Triple combination of meropenem, colistin and tigecycline was bactericidal in a dynamic model despite mere additive interactions in chequerboard assays against carbapenemase-producing <i>Klebsiella pneumoniae</i> isolates

Tsala, Marilena; Vourli, Sophia; Georgiou, Panagiota-Christina; Pournaras, Spyros; Daikos, George L.; Mouton, Johan W.; Meletiadis, Joseph

doi:10.1093/jac/dky422

Cited by 21 publications

(18 citation statements)

References 23 publications

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“…Tsala et al [14] described the bactericidal activity of the triple combination meropenem-tigecyclinecolistin against carbapenem-producing Klebsiella pneumoniae. In a checkerboard analysis, these antimicrobials showed additive interactions.…”

Section: Discussionmentioning

confidence: 99%

“…Instead, the use of triple antimicrobial combinations has been suggested, based on encouraging in vitro data [10,11]. For example, triple antimicrobial therapies consisting of gentamicin-carbenicillin-rifampin and dicloxacillin-fusidic acid-rifampicin have been proposed for the treatment of Stenotrophomonas maltophilia and Staphylococcus aureus infections, respectively [12][13][14][15]. Colistin-based combinations were assessed by Huang et al [11], who concluded that they provide good clinical treatment options.…”

Section: Introductionmentioning

confidence: 99%

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When Combined with Colistin, an Otherwise Ineffective Rifampicin–Linezolid Combination Becomes Active in Escherichia coli, Pseudomonas aeruginosa, and Acinetobacter baumannii

et al. 2020

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The synergistic action of colistin, with two antibiotics active in Gram-positive bacteria but unable to kill gram negatives (linezolid and rifampicin), was investigated, since triple combinations are emerging as a tool to overtake multidrug resistance. Checkerboard determinations demonstrated that, when combined with colistin, the combination of linezolid and rifampicin turns active in multidrug-resistant Escherichia coli, Pseudomonas aeruginosa, and Acinetobacter baumannii. Thus, the presence of sublethal concentrations of colistin resulted in a strongly synergistic interaction between these two drugs. Moreover, the minimum inhibitory concentrations of linezolid–rifampicin combinations in the presence of colistin were lower than the maximal concentrations of these antimicrobials ain blood. These findings suggest the use of this triple combination as an effective treatment of multidrug-resistant (MDR) bacterial infections.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

When Combined with Colistin, an Otherwise Ineffective Rifampicin–Linezolid Combination Becomes Active in Escherichia coli, Pseudomonas aeruginosa, and Acinetobacter baumannii

et al. 2020

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“…At the same time, we observed that the APACHE II score (p < 0.001) and SOFA score (p < 0.001) were higher in the death group. In the death group, the hospitalization days before BSI were relatively longer (8 [4,18] days versus 14 [5,22] days, p = 0.015).…”

Section: Risk Factors For Death In Patients With Klebsiella Pneumoniamentioning

confidence: 96%

“…BSI induced by these strains often aggravates the disease, resulting in difficult treatment and poor clinical prognosis. A large number of studies have shown that early identification and early appropriate antibiotic treatment are significantly related to the reduction of mortality (16)(17)(18)(19)(20). Due to the lack of attention to high risk factors, late identification and inadequate antibacterial treatment increases mortality; thus, it is necessary to obtain cultures in the early stage of infection to determine specific pathogens, drug resistance, and reasonable antibiotic treatment.…”

Section: Introductionmentioning

confidence: 99%

Clinical observation and prognostic analysis of patients with Klebsiella pneumoniae bloodstream infection

Sun

Zhang

Yang

et al. 2020

Preprint

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Background and Purpose: The clinical prognosis of Klebsiella pneumoniae bloodstream infection is poor, and the prevalence of drug-resistant bacteria makes clinical anti-infective treatment more challenging. This retrospective study evaluated the epidemiological characteristics of patients with Klebsiella pneumoniae, the risk factors for drug-resistant bacterial infection and death, and analyzed treatment options. Methods: Clinical data of 297 patients diagnosed with Klebsiella pneumoniae bacteremia between June 2014 and June 2019 were collected.Results: Intensive care unit hospitalization history, operation history, recent antibiotic use history, mechanical ventilation, and number of days hospitalized before bloodstream infection were found to be independent risk factors for drug-resistant bacterial infection. The risk of death for carbapenem-resistant Klebsiella pneumoniae infection was 2.942 times higher than that for carbapenem-sensitive Klebsiella pneumoniae infection. For extensively drug-resistant Klebsiella pneumoniae bacteremia patients, the mortality rate of combined anti-infective therapy was lower.Conclusions: Clinicians should pay attention to patients with high-risk drug-resistant bacteria infection and administer timely anti-infection treatment. The findings of this study may provide some suggestions for early identification and standardized treatment of patients with Klebsiella pneumoniae bacteremia.

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“…BSI caused by strain often aggravates the disease, resulting in difficult treatment and poor clinical prognosis. A large number of studies have shown that early identification and early appropriate antibiotic treatment are significantly related to the reduction of mortality (Schwaber and Carmeli, 2008;Daikos et al, 2014;Gomez-Simmonds et al, 2016;Tsala et al, 2019;Lee et al, 2020). Due to the lack of attention to high risk factors, late identification and inadequate antibacterial treatment increases mortality; thus, it is necessary to obtain cultures in the early stage of infection to determine specific pathogens, drug resistance, and reasonable antibiotic treatment.…”

Section: Introductionmentioning

confidence: 99%

Clinical Observation and Prognostic Analysis of Patients With Klebsiella pneumoniae Bloodstream Infection

Zhang

Yang

Wang

et al. 2020

Front. Cell. Infect. Microbiol.

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Triple combination of meropenem, colistin and tigecycline was bactericidal in a dynamic model despite mere additive interactions in chequerboard assays against carbapenemase-producing Klebsiella pneumoniae isolates

Cited by 21 publications

References 23 publications

When Combined with Colistin, an Otherwise Ineffective Rifampicin–Linezolid Combination Becomes Active in Escherichia coli, Pseudomonas aeruginosa, and Acinetobacter baumannii

When Combined with Colistin, an Otherwise Ineffective Rifampicin–Linezolid Combination Becomes Active in Escherichia coli, Pseudomonas aeruginosa, and Acinetobacter baumannii

Clinical observation and prognostic analysis of patients with Klebsiella pneumoniae bloodstream infection

Clinical Observation and Prognostic Analysis of Patients With Klebsiella pneumoniae Bloodstream Infection

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