scholarly journals Erratum for Herrera-Hidalgo et al., “Is Once-Daily High-Dose Ceftriaxone plus Ampicillin an Alternative for Enterococcus faecalis Infective Endocarditis in Outpatient Parenteral Antibiotic Therapy Programs?”

2021 ◽  
Vol 65 (6) ◽  
Author(s):  
Laura Herrera-Hidalgo ◽  
Arístides de Alarcón ◽  
Luis Eduardo López-Cortes ◽  
Rafael Luque-Márquez ◽  
Luis Fernando López-Cortes ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Antibiotic Therapy ◽  
Enterococcus Faecalis ◽  
High Dose ◽  
Parenteral Antibiotic ◽  
Once Daily ◽  
Outpatient Parenteral Antibiotic Therapy

scholarly journals Is Once-Daily High-Dose Ceftriaxone plus Ampicillin an Alternative for Enterococcus faecalis Infective Endocarditis in Outpatient Parenteral Antibiotic Therapy Programs?

2020 ◽  
Vol 65 (1) ◽  
pp. e02099-20
Author(s):  
Laura Herrera-Hidalgo ◽  
Arístides de Alarcón ◽  
Luis Eduardo López-Cortes ◽  
Rafael Luque-Márquez ◽  
Luis Fernando López-Cortes ◽  
...  
Keyword(s):  
Single Dose ◽  
Infective Endocarditis ◽  
Antibiotic Therapy ◽  
Enterococcus Faecalis ◽  
High Dose ◽  
Synergistic Activity ◽  
Parenteral Antibiotic ◽  
Once Daily ◽  
Content Type ◽  
Outpatient Parenteral Antibiotic Therapy

ABSTRACTCeftriaxone administered as once-daily high-dose short infusion combined with ampicillin has been proposed for the treatment of Enterococcus faecalis infective endocarditis in outpatient parenteral antibiotic therapy programs (OPAT). This combination requires synergistic activity, but the attainment of ceftriaxone synergic concentration (Cs) with the regimen proposed for OPAT has not been studied. This phase II pharmacokinetic study enrolled healthy adult volunteers who underwent two sequential treatment phases. During phase A, volunteers received 2 g of ceftriaxone each 12 h during 24 h followed by a 7-day wash-out. Then the participants received phase B, which consisted of a single dose of 4 g of ceftriaxone. Throughout both phases, each volunteer underwent intensive pharmacokinetic (PK) sampling over 24 h. Ceftriaxone total and unbound concentrations were measured. Twelve participants were enrolled and completed both phases. Mean ceftriaxone total and free concentrations 24 h after the administration of 2 g each 12 h were 86.44 ± 25.90 mg/liter and 3.59 ± 1.35 mg/liter, respectively, and after the 4-g single dose were 34.60 ± 11.16 mg/liter and 1.40 ± 0.62 mg/liter, respectively. Only 3 (25%) patients in phase A maintained unbound plasma concentrations superior to the suggested Cs = 5 mg/liter during 24 h, and none (0%) in phase B. No grade 3 to 4 adverse events or laboratory abnormalities were observed. Ceftriaxone optimal exposure combined with ampicillin to achieve maximal synergistic activity against E. faecalis required for the treatment of infective endocarditis remains unknown. However, the administration of a single daily dose of 4 g of ceftriaxone implies a reduction in the time of exposure to the proposed Cs. (This study has been registered in the European Union Drug Regulating Authorities Clinical Trials [EudraCT] database under identifier 2017-003127-29.)

scholarly journals Ampicillin Plus Ceftriaxone Combined Therapy for Enterococcus faecalis Infective Endocarditis in OPAT

2021 ◽  
Vol 11 (1) ◽  
pp. 7
Author(s):  
Laura Herrera-Hidalgo ◽  
Jose Manuel Lomas-Cabezas ◽  
Luis Eduardo López-Cortés ◽  
Rafael Luque-Márquez ◽  
Luis Fernando López-Cortés ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Retrospective Analysis ◽  
Enterococcus Faecalis ◽  
Combined Therapy ◽  
Clinical Results ◽  
Unplanned Readmission ◽  
High Dose ◽  
Dose Administration ◽  
Parenteral Antibiotic ◽  
Once Daily

Ampicillin plus ceftriaxone (AC) is a well-recognized inpatient regimen for Enterococcus faecalis infective endocarditis (IE). In this regimen, ceftriaxone is usually administered 2 g every 2 h (AC12). The administration of AC in outpatient parenteral antibiotic treatment (OPAT) programs is challenging because multiple daily doses are required. AC regimens useful for OPAT programs include once-daily high-dose administration of ceftriaxone (AC24) or AC co-diluted and jointly administered in bolus every 4 h (ACjoined). In this retrospective analysis of prospectively collected cases, we aimed to assess the clinical effectivity and safety of three AC regimens for the treatment of E. faecalis IE. Fifty-nine patients were treated with AC combinations (AC12 n = 32, AC24 n = 17, and ACjoined n = 10). Six relapses occurred in the whole cohort: five (29.4%) treated with AC24 regimen and one (10.0%) with ACjoined. Patients were cured in 30 (93.3%), 16 (94.1%), and eight (80.0%) cases in the AC12, AC24 and ACjoined groups, respectively. Unplanned readmission occurred in eight (25.0%), six (35.3%), and two (20.0%) patients in the AC12, AC24 and ACjoined groups, respectively. The outcome of patients with E. faecalis IE treated with AC in OPAT programs relies on an optimization of the delivery of the combination. AC24 exhibit an unexpected rate of failures, however, ACjoined might be an effective alternative which clinical results should corroborate in further studies.

scholarly journals Risk factors for failure of outpatient parenteral antibiotic therapy (OPAT) in infective endocarditis

2013 ◽  
Vol 68 (7) ◽  
pp. 1650-1654 ◽  
Author(s):  
C. J. A. Duncan ◽  
D. A. Barr ◽  
A. Ho ◽  
E. Sharp ◽  
L. Semple ◽  
...  
Keyword(s):  
Risk Factors ◽  
Infective Endocarditis ◽  
Antibiotic Therapy ◽  
Parenteral Antibiotic ◽  
Outpatient Parenteral Antibiotic Therapy

scholarly journals Once-daily tigecycline for outpatient parenteral antibiotic therapy: a single-centre observational study

2019 ◽  
Vol 1 (3) ◽  
Author(s):  
Stephen Hughes ◽  
Hui Yin Chin ◽  
Katie L Heard ◽  
Pegah Kamranpour ◽  
Brent Bartholomew ◽  
...  
Keyword(s):  
Adverse Effects ◽  
Antibiotic Therapy ◽  
Treatment Duration ◽  
Case Series ◽  
Ambulatory Care Setting ◽  
Single Centre ◽  
Retrospective Case ◽  
Parenteral Antibiotic ◽  
Once Daily ◽  
Outpatient Parenteral Antibiotic Therapy

Abstract Background Tigecycline has potential utility in the treatment of complex polymicrobial infections or those caused by MDR organisms in the ambulatory care setting owing to its breadth of antimicrobial coverage. Whilst licensed for twice-daily IV administration, its long half-life permits once-daily administration, which may facilitate successful outpatient parenteral antibiotic therapy (OPAT). Methods A retrospective case series of patients receiving once-daily tigecycline under OPAT was analysed at a single-centre NHS acute hospital (January 2016–June 2018). Patient demographics, including comorbidities, antimicrobial indication, concurrent antimicrobial therapies, treatment duration and adverse events related to treatment were recorded using medical records. Treatment outcomes were defined using the BSAC National Outcomes Registry System (NORS). Results A total of 25 treatment episodes (24 individual patients) were analysed. The most common indications were bone and joint infections (n = 8) and intra-abdominal infections (n = 7). MDR organisms were common, including ESBL-producing Enterobacterales (n = 13) and glycopeptide-resistant enterococci (n = 4). Median treatment duration was 18 days. Nineteen of 25 (76%) cases had complete cure of treatment, 3 patients experienced treatment-related adverse reactions necessitating cessation of therapy and 3 experienced failure due to disease progression. Eight patients experienced non-limiting adverse effects, such as nausea, vomiting and rash, and one patient had a transient rise in amylase 3 times the upper normal limit (with no evidence of pancreatitis). Conclusions Once-daily tigecycline can be successfully used for management of complex infections in the OPAT setting, with predominantly mild adverse effects, which can be managed with antiemetics or slow administration.

scholarly journals Rate of broad-spectrum antibiotic overuse in patients receiving outpatient parenteral antibiotic therapy (OPAT)

2021 ◽  
Vol 1 (1) ◽  
Author(s):  
Jessa R. Brenon ◽  
Stephanie E. Shulder ◽  
Sonal S. Munsiff ◽  
Colleen M. Burgoyne ◽  
Angela K. Nagel ◽  
...  
Keyword(s):  
Antibiotic Therapy ◽  
Broad Spectrum ◽  
Broad Spectrum Antibiotic ◽  
Parenteral Antibiotic ◽  
Once Daily ◽  
Antibiotic Overuse ◽  
Broad Spectrum Antibiotics ◽  
Outpatient Parenteral Antibiotic Therapy

Abstract Broad-spectrum antibiotics with once-daily dosing are often chosen for outpatient parenteral antibiotic therapy (OPAT) due to convenience even when narrower-spectrum antibiotics are appropriate. At our institution, up to 50% of select broad-spectrum OPAT regimens had potential to be narrowed, highlighting the need to re-evaluate regimens for de-escalation prior to discharge.

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