The in vitro susceptibility of 27 Campylobacter jejuni, 31 Campylobacter coli, and 30 Campylobacter fetus subsp. fetus strains to 12 antimicrobial agents was determined. Ciprofloxacin, a new quinoline derivative, was the most active agent tested. Antimicrobial susceptibility differed among the three species tested.

Objectives: To identify the most efficacious timing for tocilizumab administration in critically ill patients infected with severe acute respiratory syndrome coronavirus-2. Design: Observational multicenter cohort study. Setting: A total of 23 acute care hospitals in four states. Patients: One-hundred eighteen patients admitted between March 13, 2020, and April 16, 2020. Eighty-one patients received tocilizumab, and 37 were untreated and served as a control group. Measurements and Main Results: The main outcome was mortality and was analyzed by timing of tocilizumab dosing. Early dosing was defined as a tocilizumab dose administered prior to or within 1 day of intubation. Late dosing was defined as a dose administered greater than 1 day after intubation. A control group that was treated only with standard of care, and without tocilizumab, was used for comparison. Early tocilizumab therapy was associated with a statistically significant decrease in mortality as compared to patients who were untreated ( p = 0.003). Dosing tocilizumab late was associated with an increased mortality compared with the untreated group ( p = 0.006). Conclusions: Early tocilizumab administration was associated with decreased mortality in critically ill severe acute respiratory syndrome coronavirus-2 patients, but a potential detriment was suggested by dosing later in a patient’s course.

Among privately insured individuals below age 65, ID consultation during OPAT is associated with large and significant reductions in the rate of ED admission and hospital admission in the 30 days after an index event, as well as lower total healthcare spending.

A comparison was made of the in vitro activity of ciprofloxacin (Bay o 9867) with nine other antibiotics against isolates of Campylobacterjejuni, Salmonella spp., Shigella spp., Yersinia enterocolitica, Clostridium difficile, Vibrio spp., and Escherichia coli. Minimum inhibitory concentrations of ciprofloxacin were the lowest of any compound tested for all organisms except C. difficile.Ciprofloxacin (Bay o 9867) is a new quinolone derivative. Although structurally related to'nalidixic acid, it has an expanded spectrum of action (7). Since nalidixic acid has considerable activity against bacterial enteric patho,gens in vitro (6), we decided to evaluate the activity of ciprofloxacin and compare it with nine other antimicrobial agents which may be useful for treatment of infections caused by these pathogens.Susceptibility testing was performed by using MuellerHinton agar and standard agar dilution methods (4, 5), except for Campylobacterjejuni and Clostridium difficile for which Wilkins-Chalgren agar was used. Inocula were prepared by transferring three to five colonies'from an overnight culture of the organism into Trypticase soy broth. After 2 to 4 h of growth, the turbidity was adjusted to a 0.5' McFarland turbidity standard with sterile saline. For'C. difficile and C. jejuni, three to five colonies from a 48-h growth were inoculated into Wilkins-Chalgren broth and incubated overnight. The incubation temperature for all organisms was 35°C except for C. jejuni, which was incubated at 429C. Turbidity was then adjusted as described above. Plates were inoculated with a multipoint replicator (Cathra, St. Paul, Minn.) designed to deliver exactly 0.001 ml per spot to the surface of antibiotic-impregnated agar. The inoculum contained approximately 104 CFU of organisms per spot. Plates were inoculated from the lowest to the highest concentration of antibiotic. All organisms except C. difficile and C. jejuni were incubated in ambient atmosphere. C. difficile plates were incubated in an'anaerobic glove box with an atmosphere of 5 to 10% CO2, 5 to 10o H2, and the balance N2 and read at 48 h. C. jejuni plates were placed in a microaerophilic atmosphere utilizing the Polybag technique (3). These plates were read at 24 and 48 h. A control plate without antibiotics was inoculated before and after each antibiotic series, and appropriate control organisms were included in each series of antibiotic plates. MICs were defined as the lowest concentration of antibiotic at which there was no visible growth.A total of 127 clinical isolates of human origin were tested (Table 1) Thymidine phosphorylase (0.1 U/ml; Burroughs Wellcome) was added to all plates when testing trimethoprimsulfamethoxazole. Table 1 shows the comparative activity of ciprofloxacin against bacterial enteric pathogens, expressed as the 50% MI,C (MICo), 90% MIC (MICgo), and range of each drug. Due to the small number of organisms tested, only the MIC50 and range were given for E. coli and Vibrio spp. Overall, ciproftoxacin was the most active antibiotic. The MICgo was ...