Rifampicin + ceftriaxone versus vancomycin + ceftriaxone in the treatment of penicillin-and cephalosporin-resistant pneumococcal meningitis in an experimental rabbit model

Abstract This study was planned to compare the efficacy of ceftriaxone + vancomycin with ceftriaxone + rifampicin in a rabbit model of penicillin and cephalosporin-resistant Streptococcus pneumoniae meningitis. Meningitis was induced by intracisternal inoculation of S. pneumoniae. After 18 h of incubation, Group 1 was given saline solution (control group), whilst Groups 2 and 3 were given ceftriaxone + vancomycin and ceftriaxone + rifampicin, respectively. Cerebrospinal fluid bacterial concentrations were measured at 0, 2, 12, 14 and 24 h after therapy was initiated. In the control group, bacterial growth was present at all time points, whereas no growth was observed in either the ceftriaxone + vancomycin group or the ceftriaxone + rifampicin group after 2 h of therapy. Ceftriaxone + rifampicin was found to be as effective as ceftriaxone + vancomycin in the treatment of penicillin-resistant S. pneumoniae meningitis in experimental rabbit model

Preventing Surgical Site Infections by Measures Other Than Antibiotics

WOS: 00042095850000

Vancomycin versus linezolid in the treatment of methicillin-resistant Staphylococcus aureus meningitis in an experimental rabbit model

WOS: 000314393900001PubMed ID: 23111752Background: The aim of this study was to compare the antibacterial efficacy of vancomycin and linezolid in a rabbit model of methicillin-resistant Staphylococcus aureus (MRSA) meningitis. Material/Methods: Meningitis was induced by intracisternal inoculation of ATCC 43300 strain. After 16 h incubation time and development of meningitis, the vancomycin group received vancomycin 20 mg/kg every 12 h. The linezolid-10 and linezolid-20 groups received linezolid in 10 and 20 mg/kg dosages every 12 h, respectively. The control group did not receive any antibiotics. Cerebrospinal fluid bacterial counts were measured at the end of 16-h incubation time and at the end of 24-h treatment. Results: Bacterial counts were similar in all groups at 16 h. At the end of treatment the decrease in bacterial counts in the vancomycin group was approximately 2 logs higher than the linezolid-20 group (p>0.05) and approximately 4 logs higher than in the linezolid-10 group (p: 0.037) (Vancomycin group: -2.860 +/- 4.495 versus Linezolid-20: -0.724 +/- 4.360, versus Linezolid-10: 1.39 +/- 3.37). Full or partial bacteriological response was higher in vancomycin versus linezolid-10 (p: 0.01), but not vancomycin versus linezolid-20 or linezolid-10 versus-linezolid-20 groups. Conclusions: Our results suggest that linezolid is not statistically inferior to vancomycin in the treatment of MRSA meningitis in an experimental rabbit model in 20 mg/kg q12 h dosage; however, it is inferior in 10 mg/kg q12 h dosage. Additional data should gathered to confirm these findings in advance of clinical trials to assess efficacy in humans.Ege UniversityEge UniversityEge Universit

Nosocomial Infections in a Neurological Intensive Care Unit

WOS: 000270682900006Background: Nosocomial infections in intensive care units are common and associated with high morbidity, mortality. This study was planned to evaluate the occurance and causes of site specific nosocomial infections in a neurological intensive care unit (NICU) and their relevance to underlying diseases. Methods: Patients treated for more than 24 hours in Ege University Medical School Hospital NICU were evaluated by prospective daily surveillance for overall and site specific infections during the 12 months of the year 2005. Nosocomial infections incidence and their relation with underlying disease were investigated. Results: Three hundred and fifty six patients were included. A hundred and ten nosocomial infections were seen. The rate of infection per 100 patients was 30.8. Site-specific infections were; urinary tract infection (49.1%), pneumonia (30.9%), catheter related blood stream infections (18.1%) and primary bacteremia (1.8%). In univariate analysis, no differences were found between the patients with stroke and other NICU disorders in terms of risk factors for NICU-AI such as; age, gender, type of nosocomial infections, length of stay, and mortality. But the length of stay was significantly prolonged and mortality was significantly higher in patients with NICU-AI when compared with patients without NICU-AIs. Conclusion: The incidence of nosocomial infections in our NICU was found to be as high as in other critical care units and causes higher mortality. This was supposed to be associated with prolonged hospital stay and insufficient compliance to infection control measures instead of the underlying disease of the patients

Short-term effect of antibiotic control policy on the usage patterns and cost of antimicrobials, mortality, nosocomial infection rates and antibacterial resistance

WOS: 000247905400007PubMed ID: 17512598Objectives: In 2003 Turkish government released a new budget application instruction for regulating the usage of parenteral antibiotics inside and outside of the hospitals. In this study it was aimed to evaluate the effect of this instruction on the overall usage of restricted antibiotics, their cost, overall mortality, bacterial. resistance patterns and nosocomiat infection rates in intensive care units (ICUs) of our setting for March-October 2002 and March-October 2003 periods. Methods and results: Overall daily defined dose/1000 patients/day of restricted drugs decreased, whereas unrestricted drugs increased significantly after the instruction. The cost of all analysed drugs in 2003 period was 540,303 USD (-19.6%) less than 2002 period. Nosocomial infection rates in ICUs decreased significantly (p < 0.05). When all. microbiologically confirmed nosocomial bacteremia cases during the study period were analysed, amoxycittine/clavulanate, ciprofloxacin, cefuroxime, cefotaxime, piperacilline/tazobactam resistance and ESBL rate in Klebsiella pneumoniae decreased significantly (p < 0.05). Amikacin resistance in Escherichia coli and Acinetobacter baumannii increased significantly (p < 0.05). Conclusion: Antibiotic control is one of the most important and significant ways to save money, and to prevent antibacterial resistance. (c) 2007 The British Infection Society. Published by Elsevier Ltd. All rights reserved

Accuracy of consultations performed by infectious diseases trainees and factors associated with adherence to them

WOS: 000251212900010PubMed ID: 17467321Objectives: Infectious diseases (ID) trainees should be familiar with duties relevant to consultation practice. In this study we aimed to analyze the ID trainee night/weekend shift consultation process in terms of consultant characteristics, types of recommendations, and compliance with recommendations. Methods: All consultations performed by ID trainees on the night shift and at the weekends between 10 June and 10 August 2004 were recorded prospectively on standardized forms. Infectious diseases specialists assessed the appropriateness of recommendations the day after each consultation. Recommendations were considered complied with if they were carried out within 72 hours of the consultation. Results: Of 440 consultations, 163 were for a clinically diagnosed infection (without specific antibiotic request) and 79 were for treatment continuation. Overall, 152 consultations were for requesting specific antibiotic(s), and 327 antibiotics were recommended or approved in 270 consultations. Eight of these recommendations were inappropriate. Overall compliance to ID recommendations was 75.3% (418/555). In univariate analysis, the compliance rate to non-treatment recommendations (microbiologic cultures, radiology, biochemistry, etc.) was found to be lower than the rate of compliance to antibiotic recommendations (186/308 vs. 232/247, p < 0.05). In addition, compliance to recommendations made by the first-year trainees was lower than to the recommendations made by the other trainees. In logistic regression analysis only recommendations including antibiotic treatment was associated with higher compliance (p = 0.0001, odds ratio = 10.2, 95% CI = 5.7-18.3). Conclusions: ID trainees are capable of evaluating patients and recommending appropriate antibiotics. Methodologies to improve the compliance to non-treatment-based recommendations and optimizing antibiotic selection seem to be necessary. (C) 2007 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved

Accuracy of consultations performed by infectious diseases trainees and factors associated with adherence to them § Author&apos;s personal copy

Summary Objectives: Infectious diseases (ID) trainees should be familiar with duties relevant to consultation practice. In this study we aimed to analyze the ID trainee night/weekend shift consultation process in terms of consultant characteristics, types of recommendations, and compliance with recommendations. Methods: All consultations performed by ID trainees on the night shift and at the weekends between 10 June and 10 August 2004 were recorded prospectively on standardized forms. Infectious diseases specialists assessed the appropriateness of recommendations the day after each consultation. Recommendations were considered complied with if they were carried out within 72 hours of the consultation. Results: Of 440 consultations, 163 were for a clinically diagnosed infection (without specific antibiotic request) and 79 were for treatment continuation. Overall, 152 consultations were for requesting specific antibiotic(s), and 327 antibiotics were recommended or approved in 270 consultations. Eight of these recommendations were inappropriate. Overall compliance to ID recommendations was 75.3% (418/555). In univariate analysis, the compliance rate to nontreatment recommendations (microbiologic cultures, radiology, biochemistry, etc.) was found to be lower than the rate of compliance to antibiotic recommendations (186/308 vs. 232/247, p &lt; 0.05). In addition, compliance to recommendations made by the first-year trainees was lower than to the recommendations made by the other trainees. In logistic regression analysis only