8 research outputs found
Changing epidemiology of infections due to extended spectrum beta-lactamase producing bacteria
Calcineurinâdependent dephosphorylation of the transcription factor CrzA at specific sites controls conidiation, stress tolerance, and virulence of Aspergillus fumigatus
Isolation of antibioticâresistant gramânegative organisms from donor respiratory culture does not impact nonâlung solid organ recipient management
Serotype distribution and antibiotic resistance of Streptococcus pneumoniae isolates from 17 Chinese cities from 2011 to 2016
Optimization of anti-pseudomonal antibiotics for cystic fibrosis pulmonary exacerbations: II. cephalosporins and penicillins
Acute pulmonary exacerbations (APE) are wellâdescribed complications of cystic fibrosis (CF) and are associated with progressive morbidity and mortality. Despite aggressive management with two or more intravenous antiâpseudomonal agents, approximately 25% of exacerbations will result in a loss of lung function. The aim of this review is to provide an evidenceâbased summary of pharmacokinetic/pharmacodynamic (PK/PD), tolerability, and efficacy studies utilizing antiâpseudomonal cephalosporins (i.e., ceftazidime and cefepime) and penicillins (i.e., piperacillinâtazobactam and ticarcillinâclavulanate) in the treatment of APE and to identify areas where further study is warranted. The ceftazidime and cefepime dosing ranges from the literature are 200â400âmg/kg/day divided every 6â8âhr, maximum 8â12âg/day, and 150â200âmg/kg/day divided every 6â8âhr, up to 6â8âg/day, respectively. The literature supported dosing ranges for piperacillin and ticarcillin are 350â600âmg/kg/day divided every 4âhr, maximum 18â24âg/day of piperacillin component, and 400â750âmg/kg/day divided every 6âhr, up to 24â30âg/day of ticarcillin component, respectively. As a large portion of CF patients will not regain their lung function following an APE, we suggest the need to optimize antibiotic dosing and dosing regimens used to treat an APE in efforts to improve outcomes for CF patients infected with Pseudomonas aeruginosa. Future studies are needed to determine the clinical efficacy of higher than FDAâapproved doses of ceftazidime, cefepime, and ticarcillinâclavulanate in APE. The usefulness of high dose piperacillin (\u3e600âmg/kg/day) may be limited due to treatmentârelated adverse effects. Further understanding of these adverse effects in CF patients is needed. Pediatr Pulmonol. 2013; 48:107â122. © 2012 Wiley Periodicals, Inc