Reducing empirical use of fluoroquinolones for Pseudomonas aeruginosa infections improves outcome

Ceftolozane/tazobactam: a novel antipseudomonal cephalosporin and β-lactamase-inhibitor combination

“…The Antimicrobial Availability Task Force of the Infectious Diseases Society of America released a report titled “Bad Bugs, No Drugs: As Antibiotic R&D Stagnates, a Public Health Crisis Brews” to address the lack of antibiotic development in an era of increasing resistance 9. More specifically, infections caused by P. aeruginosa result in significant morbidity and mortality, particularly in strains demonstrating cross-resistance to the handful of agents with clinical utility against P. aeruginosa 4,54,55. Currently, several β-lactam/β-lactamase-inhibitor combinations are in clinical development (ceftazidime/avibactam, ceftaroline/avibactam, and imipenem/cilastatin) 30…”

Impact of a Multimodal Antimicrobial Stewardship Program onPseudomonas aeruginosaSusceptibility and Antimicrobial Use in the Intensive Care Unit Setting

“…Our study is one in the minority of studies to show a decrease in ciprofloxacin and ceftazidime resistance among ICU P. aeruginosa isolates with decreased ciprofloxacin and ceftazidime use. Nguyen and colleagues also recently reported a decrease in ciprofloxacin-resistant P. aeruginosa in a case-control study; however, their analysis was not limited to the ICU setting [7]. Of course, establishing a direct link between antibiotic use and any degree of attributable resistance is not easily done.…”

Urosepsis—from the view of the urologist

“…According to the level of evidence, one study was identified as a Level 1 study [8]; nine as Level 2 studies including: one systematic review [9], three randomised clinical trials [10][11][12] and two non-randomised cohort studies [13,14] and three case control studies [15][16][17] (Table 1); 14 as Level 3 studies including: one randomised clinical trial [18], one non-randomised cohort study [19], four case-control studies [20][21][22][23], eight case series [24][25][26][27][28][29][30][31] (Table 1); and 10 as Level 4 studies including: three articles based on expert opinion [32][33][34], and seven in vitro, laboratory, or animal model studies [35][36][37][38][39][40][41] (Table 1). The results of the individual studies and their level of evidence are summarised in Table 1.…”

“…The increasing rates of enterobacteriaceae producing extended spectrum ␤-lactamases (ESBL) especially pose clinically relevant problems [8,17,37] (LE 1, positive). Other developments comprise the increased rates of fluoroquinolone-resistant enterobacteria and vancomycin-resistant enterococci [21,25]. Dosing of the antibiotic generally has to be high.…”