Pharmacokinetic/Pharmacodynamic Index Linked to
            <i>In Vivo</i>
            Efficacy of the Ampicillin-Ceftriaxone Combination against Enterococcus faecalis

Jimenez-Toro, Ivone Eliana; Rodríguez, Carlos A.; Zuluaga, Andres F.; Otalvaro, Julian D.; Pérez-Madrid, Héctor; Vesga, Ómar

doi:10.1128/aac.00966-22

Cited by 5 publications

(3 citation statements)

References 35 publications

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“…Current guidelines recommend for the treatment of enterococcal endocarditis the combination of ampicillin with ceftriaxone, a regimen that is synergistic, effective and with less toxicity [113][114][115][116].…”

Section: Combination Therapiesmentioning

confidence: 99%

Enteroccocus and Endocarditis

Adriana Caliman-Sturdza

2024

Infectious Diseases

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Infective endocarditis (EI) produced by enterococci ranks third among infectious endocarditis and is a severe infection with usually subacute onset, often complicated with valvular lesions, systemic emboli and immunological changes. EI caused by enterococcus is produced in 90% of cases by Enterococcus faecalis and much less often by Enterococcus faecium or other species. Most cases are acquired in the community, but enterococcal EI can also be nosocomial. Enterococcal endocarditis is more common in the elderly or may appear against the background of some associated conditions: colorectal cancer, liver cirrhosis, diabetes, immunosuppressive treatments. Transthoracic echocardiography combined with blood cultures is the basis of the diagnosis of infective endocarditis, but in difficult cases, transesophageal ultrasound and new imaging methods such as computer tomography, PET-CT or cardiac MRI can be the solution for establishing the diagnosis. Enterococci are very tolerant to bactericidal antibiotics and their eradication requires prolonged therapy (up to 6 weeks) with synergistic bactericidal combination of cell wall inhibitors with aminoglycosides, they can also be resistant to many antibiotics, including beta-lactams, aminoglycosides and vancomycin. E. faecium is often resistant to vancomycin and beta-lactams. Linezolid may be effective in the treatment of vancomycin-resistant enterococcal endocarditis, but also daptomycin, dalbavancin and oritavancin seem promising.

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Section: Combination Therapiesmentioning

confidence: 99%

Enteroccocus and Endocarditis

Adriana Caliman-Sturdza

2024

Infectious Diseases

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“…A recently reported pharmacokinetic/pharmacodynamic study simulating human doses of ampicillin and ceftriaxone has remarked the usefulness of this combination administering ceftriaxone every 12 h [ 197 , 198 ]. This prompted us to abandon this regimen and consider other alternatives such as the co-administration of ampicillin + ceftriaxone in the same infusion.…”

Section: Outpatient Parenteral Antimicrobial Therapy (Opat)mentioning

confidence: 99%

Treatment of Enterococcus faecalis Infective Endocarditis: A Continuing Challenge

et al. 2023

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Today, Enterococcus faecalis is one of the main causes of infective endocarditis in the world, generally affecting an elderly and fragile population, with a high mortality rate. Enterococci are partially resistant to many commonly used antimicrobial agents such as penicillin and ampicillin, as well as high-level resistance to most cephalosporins and sometimes carbapenems, because of low-affinity penicillin-binding proteins, that lead to an unacceptable number of therapeutic failures with monotherapy. For many years, the synergistic combination of penicillins and aminoglycosides has been the cornerstone of treatment, but the emergence of strains with high resistance to aminoglycosides led to the search for new alternatives, like dual beta-lactam therapy. The development of multi-drug resistant strains of Enterococcus faecium is a matter of considerable concern due to its probable spread to E. faecalis and have necessitated the search of new guidelines with the combination of daptomycin, fosfomycin or tigecycline. Some of them have scarce clinical experience and others are still under investigation and will be analyzed in this review. In addition, the need for prolonged treatment (6–8 weeks) to avoid relapses has forced to the consideration of other viable options as outpatient parenteral strategies, long-acting administrations with the new lipoglycopeptides (dalbavancin or oritavancin), and sequential oral treatments, which will also be discussed.

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“…A recently reported pharmacokinetic/pharmacodynamic study simulating human doses of ampicillin and ceftriaxone has remarked the usefulness of this combination administering ceftriaxone every 12 hours 193,194 . This prompted us to abandon this regimen and consider other alternatives.…”

Section: Outpatient Parenteral Antimicrobial Therapy (Opat) With the ...mentioning

confidence: 99%

Treatment of <em>Enterococcus faecalis</em> Infective Endocarditis: A Continuing Challenge

Herrero-Hidalgo¹,

Fernández-Rubio²,

Luque‐Márquez³

et al. 2023

Preprint

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Today, enterococci (mainly Enterococcus faecalis) are one of the main causes of infective endocarditis in the world, generally affecting an elderly and fragile population, with a high mortality rate. enterococci are intrinsically resistant to many commonly used antimicrobial agents. All enterococci exhibit decreased susceptibility to penicillin and ampicillin, as well as high-level resistance to most cephalosporins and all semi-synthetic penicillins, as the result of expression of low-affinity penicillin-binding proteins, that precludes an unacceptable number of therapeutic failures with monotherapy with these drugs. For years, the synergistic combination of penicillins and aminoglycosides was the cornerstone of treatment, but the emergence of strains with high resistance to aminoglycosides led to the search for new alternatives, such as dual beta-lactam therapy. The development of multi-drug resistant strains of Enterococcus faecium is a matter of considerable concern due to its probable spread to E. faecalis and have forced the search of new alternatives with the combination of daptomycin, fosfomycin or tigecycline. Some of them have scarce clinical experience and others are still under investigation and will be analyzed in this review. In addition, the need for prolonged treatment (6-8 weeks) to avoid relapses has led to the consideration of viable options such as outpatient parenteral therapies or long-acting administrations with the new lipoglycopeptides (dalbavancin or oritavancin), and sequential oral treatments, which will also be discussed.

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Pharmacokinetic/Pharmacodynamic Index Linked to In Vivo Efficacy of the Ampicillin-Ceftriaxone Combination against Enterococcus faecalis

Cited by 5 publications

References 35 publications

Enteroccocus and Endocarditis

Enteroccocus and Endocarditis

Treatment of Enterococcus faecalis Infective Endocarditis: A Continuing Challenge

Treatment of <em>Enterococcus faecalis</em> Infective Endocarditis: A Continuing Challenge

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