Bacteraemia in Europe—antimicrobial susceptibility data from the MYSTIC surveillance programme

Ünal, Serhat; Masterton, R.G.; Goossens, Herman

doi:10.1016/j.ijantimicag.2003.07.003

Cited by 29 publications

(15 citation statements)

References 28 publications

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“…In order to put these observations into perspective, we ob- tained meropenem MIC distributions for common gram-negative nosocomial pathogens (K. pneumoniae, Enterobacter cloacae, and P. aeruginosa) from the MYSTIC database (31,39,47). Weighted averages were calculated over the MIC distributions, and the probabilities of target attainment by dose and mode of administration and are presented in Table 3.…”

Section: Resultsmentioning

confidence: 99%

“…Target pathogen MIC distributions were obtained from the MYSTIC database (31,39,47). A weighted average (expectation) over the MIC distribution and the target attainment rates was taken to obtain an estimate of the population probability of target attainment for a specific pathogen for a specific mode of administration and a specific dose.…”

Section: Subjectsmentioning

confidence: 99%

“…The low variability observed in this study with healthy volunteers may lead to confidence intervals too narrow in comparison to the clinical situation. The organism MIC distributions in the MYSTIC database represent data for a large collection of current pathogens, and the data were collected in Europe and the United States (31,39,47). Figure 5 demonstrates that K. pneumoniae and E. cloacae both have MIC distributions in which Ͼ90% of the isolates examined have meropenem MICs Յ0.25 mg/liter.…”

Section: Vol 49 2005 Continuous and Intermittent Infusion Of Meropementioning

confidence: 99%

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Evaluation by Monte Carlo Simulation of the Pharmacokinetics of Two Doses of Meropenem Administered Intermittently or as a Continuous Infusion in Healthy Volunteers

Krueger

Bulitta

Kinzig‐Schippers

et al. 2005

Antimicrob Agents Chemother

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Meropenem is a broad-spectrum carbapenem antibacterial agent. In order to optimize levels in plasma relative to the MICs, the ideal dose level and dosage regimen need to be determined. The pharmacokinetics of meropenem were studied in two groups, each comprising eight healthy volunteers who received the following doses: 500 mg as an intravenous infusion over 30 min three times a day (t.i.d.) versus a 250-mg loading dose followed by a 1,500 mg continuous infusion over 24 h for group A and 1,000 mg as an intravenous infusion over 30 min t.i.d. versus a 500-mg loading dose followed by a 3,000-mg continuous infusion over 24 h for group B. Meropenem concentrations in plasma and urine were determined by liquid chromatography-mass spectrometry/mass spectrometry and high-performance liquid chromatography with UV detection, respectively. Pharmacokinetic calculations were done by use of a two-compartment open model, and the data were extrapolated by Monte Carlo simulations for 10,000 simulated subjects for pharmacodynamic evaluation. There were no significant differences in total clearance and renal clearance between group A and group B or between the intermittent treatment and the continuous infusion. The analyses of the probability of target attainment by MIC for the high-and low-dose continuous infusions were robust up to MICs of 4 mg/liter and 2 mg/liter, respectively. The corresponding values for intermittent infusions were only 0.5 mg/liter and 0.25 mg/liter. When these observations were correlated with MICs obtained from the MYSTIC database, intermittent infusion results in adequate activity against two of the most common nosocomially acquired pathogens, Klebsiella pneumoniae and Enterobacter cloacae. However, against Pseudomonas aeruginosa, the evaluation shows a clear advantage of high-dose therapy administered as a continuous infusion. We believe that in the empirical therapy situation, the continuous-infusion mode of administration is most worth the extra efforts. We conclude that clinical trials for evaluation of the continuous infusions of meropenem in critically ill patients are warranted.Considerable evidence demonstrates that the amount of time that free drug concentrations exceed the MIC is the measure of drug exposure most closely linked to the ability of a regimen of ␤-lactam antibiotics to kill the target organisms (9,17,19,48). This linkage is likely due to the fact that the rate of organism killing is maximized rapidly with the concentration and maximal killing is attained at drug concentrations of four to six times the MIC (6). Among the ␤-lactam agents, there are differences in the fraction of the dosing interval in which the drug concentration needs to be in excess of the MIC to attain organism stasis or to attain maximal killing of the organism population. Generally, ␤-lactams have some postantibiotic effects against gram-positive cocci but only limited postantibiotic effects against gram-negative rods (4,8,18,22,48). This means that the duration of plasma levels above the MIC is the most critica...

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Section: Resultsmentioning

confidence: 99%

Section: Subjectsmentioning

confidence: 99%

Section: Vol 49 2005 Continuous and Intermittent Infusion Of Meropementioning

confidence: 99%

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Evaluation by Monte Carlo Simulation of the Pharmacokinetics of Two Doses of Meropenem Administered Intermittently or as a Continuous Infusion in Healthy Volunteers

Krueger

Bulitta

Kinzig‐Schippers

et al. 2005

Antimicrob Agents Chemother

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“…Staphylococci are the second most prevalent bacteria (46). However, a smear suggesting the presence of staphylococci in a blood culture (BC) is not sufficient for the diagnosis of true BBSI before the species is identified, because coagulase-negative staphylococci (CoNS) are part of the normal skin flora and may contaminate BC bottles during venous puncture procedures.…”

mentioning

confidence: 99%

Accuracy and Potential Usefulness of Triplex Real-Time PCR for Improving Antibiotic Treatment of Patients with Blood Cultures Showing Clustered Gram-Positive Cocci on Direct Smears

et al. 2008

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“…Los datos del programa de vigilancia de RA en Unidades de Cuidado Intensivo de Europa y EEUU demuestran que la resistencia a los carbapenémicos, cefepime y la piperacilina tazobactam se acerca a 20 %, mientras que otros antibióticos tienen tasas de resistencias aún más altas (19,(26)(27)(28)(29). El número de aislamientos probados contra meropenem durante el año 2002 fue pequeño, por lo que es difícil determinar si hubo un salto tan importante en la resistencia, o simplemente el número limitado de aislamientos no es capaz de reflejar el verdadero nivel de resistencia.…”

Section: Discussionunclassified

Resistencia Antimicrobiana en Unidades de Cuidado Intensivo de Bogotá, Colombia, 2001-2003

Álvarez¹,

Cortés²,

Arango

et al. 2006

Rev. salud pública

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Bacteraemia in Europe—antimicrobial susceptibility data from the MYSTIC surveillance programme

Cited by 29 publications

References 28 publications

Evaluation by Monte Carlo Simulation of the Pharmacokinetics of Two Doses of Meropenem Administered Intermittently or as a Continuous Infusion in Healthy Volunteers

Evaluation by Monte Carlo Simulation of the Pharmacokinetics of Two Doses of Meropenem Administered Intermittently or as a Continuous Infusion in Healthy Volunteers

Accuracy and Potential Usefulness of Triplex Real-Time PCR for Improving Antibiotic Treatment of Patients with Blood Cultures Showing Clustered Gram-Positive Cocci on Direct Smears

Resistencia Antimicrobiana en Unidades de Cuidado Intensivo de Bogotá, Colombia, 2001-2003

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