scholarly journals Ceftobiprole Perspective: Current and Potential Future Indications

Antibiotics ◽  
2021 ◽  
Vol 10 (2) ◽  
pp. 170 ◽  
Author(s):  
Tommaso Lupia ◽  
Carlo Pallotto ◽  
Silvia Corcione ◽  
Lucio Boglione ◽  
Francesco Giuseppe De Rosa
Keyword(s):  
Bacterial Infections ◽  
Life Experiences ◽  
Real Life ◽  
Empirical Therapy ◽  
Bloodstream Infections ◽  
Clinical Situation ◽  
Community Acquired Pneumonia ◽  
Severe Infections ◽  
Hospital Acquired Pneumonia ◽  
Hospital Acquired

Ceftobiprole combines an excellent spectrum for community-acquired pneumonia (CAP) and hospital-acquired pneumonia (HAP) pathogens, with a low/medium MDR risk, and the β-lactams’ safety in frail patients admitted to the hospital in internal medicine wards which may be at high risk of adverse events by anti-MRSA coverage as oxazolidinones or glycopeptides. We aimed to report the available evidence regarding ceftobiprole use in pneumonia and invasive bacterial infections, shedding light on ceftobiprole stewardship. The clinical application and real-life experiences of using ceftobiprole for bloodstream infections, including infective endocarditis, are limited but nevertheless promising. In addition, extended-spectrum ceftobiprole activity, including Enterococcus faecalis, Enterobacteriaceae, and Pseudomonas aeruginosa, has theoretical advantages for use as empirical therapy in bacteremia potentially caused by a broad spectrum of microorganisms, such as catheter-related bacteremia. In the future, the desirable approach to sepsis and severe infections will be administered to patients according to their clinical situation, the intrinsic host characteristics, the susceptibility profile, and local epidemiology, while the “universal antibiotic strategy” will no longer be adequate.

Current Issues of Empirical Therapy of Severe Bacterial Community-Acquired Pneumonia During the Season of Respiratory Viral Infections

2020 ◽  
Vol 65 (9-10) ◽  
pp. 64-70
Author(s):  
V. B. Beloborodov ◽  
I. A. Kovalev ◽  
G. V. Sapronov
Keyword(s):  
Antimicrobial Therapy ◽  
Influenza A ◽  
Bacterial Infections ◽  
Randomized Clinical Trials ◽  
Respiratory Infections ◽  
Molecular Genetic ◽  
Seasonal Fluctuation ◽  
Empirical Therapy ◽  
Community Acquired Pneumonia ◽  
Adverse Event Rate

Progredient growth of morbidity and mortality of patients with community-acquired pneumonia (CAP) requires optimization of treatment including antibacterial therapy. Implementation of molecular-genetic methods of diagnostics of viral and viral-bacterial infections in clinical practice has significantly augmented the conception of etiology of community-acquired pneumonia. Seasonal fluctuation of CAP prevalence corresponds with growth of morbidity of acute respiratory infections and influenza which contribute to the etiological structure of CAP by increasing the risk of infection caused by staphylococci. The synergy between influenza A virus and S.aureus has been shown; it is associated with an increase of virus replication in the presence of specific staphylococcal proteases and the ability of viruses to increase adhesion of S.aureusin the respiratory tract, to decrease phagocytosis of S.aureus by macrophages/neutrophils and production of antimicrobial peptides, as well as to increase the probability of secondary bacterial co-infection. Therefore, the most important requirement for the empiric therapy agents of CAP is high streptococcal and staphylococcal activity. According to the current guidelines on antimicrobial therapy of severe CAP, antipneumococcic cephalosporins, macrolides, and fluoroquinolones are the basic treatment agents, but none of them have the combined high antistaphylococcal and antipneumococcal activity inherent in ceftaroline. The advantages of ceftaroline over ceftriaxone and levofloxacin in terms of the probability of reaching target concentrations for clinically relevant pharmacokinetic/pharmacodynamic parameters are shown. Meta-analysis of randomized clinical trials showed the higher clinical efficacy of ceftaroline in comparison to ceftriaxone with similar adverse event rate. Summarized analysis of antibiotic susceptibility data, pharmacokinetic/pharmacodynamic and clinical data, as well as negative epidemiological trends confirms the necessity of optimization of antimicrobial therapy of CAP for implementation of ceftaroline advantages against pneumococci and staphylococci in comparison to other β-lactams. Therefore, empiric treatment with ceftaroline is the most rational option for the therapy of CAP in critically ill patients during the season of respiratory viral infection.

scholarly journals Management of Health-Care Associated Pneumonia (HCAP)

2013 ◽  
pp. 87-90
Author(s):  
Alessia Rosato ◽  
Claudio Santini
Keyword(s):  
Health Care ◽  
Treatment Approach ◽  
Multidrug Resistant ◽  
Outpatient Setting ◽  
Community Acquired Pneumonia ◽  
Traditional Classification ◽  
Hospital Acquired Pneumonia ◽  
Health Care Associated Pneumonia ◽  
Hospital Acquired

Introduction The traditional classification of Pneumonia as either community acquired (CAP) or hospital acquired (HAP) reflects deep differences in the etiology, pathogenesis, approach and prognosis between the two entities. Health-Care Associated Pneumonia (HCAP) develops in a heterogeneous group of patients receiving invasive medical care or surgical procedures in an outpatient setting. For epidemiology and outcomes, HCAP closely resembles HAP and possibly requires an analogous therapeutic regimen effective against multidrug-resistant pathogens. Materials and methods We reviewed the pertinent literature and the guidelines for the diagnosis and management of HCAP to analyze the evidence for the recommended approach. Results Growing evidence seems to confirm the differences in epidemiology and outcome between HCAP and CAP but fails to confirm any real advantage in pursuing an aggressive treatment for all HCAP and CAP patients. Discussion Further investigations are needed to establish the optimal treatment approach according to the different categories of patients and the different illness severities. Keywords Health Care Associated Pneumonia (HCAP); Community Acquired Pneumonia (CAP); Hospital Acquired Pneumonia (HAP); Multidrug-resistant (MDR) Pathogens

scholarly journals The Influence of Propolis on Dental Plaque Reduction and the Correlation between Dental Plaque and Severity of COVID-19 Complications—A Literature Review

Molecules ◽  
2021 ◽  
Vol 26 (18) ◽  
pp. 5516
Author(s):  
Anna Kurek-Górecka ◽  
Karolina Walczyńska-Dragon ◽  
Rafael Felitti ◽  
Aleksandra Nitecka-Buchta ◽  
Stefan Baron ◽  
...  
Keyword(s):  
Dental Plaque ◽  
Bacterial Infections ◽  
Antibacterial Properties ◽  
Cochrane Library ◽  
Respiratory Pathogens ◽  
Review Of The Literature ◽  
Oral Biofilm ◽  
Cariogenic Bacteria ◽  
Hospital Acquired Pneumonia ◽  
Hospital Acquired

Current studies suggest that cariogenic bacteria in dental plaque influence the severity of COVID-19 complications since the oral cavity is a reservoir for respiratory pathogens potentially responsible for the development of hospital-acquired pneumonia. This article focuses on the association between dental plaque and COVID-19 concerning the influence of altered oral biofilm on the risk of increased severity of SARS-CoV-2 infection. Moreover, it concentrates on the usefulness of propolis, with its apitherapeutic antibacterial properties, for treating oral bacterial infections co-occurring with SARS-CoV-2 infection. A review of the literature on PubMed, Cochrane Library and Medline between 2000 and 2021 revealed 56 published articles indicating that a link between dental plaque and COVID-19 complications was probable. Furthermore, they indicated that propolis may minimize COVID-19 severity by reducing dental plaque accumulation. The possibility that improved oral health could reduce the risk of COVID-19 complications should be of interest to scientists.

Pulmonary Infections

Chest Imaging ◽  
2019 ◽  
pp. 187-189
Author(s):  
Santiago Martínez-Jiménez
Keyword(s):  
Antibiotic Therapy ◽  
Treatment Failure ◽  
Clinical Response ◽  
Chest Radiography ◽  
Community Acquired Pneumonia ◽  
Clinical Perspective ◽  
Immunosuppressed Patients ◽  
Hospital Acquired Pneumonia ◽  
Healthcare Associated ◽  
Hospital Acquired

Pneumonia can be classified as: community-acquired pneumonia (CAP), hospital-acquired pneumonia (HAP), ventilator-associated pneumonia (VAP), healthcare-associated pneumonia (HCAP), and pneumonia in immunosuppressed patients. Although the above are similar pathologically, they are very different from a clinical perspective. Chest radiography is often performed to support the diagnosis and to determine the extent of involvement prior to the onset of therapy. Radiography should not be performed in the short term in patients who are improving clinically as it can lead to the misdiagnosis of treatment failure. Chest radiography in patients treated for pneumonia should only be obtained before 4-6 weeks after the onset of therapy if there is a failure of clinical response or if complications of pneumonia are clinically suspected. The majority of pneumonias will resolve after 6 weeks of appropriate antibiotic therapy.

scholarly journals Clinical characteristics of patients with pneumonia caused by Klebsiella pneumoniae in Taiwan and prevalence of antimicrobial-resistant and hypervirulent strains: a retrospective study

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Chih-Han Juan ◽  
Shih-Yu Fang ◽  
Chia-Hsin Chou ◽  
Tsung-Ying Tsai ◽  
Yi-Tsung Lin
Keyword(s):  
Retrospective Study ◽  
Klebsiella Pneumoniae ◽  
Clinical Characteristics ◽  
Community Acquired Pneumonia ◽  
Drug Resistant ◽  
Hospital Acquired Pneumonia ◽  
Resistant Strains ◽  
Healthcare Associated ◽  
Drug Resistant Strains ◽  
Hospital Acquired

Abstract Background We aimed to compare the clinical characteristics of patients with community-acquired pneumonia (CAP), healthcare-associated pneumonia (HCAP), and hospital-acquired pneumonia (HAP) caused by Klebsiella pneumoniae and analyze the antimicrobial resistance and proportion of hypervirluent strains of the microbial isolates. Methods We conducted a retrospective study on patients with pneumonia caused by K. pneumoniae at the Taipei Veterans General Hospital in Taiwan between January 2014 and December 2016. To analyze the clinical characteristics of these patients, data was extracted from their medical records. K. pneumoniae strains were subjected to antimicrobial susceptibility testing, capsular genotyping and detection of the rmpA and rmpA2 genes to identify hypervirulent strains. Results We identified 276 patients with pneumonia caused by K. pneumoniae, of which 68 (24.6%), 74 (26.8%), and 134 (48.6%) presented with CAP, HCAP, and HAP, respectively. The 28-day mortality was highest in the HAP group (39.6%), followed by the HCAP (29.7%) and CAP (27.9%) groups. The HAP group also featured the highest proportion of multi-drug resistant strains (49.3%), followed by the HCAP (36.5%) and CAP groups (10.3%), while the CAP group had the highest proportion of hypervirulent strains (79.4%), followed by the HCAP (55.4%) and HAP groups (41.0%). Conclusion Pneumonia caused by K. pneumoniae was associated with a high mortality. Importantly, multi-drug resistant strains were also detected in patients with CAP. Hypervirulent strains were prevalent in all 3 groups of pneumonia patients, even in those with HAP.

Pneumonia

2018 ◽  
Author(s):  
Pippa Newton
Keyword(s):  
Nosocomial Pneumonia ◽  
Acute Infection ◽  
Healthcare Setting ◽  
Community Acquired Pneumonia ◽  
Hospital Acquired Pneumonia ◽  
Pulmonary Parenchyma ◽  
Post Intubation ◽  
Hospital Acquired ◽  
Symptoms And Signs

Pneumonia is defined as acute infection of the pulmonary parenchyma, presenting with consistent symptoms and signs and associated with new radiographic shadowing. It may be acute or chronic in onset and involve either one area of a lung (e.g. lobar pneumonia) or be multifocal in nature. It may be community acquired or hospital acquired. Community- acquired pneumonia is defined as pneumonia occurring in an individual with no recent contact with a healthcare setting, or in a patient admitted to hospital with development of symptoms and/or signs of pneumonia within 48 hours of admission. Hospital-acquired pneumonia or nosocomial pneumonia occurs when a patient develops symptoms or signs of pneumonia after 48 hours of admission to a healthcare setting or in the context of a long-term nursing home resident. A subtype of nosocomial pneumonia is ventilator-associated pneumonia, defined as pneumonia occurring at least 48–72 hours post intubation.

scholarly journals Incidence and outcomes of hospitalization for community-acquired, ventilator-associated and non-ventilator hospital-acquired pneumonias in patients with type 2 diabetes mellitus in Spain

2020 ◽  
Vol 8 (1) ◽  
pp. e001447
Author(s):  
Ana Lopez-de-Andres ◽  
Romana Albadalejo-Vicente ◽  
Javier de Miguel-Diez ◽  
Valentin Hernandez-Barrera ◽  
Zichen Ji ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Incidence Rates ◽  
Community Acquired Pneumonia ◽  
Older Age ◽  
Hospital Acquired Pneumonia ◽  
Design And Methods ◽  
Hospital Acquired

IntroductionTo describe the incidence and compare in-hospital outcomes of community-acquired pneumonia (CAP), ventilator-associated pneumonia (VAP) and non-ventilator hospital-acquired pneumonia (NV-HAP) among patients with or without type 2 diabetes mellitus (T2DM) using propensity score matching.Research design and methodsThis was a retrospective observational epidemiological study using the 2016–2017 Spanish Hospital Discharge Records.ResultsOf 245 221 admissions, CAP was identified in 227 524 (27.67% with T2DM), VAP was identified in 2752 (18.31% with T2DM) and NV-HAP was identified in 14 945 (25.75% with T2DM). The incidence of pneumonia was higher among patients with T2DM (CAP: incidence rate ratio (IRR) 1.44, 95% CI 1.42 to 1.45; VAP: IRR 1.24, 95% CI 1.12 to 1.37 and NV-HAP: IRR 1.38, 95% CI 1.33 to 1.44). In-hospital mortality (IHM) for CAP was 12.74% in patients with T2DM and 14.16% in matched controls (p<0.001); in patients with VAP and NV-HAP, IHM was not significantly different between those with and without T2DM (43.65% vs 41.87%, p=0.567, and 29.02% vs 29.75%, p=0.484, respectively). Among patients with T2DM, older age and dialysis were factors associated with IHM for all types of pneumonia. In patients with VAP, the risk of IHM was higher in females (OR 1.95, 95% CI 1.28 to 2.96).ConclusionThe incidence rates of all types of pneumonia were higher in patients with T2DM. Higher mortality rates in patients with T2DM with any type of pneumonia were associated with older age, comorbidities and dialysis.

Microbiology of Ventilator–Associated Pneumonia Compared With That of Hospital-Acquired Pneumonia

2007 ◽  
Vol 28 (7) ◽  
pp. 825-831 ◽  
Author(s):  
David J. Weber ◽  
William A. Rutala ◽  
Emily E. Sickbert-Bennett ◽  
Gregory P. Samsa ◽  
Vickie Brown ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Empirical Therapy ◽  
Ventilator Associated Pneumonia ◽  
Gram Positive ◽  
Similar Frequency ◽  
Gram Negative ◽  
Hospital Acquired Pneumonia ◽  
Hospital Acquired ◽  
Gram Positive Cocci ◽  
Ventilated Patients

Objective.Nosocomial pneumonia is the leading cause of mortality attributed to nosocomial infection. Appropriate empirical therapy has been associated with improved survival, but data are limited regarding the etiologic agents of hospital-acquired pneumonia in non-ventilated patients (HAP). This evaluation assessed whether the currently recommended empirical therapy is appropriate for both ventilator-associated pneumonia (VAP) and HAP by evaluating the infecting flora.Design.Prospectively collected hospitalwide surveillance data was obtained by infection control professionals using standard Centers for Disease Control and Prevention definitions.Setting.A tertiary care academic hospital.Patients.All patients admitted from 2000 through 2003.Results.A total of 588 episodes of pneumonia were reported in 556 patients: 327 episodes of VAP in 309 patients, and 261 episodes of HAP in 247 Patients. The infecting flora in ventilated patients included gram-positive cocci (32.0% [oxacillin-susceptible Staphylococcus aureus {OSSA}, 9.25%; oxacillin-resistant Staphylococcus aureus {ORSA}, 17.75%]), gram-negative bacilli (59.0% {Pseudomonas aeruginosa, 17.50%; Stenotrophomonas maltophilia, 6.75%; Acinetobacter species, 7.75%), and miscellaneous pathogens (9.0%). The infecting flora in nonventilated patients included gram-positive cocci (42.59% [OSSA, 13.33%; ORSA, 20.37%]), gram-negative bacilli (39.63% [P. aeruginosa, 9.26%; S. maltophilia, 1.11%; Acinetobacter species, 3.33%), and miscellaneous pathogens (17.78%).Conclusions.Our data demonstrated that patients with HAP, compared with those with VAP, had a similar frequency of infection with ORSA but less commonly had infections due to P. aeruginosa, Acinetobacter species, and S. maltophilia. However, the overall frequency of infection with these pathogens was sufficiently high to warrant the use of empirical therapy likely to be active against them. Our data supports using the currently recommended empirical therapy for both HAP and VAP.

scholarly journals A Literature Review on Hospital-Acquired Pneumonia (HAP), Community-Acquired Pneumonia (CAP), and Ventilator-Associated Pneumonia (VAP)

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Pedram Bolboli Zade ◽  
Abbas Farahani ◽  
Mohammadreza Riyahi ◽  
Ali Laelabadi ◽  
Ali Salami Asl ◽  
...  
Keyword(s):  
Risk Factors ◽  
Community Acquired Pneumonia ◽  
Specific Information ◽  
Ventilator Associated Pneumonia ◽  
Artificial Airway ◽  
Control And Prevention ◽  
Hospital Acquired Pneumonia ◽  
And Gender ◽  
Hospital Acquired ◽  
Common Infection

: One of the most dangerous respiratory diseases is pneumonia, one of the ten leading causes of death globally. Hospital-acquired pneumonia (HAP) is a common infection in hospitals, which is the second most common nosocomial infection and causes inflammation parenchyma. In Community-acquired pneumonia (CAP), we have various risk factors, including age and gender, and also some specific risk factors. Ventilator-associated pneumonia (VAP) is one of the deadliest nosocomial infections. According to the Centers for Disease Control and Prevention, VAP is pneumonia that develops about 48 hours of an artificial airway. Bacterial, viral, parasitic, primordial, and other species can cause these diseases. We discuss bacterial factors. Our goal is to gather information about HAP, CAP, and VAP to give people specific information. In this study, these three issues have been examined together, but in similar studies, each of them has been examined separately, and our type of study will be more helpful in diagnosis and treatment.

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