Piperacillin–tazobactam as alternative to carbapenems for ICU patients

Pilmis, Benoît; Jullien, Vincent; Tabah, Alexis; Zahar, Jean‐Ralph; Brun‐Buisson, Christian

doi:10.1186/s13613-017-0334-x

Cited by 27 publications

(14 citation statements)

References 108 publications

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“…Bacteria synthesize β-lactamase and cleave β-lactam rings [32]. To overcome this challenge, scientists have used β-lactam antibiotics together with β-lactamase inhibitors, such as clavulanic acid (amoxyclav) [33], sulbactam (ampicillin/sulbactam) [34], and tazobactam (piperacillin/tazobactam) [35]. Amoxicillin combined with the β-lactamase inhibitor clavulanic acid was initially effective against a broad spectrum of bacteria [33].…”

Section: Introductionmentioning

confidence: 99%

Re-Potentiation of β-Lactam Antibiotic by Synergistic Combination with Biogenic Copper Oxide Nanocubes against Biofilm Forming Multidrug-Resistant Bacteria

Selvaraj¹,

Mala²,

Prasath³

2019

Molecules

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Biofilm-associated tissue and device infection is a major threat to therapy. The present work aims to potentiate β-lactam antibiotics with biologically synthesized copper oxide nanoparticles. The synergistic combination of amoxyclav with copper oxide nanoparticles was investigated by checkerboard assay and time-kill assay against bacteria isolated from a burn wound and a urinary catheter. The control of biofilm formation and extracellular polymeric substance production by the synergistic combination was quantified in well plate assay. The effect of copper oxide nanoparticles on the viability of human dermal fibroblasts was evaluated. The minimum inhibitory concentration and minimum bactericidal concentration of amoxyclav were 70 μg/mL and 140 μg/mL, respectively, against Proteus mirabilis and 50 μg/mL and 100 μg/mL, respectively, against Staphylococcus aureus. The synergistic combination of amoxyclav with copper oxide nanoparticles reduced the minimum inhibitory concentration of amoxyclav by 16-fold against P. mirabilis and 32-fold against S. aureus. Above 17.5 μg/mL, amoxyclav exhibited additive activity with copper oxide nanoparticles against P. mirabilis. The time-kill assay showed the efficacy of the synergistic combination on the complete inhibition of P. mirabilis and S. aureus within 20 h and 24 h, respectively, whereas amoxyclav and copper oxide nanoparticles did not inhibit P. mirabilis and S. aureus until 48 h. The synergistic combination of amoxyclav with copper oxide nanoparticles significantly reduced the biofilm formed by P. mirabilis and S. aureus by 85% and 93%, respectively. The concentration of proteins, carbohydrates, and DNA in extracellular polymeric substances of the biofilm was significantly reduced by the synergistic combination of amoxyclav and copper oxide nanoparticles. The fibroblast cells cultured in the presence of copper oxide nanoparticles showed normal morphology with 99.47% viability. No cytopathic effect was observed. Thus, the study demonstrated the re-potentiation of amoxyclav by copper oxide nanoparticles.

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Section: Introductionmentioning

confidence: 99%

Re-Potentiation of β-Lactam Antibiotic by Synergistic Combination with Biogenic Copper Oxide Nanocubes against Biofilm Forming Multidrug-Resistant Bacteria

Selvaraj¹,

Mala²,

Prasath³

2019

Molecules

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“…Given the scarcity of ICU-patient data and contradictory findings across studies, recent reviews raised concern, or at least recommended caution, when using non-carbapenem antibiotics to treat ESBL-producing Enterobacteriaceae infections in ICU patients [12,13].…”

Section: Introductionmentioning

confidence: 99%

Use of non-carbapenem antibiotics to treat severe extended-spectrum β-lactamase-producing Enterobacteriaceae infections in intensive care unit patients

Luyt

Faure

Bonnet

et al. 2019

International Journal of Antimicrobial Agents

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Purpose. To evaluate the use of non-carbapenem antibiotics to treat severe extendedspectrum β-lactamase-producing Enterobacteriaceae infections in intensive care unit (ICU) patients. Methods. This retrospective observational study conducted in 2 ICUs compared outcomes of patients with extended-spectrum β-lactamase-producing Enterobacteriaceae infections administered a carbapenem or a non-carbapenem antibiotic as their definitive treatment. The primary outcome was treatment failure within 30 days, a composite endpoint of extendedspectrum β-lactamase-producing Enterobacteriaceae-infection recurrence and day-30 mortality. Secondary outcomes included day-30 and in-hospital mortality rates, extended-spectrum betalactamase-producing Enterobacteriaceae-infection recurrence, and infection(s) due to other pathogen(s). Results: Among the 107 patients included, 67 received a carbapenem and 40 a noncarbapenem antibiotic as their definitive treatment. Clinical characteristics of the 2 groups were similar. Comparing patients given a non-carbapenem antibiotic to those administered carbapenem, respectively, the former had similar day-30 treatment-failure (43% vs. 60%, P =0.06) and extended-spectrum β-lactamase-producing Enterobacteriaceae-infection-recurrence rates (25% vs. 22%, P = 0.8), but lower day-30 (23% vs. 45%, P = 0.02) and in-hospital (23% vs. 49%, P = 0.002) mortality rates. Secondary infection rates caused by other pathogen(s), including Clostridium difficile, were comparable. Outcomes were comparable regardless of whether or not patients received empirical carbapenem. Conclusions. For ICU patients with severe extended-spectrum β-lactamase-producing Enterobacteriaceae infections, treatment with a non-carbapenem antibiotic was not associated with poorer outcome, compared to a carbapenem.

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“…Hence selection pressure on carbapenems need to be reduced either by reducing their consumption by using alternative drugs or developing newer therapeutic options. There are several publications about use of alternative agents for treating ESBL infections rather than carbapenems so as to reduce selection pressure without compromising clinical outcomes [17,18]. Interestingly, the current data reveals a very important picture of comparable susceptibility of CSE-1034 to minocycline and amikacin.…”

Section: Discussionmentioning

confidence: 75%

Current Susceptibility Trend of Antibiotics in a Tertiary Care Hospital - Need to Emphasize on Alternate Therapeutic Agents

Khandait¹,

Bansal

Mandale

2019

MRJI

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Introduction: In the light of changing anti-microbial resistance pattern, the understanding of the local antibiogram is essential in the antibiotic selection procedures and preparation of hospital antibiotic policy. Aim: This retrospective study was aimed to analyze the antibacterial susceptibility pattern of major isolates from ICU and IPD. Materials and Methods: Antimicrobial susceptibility testing was done for a total of 565 Gram-negative isolates including E. coli, K. pnuemoniae, A. baumannnii and P. aeruginosa from ICU and IPD patients enrolled between July 2016 to December 2016. Results: The majority of the isolates were reported from urine samples (52%) in IPD and sputum (59%) in ICU. The susceptibility to BL/BLI was 50-75% in IPD patients and Carbapenem susceptibility was reported in more than 75% except P. aeruginosa. In ICU patients, the beta-lactam/beta-lactam inhibitor (BL/BLI) susceptibility ranged between 20-60% and the carbapenem susceptibility was around 40%-75%. The susceptibility of CSE-1034 (Ceftriaxone + Sulbactam + EDTA) was almost similar to minocycline and amikacin ranging from 50-90% against different species. Compared to carbapenems, the CSE-1034 performed overall better than carbapenems against P. aeruginosa and A. baumannii and was comparable to carbapenems against Enterobacteriaceae. The susceptibility of colistin ranged from 92-97% in both IPD and ICU isolates. Conclusion: Considering the value of carbapenems and colistin as the last option for multi-drug resistant (MDR) bacterial infections, irrational prescription of these drugs should be stopped. The use of ampicillin-sulbactam, cefepime and gentamicin from 1st line antibiotics in ICU patients can help to reduce the load on 2nd line antibiotics. Among 2nd line drugs, CSE-1034 along with amikacin should be an empirical choice of treatment for bacterial infections where the 1st line drugs are suspected to fail and the need of carbapenems arises.

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Piperacillin–tazobactam as alternative to carbapenems for ICU patients

Cited by 27 publications

References 108 publications

Re-Potentiation of β-Lactam Antibiotic by Synergistic Combination with Biogenic Copper Oxide Nanocubes against Biofilm Forming Multidrug-Resistant Bacteria

Re-Potentiation of β-Lactam Antibiotic by Synergistic Combination with Biogenic Copper Oxide Nanocubes against Biofilm Forming Multidrug-Resistant Bacteria

Use of non-carbapenem antibiotics to treat severe extended-spectrum β-lactamase-producing Enterobacteriaceae infections in intensive care unit patients

Current Susceptibility Trend of Antibiotics in a Tertiary Care Hospital - Need to Emphasize on Alternate Therapeutic Agents

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