillance systems for HIV and of large cohort studies have allowed for the construction of models that more accurately describe the HIV epidemic. This review focuses on changes in the epidemiological pattern, and the effect of changes in behaviour and of antiretroviral therapy. ...

    journal_title:Current opinion in infectious diseases

    pub_type: 杂志文章

    doi:10.1097/00001432-199802000-00004

    authors: Greco D

    更新日期:1998-02-01 00:00:00

  • Rotavirus vaccines.

    abstract::The past few years have seen important developments in understanding the epidemiological and virological characteristics of rotaviruses, and rapid progress has been made in rotavirus vaccine development, but further challenges remain before a vaccine is introduced into widespread use. The licensure of the first rotavi...

    journal_title:Current opinion in infectious diseases

    pub_type: 杂志文章

    doi:10.1097/00001432-200010000-00011

    authors: Lynch M,Bresee JS,Gentsch JR,Glass RI

    更新日期:2000-10-01 00:00:00

  • The skin and soft tissue infections in hematological patients.

    abstract:PURPOSE OF REVIEW:Skin and soft tissue infections (SSTIs) in patients with hematological malignancies are frequent, but dedicated epidemiological studies are limited. The aim of this review is to provide updated description of the main etiological agents, differential diagnosis, and treatment. RECENT FINDINGS:In addit...

    journal_title:Current opinion in infectious diseases

    pub_type: 杂志文章

    doi:10.1097/QCO.0000000000000632

    authors: Ungaro R,Mikulska M

    更新日期:2020-04-01 00:00:00

  • Clinical aspects of visceral leishmaniasis in HIV infection.

    abstract:PURPOSE OF REVIEW:HIV infection profoundly impairs the immune mechanisms needed to control and clear Leishmania infection, and outcomes in patients with HIV-associated visceral leishmaniasis are poor. This review summarizes recent work describing the epidemiology, presentation and outcomes of HIV-associated visceral le...

    journal_title:Current opinion in infectious diseases

    pub_type: 杂志文章,评审

    doi:10.1097/QCO.0b013e32835c2198

    authors: Jarvis JN,Lockwood DN

    更新日期:2013-02-01 00:00:00

  • Decision support systems for antibiotic prescribing.

    abstract:PURPOSE OF REVIEW:To explore recent developments in computerized evidence-based guidelines and decision support systems that have been designed to improve the effectiveness and efficiency of antibiotic prescribing. RECENT FINDINGS:The most frequently utilized decision support systems are electronic guidelines and prot...

    journal_title:Current opinion in infectious diseases

    pub_type: 杂志文章,评审

    doi:10.1097/qco.0b013e3283118932

    authors: Sintchenko V,Coiera E,Gilbert GL

    更新日期:2008-12-01 00:00:00

  • The role of surveillance cultures in guiding ventilator-associated pneumonia therapy.

    abstract:PURPOSE OF REVIEW:Ventilator-associated pneumonia (VAP) is the most frequent cause of death among the nosocomial infections acquired in the ICU. Routine surveillance endotracheal aspirate (ETA) cultures in patients on mechanical ventilation have been proposed to predict the cause of VAP. Our aim is to review the availa...

    journal_title:Current opinion in infectious diseases

    pub_type: 杂志文章,评审

    doi:10.1097/QCO.0000000000000042

    authors: Luna CM,Bledel I,Raimondi A

    更新日期:2014-04-01 00:00:00

  • Skin complications of Bacillus Calmette-Guérin immunization.

    abstract:PURPOSE OF REVIEW:Bacillus Calmette-Guerin (BCG) vaccination has been performed since 1921, and remains the best method of preventing severe infections caused by Mycobacterium tuberculosis. Tuberculosis, in its various forms, remains a public health problem, and more than 100 countries continue BCG vaccination in an ef...

    journal_title:Current opinion in infectious diseases

    pub_type: 杂志文章,评审

    doi:10.1097/01.qco.0000160895.97362.4f

    authors: Bellet JS,Prose NS

    更新日期:2005-04-01 00:00:00

  • Administration of first hospital antibiotics for community-acquired pneumonia: does timeliness affect outcomes?

    abstract:PURPOSE OF REVIEW:Associations between processes of care for hospitalized community-acquired pneumonia patients and clinical outcomes are important because of the high incidence of such admissions and substantial related mortality. Several studies have examined these associations. RECENT FINDINGS:Large retrospective s...

    journal_title:Current opinion in infectious diseases

    pub_type: 杂志文章,评审

    doi:10.1097/01.qco.0000160905.94684.91

    authors: Houck PM,Bratzler DW

    更新日期:2005-04-01 00:00:00

  • New anti-cancer therapies, new opportunities for infection.

    abstract::Therapeutic approaches in the practice of haematology/oncology are increasing in complexity. Agents such as the purine analogues and monoclonal antibodies may introduce a new spectrum of infection as a consequence of prolonged/profound lymphoid suppression. The use of high dose therapy with stem cells support is incre...

    journal_title:Current opinion in infectious diseases

    pub_type: 杂志文章

    doi:10.1097/00001432-199908000-00009

    authors: Potter M

    更新日期:1999-08-01 00:00:00

  • Childhood tuberculosis: advances in immunopathogenesis, treatment and prevention.

    abstract::Tuberculosis in childhood is an important cause of mortality worldwide. The disease is difficult to diagnose and the underlying immune mechanisms are poorly understood. Advances in the application of molecular genetic tools, as illustrated by the recent completion of the genome sequence of Mycobacterium tuberculosis, ...

    journal_title:Current opinion in infectious diseases

    pub_type: 杂志文章

    doi:

    authors: Kampmann B,Young D

    更新日期:1998-06-01 00:00:00

  • What is healthcare-associated pneumonia, and how should it be treated?

    abstract:PURPOSE OF REVIEW:In contrast to patients at risk for hospital-acquired pneumonia or mechanically ventilated patients at risk for ventilator-associated pneumonia, healthcare-associated pneumonia is a relatively new clinical entity that includes a spectrum of adult patients who have close association with acute care hos...

    journal_title:Current opinion in infectious diseases

    pub_type: 杂志文章,评审

    doi:10.1097/01.qco.0000216626.05821.40

    authors: Craven DE

    更新日期:2006-04-01 00:00:00

  • In-vitro and in-vivo efficacy of influenza neuraminidase inhibitors.

    abstract::Influenza continues to be a major health concern and there is always the threat of a pandemic due to the emergence of a viral strain new to the human population, as exemplified by the avian influenza A/H5N1 virus which was responsible for six deaths in Hong Kong last year. Data reported in the past year, based on in-v...

    journal_title:Current opinion in infectious diseases

    pub_type: 杂志文章

    doi:10.1097/00001432-199812000-00013

    authors: Mendel DB,Roberts NA

    更新日期:1998-12-01 00:00:00

  • Pathogenesis of the immune reconstitution inflammatory syndrome in HIV-infected patients.

    abstract:PURPOSE OF REVIEW:The immune reconstitution inflammatory syndrome (IRIS) is an important clinical complication in HIV-infected patients initiating antiretroviral therapy. This review focuses on the latest literature pertaining to the pathogenesis of IRIS. RECENT FINDINGS:The clinical manifestations of IRIS are heterog...

    journal_title:Current opinion in infectious diseases

    pub_type: 杂志文章,评审

    doi:10.1097/QCO.0b013e328352b664

    authors: Martin-Blondel G,Mars LT,Liblau RS

    更新日期:2012-06-01 00:00:00