colistin and Endocarditis--Bacterial

The literature on the clinical use of rifampicin in combination for the treatment of non-mycobacterial diseases is reviewed. From the published evidence, the most promising associations are, for staphylococcal infections, gentamicin, erythromycin, kanamycin and fusidic acid. In the field of Gram-negative infections, Psuedomonas-induced sepsis in particular, data are not so impressive but promising results have been obtained with the associated use of rifampicin and gentamicin or colistin. Some systemic fungal diseases may be successfully treated with rifampicin in combination with amphotericin-B. Although only few reports are available on this subject, the importance of such an application is stressed in view of the severity of these diseases and of the lack of appropriate treatments.

Topics: Amphotericin B; Cephalosporins; Chloramphenicol; Colistin; Drug Therapy, Combination; Endocarditis, Bacterial; Erythromycin; Gentamicins; Humans; Kanamycin; Lincomycin; Mycoses; Nalidixic Acid; Penicillins; Pseudomonas Infections; Respiratory Tract Infections; Rifampin; Staphylococcal Infections; Sulfamethoxazole; Tetracyclines; Trimethoprim; Urinary Tract Infections; Vancomycin

Topics: Colistin; Diagnosis; Drug Hypersensitivity; Endocarditis; Endocarditis, Bacterial; Humans; Methicillin; Penicillin G; Penicillins; Toxicology

Serious infections such as endocarditis due to extremely drug-resistance gram-negative bacteria are an increasing challenge. Here, we present successful adjunctive use of cefiderocol for a patient with persistently bacteremic healthcare-associated native aortic valve endocarditis due to an extended-spectrum beta-lactamase-positive Pseudomonas aeruginosa susceptible in vitro only to colistin, following failure of conventional therapeutic options.

Topics: Aged; Anti-Bacterial Agents; Aortic Valve; beta-Lactamases; Cefiderocol; Cephalosporins; Colistin; Compassionate Use Trials; Drug Resistance, Multiple, Bacterial; Endocarditis, Bacterial; Female; Humans; Microbial Sensitivity Tests; Pseudomonas aeruginosa; Pseudomonas Infections; Treatment Outcome

Enterobacteriaceae are rarely the etiologic agents of endocarditis, with Klebsiella species being especially rare. From the end of 2005, isolates of carbapenem-resistant Klebsiella pneumoniae began to appear in various hospitals across Israel, sensitive only to colistin and gentamicin. We present a case of hospital-acquired endocarditis caused by carbapenem-resistant K. pneumoniae in a young adult.. An 18-year-old man with 40% full thickness burns developed acute bacterial endocarditis complicated by embolic myocardial infarction. Carbapenem-resistant K. pneumoniae carrying the blaKPC3 gene was isolated from multiple blood cultures. He recovered fully after antibiotic treatment with colistin and gentamicin.. To our knowledge, this is the first reported case of acute bacterial endocarditis caused by carbapenem-resistant K. pneumoniae. The combination of intravenous colistin and gentamicin was effective and resulted in the cure of this patient's endocarditis without the need for surgical intervention.

Topics: Adolescent; Anti-Bacterial Agents; Bacterial Proteins; beta-Lactam Resistance; beta-Lactamases; Carbapenems; Colistin; Drug Therapy, Combination; Endocarditis, Bacterial; Gentamicins; Humans; Klebsiella Infections; Klebsiella pneumoniae; Male; Treatment Outcome

The in-vivo activity of colistin was evaluated in an experimental rabbit model of Acinetobacter baumannii endocarditis with a strain susceptible to colistin and intermediate to imipenem. Compared to a control group, colistin was effective (p < 0.05) in bacterial clearance from blood and in the sterilisation of blood cultures, but was not effective in clearing A. baumannii from vegetations. Thus, although colistin may be effective in treating bacteraemia caused by susceptible strains of A. baumannii, it may not be a suitable treatment for endocarditis, perhaps because of poor penetration into vegetations and a low C(max)/MIC ratio in tissue.

Topics: Acinetobacter baumannii; Acinetobacter Infections; Animals; Anti-Bacterial Agents; Bacteremia; Colistin; Colony Count, Microbial; Disease Models, Animal; Endocarditis, Bacterial; Heart Valves; Humans; Microbial Sensitivity Tests; Rabbits; Treatment Outcome

Topics: Adult; Aortic Valve; Colistin; Drug Therapy, Combination; Endocarditis, Bacterial; Heart Valve Prosthesis; Humans; Male; Postoperative Complications; Pseudomonas Infections; Rifampin; Tobramycin

Endocarditis of the tricuspid valve due to Pseudomonas aeruginosa in a heroin addict failed to respond to therapy with gentamicin, carbenicillin, and amikacin. Clinical and bacteriologic cure was achieved with oral administration of a trimethoprim-sulfamethoxazole mixture plus parenteral therapy with colistin. In vitro synergism was demonstrated for the three drugs at concentrations achievable in the serum. Therapy for endocarditis due to Pseudomonas continues to be a major problem; however, the successful treatment of this patient warrants consideration for instituting therapy with a trimethoprim-sulfamethoxazole misture plus colistin in individuals with this infection who fail to respond to standard therapeutic regimens for severe infections with Pseudomonas.

Topics: Adult; Colistin; Drug Combinations; Endocarditis, Bacterial; Heart Valve Diseases; Heroin Dependence; Humans; Male; Pseudomonas Infections; Sulfamethoxazole; Tricuspid Valve; Trimethoprim

Although the serum bactericidal test is commonly used in the management of infective endocarditis, little has been written about its validity or limitations. We report three cases of gram-negative bacillary endocarditis (Pseudomonas aeruginosa, Vibrio fetus and Serratia marcescens) encountered in 1 year at a Veterans Administration hospital. Serum bactericidal titers were considered necessary to identify inadequate antibiotic regimens or to avoid unnecessary drug toxicity. The limitations of the test, particularly those pertaining to gram-negative infections, are reviewed. Misleading results during treatment with aminoglycoside antibiotics could be due to the tendency of serum to become alkaline on standing. A detailed study of the interaction of the complement-dependent bactericidal system of serum with eight antibiotics is presented. In the context of the serum bactericidal test, the interaction was additive or synergistic in 15 of 16 determinations, indicating the need to include a control study of serum sensitivity of the infecting microorganism in each case.

Topics: Adult; Anti-Bacterial Agents; Bacteria; Blood Bactericidal Activity; Campylobacter fetus; Carbenicillin; Colistin; Endocarditis, Bacterial; Gentamicins; Humans; Hydrogen-Ion Concentration; Male; Microbial Sensitivity Tests; Middle Aged; Pseudomonas aeruginosa; Pseudomonas Infections; Serratia marcescens; Tetracycline; Vibrio Infections

Topics: Adult; Blood; Carbenicillin; Cephalothin; Colistin; Drug Synergism; Drug Therapy, Combination; Endocarditis, Bacterial; Female; Gentamicins; Heart Valve Prosthesis; Heroin Dependence; Humans; Male; Mesylates; Polymyxins; Pseudomonas aeruginosa; Pseudomonas Infections; Sepsis; Staphylococcal Infections; Tricuspid Valve

Topics: Adult; Aortic Valve; Carbenicillin; Colistin; Corynebacterium diphtheriae; Corynebacterium Infections; Endocarditis, Bacterial; Fascia Lata; Heart Valve Prosthesis; Humans; Male; Penicillin Resistance; Penicillins; Postoperative Complications; Sepsis; Streptomycin

Topics: Acute Kidney Injury; Adolescent; Adult; Amphotericin B; Anti-Bacterial Agents; Bacterial Infections; Colistin; Deafness; Endocarditis, Bacterial; Female; Humans; Kanamycin; Kidney; Kidney Function Tests; Male; Middle Aged; Pseudomonas Infections; Sepsis; Staphylococcal Infections; Streptococcal Infections; Urea; Vancomycin

Topics: Child; Colistin; Endocarditis, Bacterial; Female; Gentamicins; Heart Failure; Heart Valve Prosthesis; Humans; Polymers; Postoperative Complications; Prognosis; Pseudomonas aeruginosa; Pseudomonas Infections; Silicones; Splenomegaly; Tetralogy of Fallot

Topics: Ampicillin; Anti-Bacterial Agents; Cephalosporins; Child; Cloxacillin; Colistin; Drug Synergism; Dysentery, Bacillary; Endocarditis, Bacterial; Humans; Infections; Lincomycin; Meningitis; Nafcillin; Neomycin; Oxacillin; Penicillin Resistance; Penicillins; Pneumococcal Infections; Polymyxins; Shigella; Streptococcal Infections; Sulfamethoxazole; Tetracycline; Urinary Tract Infections

Topics: Abortion, Criminal; Adult; Anti-Bacterial Agents; Chloramphenicol; Colistin; Dexamethasone; Drug Synergism; Electrocardiography; Endocarditis, Bacterial; Female; Humans; Penicillins; Staphylococcal Infections; Tricuspid Valve Stenosis

Topics: Bacitracin; Child; Colistin; Drug Therapy; Endocarditis; Endocarditis, Bacterial; Enterobacter aerogenes; Escherichia coli Infections; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Infections; Klebsiella; Liver Abscess; Oxacillin; Penicillins; Pseudomonas Infections; Staphylococcal Infections; Streptococcal Infections; Toxicology

Topics: Cardiac Surgical Procedures; Colistin; Drug Resistance; Drug Resistance, Microbial; Drug Therapy; Endocarditis, Bacterial; Heart Valve Diseases; Heart Valve Prosthesis; Humans; Kanamycin; Klebsiella; Polymyxins; Thoracic Surgery

Topics: Acinetobacter; Anti-Bacterial Agents; Chlortetracycline; Colistin; Dihydrostreptomycin Sulfate; Drug Resistance; Drug Resistance, Microbial; Endocarditis; Endocarditis, Bacterial; Neomycin; Nitrofurantoin; Oxytetracycline; Pathology; Penicillins; Tetracycline

Topics: Amphotericin B; Anti-Bacterial Agents; Chloramphenicol; Colistin; Drug Resistance; Drug Resistance, Microbial; Endocarditis; Endocarditis, Bacterial; Enterobacter aerogenes; Enterobacteriaceae; Erythromycin; Escherichia coli Infections; Kanamycin; Penicillin G; Penicillins; Proteus Infections; Pseudomonas Infections; Ristocetin; Staphylococcal Infections; Streptococcal Infections; Streptomycin; Tetracycline; Vancomycin

Topics: Burns; Colistin; Drug Therapy; Endocarditis; Endocarditis, Bacterial; Humans; Penicillins; Polymyxins; Pseudomonas; Pseudomonas aeruginosa; Pseudomonas Infections; Streptomycin

Topics: Bacillus; Colistin; Diagnosis; Drug Therapy; Endocarditis; Endocarditis, Bacterial; Geriatrics; Humans; Pseudomonas aeruginosa; Pseudomonas Infections