scholarly journals Pharmacokinetic Profile of Meropenem, Administered at 500 Milligrams Every 8 Hours, in Plasma and Cantharidin-Induced Skin Blister Fluid

2003 ◽  
Vol 47 (5) ◽  
pp. 1771-1773 ◽  
Author(s):  
Dana Maglio ◽  
Renli Teng ◽  
Per T. Thyrum ◽  
Charles H. Nightingale ◽  
David P. Nicolau
Keyword(s):  
Soft Tissue ◽  
Elimination Rate ◽  
Pharmacokinetic Profile ◽  
Soft Tissue Infections ◽  
Blister Fluid ◽  
Skin Blister ◽  
The Mean

ABSTRACT The pharmacokinetic disposition of meropenem, administered at 500 mg every 8 h, in plasma and cantharidin-induced blister fluid is described. Peak meropenem concentrations in blister fluid lagged behind peak meropenem concentrations in plasma, while a lower elimination rate from blister fluid was also noted. The mean penetration of meropenem into blister fluid was 67%. The pharmacokinetic profile of meropenem in blister fluid supports the utility of this dose in the management of skin and soft tissue infections.

scholarly journals Tissue Penetration of Telavancin after Intravenous Administration in Healthy Subjects

2006 ◽  
Vol 50 (2) ◽  
pp. 788-790 ◽  
Author(s):  
Heather K. Sun ◽  
Kenneth Duchin ◽  
Charles H. Nightingale ◽  
Jeng-Pyng Shaw ◽  
Julie Seroogy ◽  
...  
Keyword(s):  
Body Weight ◽  
Soft Tissue ◽  
Intravenous Administration ◽  
Healthy Subjects ◽  
Soft Tissue Infections ◽  
Blister Fluid ◽  
Tissue Penetration ◽  
Skin Blister ◽  
The Mean

ABSTRACT The pharmacokinetic disposition of telavancin administered 7.5 mg/kg of body weight every 24 h was determined in plasma and skin blister fluid. The mean penetration of telavancin into blister fluid was 40%. This study reveals that adequate concentrations are achieved in both plasma and blister fluid for pathogens frequently implicated in skin and soft tissue infections.

scholarly journals Necrotizing Soft Tissue Infections in Intensive Care

2021 ◽  
pp. 088506662110101
Author(s):  
Alexandru Ogica ◽  
Christoph Burdelski ◽  
Holger Rohde ◽  
Stefan Kluge ◽  
Geraldine de Heer
Keyword(s):  
Septic Shock ◽  
Intensive Care ◽  
Soft Tissue ◽  
Sofa Score ◽  
Laboratory Data ◽  
Serum Lactate ◽  
Soft Tissue Infections ◽  
Necrotizing Soft Tissue Infections ◽  
The Mean ◽  
Organ Dysfunctions

Background: Necrotizing soft tissue infections (NSTIs) are typically characterized by extensive soft tissue destruction with systemic signs of toxicity, ranging from sepsis to septic shock. Our aim was to analyze the clinical characteristics, microbiological results, laboratory data, therapies, and outcome of patients with NSTIs admitted to an intensive care unit (ICU). Methods: A monocentric observational study of patients admitted to the ICU of a university hospital between January 2009 and December 2017. The demographic characteristics, comorbidities, clinical features, microbiology and laboratory results, organ dysfunctions, therapies, and outcome were retrospectively analyzed. Results: There were 59 patients and 70% males. The mean age (± SD) was 55 ± 18; type II (monomicrobial) NSTI was present in 36 patients (61%); the most common isolated pathogen was Streptococcus pyogenes in 28 patients (48%). Septic shock was diagnosed in 41 patients (70%). The most common organ dysfunctions were circulatory and renal in 42 (71%) and 38 patients (64%). The mean value (± SD) of serum lactate at admission to the ICU was 4.22 ± 5.42 mmol/l, the median SOFA score and SAPS II were 7 (IQR 4 - 10) and 46 (IQR 30.5 - 53). ICU mortality rate was 25%. Both SOFA score and serum lactate demonstrated a good prognostic value regarding ICU outcome (OR 1.29, 95%CI 1.07-1.57, P < 0.007 and OR 1.53, 95%CI 1.19-1.98, P < 0.001). A cut-off value for serum lactate of 6.55 mmol/L positively predicted mortality with 67% sensitivity and 97% specificity. Conclusion: NSTIs carry a high risk of septic shock and multiple organ dysfunction syndrome and thus are still associated with high mortality. In our study, the value of serum lactate at admission to the ICU correlated well with mortality. This easy-to-measure parameter could play a role in the decision-making process regarding prognosis and continuation of care.

scholarly journals A Retrospective Analysis of Practice Patterns in the Treatment of Methicillin-ResistantStaphylococcus aureusSkin and Soft Tissue Infections at Three Canadian Tertiary Care Centres

2003 ◽  
Vol 14 (6) ◽  
pp. 315-321 ◽  
Author(s):  
John M Conly ◽  
H Grant Stiver ◽  
Karl A Weiss ◽  
Debbie L Becker ◽  
Andrew J Rosner ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Oral Treatment ◽  
Tertiary Care ◽  
Treatment Patterns ◽  
Soft Tissue Infections ◽  
Alternative Analysis ◽  
Eligibility Criteria ◽  
Switch Therapy ◽  
Oral Switch ◽  
The Mean

BACKGROUND: Methicillin-resistantStaphylococcus aureus(MRSA) infections are increasingly being encountered and pose an increasing burden to the health care system in Canada.OBJECTIVE: To elucidate and characterize the factors influencing the current MRSA treatment patterns in patients with skin and soft tissue infections (SSTIs) before linezolid became available on the Canadian market.METHODS: A retrospective study collected demographic, treatment and resource use data on patients hospitalized at one of three geographically distinct tertiary care facilities, where MRSA SSTI treatment was initiated with intravenous (IV) vancomycin. Analysis of opportunities for IV-to-oral switch therapy was based on eligibility criteria.RESULTS: Of 89 patients identified over a 43-month period, the mean (±SD) durations of anti-infective treatment and hospitalization were 22.4±21 days and 28.9±20.8 days, respectively. An infected surgical wound was most common, representing 62.9% of infections. The mean duration of vancomycin treatment was 19.5 days and the mean number of 1 g doses received was 29.0±32.9. The majority of patients (55.1%) initiated vancomycin therapy a mean of 5.4±8.9 days after confirmation of MRSA. Of the 70% of patients meeting criteria for IV-to-oral switch therapy, only 10% received oral treatment. The most common reason cited for not switching was lack of an effective oral alternative. Analysis of switch therapy criteria found that IV treatment continued for a mean of 13 days despite the appropriateness of the oral route.CONCLUSIONS: Considerable variation exists in treatment patterns for MRSA infections. Improvements in the initiation of therapy and the use of IV-to-oral switch therapy may improve care and reduce the duration of hospitalization for MRSA SSTIs.

scholarly journals Efficacy of linezolid against Staphylococcus aureus in different rodent skin and soft tissue infections models

2011 ◽  
Vol 2 (1) ◽  
pp. 3
Author(s):  
Madhvi Rao ◽  
Tarani Kanta Barman ◽  
Manoj Kumar ◽  
Tarun Mathur ◽  
Gunjan Shukla ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Soft Tissue ◽  
Pharmacokinetic Profile ◽  
Infection Model ◽  
Base Line ◽  
Soft Tissue Infections ◽  
Standard Drug ◽  
Static Effect ◽  
Different Strains ◽  
Groin Abscess

<p>Linezolid is approved for complicated and uncomplicated skin and soft tissue infections. We have evaluated the efficacy of this drug in murine as well as in rat skin and soft tissue infection models using <em>Staphylococcus aureus</em> ATCC and clinical strains. In thigh infection model the dose of linezolid required for more than 1 log<sub>10</sub> kill from baseline inoculum in neutropenic mice and rats was 100 mg/kg and 50 mg/Kg BW bid /day, respectively, which was 5 and 4 folds more than that in immunocompetent animals, respectively. Dose required to achieve 1 log<sub>10</sub> killing was similar against different strains of <em>S. aureus </em>in immunocompetent mouse thigh infection model. However, in murine groin abscess infection model, a dose of 100 mg/kg, b.i.d/day of linezolid produce static effect in 2 days, but revealed to be superior in 4 days treatment and showed approximately 1 log<sub>10</sub> killing from base line inoculums. Based upon pharmacokinetic profile, a 24-h AUC/MIC required for linezolid efficacy in murine groin abscess model was 91.5 for the strain used in this study. As linezolid is taken as a gold standard drug in the evaluation of new chemical entity, this data could be useful for comparing the preclinical efficacy of new anti-MRSA agents.</p>

scholarly journals Pharmacokinetic Profile of Tigecycline in Serum and Skin Blister Fluid of Healthy Subjects after Multiple Intravenous Administrations

2005 ◽  
Vol 49 (4) ◽  
pp. 1629-1632 ◽  
Author(s):  
Heather K. Sun ◽  
Christine T. Ong ◽  
Ambreen Umer ◽  
Dawn Harper ◽  
Steven Troy ◽  
...  
Keyword(s):  
Half Life ◽  
Healthy Subjects ◽  
Penetration Rate ◽  
Pharmacokinetic Profile ◽  
Loading Dose ◽  
Blister Fluid ◽  
Skin Blister

ABSTRACT The pharmacokinetics of tigecycline, when given as a 100-mg loading dose followed by 50 mg every 12 h, were determined in serum and blister fluid. The peak tigecycline concentration and half-life in serum were greater than those in blister fluid. Tigecycline penetrates into blister fluid well, with a mean penetration rate of 74%.

scholarly journals Distribution and Antimicrobial Activity of Fosfomycin in the Interstitial Fluid of Human Soft Tissues

2000 ◽  
Vol 44 (10) ◽  
pp. 2728-2732 ◽  
Author(s):  
Martin Frossard ◽  
Christian Joukhadar ◽  
Boban M. Erovic ◽  
Peter Dittrich ◽  
Paulus E. Mrass ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Soft Tissues ◽  
Pharmacokinetic Profile ◽  
Interstitial Space ◽  
Soft Tissue Infections ◽  
Time Curve ◽  
Tract Infections ◽  
High Degree

ABSTRACT Fosfomycin is a broad-spectrum antibiotic which is established as therapy for uncomplicated lower urinary tract infections. In addition, preliminary data indicate that fosfomycin has a potential role in the treatment of soft tissue infections. However, the use of fosfomycin has not been established for this condition, and it is unclear whether the level of fosfomycin penetration into human soft tissues is high enough to eradicate relevant pathogens. To better characterize the antibiotic potential of fosfomycin, we applied a combined in vivo pharmacokinetic-in vitro pharmacodynamic model to human volunteers. For this purpose fosfomycin concentrations in vivo in the fluid of the interstitial space of human soft tissues were measured by microdialysis following intravenous infusion of 4 or 8 g of fosfomycin (n = 6). Subsequently, bacterial isolates with relevance for soft tissue infections were exposed to concentrations according to the in vivo pharmacokinetic profile in the interstitial space fluid obtained by microdialysis. Our experiments indicated a high degree of soft tissue penetration for fosfomycin, with ratios of the area under the concentration-time curve from 0 to 8 h for muscle (AUC0–8muscle )/AUC0–8serum of 0.48 ± 0.08 and 0.53 ± 0.04 and ratios of AUC0–8adipose tissue /AUC0–8serum of 0.74 ± 0.12 and 0.71 ± 0.11 following administration of 4 and 8 g, respectively. In corresponding in vitro simulation experiments with selected isolates of Staphylococcus aureus,Enterobacter cloacae, and Serratia marcescensfor which MICs were 16 μg/ml, organisms were undetectable after a single dosing interval. Fosfomycin exhibits a strong ability to penetrate into the fluid of the interstitial space of soft tissues and reaches levels sufficient to substantially inhibit the growth of relevant bacteria at the target site. We therefore conclude that fosfomycin might qualify as an alternative candidate for the therapy of soft tissue infections.

scholarly journals Pharmacokinetics of cefetamet in plasma and skin blister fluid.

1996 ◽  
Vol 40 (1) ◽  
pp. 102-104 ◽  
Author(s):  
W Zimmerli ◽  
S Sansano ◽  
B Wittke
Keyword(s):  
High Performance ◽  
Interstitial Fluid ◽  
Blister Fluid ◽  
Oral Cephalosporin ◽  
Chromatography Method ◽  
Beta Lactamases ◽  
Penicillin Binding Proteins ◽  
Skin Blister ◽  
The Mean ◽  
Liquid Chromatography Method

Cefetamet pivoxil is an oral cephalosporin with enhanced affinity for the target penicillin-binding proteins 1 and 3 and an increased stability to beta-lactamases compared with older cephalosporins, such as cefalexin or cefaclor. The pharmacokinetics of cefetamet pivoxil was determined after the seventh and final dose of 500 mg of cefetamet pivoxil in eight healthy volunteers. Concentrations in plasma and cantharidin-induced skin blister fluid were determined by a high-performance liquid chromatography method. In addition, protein binding was assessed. Cmax was 4.8 +/- 1.7 micrograms/ml in skin blister fluid and 5.1 +/- 2.1 micrograms/ml in plasma. Tmax was delayed in skin blister fluid compared with plasma (3.9 +/- 1 versus 2.8 +/- 0.8 h; P < 0.001), and t1/2 was longer in skin blister fluid than in plasma (3.1 +/- 0.5 versus 2.3 +/- 0.3; P < 0.005). The mean percent penetration into cantharide blister fluid was 129% +/- 24% when measured as total drug and 149% +/- 28% when measured as free drug (P < 0.001). These data suggest that cefetamet has an excellent penetration into inflammatory interstitial fluid.

Case Report: When all claims that it is necrotizing fasciitis but Point of care ultrasound (POCUS) proves the opposite!

POCUS Journal ◽  
2018 ◽  
Vol 3 (1) ◽  
pp. 13-14
Author(s):  
Hadiel Kaiyasah, MD, MRCS (Glasgow), ABHS-GS ◽  
Maryam Al Ali, MBBS
Keyword(s):  
Emergency Department ◽  
Critical Care ◽  
Case Report ◽  
Soft Tissue ◽  
Necrotizing Fasciitis ◽  
Soft Tissue Infection ◽  
Critical Care Unit ◽  
Point Of Care ◽  
Point Of Care Ultrasound ◽  
Soft Tissue Infections

Soft tissue ultrasound (ST-USS) has been shown to be of utmost importance in assessing patients with soft tissue infections in the emergency department or critical care unit. It aids in guiding the management of soft tissue infection based on the sonographic findings.

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