ro13-9904 and Intraabdominal-Infections

Ertapenem has been demonstrated to be highly effective for the treatment of complicated infections. The aim of this study was to compare the efficacy and safety of ertapenem with ceftriaxone.. We searched the PubMed, EMBASE, and the Cochrane Library for published randomized controlled trials (RCTs) that compared the efficacy and safety of ertapenem with ceftriaxone for the treatment of complicated infections including community-acquired pneumonia (CAP), complicated urinary tract infections (cUTIs), and complicated intra-abdominal infections (cIAIs). Meta-analysis was performed by RevMan 5.0.. Eight RCTs, involving 2 883 patients, were included in our meta-analysis. Ertapenem was associated with similar clinical treatment success with ceftriaxone for complicated infections (1 326 patients, fixed-effect model, OR: 1.13, 95% CI: 0.75-1.71). There was no difference between the compared treatment groups with regard to the microbiological treatment success, and no difference was found with regard to the incidence of clinical and laboratory drug-related adverse events between ertapenem and ceftriaxone groups. As to local tolerability, overall, there was no difference between the compared groups; however, in the subgroup analysis, local reaction was significantly less in the ertapenem subgroup than the ceftriaxone plus ceftriaxone subgroup.. Ertapenem can be used as effectively and safely as ceftriaxone for the treatment of complicated infections. It is an appealing option for the treatment of these complicated infections.

Topics: Anti-Bacterial Agents; beta-Lactams; Ceftriaxone; Ertapenem; Humans; Intraabdominal Infections; Pneumonia; Randomized Controlled Trials as Topic; Urinary Tract Infections

This randomized, open-label, multi-center trial compared tigecycline (TGC), a broad-spectrum glycylcycline, with ceftriaxone-metronidazole (CTX/MET) for the treatment of complicated intra-abdominal infections (cIAI).. Eligible subjects were randomized to receive TGC 100 mg followed by 50 mg q 12 h or CTX 2 g qd plus MET 1-2 g daily for 4-14 days. Subjects were stratified by Acute Physiology and Chronic Health Evaluation (APACHE) II score ≤10 or >10 and could not receive oral therapy. The primary endpoint was clinical response in the clinically evaluable (CE) population at the test of cure (TOC) assessment 8-44 days after the last drug dose.. Clinical responses in the CE population were 81.8% (162/198) vs. 79.4% (150/189) for TGC and CTX/MET, respectively; a weighted estimate of the difference of 1.6 (95% confidence interval [CI] -6.4, 9.6). In the microbiologically evaluable (ME) population, microbiological eradication rates were 82.4% (98/119) for TGC vs. 79.6% (86/108) for CTX/MET: a difference of 2.7 (95% CI -7.9, 13.3). Common adverse events were nausea (21.6% TGC vs. 21.3% CTX/MET) and vomiting (17.7% TGC vs. 13.2% CTX/MET). Discontinuation rates because of adverse events were 7.8% for TGC and 6.4% for CTX/MET.. Tigecycline was effective in the treatment of cIAI and was non-inferior to CTX/MET for the treatment of cIAI in hospitalized adults. Clinical Trials Identifier: NCT00230971.

Topics: Adult; Aged; Anti-Bacterial Agents; Ceftriaxone; Drainage; Drug Therapy, Combination; Female; Humans; Infusions, Intravenous; Intraabdominal Infections; Male; Metronidazole; Middle Aged; Minocycline; Tigecycline; Treatment Outcome

In this study, we aimed to investigate the results of intraoperative culture and antibiogram in children who underwent surgery with the diagnosis of community-acquired intraabdominal infections (CA-IAIs) to determine the causative microorganisms and antibiotic susceptibility of the bacterial agents.. Antibiotic susceptibility of isolated bacteria was investigated with disk diffusion method according to EUCAST (European Committee on Antimicrobial Susceptibility Testing) suggestions directly from the patients' intraabdominal peritoneal fluid or tissues, aged <18 years.. Bacterial growth was found in 17 (34%) of the blood cultures taken before the operation and 38 (76%) of the intraoperative abdominal cultures. According to the isolated strains; 44 (80%) were Gram-negative and 11 (20%) were Gram-positive, however, the most commonly isolated microorganisms were Escherichia coli (52.72%), Klebsiella pneumonia (14.54%), and Enterobacter cloacae (5.45%); extended-spectrum beta-lactamase (ESBL) resistance was detected in 12 of the Escherichia coli strains (41.38%) and the rates of ampicillin-sulbactam, ceftriaxone, and cefotaxime resistance were 43.2%, 40.9%, and 6.8%, respectively.. In our study, ESBL-resistant gram-negative microorganisms in CA-IAIs presented as primary agents to be considered. Ampicillin-sulbactam, ceftriaxone and cefotaxime should not be preferred in the monotherapy of complicated CA-IAIs due to their high resistance rates, but they can be combined with aminoglycosides. Quinolones can be included in the treatment because of their low resistance rates. It is considered that routine intraoperative culture and evaluation of antibiotic susceptibility in complicated CA-IAIs will provide an insight into the outcomes of empirical treatment.. Antimicrobial resistance, Intraabdominal infection, Surgery.. In questo studio abbiamo analizzato i risultati delle colture intraoperatorie con antibiogramma in bambini operati con diagnosi di infezione intraaddominale acquisita da comunità (CA-IAIs) per determinare gli agenti microbici responsabili e la relativa sensibilità ad antibiotici.. Sono stati inclusi nello studio pazienti di età <18 anni, presentati all’ambulatorio di chirurgia pediatrica nel periodo compreso tra marzo 2017 e marzo 2018, e sottoposti ad intervento chirurgico con la diagnosi di CB-IAI. Sangue prelevato preoperatoriamente e da 1 a 10 ml di liquido peritoneale sono stati inoculati su piastre di agar sangue e agar EMB. Le sensibilità agli antibiotici dei microrganismi isolati sono state valutate in conformità alle raccomandazioni EUCAST (European Committee on Antimicrobial Susceptibility Testing)con il metodo della diffusione dei dischi.. Dei 50 pazienti sottoposti all’operazione, 31 (62%) erano ragazzi e 19 (38%) ragazze. L’età media era di 10,96±4,67 anni. Lo sviluppo batterico è stato rilevato in 17 (34%) delle colture di sangue e in 38 (76%) delle colture addominali intraoperatorie. Dei ceppi isolati, 44 (80%) erano Gram-negativi e 11 (20%) erano Gram-positivi. I microrganismi più frequentemente isolati erano E.coli 52,72%, K.pneumonia 14,54%, Enterobatteri 5,45%. La resistenza alla beta-lattamasi a spettro esteso (ESBL) è stata rilevata in 12 (41,38%) dei ceppi di E.coli. Il tasso di resistenza all’ampicillina-sulbactam era del 43,2%, il tasso di resistenza al ceftriaxone e al cefotaxime era del 40,9%, mentre il tasso di resistenza alla ciprofloxacina era del 6,8%.. Nel nostro studio, i microrganismi gramnegativi resistenti alle GSBL nella CB-IAI sono i fattori che dovrebbero essere considerati per primi. Nel trattamento delle CB-IAI complicate, ampicillina-sulbactam e ceftriaxone e cefotaxime non dovrebbero essere preferiti in monoterapia a causa dei loro alti tassi di resistenza, ma possono essere associati con aminoglicosidi. I chinoloni possono essere inclusi nel trattamento perché i loro tassi di resistenza sono bassi. Come si può vedere, la coltura intraoperatoria di routine e la valutazione della suscettibilità antibiotica nelle CB-IAI complicate rappresentano informazioni utili per l’adozione di un trattamento empirico.

Topics: Anti-Bacterial Agents; Ceftriaxone; Child; Community-Acquired Infections; Escherichia coli; Humans; Intraabdominal Infections; Microbial Sensitivity Tests

A positive experience was described in the work, concerning application of Hepacef combi (cefoperazon/sulbactam, manufactured by "ARTERIUM" (Corporation, Ukraine) in the treatment of inflammatory-purulent diseases of abdominal organs as a method of empirical therapy. There was the preparation action efficacy estimated together with the diseases outcomes analysis, and possible recommendations for its application suggested. The preparation may be recommended for application as the empirical therapy agent in the abdominal infection treatment.

Topics: Abdominal Cavity; Adult; Anti-Bacterial Agents; Blood Cell Count; Cefoperazone; Ceftriaxone; Drug Administration Schedule; Drug Combinations; Drug Synergism; Female; Gram-Negative Bacteria; Gram-Positive Bacteria; Humans; Intraabdominal Infections; Male; Middle Aged; Postoperative Complications; Sulbactam; Treatment Outcome; Ukraine