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

The Advocate - June 8, 1961

Original title (1951-1987)--The Advocate: official publication of the Archdiocese of Newark (N.J.)

Vancomycin versus Linezolid in the Treatment of Methicillin-Resistant Staphylococcus aureus Meningitis

Abstract Background: Vancomycin is the mainstay of treatment for methicillin-resistant Staphylococcus aureus (MRSA) meningitis. However, successful outcomes with linezolid have not been reported in a large series of patients. We conducted a single-center retrospective cohort study to compare vancomycin with linezolid in the treatment of MRSA meningitis. Methods: We extracted data and outcomes for all adult patients (age > 18 years) with culture-proved MRSA meningitis who received vancomycin or linezolid between January 2006 and June 2011. A definite diagnosis of meningitis was based on the isolation of MRSA in at least one cerebrospinal fluid (CSF) culture and findings in CSF that are typical of the infection. Linezolid was given intravenously (IV) at a dosage of 600 mg q12h and vancomycin IV at 500 mg q6h. Results: A total of 8 patients with MRSA meningitis (5 male, 3 female; age [mean -SD] 61.6 -13.2 years) received vancomycin and 9 patients (7 male, 2 female; age 59.1 -15.6 years) received linezolid. All isolated strains of MRSA were susceptible to both vancomycin and linezolid. The rates of microbiologic success with linezolid or vancomycin, in terms of clearance of MRSA from CSF on day 5, were 7/9 and 2/8 (p = 0.044, Fisher exact test). No severe adverse events occurred in either treatment arm of the study. One-month survival of the patients in whom treatment was successful microbiologically was 2/2 in the vancomycin-treated group and 4/7 in the linezolidtreated group. Minimum inhibitory concentration (MIC) data for vancomycin were available for 5/6 treatment failures with vancomycin, and vancomycin MIC values of these five strains were 2 mg/L. Conclusion: Analysis of the findings in the limited cohorts in our study suggests that linezolid is superior to vancomycin for treating MRSA meningitis, especially in cases in which there is a high MIC (2 mg/L) for vancomycin. A clinical study involving larger cohorts may increase the evidence available in relation to this question

Predictors for prolonged hospital stay solely to complete intravenous antifungal treatment in patients with candidemia: Results from the ECMM candida III multinational European observational cohort study

Background To date, azoles represent the only viable option for oral treatment of invasive Candida infections, while rates of azole resistance among non-albicans Candida spp. continue to increase. The objective of this sub-analysis of the European multicenter observational cohort study Candida III was to describe demographical and clinical characteristics of the cohort requiring prolonged hospitalization solely to complete intravenous (iv) antifungal treatment (AF Tx). Methods Each participating hospital (number of eligible hospitals per country determined by population size) included the first ~ 10 blood culture proven adult candidemia cases occurring consecutively after July 1st, 2018, and treating physicians answered the question on whether hospital stay was prolonged only for completion of intravenous antifungal therapy. Descriptive analyses as well as binary logistic regression was used to assess for predictors of prolonged hospitalization solely to complete iv AF Tx. Findings Hospital stay was prolonged solely for the completion of iv AF Tx in 16% (100/621) of candidemia cases by a median of 16 days (IQR 8 – 28). In the multivariable model, initial echinocandin treatment was a positive predictor for prolonged hospitalization to complete iv AF Tx (aOR 2.87, 95% CI 1.55 – 5.32, p < 0.001), while (i) neutropenia, (ii) intensive care unit admission, (iii) catheter related candidemia, (iv) total parenteral nutrition, and (v) C. parapsilosis as causative pathogen were found to be negative predictors (aOR 0.22 – 0.45; p < 0.03). Interpretation Hospital stays were prolonged due to need of iv AF Tx in 16% of patients with candidemia. Those patients were more likely to receive echinocandins as initial treatment and were less severely ill and less likely infected with C. parapsilosis

What Should Be the Ideal Definite Coronavirus Disease 2019 (COVID-19) Case Definition?

[No Abstract Available

Farewell

WOS: 000579899200017[No abstract available

EDITORIAL

WOS: 00043626800000