Amoxicillin plus temocillin as an alternative empiric therapy for the treatment of severe hospital-acquired pneumonia: results from a retrospective audit

Habayeb, Hani; Sajin, B.; Patel, Karishma; Grundy, Clive; Al-Dujaili, Arshad Noori; Velde, Sebastien Van de

doi:10.1007/s10096-015-2406-x

Cited by 21 publications

(14 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It is the 6-α-methoxy derivative of ticarcillin, and is resilient to all classical and extended-spectrum TEM, SHV, and CTX-M enzymes and AmpC β-lactamases. Temocillin is used in few Western Europe countries [3], and only limited data are available on temocillin susceptibility in Eastern Europe, where microbial resistance to many antimicrobials is prevalent. According to the most recent report from the European Centre for Disease Prevention and Control in Poland over 65% of Klebsiella pneumoniae isolates reported to the European Antimicrobial Resistance Surveillance Network (EARS-Net) in 2018 were resistant to extended-spectrum cephalosporins; this represents an increase compared to previous years [4].…”

Section: Introductionmentioning

confidence: 99%

Activity of temocillin against ESBL-, AmpC-, and/or KPC-producing Enterobacterales isolated in Poland

Kuch

Zieniuk

Żabicka

et al. 2020

Eur J Clin Microbiol Infect Dis

View full text Add to dashboard Cite

We evaluated the in vitro effectiveness of temocillin and several commonly used antimicrobials against Enterobacterales bacteria in isolates from Polish patients. We tested 400 isolates: 260 extended-spectrum β-lactamase (ESBL)-and/or ampC β-lactamase (AmpC)-producing isolates; 40 Klebsiella pneumoniae carbapenemase (KPC)-producing isolates; and 100 ESBL-, AmpC-, and KPC-negative isolates. The minimal inhibitory concentrations (MICs) of temocillin and 16 other antimicrobials were determined by reference microdilution. We also determined the activities of fosfomycin and ceftazidime/avibactam in KPC-producing isolates. The antibiotic sensitivities were interpreted according to EUCAST, BSAC, and CLSI criteria. Overall, 91% of the isolates were susceptible to temocillin using the urinary tract infection breakpoint (≤ 32 mg/L), and 61.8% were susceptible using the systemic infection breakpoint (≤ 8 mg/L). Meropenem and imipenem were the most active drugs (MIC 50 values of 0.06 and 0.5 mg/L, respectively). Colistin and ertapenem (both MIC 50 = 0.12 mg/L) were less active than meropenem or imipenem, but some strains were 77% susceptible to each of them. Among the KPC-producing isolates, 42.5% had MIC values of ≤ 32 mg/L (urinary tract infection breakpoint), but 100% were resistant to temocillin (systemic infection breakpoint). Ceftazidime/avibactam was active against 100% of the KPC-producing isolates, and fosfomycin was active against 40%. The empirical susceptibility rate observed among the urinary isolates suggests that temocillin may be considered as an alternative to carbapenems in the absence of KPC-producing bacteria. With regard to isolates from other sources, temocillin might be useful as a documented therapy agent or an empirical treatment in hospitals with a low prevalence of ESBL/AmpC-producing strains.

show abstract

Section: Introductionmentioning

confidence: 99%

Activity of temocillin against ESBL-, AmpC-, and/or KPC-producing Enterobacterales isolated in Poland

Kuch

Zieniuk

Żabicka

et al. 2020

Eur J Clin Microbiol Infect Dis

View full text Add to dashboard Cite

show abstract

“…Five studies were not included in the meta-analysis due to differences in antibiotic exposure measurement; two Canadian studies used no antibiotic exposure as the reference category, 31, 32 one study examined duration and dosage of antibiotic exposure 33 and two UK studies used historical controls to examine the impact of changes to antibiotic formulary changes. 34, 35 The main results are summarised below.…”

Section: Resultsmentioning

confidence: 99%

“…In patients with severe hospital-acquired pneumonia, none of the patients treated with amoxicillin plus temocillin (n=98) developed CDI compared to 7.4% (7/94) of patients who had previously been treated with piperacillin-tazobactam (both beta-lactamase inhibitor combinations). 34 In a study comparing gentamicin (aminoglycoside) with cefuroxime (2 nd generation cephalosporin) for total hip and knee replacement surgery prophylaxis, there were no CDI cases in the gentamicin group (n=2101) compared to 11 cases (0.2%) in the cefuroxime group (n=6094). 35…”

Section: Resultsmentioning

confidence: 99%

“…In addition, a more diverse range of patient populations have been studied since 2013, with an increase in focused studies on clinical patient groups, such as surgical 35, 42, 43 and ICU patients, 44 or patients with particular conditions such as HA-pneumonia, 33, 34, 45 compared to earlier studies that predominantly studied general inpatients. Studies using patient sub-groups tended to have weaker associations.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Antibiotics and hospital-associatedClostridioides difficileinfection: systematic review and meta-analysis 2020 update

Slimings

Riley

2021

Preprint

View full text Add to dashboard Cite

Background: Clostridioides difficile infection (CDI) is the most common cause of healthcare facility associated (HCFA) infectious diarrhoea in high income countries. Antibiotic use is the most important modifiable risk factor for CDI. The most recent systematic review covered studies published until 31st December 2012. Objectives: To update the evidence for epidemiological associations between specific antibiotic classes and HCFA CDI for the period 1st January 2013 to 31st December 2020. Data sources: PubMed, Scopus, Web of Science Core Collection, WorldCat, and Proquest Dissertations and Theses. Study eligibility criteria, participants and exposures: Eligible studies were those conducted among adult hospital inpatients, measured exposure to individual antibiotics or antibiotic classes, included a comparison group, and measured the occurrence of HCFA CDI as an outcome. Study appraisal and synthesis methods: The Newcastle Ottawa Scale for the Assessment of Quality was used to appraise study quality. To assess the association between each antibiotic class and HACDI, a pooled random effects meta-analysis was undertaken. Metaregression and sub-group analysis was used to investigate study characteristics identified a priori as potential sources of heterogeneity. Results: Carbapenems, and 3rd and 4th generation cephalosporin antibiotics remain most strongly associated with HCFA CDI, with cases more than twice as likely to have recent exposure to these antibiotics prior to developing CDI. Modest associations were observed for fluoroquinolones clindamycin, and betalactamase inhibitor combination penicillin antibiotics. Limitations: Individual study effect sizes were variable and heterogeneity was observed for most antibiotic classes. Availability of a single reviewer to select, extract and critically appraise the studies. Conclusions: This review provides the most up to date synthesis of evidence in relation to the risk of HCFA CDI associated with exposure to specific antibiotic classes. Studies were predominantly conducted in North America or Europe and more studies outside of these settings are needed.

show abstract

“…Temocillin has been introduced into the UK and a number of European countries for the treatment of infections caused by ESBL-producing Enterobacteriaceae [ 5 , 6 ]. Temocillin, a narrow spectrum penicillin (6-α-methoxy-ticarcillin) with intrinsic stability to AmpCs, ESBLs and some carbapenemases, has been considered potentially a “carbapenem-sparing agent”, especially in the treatment of ESBL-producing enterobacterial infections of the urinary tract [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Activity of temocillin and 15 other agents, including fosfomycin and colistin, against Enterobacteriaceae in Hong Kong

Lai

Fung

et al. 2017

Eur J Clin Microbiol Infect Dis

View full text Add to dashboard Cite

Limited data are available on temocillin susceptibilities in Enterobacteriaceae from Asian countries where antimicrobial resistance is prevalent. The in vitro activities of temocillin and 15 commonly used antimicrobials against 613 non-duplicate blood (n = 310) and urine (with clinically significant bacteriuria; n = 303) isolates of Enterobacteriaceae from patients who attended 3 out of 7 clusters of public hospitals of the Hospital Authority, Hong Kong, during 2015/2016 were tested. Minimum inhibitory concentrations (MICs) were determined by Clinical and Laboratory Standards Institute (CLSI) microbroth dilution (agar dilution with fosfomycin). For temocillin, MICs were also obtained using the British Society of Antimicrobial Chemotherapy (BSAC) microbroth dilution method and interpreted using the BSAC breakpoints. Overall, 93.0% (570) isolates were susceptible to temocillin using BSAC systemic breakpoint (≤8 mg/L) and all except 2 isolates were susceptible using the urinary breakpoint (≤32 mg/L). The extended spectrum beta-lactamase (ESBL) positivity rate was 23.2% (118 out of 508 E. coli, Klebsiella spp., Proteus spp.). Temocillin resistance rate to ESBL-positive isolates was 16.1% using the systemic breakpoint of ≤8 mg/L (MIC50 and MIC90 were 8 mg/L and 16 mg/L respectively). Two isolates (1 E. coli, temocillin MIC 64 mg/L, 1 Klebsiella sp., MIC 32 mg/mL) were resistant to meropenem and possessed the NDM-5 and KPC-2 genes respectively. Other susceptibility rates were: amoxicillin/clavulanate (59.1%), trimethoprim/sulfamethoxazole (62.5%), ciprofloxacin (71.5%), ceftriaxone (75.4%), nitrofurantoin (76.4%), gentamicin (78.3%), cefepime (81.1%), ceftazidime (83.5%), piperacillin/tazobactam (86%), colistin (88.8%), tigecycline (89.4%), fosfomycin (92.8%), ertapenem (99.0%), amikacin (99.2%) and meropenem (99.7%). Temocillin may be a useful alternative for the treatment of infections caused by ESBL and multi-drug-resistant Enterobacteriaceae in Hong Kong, particularly as resistance rates to ciprofloxacin, nitrofurantoin and piperacillin/tazobactam are high.Electronic supplementary materialThe online version of this article (10.1007/s10096-017-3091-8) contains supplementary material, which is available to authorized users

show abstract

Amoxicillin plus temocillin as an alternative empiric therapy for the treatment of severe hospital-acquired pneumonia: results from a retrospective audit

Cited by 21 publications

References 30 publications

Activity of temocillin against ESBL-, AmpC-, and/or KPC-producing Enterobacterales isolated in Poland

Activity of temocillin against ESBL-, AmpC-, and/or KPC-producing Enterobacterales isolated in Poland

Antibiotics and hospital-associatedClostridioides difficileinfection: systematic review and meta-analysis 2020 update

Activity of temocillin and 15 other agents, including fosfomycin and colistin, against Enterobacteriaceae in Hong Kong

Contact Info

Product

Resources

About