▾ Temocillin injection for gram-negative infections only

1991 ◽  
Vol 29 (14) ◽  
pp. 55-56
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Third Generation ◽  
Gram Negative ◽  
Third Generation Cephalosporins

Temocillin (Temopen - SKB) is a penicillin which is β-lactamase-resistant and specifically effective against Gram-negative aerobic organisms. It is active against coliforms resistant to third generation cephalosporins but not against Pseudomonas aeruginosa.1

scholarly journals 1107. Third Generation Cephalosporins Monotherapy Experience in Pediatric Patients with High-Risk Febrile Neutropenia

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S584-S584
Author(s):  
Valentina Gutierrez ◽  
Ximena Claverie
Keyword(s):  
Pseudomonas Aeruginosa ◽  
High Risk ◽  
Febrile Neutropenia ◽  
Pediatric Patients ◽  
Gram Negative Bacteria ◽  
Third Generation ◽  
Gram Negative ◽  
Third Line ◽  
Third Generation Cephalosporins ◽  
Clinical Worsening

Abstract Background Fever during neutropenia is common in children with cancer. The updated guidelines recommend empirical antibiotic monotherapy using an antipseudomonal ß-lactam, a fourth generation cephalosporin or a carbapenem for high-risk febrile neutropenia. However, local epidemiology and resistance patterns should be evaluated regularly. In our hospital there are not Pseudomonas aeruginosa isolates in oncology pediatric patients, therefore, we use ceftriaxone as monotherapy in high risk febrile neutropenia without other risk factors. The goal of our investigation is to describe the experience of using third generation cephalosporins in these patients. Methods Descriptive study of high-risk febrile neutropenia episodes in patients admitted to the Pediatric Oncology Unit of Hospital Dr. Sótero del Río, Santiago, Chile. We included patients ≤15 years from June 2016 until December 2019. Results We found 140 episodes in 53 patients, 42 (79%) were leukemia and 11 (21%) solid tumor patients. Of the 140 episodes, 97 (69%) had clinical signs at admission, mostly respiratory in 48 (49%) of the cases. Ninety one (65%) cases started ceftriaxone at admission, 27 (30%) maintained ceftriaxone for 7 days of treatment. Sixty four (70%) cases changed treatment: 38/64 (42%) started second line antibiotics for clinical worsening, 19/64 (20%) required second and third line antibiotics for persistent fever and clinical worsening, and 7/64 (8%) received third line antibiotics from the start for past microbiological history. Eighteen (13%) cases evolved with sepsis requiring intensive care unit management.We had 32 (23%) episodes with positive blood culture, 13 (41%) due to gram positive bacteria, 16 (50%) gram negative bacteria, and 3 (9%) cases of fungal infections. Of the gram negative bacteria, 7 (44%) were ESBL producers, without Pseudomonas aeruginosa isolates.One case died (0.7%) for refractory sepsis due to gram negative bacteria. Conclusion Monotherapy with ceftriaxone is not a good option as initial therapy for high risk febrile neutropenia patients due to the spread of ESBL strains. The empiric therapy has to be evaluated regularly and should always be based in local epidemiology. Disclosures All Authors: No reported disclosures

Norfloxacin: A Quinoline Antibiotic

1986 ◽  
Vol 20 (4) ◽  
pp. 261-266 ◽  
Author(s):  
Dwight A. Marble ◽  
John A. Bosso
Keyword(s):  
Side Effects ◽  
Nalidixic Acid ◽  
Antimicrobial Agents ◽  
Bitter Taste ◽  
Gram Negative Bacteria ◽  
Third Generation ◽  
Gram Negative ◽  
Intravenous Antibiotics ◽  
Third Generation Cephalosporins ◽  
Quinolinecarboxylic Acid

Norfloxacin is a quinoline (quinolinecarboxylic acid) that should prove successful in treating infections that currently require hospitalization and intravenous antibiotics. Although a nalidixic acid derivative, it possesses greater antibacterial activity against gram-positive and gram-negative bacteria. Compared with other antimicrobial agents, norfloxacin is more potent than the aminoglycosides, first-, second-, and third-generation cephalosporins, tetracycline, trimethoprim-sulfamethoxazole, carbenicillin, piperacillin, nalidixic acid, oxolinic acid, cinoxacin, and enoxacin. In the clinical studies to date, the side effects of norfloxacin have been minimal, but include nausea, vomiting, anorexia, dizziness, headache, drowsiness, depression, and a bitter taste in the mouth. In studies with more than 4000 patients, the incidence of side effects ranged from 3.9 to 4.7 percent, with most appearing by the second day of therapy.

scholarly journals Prevelance of Common Organisms Involved in Acute Appendicitis in Althowra Hospital, Elbyda, Libya

2021 ◽  
pp. 76-81
Author(s):  
Salma S. Mohamed ◽  
Nasser Musbah ◽  
Mohamed Sergaiwa
Keyword(s):  
Acute Appendicitis ◽  
Local Population ◽  
Anaerobic Bacteria ◽  
Antibiotic Sensitivity ◽  
Third Generation ◽  
Gram Negative ◽  
Escherchia Coli ◽  
Antibiotic Sensitivity Test ◽  
Third Generation Cephalosporins ◽  
Aerobic And Anaerobic

Background: Bacteria have been involved in the aetiopathogenesis of acute appendicitis. The known of bacteria and antibiotic sensitivity mode will assist in modulating treatment regime for acute appendicitis. Aim: This study aimed to find out the incidence of the offending organisms in acute appendicitis                                  to determine the most effective antibiotic in a local population in Albyda city. Methods: Patients with acute appendicitis presenting between January 2019 and December    2019 were studied, At surgery 1cm rim of appendix was cut from the base and sent into the transport medium. The specimen was cultured for aerobic and anaerobic bacteria, Antibiotic sensitivity test was performed. Results: Sixty patients were conscript; Escherchia coli, gram negative bacilli were the commonest organism isolated. They were sensitive to) ciprofluxacin (65%), chloramphnical (60%) and third generation cephalosporins (52%) resistant to amoxycilin with clavulanic acid and tetracycline. The anaerobes were sensitive to metronidazole (96.5%).

scholarly journals When first line treatment of neonatal infection is not enough: blood culture and resistance patterns in neonates requiring second line antibiotic therapy in Bangui, Central African Republic

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Andrea Nebbioso ◽  
Oluwakemi F. Ogundipe ◽  
Ernestina Carla Repetto ◽  
Calorine Mekiedje ◽  
Hugues Sanke-Waigana ◽  
...  
Keyword(s):  
Blood Culture ◽  
Klebsiella Oxytoca ◽  
Neonatal Infection ◽  
Sub Saharan Africa ◽  
Gram Negative Bacteria ◽  
Third Generation ◽  
Antibiotic Resistant ◽  
Gram Negative ◽  
Sub Saharan ◽  
Third Generation Cephalosporins

Abstract Background Infectious diseases account for the third most common cause of neonatal deaths. Globally, antibiotic resistance (ABR) has been increasingly challenging neonatal sepsis treatment, with 26 to 84% of gram-negative bacteria resistant to third-generation cephalosporins. In sub-Saharan Africa, limited evidence is available regarding the neonatal microbiology and ABR. To our knowledge, no studies have assessed neonatal bacterial infections and ABR in Central-African Republic (CAR). Therefore, this study aimed to describe the pathogens isolated and their specific ABR among patients with suspected antibiotic-resistant neonatal infection admitted in a CAR neonatal unit. Methods This retrospective cohort study included neonates admitted in the neonatal unit in Bangui, CAR, from December 2018 to March 2020, with suspected antibiotic-resistant neonatal infection and subsequent blood culture. We described the frequency of pathogens isolated from blood cultures, their ABR prevalence, and factors associated with fatal outcome. Results Blood cultures were positive in 33 (26.6%) of 124 patients tested (17.9% for early-onset and 46.3% for late-onset infection; p = 0.002). Gram-negative bacteria were isolated in 87.9% of positive samples; with most frequently isolated bacteria being Klebsiella pneumoniae (39.4%), Escherichia coli (21.2%) and Klebsiella oxytoca (18.2%). All tested bacteria were resistant to ampicillin. Resistance to third-generation cephalosporins was observed in 100% of tested Klebsiella pneumoniae, 83.3% of isolated Klebsiella oxytoca and 50.0% of tested Escherichia coli. None of the tested bacteria were resistant to carbapenems. Approximately 85.7 and 77.8% of gram-negative tested bacteria were resistant to first-line (ampicillin-gentamicin) and second-line (third-generation cephalosporins) treatments, respectively. In hospital mortality, adjusted for blood culture result, presence of asphyxia, birth weight and sex was higher among neonates with positive blood culture (adjusted relative risk [aRR] = 2.32; 95% confidence interval [CI] = 1.17–4.60), male sex (aRR = 2.07; 95% CI = 1.01–4.26), asphyxia (aRR = 2.42; 95% CI = 1.07–5.47) and very low birth weight (1000–1499 g) (aRR = 2.74; 95% CI = 1.3–5.79). Conclusion Overall, 77.8% of confirmed gram-negative neonatal infections could no longer effectively be treated without broad-spectrum antibiotics that are not routinely used in sub-Saharan Africa referral hospitals. Carbapenems should be considered an option in hospitals with surveillance and antibiotic stewardship.

Cefepime: A Fourth-Generation Parenteral Cephalosporin

1996 ◽  
Vol 30 (12) ◽  
pp. 1414-1424 ◽  
Author(s):  
Michael A Wynd ◽  
Joseph A Paladino
Keyword(s):  
Clinical Trials ◽  
Clinical Efficacy ◽  
Fourth Generation ◽  
Third Generation ◽  
Gram Positive ◽  
Gram Negative ◽  
Beta Lactamases ◽  
Tract Infections ◽  
Third Generation Cephalosporins

OBJECTIVE: To review the chemistry, microbiology, pharmacokinetics, therapeutic efficacy, adverse effect profile, drug interactions, dosing, and administration of cefepime, a new fourth-generation parenteral cephalosporin. DATA SOURCES: A MEDLINE search of the available literature, including clinical trials and reviews, was performed. Abstracts presented at recent scientific conferences and current publications were also reviewed. DATA SELECTION: In vitro and preclinical data were included, as well as data from Phase II and III clinical trials. DATA SYNTHESIS: Cefepime is an extended-spectrum parenteral cephalosporin antibiotic active in vitro against a broad spectrum of gram-positive and gram-negative aerobic bacteria. The gram-positive spectrum is similar to that of cefotaxime, the gram-negative spectrum is similar to that of ceftazidime, and many, though not all, organisms resistant to these two agents remain susceptible to cefepime, prompting the fourth-generation designation. Cefepime has a high affinity for penicillin-binding proteins and, due to its zwitterionic configuration, rapidly penetrates outer-membrane porin channels of bacteria. Beta-lactamases appear to have a low affinity for the drug. Cefepime has a decreased propensity to induce beta-lactamases compared with other beta-lactam antibiotics. Cefepime has a pharmacokinetic disposition similar to that of other renally eliminated cephalosporins, with a half-life of approximately 2 hours. Cefepime has demonstrated clinical efficacy against a variety of infections, including urinary tract infections, pneumonia, and skin and skin structure infections. Cefepime is generally well tolerated. CONCLUSIONS: Cefepime may have several chemical and pharmacologic advantages over currently available third-generation cephalosporins. In vitro data indicate that cefepime retains activity against some, but not all, gram-negative bacteria resistant to third-generation cephalosporins; however, clinical efficacy against infections due to resistant pathogens remains to be established. Cefepime was at least as effective as comparators during clinical trials, and may prove to be a viable alternative to other currently available agents.

Case 34

2020 ◽  
pp. 233-240
Author(s):  
Hilary Humphreys
Keyword(s):  
Genome Sequencing ◽  
Prevention And Control ◽  
Infection Prevention And Control ◽  
Whole Genome ◽  
Third Generation ◽  
Gram Negative ◽  
First Choice ◽  
Phenotypic Tests ◽  
And Control ◽  
Third Generation Cephalosporins

Multi-drug-resistant Enterobacteriales are an increasing problem and include those mediated by extended-spectrum β‎-lactamases (ESBLs) and carpapenemase production (CPE). Third-generation cephalosporins are inactivated by ESBLs but for CPEs there are much fewer options for treatment. The challenge in detection, management, and treatment is compounded by CPEs occurring amongst such a broad category of Gram-negative bacilli and because the genetic elements are very mobile, often being quickly and widely disseminated through plasmids. Phenotypic tests for identification have their limitations and there is increasing emphasis on PCR with microarrays and whole genome sequencing being available in specialist centres. Colistin is often the drug of first choice for CPE infections but is usually combined with another agent such as an aminoglycoside. Aggressive infection prevention and control precautions are mandatory given the propensity to spread, the reduced options for treatment, and a lack of insight to patterns and duration of carriage.

Carriage of Staphylococcus aureus and of Gram-Negative Bacilli Resistant to Third-Generation Cephalosporins in Cirrhotic Patients A Prospective Assessment of Hospital-Acquired Infections

2001 ◽  
Vol 22 (7) ◽  
pp. 427-432 ◽  
Author(s):  
Catherine Dupeyron ◽  
Bernard Campillo ◽  
Nicole Mangeney ◽  
Muriel Bordes ◽  
Jean-Philippe Richardet ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Third Generation ◽  
Gram Negative ◽  
Bacterial Peritonitis ◽  
Prospective Assessment ◽  
Cirrhotic Patients ◽  
Tract Infections ◽  
Third Generation Cephalosporins

AbstractObjective:To study the relation between Staphylococcus aureus nasal and stool colonization, stool carriage of gram-negative bacilli resistant to third-generation cephalosporins (CephR), and subsequent infections during hospitalization.Design:Prospective study.Patients:551 cirrhotic patients with 589 consecutive hospital stays. All patients were screened within 48 hours of admission; 589 nasal swabs, 417 stool specimens, and 589 urine samples were analyzed.Results:Carriage rates were 18.8% for methicillin-sensitive S aureus (MSSA), 16.3% for methicillin-resistant S aureus (MRSA), and 13.7% for CephR. We observed 87 episodes of spontaneous bacterial peritonitis, 63 cases of bacteremia, and 167 urinary tract infections occurred. Only 1 case of bacteremia and 4 urinary tract infections due to CephR occurred in patients carrying the same organism in their stools. The risk of MRSA ascitic fluid infections, bacteremia, and urinary tract infections was 3.1% versus 1% (not significant), 8.3% versus 0.8% (P<.001), and 11.4% versus 0.6% (P<.001) in carriers and noncarriers, respectively. Pulsed-field gel electrophoresis (PFGE) of isolates from 16 patients infected by MSSA (3 cases) and MRSA (13 cases) demonstrated that the colonizing strains matched the invasive strains in the 3 MSSA cases and in 8 of 13 MRSA cases.Conclusion:Carriage of CephR strains is not associated with subsequent infection by these organisms in hospitalized cirrhotic patients. In contrast, MRSA carriage was an important risk factor for MRSA bacteremia and urinary tract infection.

Resistance to third-generation cephalosporins in adult gram-negative bacillary meningitis

Infection ◽  
1999 ◽  
Vol 27 (3) ◽  
pp. 208-211 ◽  
Author(s):  
C. H. Lu ◽  
W. N. Chang ◽  
Y. C. Chuang
Keyword(s):  
Third Generation ◽  
Gram Negative ◽  
Third Generation Cephalosporins
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