Determination of the Frequency of Inadequate Antibiotic Therapy Using Calculation of Indication Failure (IF), Cumulative Indication Failure (CIF), and Balanced Indication Failure (BIF)

Combined antibiotic therapy is widely used for infections caused by carbapenem-resistant K. pneumoniae. The objective of this work was to identify the synergistic activity of combinations of two carbapenems against multidrug- and extensively drug-resistant K. pneumoniae strains producing various types of carbapenemases. For 60 antibiotic-resistant K. pneumoniae strains isolated in 8 cities of Belarus, the minimum inhibitory concentrations (MIC) of colistin and carbapenems were determined by subsequent broth microdilution method, and the genes of carbapenemases and phosphoethanolamine transferases were detected. The checkerboard method was used to determine the sensitivity to the combination of ertapenem and doripenem. High MIC values of carbapenems were revealed for NDM carbapenemase-producing strains (MIC50 of meropenem 64 mg/L, MIC50 of doripenem 64 mg/L). Doripenem was more active; MIC of doripenem ≤ 16 mg/L (low level of resistance) was determined in 28 (46.7%) strains, MIC of meropenem ≤ 16 mg/L - in 8 (13.3% of strains). The effect of potentiating the activity of doripenem with ertapenem at a fixed pharmacokinetic / pharmacodynamic concentration was observed for 20.0% of the strains producing KPC carbapenemase and 29.0% of the strains producing OXA-48 carbapenemase. The potentiating effect was independent of the presence of colistin resistance. Thus, the ability of ertapenem to potentiate the antimicrobial activity of doripenem and meropenem against some of the strains producing serine carbapenemases (KPC and OXA-48) was confirmed. The necessity of routine determination of the true MIC values of carbapenems was shown to optimize their dosage regimens and select the combination antibiotic therapy regimens.

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Inadequate Antibiotic Therapy Results in Higher Recurrence Rate after Drainage of Complicated Peri-Rectal Abscess

Surgical Infections ◽

10.1089/sur.2019.308 ◽

2020 ◽

Vol 21 (10) ◽

pp. 823-827

Author(s):

Rohit K. Rasane ◽

Adrian A. Centeno Coleoglou ◽

Christopher B. Horn ◽

Marlon Barboza Torres ◽

Eden Nohra ◽

...

Keyword(s):

Antibiotic Therapy ◽

Recurrence Rate ◽

Inadequate Antibiotic Therapy

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Acute Urticaria Associated with Streptococcal Infection

PEDIATRICS ◽

10.1542/peds.65.3.592 ◽

1980 ◽

Vol 65 (3) ◽

pp. 592-596

Author(s):

Diane E. Schuller ◽

Sharon M. Elvey

Keyword(s):

Antibiotic Therapy ◽

Causative Agent ◽

Streptococcal Infection ◽

Enzyme Level ◽

Streptococcal Pharyngitis ◽

Throat Culture ◽

Acute Urticaria ◽

Causative Factors ◽

Routine Procedures

Eighty-one cases of acute urticana were treated in our institution over a two-year period. In 13 of 32 cases screened for streptococcal pharyngitis, either positive throat culture, significant streptococcal exoenzyme antibodies (Streptozyme test), or both were found. Other causative factors for the acute urticania had been excluded. It is our feeling that β-hemolytic streptococcal infection may be a causative agent in many cases of acute urticaria, and that the infection may not always be clinically apparent. We therefore recommend a throat culture and determination of streptococcal enzyme level as routine procedures in evaluating acute urticaria. We also suggest, based on the findings in one case, that discontinuing antibiotic therapy for a streptococcal infection when urticaria develops, even though necessary, might be inappropriate.

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Surgical Site Infections: Does Inadequate Antibiotic Therapy Affect Patient Outcomes?

Surgical Infections ◽

10.1089/sur.2008.053 ◽

2009 ◽

Vol 10 (4) ◽

pp. 323-331 ◽

Cited By ~ 35

Author(s):

Kathryn J. Eagye ◽

Aryun Kim ◽

Somvadee Laohavaleeson ◽

Joseph L. Kuti ◽

David P. Nicolau

Keyword(s):

Antibiotic Therapy ◽

Patient Outcomes ◽

Surgical Site Infections ◽

Inadequate Antibiotic Therapy

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A new approach to determination of bactericidal activity of benzylpenycylin on Corynebacterium diphtheriae

Reports of Vinnytsia National Medical University ◽

10.31393/reports-vnmedical-2018-22(2)-29 ◽

2018 ◽

Vol 22 (2) ◽

pp. 368-371

Author(s):

O.I. Motyka ◽

O.M. Slesarchuk ◽

R.B. Pavlii ◽

K.E. Kapustiak

Keyword(s):

Antibiotic Therapy ◽

Bactericidal Activity ◽

Minimum Bactericidal Concentration ◽

Corynebacterium Diphtheriae ◽

Dilution Method ◽

Bactericidal Action ◽

New Approach ◽

The Relationship ◽

Broth Dilution

Information on the bactericidal activity of benzylpenycylin is important when planning antibiotic therapy for a number of diseases caused by Corynebacterium diphtheriae (endocarditis, bacteremia, septicemia, etc.). However, methods for determining the minimum bactericidal concentration (MBC) of antibiotics are complicated. The aim of the study was to develop a method for testing of diphtheria causative agent susceptibility to the bactericidal action of penicillin without MBC determination. The minimum inhibitory concentrations (MICs) and MBCs in 80 strains of C. diphtheriae were determined using the standard broth dilution method (macromethod). The MICs were registered after 24 and 48 years of growth. After the first day of growth the MIC of penicillin was in the range of 0.017 to 0.5 mg / L, after second day — in the range of 0.035 to 0.5 mg / liter. The increase of the MICs for the second day of growth was observed in 47.5±5.6% of strains. MIC50 and MIC90 both after 24 hours and after 48 hours of growth were 0.13 and 0.25 mg/L, respectively. MBCs of penicillin was in the range of 0.5 to 32.0 mg/L, MBC50 was 4.0 mg/l, MBC90 – 8.0 mg/l. In 35,0±5,3% of the studied strains, high MBCs (8.0 mg / l or higher) was detected. It has been established that in C.diphtheriae the relationship between the MIC and the MBC of penicillin is clearly expressed, taking into account the two values of the MIC – for the first and second day of growth. Investigated strains are divided into three conditional groups: 1) with MIC 0.13 mg/L and basically with low MBCs; 2) with MIC 0.25 mg/L, in most cases are not susceptible to bactericidal action, and 3) strains with MIC 0.5 mg/L and high MBCs. The most pronounced were differences in the prevalence of corynebacteria with high MBCs in two groups of strains: MICs which did not exceed 0.13 mg/L after 24 and 48 hours, and those in whom the MIC was 0.25 mg/L or higher already on the first day of incubation (Student's coefficient t=4.13, p<0.001). The obtained results can be used to improve the methods for determining of corynebacteria susceptibility to antimicrobials.

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General Principles of Antibiotic Therapy

10.2310/fm.1475 ◽

2021 ◽

Author(s):

Alyssa R. Letourneau ◽

Michael S. Calderwood

Keyword(s):

Clostridium Difficile ◽

Antibiotic Therapy ◽

Drug Targets ◽

Essential Feature ◽

Host Factors ◽

Factors Affecting ◽

Antibiotic Susceptibilities ◽

Antibiotic Drug ◽

Antibiotic Agents

The essential feature of effective antibiotic agents is the ability to inhibit the growth of microorganisms at concentrations tolerated by the host. Antibiotic agents generally target anatomic structures or biosynthetic pathways unique to bacteria. The appropriate choice of an antibiotic for an infection depends on the following: clinician’s level of suspicion; the infecting organism and its antibiotic susceptibilities; the type of infection; factors associated with specific antibiotic agents; host factors; and public health considerations. This review provides an overview of antibiotic therapy and covers identifying the cause of an infection, determination of bacterial susceptibility to specific drugs, site of infection and ancillary therapy, antibiotic drug targets, pharmacodynamic parameters, factors affecting dosage and route of administration, host factors, complications of antibiotic therapy, Clostridium difficile infection, and antimicrobial resistance. This review contains 2 figures, 7 tables, and 45 references. Key words: Antimicrobial therapy, antibiotic, infection, microorganism, renal dosing, hepatic dosing, Clostridium difficile

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Predictive Value of Sputum Gram Stain for the Determination of Appropriate Antibiotic Therapy in Ventilator-Associated Pneumonia

Journal of Trauma and Acute Care Surgery ◽

10.1097/ta.0b013e3180479889 ◽

2007 ◽

Vol 62 (6) ◽

pp. 1377-1383 ◽

Cited By ~ 13

Author(s):

Krishnan Raghavendran ◽

Jiping Wang ◽

Christopher Belber ◽

Sarojini R. Misra ◽

Kimberly Brunton ◽

...

Keyword(s):

Antibiotic Therapy ◽

Predictive Value ◽

Ventilator Associated Pneumonia ◽

Gram Stain

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Constructing Unit-Specific Empiric Treatment Guidelines for Catheter-Related and Primary Bacteremia by Determining the Likelihood of Inadequate Therapy

Infection Control and Hospital Epidemiology ◽

10.1086/664756 ◽

2012 ◽

Vol 33 (4) ◽

pp. 416-420 ◽

Cited By ~ 7

Author(s):

Megan E. Davis ◽

Deverick J. Anderson ◽

Michelle Sharpe ◽

Luke F. Chen ◽

Richard H. Drew

Keyword(s):

Antibiotic Therapy ◽

Treatment Guidelines ◽

Bloodstream Infections ◽

Empiric Antibiotic Therapy ◽

In Vitro Susceptibility ◽

Empiric Treatment ◽

Inadequate Therapy ◽

Empiric Antibiotic

This study aimed to determine the feasibility of using likelihood of inadequate therapy (LIT), a parameter calculated by using pathogen frequency and in vitro susceptibility for determination of appropriate empiric antibiotic therapy for primary bloodstream infections. Our study demonstrates that LIT may reveal differences in traditional antibiograms.

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