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Your search keyword '"double-carbapenem regimen"' showing total 2 results
Start Over Descriptor "double-carbapenem regimen" Topic carbapenem-resistant klebsiella pneumoniae
2 results on '"double-carbapenem regimen"'

1. Bactericidal and synergistic activity of double-carbapenem regimen for infections caused by carbapenemase-producing Klebsiella pneumoniae.

Author

Oliva, A., Gizzi, F., Mascellino, M.T., Cipolla, A., D'Abramo, A., D'Agostino, C., Trinchieri, V., Russo, G., Tierno, F., Iannetta, M., Mastroianni, C.M., and Vullo, V.

Subjects
*CARBAPENEMASE, *CARBAPENEMS, *KLEBSIELLA pneumoniae, *COLISTIN, *NEPHROTOXICOLOGY, *DRUG resistance, *THERAPEUTICS
Abstract

Available therapeutic options against carbapenem-resistant Klebsiella pneumoniae (CR-Kp) are limited because of the high level of resistance to other antimicrobial classes including polymyxins. The double-carbapenem regimen has been recently considered a possible therapeutic strategy. In the present study, we evaluated the in vitro bactericidal and synergistic activity of a double-carbapenem regimen consisting of ertapenem plus high-dose meropenem in a series of patients with healthcare-associated CR-Kp infections in whom the use of colistin was not indicated because of potential nephrotoxicity and/or resistance. In vitro synergy was evaluated using checkerboard and killing studies. A total of 15 patients were included in the study, with sepsis, severe sepsis and septic shock found in two (13.3%), five (33.3%) and one (6.7%) patients, respectively. Overall, the clinical/microbiological response was 12/15 (80%). Synergy was observed in 11/14 (78.6%) isolates using the checkerboard method whereas in killing studies 12/14 (85.7%) and 14/14 (100%) strains were synergistic and bactericidal at 24 h at concentrations of 1 × MIC MEM + 1 × MIC ERT and 2 × MEM + 1 × MIC ERT, respectively, with a significant decrease of log CFU/mL compared with other combinations (p <0.0001). The double-carbapenem regimen showed clinical and in vitro effectiveness in patients with CR-Kp infections. [ABSTRACT FROM AUTHOR]

Published
2016
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2. Bactericidal and synergistic activity of double-carbapenem regimen for infections caused by carbapenemase-producing Klebsiella pneumoniae

Author

Alessia Cipolla, Claudio Maria Mastroianni, Francesca Tierno, Gianluca Russo, Claudia D'Agostino, Francesca Gizzi, Marco Iannetta, Alessandra Oliva, Vito Trinchieri, Alessandra D'Abramo, Maria Teresa Mascellino, and Vincenzo Vullo

Subjects
Male, 0301 basic medicine, Carbapenem, Klebsiella pneumoniae, Polymyxin, synergy, sepsis, chemistry.chemical_compound, bactericidal activity, carbapenem-resistant klebsiella pneumoniae, double-carbapenem regimen, time-kill studies, microbiology (medical), infectious diseases, Drug Resistance, Multiple, Bacterial, polycyclic compounds, Cross Infection, biology, Drug Synergism, General Medicine, Middle Aged, Antimicrobial, Anti-Bacterial Agents, Infectious Diseases, Female, Ertapenem, medicine.drug, Microbiology (medical), medicine.drug_class, 030106 microbiology, Microbial Sensitivity Tests, Bactericidal activity, beta-Lactams, Meropenem, Microbiology, 03 medical and health sciences, medicine, Humans, Aged, Dose-Response Relationship, Drug, carbapenem-resistant Klebsiella pneumoniae, business.industry, biology.organism_classification, Settore MED/17, Klebsiella Infections, Regimen, chemistry, Colistin, Thienamycins, business
Abstract

Available therapeutic options against carbapenem-resistant Klebsiella pneumoniae (CR-Kp) are limited because of the high level of resistance to other antimicrobial classes including polymyxins. The double-carbapenem regimen has been recently considered a possible therapeutic strategy. In the present study, we evaluated the in vitro bactericidal and synergistic activity of a double-carbapenem regimen consisting of ertapenem plus high-dose meropenem in a series of patients with healthcare-associated CR-Kp infections in whom the use of colistin was not indicated because of potential nephrotoxicity and/or resistance. In vitro synergy was evaluated using checkerboard and killing studies. A total of 15 patients were included in the study, with sepsis, severe sepsis and septic shock found in two (13.3%), five (33.3%) and one (6.7%) patients, respectively. Overall, the clinical/microbiological response was 12/15 (80%). Synergy was observed in 11/14 (78.6%) isolates using the checkerboard method whereas in killing studies 12/14 (85.7%) and 14/14 (100%) strains were synergistic and bactericidal at 24 h at concentrations of 1 × MIC MEM+1 × MIC ERT and 2 × MEM+1 × MIC ERT, respectively, with a significant decrease of log CFU/mL compared with other combinations (p

Published
2016
Full Text
View/download PDF

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