Statistical comparison of the antibacterial activities of broad-spectrum penicillins against gram-negative bacilli

Fass, Robert J.

doi:10.1128/aac.24.2.156

Cited by 10 publications

(2 citation statements)

References 22 publications

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“…In general, piperacillin has been the most active penicillin derivative against nonfermenters, although it was only moderately active against P. aeruginosa and A. baumannii isolates and was relatively inactive against S. maltophilia isolates (5,7,22). In the present study, it was highly active against Alcaligenes spp., B. bronchiseptica, and W. virosa; moderately active against A. baumannii, B. diminuta, B. pickettii, and Pseudomonas spp.…”

Section: Resultsmentioning

confidence: 46%

In vitro activities of quinolones, beta-lactams, tobramycin, and trimethoprim-sulfamethoxazole against nonfermentative gram-negative bacilli

Fass

Barnishan

Solomon

et al. 1996

Antimicrob Agents Chemother

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From 1991 to 1995, 8,975 nonfermentative gram-negative bacilli were isolated from patients at The Ohio State University Medical Center: 71% Pseudomonas aeruginosa, 14% Stenotrophomonas maltophilia, 7.6% Acinetobacter baumannii, and <2% each of 25 other species. The MICs of trovafloxacin (CP-99,219), ciprofloxacin, ofloxacin, ampicillin-sulbactam, piperacillin, piperacillin-tazobactam, ceftazidime, cefoperazone, ceftriaxone, imipenem, tobramycin, and trimethoprim-sulfamethoxazole (TMP-SMZ) were determined for 308 isolates, representing 13 species, by a standardized broth microdilution method. The activities of all drugs were species dependent. The fluoroquinolones had inconsistent activity against most species, although several relatively uncommon nonfermenters were consistently susceptible or resistant. Trovafloxacin was considerably more active than ciprofloxacin and ofloxacin against S. maltophilia, A. baumannii, and several less common species. Among the ␤-lactams, relative activities varied considerably; overall, imipenem had the broadest spectrum of activity but was inactive against S. maltophilia and Burkholderia cepacia isolates. Tobramycin and TMP-SMZ had stereotypic spectra of activity. Tobramycin was active against most species except S. maltophilia, Alcaligenes xylosoxidans subsp. xylosoxidans, Burkholderia spp., and Weeksella virosa. TMP-SMZ was active against most species except P. aeruginosa and Pseudomonas fluorescens-putida. A review of laboratory records indicated few changes in susceptibility patterns from 1991 to 1995; the only clear trend was toward increasing P. aeruginosa resistance to all classes of drugs.

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Section: Resultsmentioning

confidence: 46%

In vitro activities of quinolones, beta-lactams, tobramycin, and trimethoprim-sulfamethoxazole against nonfermentative gram-negative bacilli

Fass

Barnishan

Solomon

et al. 1996

Antimicrob Agents Chemother

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“…In order to prevent hydrolysis of piperacillin by bacterial ß-lactamases, it was combined with the ß-lactamase inhibitor tazobactam, which inhibits a broad spectrum of commonly occurring plasmid-mediated ß-lactamases [6][7][8][9][10][11]. In vitro studies have demonstrated that the combination of piperacillin and tazobactam is effective against a broad spectrum of bacteria, including many members of the family Enterobacteriaceae, anaerobic species of the both cocci and bacilli and streptococcal species [12,13].…”

Section: Introductionmentioning

confidence: 99%

Determination of Nontoxic Concentrations of Piperacillin/Tazobactam for Intravitreal Application

Özkırış

Evereklioğlu²,

Kontaş³

et al. 2004

Ophthalmic Res

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Background: To investigate the highest nontoxic intravitreal dose of piperacillin/tazobactam in rabbits. Material and Methods: Forty New Zealand white albino rabbits were used in this study. The rabbits were divided into four equal groups (10 rabbits in each) and the right eyes were treated with 0.1 ml intravitreal injections of 1,000 µg piperacillin/tazobactam in group 1, 500 µg in group 2, 250 µg in group 3, and 100 µg in group 4. The left eyes served as controls and were injected with 0.1 ml of saline solution. Ganzfeld electroretinogram (ERG) was performed on all eyes before and after 4 weeks of intravitreal injections. Then, the rabbits were killed and the eyes were enucleated for histopathological evaluation of the retina. Retinal sections were evaluated by morphometric analyses on cell counts of ganglion cell layer and thickness of the various retinal layers. Results: Baseline ERGs were similar among the groups (p > 0.05). After 4 weeks of injection, there were a reduction of the b-wave amplitude and extension of the b-wave implicit time in photopic and scotopic ERGs in group 1 and group 2 when compared with controls (for each, p < 0.001). Intravitreal injection of 100 and 250 µg piperacillin/tazobactam did not cause any deterioration of the b-wave of ERGs throughout the follow-up period of 4 weeks (for each, p > 0.05). After morphometric analysis of retinal sections in all groups, there were no statistically significant differences in the mean number of surviving ganglion cells, thickness of the whole retina and the inner plexiform layer compared with controls (p > 0.05). Conclusion: 250 µg/0.1 ml piperacillin/tazobactam is the highest nontoxic dose to the normal retinas of adult albino rabbits as intravitreal injection. Piperacillin/tazobactam may be a new, potentially important drug in the treatment of endophthalmitis as it has a broad antimicrobial spectrum.

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Therapeutic evaluation of piperacillin for acute pulmonary exacerbations in cystic fibrosis

Reed

Stern

Myers

et al. 1987

Pediatric Pulmonology

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The efficacy and pharmacokinetics of piperacillin monotherapy were studied in 46 patients with cystic fibrosis. Two patients were dropped from the study within 24 hr of enrollment because of drug-associated nausea and vomiting. Initially fourteen older patients (greater than 12 years) receiving piperacillin 450 mg/kg/day underwent a preliminary evaluation. Based on the results, 30 younger patients (less than or equal to 12 years) randomized in a double-blind fashion received either 600 or 900 mg/kg/day of piperacillin in six divided doses. Pharmacokinetic parameter estimates for t1/2 Vdss, and Cl were similar for first dose and steady-state evaluations. In 27 patients, approximately 43% of the administered dose was recovered in the urine after 4 hr. Piperacillin CiR averaged 49% of the total Cl. No difference in overall clinical efficacy could be identified between 600 and 900 mg/kg/day of piperacillin using two different objective scoring systems. Although a reduction in sputum Pseudomonas colony counts was greater following the 900 mg/kg/day regimen, this appeared to be independent of clinical effect. In 14 patients (32%), a distinct adverse serum-sicknesslike reaction was observed. The incidence of this reaction appeared to increase as the dose of piperacillin increased. All signs and symptoms of this reaction resolved within 36 hr of discontinuing piperacillin administration but recurred immediately on rechallenge in four patients. All patients with the adverse reaction were subsequently treated with beta-lactam antibodies without ill effect. Overall, clinical improvement appeared to be independent of the piperacillin dose. Our data support the use of total daily piperacillin dosages not exceeding 600 mg/kg.

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Statistical comparison of the antibacterial activities of broad-spectrum penicillins against gram-negative bacilli

Cited by 10 publications

References 22 publications

In vitro activities of quinolones, beta-lactams, tobramycin, and trimethoprim-sulfamethoxazole against nonfermentative gram-negative bacilli

In vitro activities of quinolones, beta-lactams, tobramycin, and trimethoprim-sulfamethoxazole against nonfermentative gram-negative bacilli

Determination of Nontoxic Concentrations of Piperacillin/Tazobactam for Intravitreal Application

Therapeutic evaluation of piperacillin for acute pulmonary exacerbations in cystic fibrosis

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