High Dose Intramuscular Methylprednisolone in Experimental Staphylococcus aureus Endophthalmitis

1999 ◽  
Vol 15 (1) ◽  
pp. 91-96 ◽  
Author(s):  
MARC O. YOSHIZUMI ◽  
AMIR KASHANI ◽  
JAMES PALMER ◽  
GRACE LEE ◽  
BARTLY MONDINO
2011 ◽  
Vol 55 (12) ◽  
pp. 5480-5484 ◽  
Author(s):  
Yuhan Chang ◽  
Wen-Chien Chen ◽  
Pang-Hsin Hsieh ◽  
Dave W. Chen ◽  
Mel S. Lee ◽  
...  

ABSTRACTThe objective of this study was to evaluate the antibacterial effects of polymethylmethacrylate (PMMA) bone cements loaded with daptomycin, vancomycin, and teicoplanin against methicillin-susceptibleStaphylococcus aureus(MSSA), methicillin-resistantStaphylococcus aureus(MRSA), and vancomycin-intermediateStaphylococcus aureus(VISA) strains. Standardized cement specimens made from 40 g PMMA loaded with 1 g (low-dose), 4 g (middle-dose) or 8 g (high-dose) antibiotics were tested for elution characteristics and antibacterial activities. The patterns of release of antibiotics from the cement specimens were evaluated usingin vitrobroth elution assay with high-performance liquid chromatography. The activities of broth elution fluid against differentStaphylococcus aureusstrains (MSSA, MRSA, and VISA) were then determined. The antibacterial activities of all the tested antibiotics were maintained after being mixed with PMMA. The cements loaded with higher dosages of antibiotics showed longer elution periods. Regardless of the antibiotic loading dose, the teicoplanin-loaded cements showed better elution efficacy and provided longer inhibitory periods against MSSA, MRSA, and VISA than cements loaded with the same dose of vancomycin or daptomycin. Regarding the choice of antibiotics for cement loading in the treatment ofStaphylococcus aureusinfection, teicoplanin was superior in terms of antibacterial effects.


2016 ◽  
Vol 35 (5) ◽  
pp. 517-518 ◽  
Author(s):  
Sumant Prabhudesai ◽  
Amruta Kanjani ◽  
P. Senthur Nambi ◽  
S. Gnanasambandam ◽  
Bala Ramachandran

2018 ◽  
Vol 63 (2) ◽  
pp. e01844-18 ◽  
Author(s):  
Matthieu Grégoire ◽  
Benjamin Gaborit ◽  
Colin Deschanvres ◽  
Raphaël Lecomte ◽  
Guillaume Deslandes ◽  
...  

ABSTRACT A patient received continuous infusion of cefazolin 10 g then 8 g daily for an external ventricular drainage-related methicillin-susceptible Staphylococcus aureus (MSSA) ventriculitis. Median free concentrations in the cerebrospinal fluid were 11.9 and 6.1 mg/liter after 10- and 8-g doses, respectively. Free concentrations in the cerebrospinal fluid were always above the MIC usually displayed by methicillin-susceptible Staphylococcus aureus (MSSA) isolates. These results support the use of high-dose cefazolin to achieve sufficient meningeal concentrations.


2021 ◽  
pp. 114-118
Author(s):  
Raghavendra Rao M. V ◽  
Mubasheer Ali ◽  
Yogendra Kumar Verma ◽  
Dilip Mathai ◽  
Tina Priscilla ◽  
...  

Methicillin-resistant Staphylococcus aureus (MRSA) is difcult to treat with methicillin, amoxicillin, penicillin, oxacillin, and other commonly used antibiotics because of its resistance. Staphylococcus organisms rapidly develop drug resistance as many as 50% of the domiciliary and 80% of the hospital strains are now penicillin resistant. Staphylococcus aureus also show multiple drug resistance. Therefore, Staphylococcal isolates should always be tested for antimicrobial sensitivity and chronic infection should be treated by more than one drug. Before 1960,when methicillin, is the rst penicillin's-resistant penicillin's, was brought into use, about 1%of the strains of the Staphylococcus aureus were "methicillin resistant" and by 1970 in Britain their proportion has risen to about 5%.These strains are tolerant of, low therapeutic concentrations of methicillin, cloxacillin, benzyl penicillin and ampicillin.They do not destroy methicillin and cloxacillin, but most of them are penicillinase-producing as well as being "methicillin resistant" and therefore inactivate benzyl penicillin and ampicillin. Its resistance is uncertain since infections may be cured with a high dose of methicillin.


2020 ◽  
Vol 75 (11) ◽  
pp. 3239-3243
Author(s):  
Carolyne Horner ◽  
Shazad Mushtaq ◽  
David M Livermore ◽  
M Allen ◽  
D F J Brown ◽  
...  

Abstract Background Ceftaroline and ceftobiprole inhibit most MRSA and MDR pneumococci. Few direct comparisons of their activity have been published, but in several years (2008, 2013, 2017 and 2018) both were tested in parallel in the BSAC Resistance Surveillance Programme, giving paired results. These are reviewed. Methods Isolates included were bloodstream Staphylococcus aureus [n = 1884 (MRSA, n = 234)], bloodstream CoNS (n = 813; 574 methicillin resistant), and bloodstream (n = 852) and respiratory (n = 670) Streptococcus pneumoniae. MICs were determined by BSAC agar dilution and reviewed against EUCAST breakpoints; S. aureus breakpoints were assumed for CoNS. Results Ceftaroline MICs were mostly 2-fold lower than those of ceftobiprole, but, for all groups, MICs of both agents were strongly inter-related. Methicillin-susceptible staphylococci were universally susceptible to both agents; all MRSA were susceptible to ceftobiprole, whereas 10/234 had intermediate/high-dose susceptibility to ceftaroline. Among methicillin-resistant CoNS, 88% were susceptible to both agents, but reduced ceftaroline susceptibility and ceftobiprole resistance were frequent (65%) among methicillin-resistant Staphylococcus haemolyticus. One S. pneumoniae was resistant to both ceftaroline (MIC 0.5 mg/L) and ceftobiprole (MIC 1 mg/L) and seven others were only resistant to ceftobiprole (MIC 1 mg/L); seven of these eight pneumococci belonged to serotype 19A or 19F. No time trend in susceptibility was seen for either cephalosporin. Conclusions Ceftaroline and ceftobiprole have similarly good activity against staphylococci and pneumococci. Therapeutic choices between these agents should be predicated on other differentiating factors, including licensed indications, clinical experience and need for Gram-negative coverage.


2012 ◽  
Vol 56 (11) ◽  
pp. 5990-5993 ◽  
Author(s):  
Lisa M. Avery ◽  
Molly E. Steed ◽  
Ashley E. Woodruff ◽  
Muhammad Hasan ◽  
Michael J. Rybak

ABSTRACTWe report two cases of daptomycin (DAP)-nonsusceptible (DNS) vancomycin-intermediateStaphylococcus aureus(VISA) vertebral osteomyelitis cases complicated by bacteremia treated with high-dose daptomycin and trimethoprim-sulfamethoxazole. Both patients responded rapidly and favorably to this combination. The clinical isolates from the two patients were testedpost hocin anin vitropharmacokinetic/pharmacodynamic (PK/PD) model to confirm the bactericidal activity and enhancement of daptomycin and trimethoprim-sulfamethoxazole. The combination of high-dose daptomycin and trimethoprim-sulfamethoxazole should be explored further for the treatment of DNS VISA strains.


2009 ◽  
Vol 53 (9) ◽  
pp. 3894-3901 ◽  
Author(s):  
Yoriko Harigaya ◽  
Jürgen B. Bulitta ◽  
Alan Forrest ◽  
George Sakoulas ◽  
Alan J. Lesse ◽  
...  

ABSTRACT Little is known regarding killing activity of vancomycin against methicillin (meticillin)-resistant Staphylococcus aureus (MRSA) in pneumonia since the extent of vancomycin penetration into epithelial lining fluid (ELF) has not been definitively established. We evaluated the impact of the extent of ELF penetration on bacterial killing and resistance by simulating a range of vancomycin exposures (24-h free drug area under the concentration-time curve [ƒAUC24]/MIC) using an in vitro pharmacodynamic model and population-based mathematical modeling. A high-dose, 1.5-g-every-12-h vancomycin regimen according to American Thoracic Society/Infectious Diseases Society of America guidelines (trough concentration, 15 mg/liter) with simulated ELF/plasma penetration of 0, 20, 40, 60, 80, or 100% (ƒAUC24/MIC of 0, 70, 140, 210, 280, or 350) was evaluated against two agr-functional, group II MRSA clinical isolates obtained from patients with a bloodstream infection (MIC = 1.0 mg/liter) at a high inoculum of 108 CFU/ml. Despite high vancomycin exposures and 100% penetration, all regimens up to a ƒAUC24/MIC of 350 did not achieve bactericidal activity. At regimens of ≤60% penetration (ƒAUC24/MIC ≤ 210), stasis and regrowth occurred, amplifying the development of intermediately resistant subpopulations. Regimens simulating ≥80% penetration (ƒAUC24/MIC ≥ 280) suppressed development of resistance. Resistant mutants amplified by suboptimal vancomycin exposure displayed reduced rates of autolysis (Triton X-100) at 72 h. Bacterial growth and death were well characterized by a Hill-type model (r 2 ≥ 0.984) and a population pharmacodynamic model with a resistant and susceptible subpopulation (r 2 ≥ 0.965). Due to the emergence of vancomycin-intermediate resistance at a ƒAUC24/MIC of ≤210, exceeding this exposure breakpoint in ELF may help to guide optimal dosage regimens in the treatment of MRSA pneumonia.


2006 ◽  
Vol 6 (1) ◽  
Author(s):  
Heinz J Schaad ◽  
Manuela Bento ◽  
Daniel P Lew ◽  
Pierre Vaudaux

2014 ◽  
Vol 307 (11) ◽  
pp. E994-E1008 ◽  
Author(s):  
Irene Cortés-Puch ◽  
Caitlin W. Hicks ◽  
Junfeng Sun ◽  
Steven B. Solomon ◽  
Peter Q. Eichacker ◽  
...  

The clinical significance and even existence of critical illness-related corticosteroid insufficiency is controversial. Here, hypothalamic-pituitary-adrenal (HPA) function was characterized in severe canine Staphylococcus aureus pneumonia. Animals received antibiotics and titrated life-supportive measures. Treatment with dexamethasone, a glucocorticoid, but not desoxycorticosterone, a mineralocorticoid, improves outcome in this model. Total and free cortisol, adrenocorticotropic hormone (ACTH). and aldosterone levels, as well as responses to exogenous ACTH were measured serially. At 10 h after the onset of infection, the acute HPA axis stress response, as measured by cortisol levels, exceeded that seen with high-dose ACTH stimulation but was not predictive of outcome. In contrast to cortisol, aldosterone was largely autonomous from HPA axis control, elevated longer, and more closely associated with survival in early septic shock. Importantly, dexamethasone suppressed cortisol and ACTH levels and restored ACTH responsiveness in survivors. Differing strikingly, nonsurvivors, sepsis-induced hypercortisolemia, and high ACTH levels as well as ACTH hyporesponsiveness were not influenced by dexamethasone. During septic shock, only serial measurements and provocative testing over a well-defined timeline were able to demonstrate a strong relationship between HPA axis function and prognosis. HPA axis unresponsiveness and high aldosterone levels identify a septic shock subpopulation with poor outcomes that may have the greatest potential to benefit from new therapies.


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