Tuesday, February 26, 2008
Prophylactic antibiotics given within 24 hours of surgery, compared with antibiotics given for 72 hours perioperatively increased rate of MRSA
J Infect Chemother. 2008 Feb
Kusachi S, Sumiyama Y, Nagao J, Arima Y, Yoshida Y, Tanaka H, Nakamura Y, Saida Y, Watanabe M, Watanabe R, Sato J.
Third Department of Surgery, Toho University Ohashi Medical Center Hospital, 2-17-6 Ohashi, Meguro-ku, Tokyo, 153-8515, Japan, firstname.lastname@example.org.
The purpose of this research was to find which method better prevented MRSA isolation from postoperative infection sites: the administration of postoperative infection control agents within 72 h of surgery, including the day of surgery, or the administration of these agents within 24 h of surgery. More than 3000 patients who underwent elective surgery of the digestive system were studied. Cefazolin or cefotiam was used as the prophylactic antibiotic. The number of patients, sex, age, clinical stage, incidence of surgical site infection (SSI), isolated bacteria, distal pancreatectomy with or without gastrectomy, the rate of laparoscopic surgery, and the rate of abdominoperineal resection (APR) were examined in a prospective controlled study over three time periods. There were no significant differences in the demographics of patients in the three periods. The duration of antibiotic administration was 96.1 +/- 11.2 h in period A, 18.2 +/- 2.7 h in period B, and 66.9 +/- 11.1 hours in period C (P less then 0.05). There was no significant difference in the incidence of SSI in the three periods. Methicillin-resistant Staphylococcus aureus (MRSA) was isolated from the infectious site in 0.47% of patients in period A, and from 2.1% and 0.34% of patients in periods B and C, respectively, and the incidence of MRSA was significantly higher in period B as compared with periods A and C. The isolation rates of MRSA and methicillin-sensitive S. aureus (MSSA) were both significantly higher in period B patients. We concluded that the administration of prophylactic antibiotics within 24 h of surgery increased the rate of isolation of MRSA.
Saturday, February 23, 2008
Department of Internal Medicine, Inselspital, Bern, Switzerland. Philippe.Cottagnoud@insel.ch.
Daptomycin, a new lipopeptide antibiotic, is highly bactericidal against the majority of Grampositive human pathogens, including methicillinresistant (MRSA) and vancomycin-resistant enterococci. Its mechanism of action is unique resulting in the destruction of the membrane potential without lysing the cell wall. The mechanism of action of daptomycin, its antibacterial spectrum, the development of resistance and pre- and clinical studies are discussed in this review.
PMID: 18293118 [PubMed - in process]
Friday, February 22, 2008
Comparison of efficacy of azithromycin vs. doxycycline in the treatment of rosacea: a randomized open clinical trial.
Int J Dermatol. 2008 Mar
Akhyani M, Ehsani AH, Ghiasi M, Jafari AK.
Department of Dermatology, Razi Hospital, Tehran, Iran.
BACKGROUND: Rosacea is a common inflammatory disorder of the skin. Systemic antibiotics currently used in the treatment of rosacea are sometimes associated with uncomfortable side effects. Therefore, a need for an effective agent with few side effects and good patient compliance exists. Azithromycin, a macrolide antibiotic with prolonged mode of action, has recently been found to be an effective alternative in the treatment of inflammatory acne.
METHODS: For evaluation of the efficacy of azithromycin in the treatment of rosacea, we planned a randomized, open, clinical trial study to compare the efficacy of azithromycin with doxycycline in the treatment of this disease. Sixty-seven patients were randomized to receive either azithromycin 500 mg thrice weekly (on Monday, Wednesday, and Saturday) in the first, 250 mg thrice weekly (on Monday, Wednesday, and Saturday) in the second, and 250 mg twice weekly (on Tuesday, and Saturday) in the third month. The other group was given doxycycline 100 mg/day for the three months. Clinical assessment was made at baseline, at the end of first, second, third, and 2 months after treatment. Side affects were recorded. The limitation of this study is that there was no blindness.
RESULTS: Statistically significant improvement was obtained with both drugs. Neither drug was shown to be more effective than the other. In the azithromycin group four patients had diarrhea, while epigastric burning was seen in two patients using doxycycline.
CONCLUSION: This study indicates that azithromycin is at least as effective as doxycycline in the treatment of rosacea.
PMID: 18289334 [PubMed - in process]
Monday, February 18, 2008
J Antibiot (Tokyo). 2008
Ji Z, Wang M, Zhang J, Wei S, Wu W.
Institute of Pesticide Science, Northwest Agricultural & Forestry University.
Keywords: Streptomyces qinlingensis, streptothricin, structural elucidation
Four streptothricin-group antibiotics (1~4) were isolated from the fermentation broth of Streptomyces qinlingensis sp. nov. Along with the known antibiotics streptothricins F (1) and D (3), two new members of this class (2, 4) were identified as 12-carbamoyl derivatives of 1 and 3, respectively, mainly by analysis of the IR, HR-MS and NMR spectral data. The antibacterial activities of 1~4 against Escherichia coli (MICs 3.1, 25.0, 3.1 and 12.5 mug/ml), Bacillus subtilis (MICs 6.3, 25.0, 3.1 and 50 mug/ml), Staphylococcus aureus (MICs 12.5, >100.0, 6.3, >100.0 mug/ml), Bacillus cereus (MICs 25.0, 50.0, 25.0 and 50.0 mug/ml) and Pseudomonas aeruginosa (MICs 50.0, >100.0, 50.0, >100.0 mug/ml) were assayed by micro-broth dilution.
The results based on MIC data indicated that 2 and 4 exhibited significantly less potent antibacterial activities when compared to that of 1 and 3.Journal of Antibiotics
Saturday, February 16, 2008
Am J Med Sci. 2008 Feb
Haerian H, McHugh P, Brown R, Somes G, Solomon SS.
From Research (sss), Medical (hh, pm, sss), and Pharmacy Services, VAMC Memphis, Memphis, Tennessee; and the Departments of Medicine (hh, pm, sss), Pharmacology (sss), and Preventive Medicine (gs) of the College of Medicine and College of Pharmacy (rb), University of Tennessee, the Health Science Center, Memphis, Tennessee.
BACKGROUND: Gatifloxacin, until recently one of the most commonly prescribed antibiotics, has been shown to produce hypoglycemia.
METHODS: To further examine the effects of Gatifloxicin (G) on blood glucose (BS), we conducted a retrospective chart review on 264 inpatients, examining for both hypoglycemia and hyperglycemia, comparing G with another quinolone, Ciproflaxin (C), and nonquinolone, Ceftriaxone (R).
RESULTS: We found that of 292 patient encounters, 28 hypoglycemia and 48 hyperglycemic events occurred. Patients given G were 5 times as likely to become hypoglycemic as C
CONCLUSIONS: In summary, G was clearly associated with both hypoglycemia and hyperglycemia compared with C and R. The risk of hyperglycemia increased in the presence of DM, steroid use, and "sick enough" to be in the intensive care unit.
PMID: 18277115 [PubMed - as supplied by publisher]
Sunday, February 03, 2008
Ceftobiprole Medocaril with Vancomycin plus Ceftazidime for the Treatment of Patients with Complicated Skin Infections
Noel GJ, Bush K, Bagchi P, Ianus J, Strauss RS.
Johnson & Johnson Pharmaceutical Research and Development, Raritan, New Jersey.
Background: A randomized, double-blind, multicenter trial involving patients with a broad range of complicated skin and skin-structure infections due to either gram-positive or gram-negative bacteria was conducted to compare ceftobiprole monotherapy with treatment with vancomycin plus ceftazidime.
Methods: Patients were randomized 2:1 to receive ceftobiprole or to receive vancomycin plus ceftazidime. Outcomes were determined at a test-of-cure visit (7-14 days after completion of therapy) and were analyzed for all patients with complicated skin and skin-structure infections, as well as for subgroups, on the basis of major types of infections and severity of disease.
Results: Among the clinically evaluable and the intent-to-treat populations, clinical cure rates at the test-of-cure visit were similar in the ceftobiprole and comparator treatment arms (clinical cure rate, 90.5% [439 of 485 patients] and 90.2% [220 of 244 patients] in the clinically evaluable population, respectively; 81.9% [448 of 547 patients] and 80.8% [227 of 281 patients] in the intent-to-treat population, respectively). Clinical cure rates in ceftobiprole-treated patients ranged from 86.2% (125 of 145 patients) among those with diabetes who had foot infections to 93.0% (80 of 86 patients) among those with cellulitis.
Among patients treated with ceftobiprole, clinical cure rates were similar among patients from whom gram-negative bacteria were isolated (87.9% [109 of 124 patients]) and among patients from whom gram-positive bacteria were isolated (91.8% [292 of 318 patients]) and were not statistically different from the clinical cure rates among comparator-treated patients (89.7% [61 of 68 patients] and 90.3% [149 of 165 patients], respectively). Rates of adverse events and serious adverse events in the 2 treatment groups were similar.
Conclusions: Ceftobiprole monotherapy is as effective as vancomycin plus ceftazidime for treating patients with a broad range of complicated skin and skin-structure infections and infections due to gram-positive and gram-negative bacteria.
PMID: 18225981 [PubMed - as supplied by publisher]