Navegando por Palavras-chave "ceftriaxone"
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- ItemSomente MetadadadosBactericidal activity of cefepime and ceftriaxone tested against Streptococcus pneumoniae(Elsevier B.V., 2007-03-01) Pottumarthy, Sudha; Sader, Helio S.; Jones, Ronald N.; JMI Labs; Houston Dept Hlth & Human Serv; Universidade Federal de São Paulo (UNIFESP); Tufts UnivThe bactericidal activities of cefepime, and ceftriaxone were assessed by testing a contemporary collection of 50 Streptococcus pneumoniae strains. Minimum inhibitory and bactericidal concentrations (MIC and MBC, respectively) of cefepime and ceftriaxone were determined, and time-kill studies were performed on 14 selected strains (10 penicillin-resistant, 2-intermediate, and 2-susceptible). Cefepime and ceftriaxone showed essentially identical potency (MIC50, 1 mu g/mL and MIC90, 2 mu g/mL, for both compounds) and MBC values (MBC50, 1 mu g/mL for both). MBC/MIC ratios were <= 4 for cefepime and <= 8 for ceftriaxone on 48 (96.0%) strains, and 2 strains (4.0%) displayed MBC/MIC ratios >= 32 (tolerance) to the 2 cephalosporins. Time-kill curves corroborated the MBC/MIC studies. Cefepime and ceftriaxone bactericidal activity (>= 3 log(10) CFU/mL reduction in inoculum) was demonstrable after 24 h of exposure to 8 X MIC for 13 (92.9%) of 14 strains, whereas I strain showed approximately 2 log(10) CFU/mL reduction. in conclusion, our results indicate that cefepime and ceftriaxone exhibit comparable potency and bactericidal activities when tested against contemporary pneumococcal strains with varying penicillin susceptibility patterns. Both parenteral cephems offer alternative therapeutic choices for the treatment of invasive pneumococcal infections. (c) 2007 Elsevier Inc. All rights reserved.
- ItemAcesso aberto (Open Access)Evaluation of ticarcillin/clavulanic acid versus ceftriaxone plus amikacin for fever and neutropenia in pediatric patients with leukemia and lymphoma(Brazilian Society of Infectious Diseases, 2003-04-01) Petrilli, Antonio Sergio [UNIFESP]; Cypriano, Monica [UNIFESP]; Dantas, Lenice Silva [UNIFESP]; Lee, Lúcia Martino [UNIFESP]; Luisi, Maria Flávio Augusto Vercillo [UNIFESP]; Silva, Katia Veronica Torres B. [UNIFESP]; Pereira, Carlos Alberto Pires [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)BACKGROUND: The empirical use of antibiotic treatments is widely accepted as a means to treat cancer patients in chemotherapy who have fever and neutropenia. Intravenous monotherapy, with broad spectrum antibiotics, of patients with a high risk of complications is a possible alternative. METHODS: We conducted a prospective open-label, randomized study of patients with lymphoma or leukemia who had fever and neutropenia during chemotherapy. Patients received either monotherapy with ticarcillin/clavulanic acid (T) or ceftriaxone plus amikacin (C+A). RESULTS: Seventy patients who presented 136 episodes were evaluated, 68 in each arm of the study. The mean neutrophil counts at admission were 217cells/mm³ (T) and 201cells/mm³ (C+A). The mean duration of neutropenia was 8.7 days (T) and 7.6 days (C+A). Treatment was successful without the need for modifications in 71% of the episodes in the T group and 81% in the C+A group (p=0.23). Treatment was considered to have failed because of death in two episodes (3%) in the T group and three episodes (4%) in the C+A group, and because of a change in the drug applied in one episode in the T group and two episodes in the C+A group. Overall success was 96% (T) and 93% (C+A). Adverse events that occurred in group T were not related to the drugs used in this study. CONCLUSION: In pediatric and adolescent patients with leukemia or lymphoma, who presented with fever and neutropenia, during chemotherapy, ticarcillin/clavulanic acid was as successful as the combination of ceftriaxone plus amikacin. It should be considered an appropriate option for this group of patients at high risk for infections.
- ItemSomente MetadadadosRe-evaluation of the role of broad-spectrum cephalosporins against staphylococci by applying contemporary in-vitro results and pharmacokinetic-pharmacodynamic principles(Esift Srl, 2007-02-01) Sader, Helio Silva [UNIFESP]; Bhavnani, S. M.; Ambrose, P. G.; Jones, R. N.; Pfaller, M. A.; JMI Labs; Universidade Federal de São Paulo (UNIFESP); Ordway Res Inst; Tufts Univ; Univ Iowa; Coll Publ HlthThe potency of cefepime, ceftriaxone, and ceftazidime was assessed by CLSI broth microdilution methods against 41,644 S. aureus (63.2% oxacillin-susceptible) and 14,266 coagulase-negative staphylococci (CoNS; 22.2% oxacillin-susceptible) through the SENTRY Antimicrobial Surveillance Program database (1998-2004). Using normal volunteer pharmacokinetic data and a linear intermittent intravenous infusion model, and an animal-derived pharmacokinetic/pharmacodynamic (PK-PD) target of >= 40% time above MIC, expected probabilities of target attainment (PTA) for cephems were evaluated using Monte Carlo simulation. Current CLSI breakpoints would rank the tested agents cefepime 2: ceftriaxone > ceftazidime and by PK-PD PTA cefepime > ceftazidime > ceftriaxone. Cefepime has a potency advantage over ceftazidime (four- to eight-fold) and superiority at the usual dosing over ceftriaxone (22.7-66.1%) for oxacillin-susceptible staphylococci. Ceftazidime pharmacokinetic overcomes by-weight activity disadvantages, while a low proportion (< 5%) of active free-drug penalizes ceftriaxone in the PTA calculations. PTA remained at >= 0.9 to a breakpoint of 8 mg/L for cefepime (1 g q8 or 12 hours) and ceftazidime and to a breakpoint of 2 mg/L for ceftriaxone. Regardless of applied breakpoint (CLSI or PK-PD), cefepime has the widest and most potent anti-staphylococcal activity among commonly used third- or fourth-generation cephems. When used at doses >= 3 g/day, cefepime assures maximal coverage of oxacillin-susceptible staphylococci whether using existing (CLSI) or modified (PK-PD) breakpoints. Ceftriaxone should be used with caution.