Present Status of Therapy for Anaerobic Infections

Size: px
Start display at page:

Download "Present Status of Therapy for Anaerobic Infections"

Transcription

1 89 Present Status of Therapy for Anaerobic Infections Sydney M. Finegold and Hannah M. Wexler From the Medical and Research Services, Veterans Affairs Medical Center West Los Angeles, and the Department of Medicine, UCLA School of Medicine, Los Angeles, California Therapeutic approaches to anaerobic infections are changing. Debridement, drainage, and other surgical approaches remain extremely important. Resistance to antimicrobial agents currently used for treatment of anaerobic infections is increasing. However, promising new agents are being introduced. We review the current status of therapy for anaerobic infections and discuss the potential role of these new agents. We stress an empirical approach to therapy that is based on the usual infecting flora in various types of infections. Treatment of anaerobic infections may be difficult. Failure to provide coverage for anaerobes in mixed infections may lead to a poor response or to no response. Many antibacterial agents including aminoglycosides, trimethoprim-sulfamethoxazole, most quinolones, and monobactams have poor activity against many or most anaerobes. Antimicrobial resistance is increasing among anaerobes. All of these factors account for the difficulty in managing anaerobic infections. At the same time, there are some promising new agents that have recently become available. Classification of The most important anaerobes clinically are the genera of gram-negative rods. Bacteroides, especially the B. Jragilis group (made up of 10 species, one of which is the species B. Jragilis), is particularly important. The other principal gram-negative genera are Prevotella, Fusobacterium, Porphyromonas, Bilophila, and Sutterella. Among the gram-positive anaerobes, there are cocci (primarily Peptostreptococcus) and spore-forming (Clostridium) and non-spore-forming bacilli (especially Actinomyces and Propionibacterium). Table I lists the anaerobes most commonly encountered. Therapeutic Considerations The two key approaches to treatment of anaerobic infections are surgery (or nonsurgical drainage) and antimicrobial therapy. Debridement and drainage typically are essential. Failure to carry out necessary surgical therapy promptly and thoroughly may lead to failure of response to appropriate antimicrobial This article has been modified from a chapter in [9]. Reprints or correspondence: Dr. Sydney M. Finegold, Infectious Disease Section (Ill-F), Veterans Affairs Medical Center West Los Angeles, Wilshire Boulevard, Los Angeles, California Clinical Infectious Diseases 1996;23 (Suppl1):S by The University of Chicago. All rights reserved /96/ $02.00 agents. Some abscesses are amenable to percutaneous drainage under ultrasonographic or CT guidance. Hyperbaric oxygen (HBO) therapy may be of value only in selected circumstances, such as cases of gas gangrene; in the case of an infected extremity, demarcation of the infection may indicate at what level amputation should be done. However, there has never been clear-cut clinical evidence that HBO therapy is significantly beneficial; thus one should certainly never delay needed surgical therapy to administer HBO. Initial antimicrobial therapy for anaerobic infections is necessarily empirical: it may take several days or longer to obtain definitive information on the infecting flora because such floras are usually complex. Rational empirical therapy is based on the following factors: the clinician's assessment of the nature of the infectious process, his/her knowledge of the usual flora in such infections (tables 2-6), and patterns of resistance to antimicrobial drugs in the hospital where he/she practices. The clinician must also take into account how the usual flora may have been modified by pathophysiology or disease or by prior antimicrobial prophylaxis or therapy. Careful analysis of a gram stain of the specimen may also suggest the need to modify the empirical approach. In certain situations, the pharmacological properties of drugs and their bactericidal activity are important considerations. For example, one must use a drug that crosses the blood-brain barrier well for treatment of CNS infections; accordingly, clindamycin would not be suitable. Bactericidal activity is an important consideration in the treatment of CNS infections, endocarditis, and infections in patients with impaired defenses. Most of the drugs that are active against anaerobes have good bactericidal activity; chloramphenicol is the principal exception. Other factors may need to be taken into consideration under certain circumstances. Stevens et al. [6] have shown that clindamycin and metronidazole may suppress the production of toxins by clostridia and that clindamycin may have important inmlunomodulatory effects. Good clinicians maintain close contact with the microbiology laboratory, particularly in the case of a very sick pa-

2 SIO Finegold and Wexler em 1996;23 (Suppl 1) Table 1. most commonly encountered in infections. Bacteroides fragilis group (especially B. fragilis) Pigmented and nonpigmented Prevotella species Fusobacterium nucleatum Peptostreptococcus Clostridium perfringens, Clastridium ramosum NOTE. These five groups together account for about two-thirds of anaerobes recovered from clinically significant infections involving anaerobes. Table 2. Usual flora recovered from patients with anaerobic pleuropulmonary infections. Peptostreptococcus (P. micros, P. anaerobius, and P. magnus) Pigmented Prevotella (P. denticola, P. melaninogenica, P. intermedia, P. nigrescens, and P. loescheii) Nonpigmented Prevotella (P. oris, P. buccae, and P. oralis) Fusobacterium nucleatum (subspecies nucleatum and polymorphum) Bacteroides fragilis group Non-spore-forming, gram-positive rods (Actinomyces, Eubacterium, and Lactobacillus) Viridans streptococci NOTE. In hospital-acquired infections (e.g., aspiration pneumonia), various nosocomial pathogens such as Staphylococcus aureus, Enterobacteriaceae, and Pseudomonas may be involved in addition to the elements of the indigenous flora listed above. Data are from [1]. tient. Such contact should begin before the specimen is submitted and be maintained until the full culture results are available. The microbiologist may decide to use special selective media or other media in setting up a culture because of information Table 3. Usual flora recovered from patients with intra-abdominal infections. Predominant anaerobes Bacteroides fragilis Bacteroides thetaiotaomicron Bilophila wadsworthia Peptostreptococcus (especially P. micros) Clostridium Predominant aerobes and facultatives Escherichia coli Streptococci (viridans group and group D) Pseudomonas aeruginosa Predominant organisms isolated from patients with biliary tract infections Uncomplicated E. coli, Klebsiella, Enterococcus, and Clostridium perfringens Complicated (prior surgery or malignancy) Bacteroides fragilis group may also be involved NOTE. In hospital-acquired infections, nosocomial pathogens such as Staphylococcus aureus and various Enterobacteriaceae may also be involved. Data are from [2]. Table 4. Usual flora recovered from patients with female genital tract infections. Peptostreptococcus Bacteroides fragilis group Prevotella (especially P. bivia, P. disiens, and pigmented Prevotella) Clostridium (especially C. perfringens) Actinomyces, Eubacterium (in intrauterine contraceptive deviceassociated infections) Nonanaerobes Streptococcus (groups A and B and others) Escherichia coli Klebsiella Gonococcus (in sexually active females) Chlamydia trachomatis (in sexually active females) Mycoplasma hominis (in postpartum patients) NOTE. Data are from [3]. provided by the clinician, and the culture might be examined more frequently than would be done for routine cultures (this can be done with use of a device that permits examination of the culture without exposing it to oxygen during the crucial early period of incubation). Preliminary culture results may suggest a need for modification of the initial empirical antimicrobial regimen. Table 7 summarizes the activity of various antimicrobials against the major anaerobes encountered clinically, as determined by the Wadsworth Anaerobic Bacteriology Laboratory (Veterans Affairs Medical Center West Los Angeles, Los Angeles) with use of the Wadsworth agar dilution method. Antimicrobials not listed in the table are not approved by the U.S. Food and Drug Administration or are generally not recommended for treatment of anaerobic infections. In most cases, clinical data are available and support the use of these agents as therapy for infection with anaerobes. Susceptibility patterns Table 5. Usual flora recovered from diabetic foot ulcers. Peptostreptococcus (especially P. magnus, P. prevotii, P. anaerobius, and P. asaccharolyticus) Bacteroides fragilis group (especially B. fragilis and B. thetaiotaomicron) Other Bacteroides Pigmented Prevotella Nonanaerobes Enterococcus Staphylococcus aureus Streptococci (especially group B) Proteus mirabilis Escherichia coli Other Enterobacteriaceae Pseudomonas aeruginosa NOTE. Data are from [4].

3 em 1996; 23 (Supp! 1) Therapy for Anaerobic Infections Sll Predominant flora recovered from skin and soft-tissue ab Table 6. scesses. In intravenous drug abusers Fusobacterium nucleatum Peptostreptococcus micros Actinomyces odontolyticus Pigmented Prevotella N onanaerobes Staphylococcus aureus Streptococcus (" S. milleri group," viridans group, and group A) In nonintravenous drug abusers Peptostreptococcus (P. magnus, P. micros, and P. asaccharolyticus) Pigmented Prevotella Actinomyces species F. nucleatum Nonanaerobes S. aureus Streptococcus ("s. milleri group," viridans group, and group A) NOTE. Data are from [5]. vary in different geographic locations and even in different hospitals in the same city, which is primarily related to patterns of antibiotic use. Thus, periodic susceptibility testing should be carried out to establish patterns of resistance in local hospitals [8]. Susceptibility testing of individual isolates recovered from patients also may be indicated. Such testing would be of special importance in cases in which an antibiotic plays a pivotal role in the outcome, an empirical decision is difficult because of lack of precedent, or the susceptibility pattern of the organism is not well known or displays considerable variability (e.g., that of the B. fragilis group, certain other anaerobic gram-negative bacilli, and clostridia other than Clostridium perfringens). In terms of infections per se, susceptibility testing is indicated for serious infections (e.g., brain abscess, bacteremia, or endocarditis), infections requiring prolonged therapy (e.g., osteomyelitis or an infection associated with a prosthesis), and infections that fail to respond to empirical therapy or that relapse after an initial response to such therapy. Four drugs or groups of drugs are active against the majority of anaerobic bacteria of clinical significance; these are nitroimidazoles such as metronidazole, carbapenems such as imipenem, chloramphenicol, and combinations of,b-lactam drugs with a,b-iactamase inhibitor. Non-sporeforming, anaerobic, gram-positive bacilli (e.g., Actinomyces, Eubacterium, and Propionibacterium) are commonly resistant to metronidazole, as are a number of strains of Sutterella. There have been disturbing reports of resistance to all of the above agents in small numbers of strains of the B. fragilis group. Three other drugs or groups of drugs have good activity against anaerobes but are less active than the four groups mentioned above; these agents are cefoxitin, clindamycin, and broad-spectrum penicillins such as ticarcillin or piperacillin. Of B. fragilis group strains, 15%-25% are resistant to these compounds in many hospitals in the United States and elsewhere. and clindamycin have relatively weak activity against clostridia other than C. perfringens (20%-35% of such strains are resistant to these drugs), and some anaerobic cocci are resistant to clindamycin. Penicillin G is not reliable for treating serious infections involving any of the anaerobic gram-negative bacilli because the incidence of,b-iactamase production among these organisms is high. Some of the newer cephalosporins such as ceftizoxime and cefotetan have sufficient antianaerobic activity to be useful in treating certain anaerobic infections, and these drugs have been found to be comparable to cefoxitin and clindamycin plus gentamicin in double-blind comparative studies of therapy for some anaerobic infections. The three types of infections for which these newer cephalosporins clearly have been shown to be effective are appendicitis (with only localized complications), female genital tract infections such as pelvic inflammatory disease and endometritis, and infected foot ulcers or similar soft-tissue infections (with or without underlying bone infection). Some of these agents are less expensive. Use of such agents also serves to save the more potent drugs for serious infections. However, it is important not to treat patients who are quite ill with these drugs unless and until careful studies establish that to do so would be reasonable. Most anaerobic infections are mixed, involving aerobic or facultative bacteria in addition to anaerobes; antimicrobial therapy must cover the key pathogens of all types. Some of the drugs discussed above have significant activity against certain nonanaerobes, but it is ordinarily necessary to add another agent to cover all of the flora. In general, for treatment of serious anaerobic infections, antimicrobials should be given parenterally in the maximum approved dosages based on the weight and renal and hepatic function of the patient. This dosage recommendation is based on the fact that penetration of drugs into abscesses, necrotic tissue, or poorly perfused tissue (all common situations in serious anaerobic infections) is less than optimal. To minimize the risk of relapse, duration of therapy is also an important consideration for patients with anaerobic infections; for example, lung abscesses usually require therapy for several weeks, empyema requires therapy for 2-3 months, and actinomycosis requires therapy for 6-12 months or longer. Duration of therapy must be individualized, taking into account the site, type, extent, and severity of the infection; the nature of the infecting organisms; whether the host is immunocompromised or in poor condition because of associated or underlying illness; and the speed of response to treatment.

4 [fj tv Table 7. Susceptibility of anaerobes to antimicrobial agents. Percent sllsceptible* Bacteroides Fagilis Other B. }Yagilis group! Bacteroides gracilis Other Bacteroides Prevotella POlphyromonas Sutterella wadsworthensis > )0-69 <50 Ampicillin + + tazobactam Cefoperazone + Cefotetan Cefoperazone Ceftazidime Penicillin at Ciprofioxacin Ampicillin + Cefoperazone + + tazobactam c1avulanate Cefoperazone Cefolelan Penicillin a Ceftazidime + tazobactam Meropenem Ciprofioxacin Fleroxocin Ampicillin + Cefoperazone Cefoperazone + Cefolelan Ceftazidime Penicillin G Ciprofioxacin Ciprofloxacin Clinaftoxacin Ciproftoxacin c1avulanate clavulanatc + tazobactarn.." S (JQ '" 0 0: '" 0. " '" x 1:f n 5 'D "-D p' tv '" (/3

5 n Table 7. (Continued) 8 -\0 \0 Fusobacterium. Percent Fusobacterium mortiferuml Other Bilophila Clostridium Clostridium Clostridium Other N V.l susceptible nucleatum varium Fusobacterium wadsworthia Peptostreptococcus difficilei ramosum perfringeus Clostridium NSF-GPRiI til >95 Ampicillin + Ampicillin + Ampicillin + Ampicillin Ampicillin + Ampicillin + '-'- Ampicillin + Penicillin G Ampicillin + + Penicillin G tazobactam Amoxicillin + Carbenicillin Penicillin G + Ticarcillin c1avulanate tazobactam Penicillin G tazobactam Cefoperazone Ampicillin Cefoperazone + Ticarcillin Ticarcillin Cefotetan Ampicillin Clinafioxacin Cefotetan lmipenem Ciprofioxacin Ceftazidime Ticarcillin Clinafioxacin Cefttiaxone Cefotetan hnipenem Ciprofioxacin lmipenem Ciprofloxacin Ampicillin + Cefoperazone +.,... '" Cefoperazone Ampicillin Cefotetan Cefoperazone + S' (t> ("). Cefotetan '" Cefttiaxone Ciprofioxacin Ceftazidime Cefoperazone Ciprofloxacin Cefoperazone Ciprofioxacin Cefttiaxone <50 Amoxicillin Ciprofioxacin Ceftazidime Ampicillin Ciprofioxacin Penicillin G Ciprofloxacin.a (j>... NOTE. Data from Wadsworth Anaerobic Bacteriology Laboratory. Drugs not listed have not been tested. The order of listing of drugs within percent susceptible categories is not significant. According to the NCCLS-approved breakpoints (Mll-A3), using the intermediate category as susceptible. t NCCLS-approved breakpoint is 4 j.<glml. However, the breakpoint should probably be lowered to I j.<glml, which will considerably lower the values for percent snsceptible. For example, at I j.<glml, no strains of the B. fragilis group were susceptible.! Excluding B. fragilis. i Breakpoint is used ouly as a reference point. C. difficile is primarily of interest in relation to antimicrobial-induced pseudomembranous colitis. These data mnst be interpreted in the context of level of drug achieved in the colon and effect of agent on indigenous colonic flora. II Non-spore-forming gram-positive rod. en -V.l

6 S14 Finegold and Wexler cm 1996;23 (Suppl 1) References 1. Civen R, Jousimies-Somer H, Marina M, Borenstein L, Shah H, Finegold SM. A retrospective review of cases of anaerobic empyema and update of bacteriology. Clin Infect Dis 1995;20 (suppi2):s Bennion RS, Thompson JE, Baron EJ, Finegold SM. Gangrenous and perforated appendicitis with peritonitis-treatroent and bacteriology. Clin Ther 1990; 12(suppl C): Duerden BI. in genitourinary infections. In: Duerden BI, Drasar BS, eds. in human disease. New York: Wiley-Liss, Sapico FL, Canawati HN, Witte JL, et al. Quantitative aerobic and anaerobic bacteriology of infected diabetic feet. J Clin Microbiol1980; 12: Summanen PH, Talan DA, Strong C, et al. Bacteriology of skin and softtissue infections: comparison of infections in intravenous drug users and individuals with no history of intravenous drug use. Clin Infect Dis 1995; 20(suppl 2):S Stevens DL, Maier KA, Laine BM, Mitten JE. Comparison of clindamycin, rifampin, tetracycline, metronidazole, and penicillin for efficacy in prevention of experimental gas gangrene due to Clostridium perfringens. J Infect Dis 1987; 155: Wexler HM, Reeves D, Summanen PH, et al. Sutterella wadsworthensis gen. nov., sp. nov., bile-resistant microaerophilic Campylobacter gracilis-like clinical isolates. Int J Syst BacterioI1996;46: National Committee for Clinical Laboratory Standards. Methods for antimicrobial susceptibility testing of anaerobic bacteria: approved standard; 3rd ed. NCCLS document Mll-A3. Villanova, Pennsylvania: National Committee for Clinical Laboratory Standards, Finegold SM, Wexler HM. Anaerobic infections. In: Schlossberg D, ed. Current therapy of infectious disease. st. Louis: Mosby, 1996: Suggested Reading Borriello SP, ed. Clinical and molecular aspects of anaerobes. Petersfield, United Kingdom: Wrightson Biomedical Publications, Brook I. Pediatric anaerobic infection. Diagnosis and management. 2nd ed. St. Louis: Mosby, Duerden BI, Drasar BS, eds. in human disease. New York: Wiley Liss, Finegold SM. Anaerobic bacteria in human disease. New York: Academic Press, Finegold SM. Anaerobic infections in humans: an overview. Anaerobe 1995; 1:3-9. Finegold SM, George WL eds. Anaerobic infections in humans. San Diego: Academic Press, Summanen P. Microbiology terminology update: clinically significant anaerobic gram-positive and gram-negative bacteria (excluding spirochetes). Clin Infect Dis 1995;21: Summanen P, Baron EJ, Citron DM, Strong CA, Wexler HM, Finegold SM: Wadsworth anaerobic bacteriology manual. 5th ed. Belmont, California: Star Publishing Co., Willis AT. Clostridia of wound infection. London: Butterworths, 1969.

Secondary bacterial infections complicating skin lesions

Secondary bacterial infections complicating skin lesions J. Med. Microbiol. Vol. 51 (2002), 808 812 # 2002 Society for General Microbiology ISSN 0022-2615 REVIEW ARTICLE Secondary bacterial infections complicating skin lesions ITZHAK BROOK Department of Pediatrics,

More information

ANTI-ANAEROBIC ACTIVITIES OF SULOPENEM COMPARED TO SIX OTHER. Departments of Pathology, Hershey Medical Center, Hershey, PA 17033

ANTI-ANAEROBIC ACTIVITIES OF SULOPENEM COMPARED TO SIX OTHER. Departments of Pathology, Hershey Medical Center, Hershey, PA 17033 AAC Accepts, published online ahead of print on 17 February 2009 Antimicrob. Agents Chemother. doi:10.1128/aac.01557-08 Copyright 2009, American Society for Microbiology and/or the Listed Authors/Institutions.

More information

Aberdeen Hospital. Antibiotic Susceptibility Patterns For Commonly Isolated Organisms For 2015

Aberdeen Hospital. Antibiotic Susceptibility Patterns For Commonly Isolated Organisms For 2015 Aberdeen Hospital Antibiotic Susceptibility Patterns For Commonly Isolated s For 2015 Services Laboratory Microbiology Department Aberdeen Hospital Nova Scotia Health Authority 835 East River Road New

More information

Antibiotic. Antibiotic Classes, Spectrum of Activity & Antibiotic Reporting

Antibiotic. Antibiotic Classes, Spectrum of Activity & Antibiotic Reporting Antibiotic Antibiotic Classes, Spectrum of Activity & Antibiotic Reporting Any substance of natural, synthetic or semisynthetic origin which at low concentrations kills or inhibits the growth of bacteria

More information

SESSION XVI NEW ANTIBIOTICS

SESSION XVI NEW ANTIBIOTICS SESSION XVI NEW ANTIBIOTICS New Antibiotics to Treat Anaerobic Infections 2 Goldstein, E.J.C.;* Citron, D.M. Antibiotic Pharmacodynamics 3 Stein, G.E.* Targeting Selenium Metabolism in Stickland Fermentors:

More information

Principles of Infectious Disease. Dr. Ezra Levy CSUHS PA Program

Principles of Infectious Disease. Dr. Ezra Levy CSUHS PA Program Principles of Infectious Disease Dr. Ezra Levy CSUHS PA Program I. Microbiology (1) morphology (e.g., cocci, bacilli) (2) growth characteristics (e.g., aerobic vs anaerobic) (3) other qualities (e.g.,

More information

THERAPY OF ANAEROBIC INFECTIONS LUNG ABSCESS BRAIN ABSCESS

THERAPY OF ANAEROBIC INFECTIONS LUNG ABSCESS BRAIN ABSCESS THERAPY OF ANAEROBIC INFECTIONS Douglas Black, Pharm.D. Associate Professor School of Pharmacy University of Washington dblack@u.washington.edu LUNG ABSCESS A lung abscess is a localized pus cavity in

More information

Super Bugs and Wonder Drugs: Protecting the One While Respecting the Many

Super Bugs and Wonder Drugs: Protecting the One While Respecting the Many Super Bugs and Wonder Drugs: Protecting the One While Respecting the Many Vicki Stringfellow, MSN, CPNP-AC/PC Werner Division of Pediatric Critical Care University of Kentucky Lexington, KY Disclosure

More information

Antibiotic Updates: Part II

Antibiotic Updates: Part II Antibiotic Updates: Part II Fredrick M. Abrahamian, DO, FACEP, FIDSA Health Sciences Clinical Professor of Emergency Medicine David Geffen School of Medicine at UCLA Los Angeles, California Financial Disclosures

More information

Antibiotic Abyss. Discussion Points. MRSA Treatment Guidelines

Antibiotic Abyss. Discussion Points. MRSA Treatment Guidelines Antibiotic Abyss Fredrick M. Abrahamian, D.O., FACEP, FIDSA Professor of Medicine UCLA School of Medicine Director of Education Department of Emergency Medicine Olive View-UCLA Medical Center Sylmar, California

More information

Intra-abdominal anaerobic infections. Diagnostics and therapy

Intra-abdominal anaerobic infections. Diagnostics and therapy Intra-abdominal anaerobic infections. Diagnostics and therapy Elisabeth Nagy MD. PhD. DSc. Institute of Clinical Microbiology, Faculty of Medicine, University of Szeged 4th ESCMID School, Szeged, Hungary

More information

Childrens Hospital Antibiogram for 2012 (Based on data from 2011)

Childrens Hospital Antibiogram for 2012 (Based on data from 2011) Childrens Hospital Antibiogram for 2012 (Based on data from 2011) Prepared by: Department of Clinical Microbiology, Health Sciences Centre For further information contact: Andrew Walkty, MD, FRCPC Medical

More information

QUICK REFERENCE. Pseudomonas aeruginosa. (Pseudomonas sp. Xantomonas maltophilia, Acinetobacter sp. & Flavomonas sp.)

QUICK REFERENCE. Pseudomonas aeruginosa. (Pseudomonas sp. Xantomonas maltophilia, Acinetobacter sp. & Flavomonas sp.) Pseudomonas aeruginosa (Pseudomonas sp. Xantomonas maltophilia, Acinetobacter sp. & Flavomonas sp.) Description: Greenish gray colonies with some beta-hemolysis around each colony on blood agar (BAP),

More information

Secondary peritonitis

Secondary peritonitis Secondary peritonitis Caused by spillage of gastrointestinal microorganisms into the peritoneal cavity secondary to loss of the integrity of the mucosal barriers Etiology: perforation of peptic ulcer traumatic

More information

on February 12, 2018 by guest

on February 12, 2018 by guest AAC Accepted Manuscript Posted Online 12 February 2018 Antimicrob. Agents Chemother. doi:10.1128/aac.00047-18 Copyright 2018 Stapert et al. This is an open-access article distributed under the terms of

More information

Intra-Abdominal Infections. Jessica Thompson, PharmD, BCPS (AQ-ID) Infectious Diseases Pharmacy Clinical Specialist Renown Health April 19, 2018

Intra-Abdominal Infections. Jessica Thompson, PharmD, BCPS (AQ-ID) Infectious Diseases Pharmacy Clinical Specialist Renown Health April 19, 2018 Intra-Abdominal Infections Jessica Thompson, PharmD, BCPS (AQ-ID) Infectious Diseases Pharmacy Clinical Specialist Renown Health April 19, 2018 Select guidelines Mazuski JE, et al. The Surgical Infection

More information

The β- Lactam Antibiotics. Munir Gharaibeh MD, PhD, MHPE School of Medicine, The University of Jordan November 2018

The β- Lactam Antibiotics. Munir Gharaibeh MD, PhD, MHPE School of Medicine, The University of Jordan November 2018 The β- Lactam Antibiotics Munir Gharaibeh MD, PhD, MHPE School of Medicine, The University of Jordan November 2018 Penicillins. Cephalosporins. Carbapenems. Monobactams. The β- Lactam Antibiotics 2 3 How

More information

Table 1. Commonly encountered or important organisms and their usual antimicrobial susceptibilities.

Table 1. Commonly encountered or important organisms and their usual antimicrobial susceptibilities. Table 1. Commonly encountered or important organisms and their usual antimicrobial susceptibilities. Gram-positive cocci: Staphylococcus aureus: *Resistance to penicillin is almost universal. Resistance

More information

2015 Antibiogram. Red Deer Regional Hospital. Central Zone. Alberta Health Services

2015 Antibiogram. Red Deer Regional Hospital. Central Zone. Alberta Health Services 2015 Antibiogram Red Deer Regional Hospital Central Zone Alberta Health Services Introduction. This antibiogram is a cumulative report of the antimicrobial susceptibility rates of common microbial pathogens

More information

2017 Antibiogram. Central Zone. Alberta Health Services. including. Red Deer Regional Hospital. St. Mary s Hospital, Camrose

2017 Antibiogram. Central Zone. Alberta Health Services. including. Red Deer Regional Hospital. St. Mary s Hospital, Camrose 2017 Antibiogram Central Zone Alberta Health Services including Red Deer Regional Hospital St. Mary s Hospital, Camrose Introduction This antibiogram is a cumulative report of the antimicrobial susceptibility

More information

Chapter Anaerobic infections (individual fields): prevention and treatment of postoperative infections

Chapter Anaerobic infections (individual fields): prevention and treatment of postoperative infections J Infect Chemother (2011) 17 (Suppl 1):62 66 DOI 10.1007/s10156-010-0141-x GUIDELINES Chapter 2-5-1. Anaerobic infections (individual fields): prevention and treatment of postoperative infections Ó Japanese

More information

Bacteriology and antibiotic susceptibility of communityacquired intra-abdominal infection in children

Bacteriology and antibiotic susceptibility of communityacquired intra-abdominal infection in children J Microbiol Immunol Infect 2006;39:249-254 Lin et al Bacteriology and antibiotic susceptibility of communityacquired intra-abdominal infection in children Wei-Jen Lin 1, Wen-Tsung Lo 1, Chih-Chun Chu 2,

More information

GENERAL NOTES: 2016 site of infection type of organism location of the patient

GENERAL NOTES: 2016 site of infection type of organism location of the patient GENERAL NOTES: This is a summary of the antibiotic sensitivity profile of clinical isolates recovered at AIIMS Bhopal Hospital during the year 2016. However, for organisms in which < 30 isolates were recovered

More information

INFECTIOUS DISEASES DIAGNOSTIC LABORATORY NEWSLETTER

INFECTIOUS DISEASES DIAGNOSTIC LABORATORY NEWSLETTER INFECTIOUS DISEASES DIAGNOSTIC LABORATORY NEWSLETTER University of Minnesota Health University of Minnesota Medical Center University of Minnesota Masonic Children s Hospital May 2017 Printed herein are

More information

2012 ANTIBIOGRAM. Central Zone Former DTHR Sites. Department of Pathology and Laboratory Medicine

2012 ANTIBIOGRAM. Central Zone Former DTHR Sites. Department of Pathology and Laboratory Medicine 2012 ANTIBIOGRAM Central Zone Former DTHR Sites Department of Pathology and Laboratory Medicine Medically Relevant Pathogens Based on Gram Morphology Gram-negative Bacilli Lactose Fermenters Non-lactose

More information

Intra-abdominal infections: review of the bacteriology, antimicrobial susceptibility and the role of ertapenem in their therapy

Intra-abdominal infections: review of the bacteriology, antimicrobial susceptibility and the role of ertapenem in their therapy Journal of Antimicrobial Chemotherapy (2004) 53, Suppl. S2, ii29 ii36 DOI: 10.1093/jac/dkh201 Intra-abdominal infections: review of the bacteriology, antimicrobial susceptibility and the role of ertapenem

More information

2016 Antibiogram. Central Zone. Alberta Health Services. including. Red Deer Regional Hospital. St. Mary s Hospital, Camrose

2016 Antibiogram. Central Zone. Alberta Health Services. including. Red Deer Regional Hospital. St. Mary s Hospital, Camrose 2016 Antibiogram Central Zone Alberta Health Services including Red Deer Regional Hospital St. Mary s Hospital, Camrose Introduction This antibiogram is a cumulative report of the antimicrobial susceptibility

More information

Drug Class Prior Authorization Criteria Intravenous Antibiotics

Drug Class Prior Authorization Criteria Intravenous Antibiotics Drug Class Prior Authorization Criteria Intravenous Antibiotics Line of Business: Medicaid P&T Approval Date: August 15, 2018 Effective Date: October 1, 2018 This drug class prior authorization criteria

More information

Help with moving disc diffusion methods from BSAC to EUCAST. Media BSAC EUCAST

Help with moving disc diffusion methods from BSAC to EUCAST. Media BSAC EUCAST Help with moving disc diffusion methods from BSAC to EUCAST This document sets out the main differences between the BSAC and EUCAST disc diffusion methods with specific emphasis on preparation prior to

More information

Anaerobic bacteria in 118 patients with deepspace head and neck infections from the University Hospital of Maxillofacial Surgery, Sofia, Bulgaria

Anaerobic bacteria in 118 patients with deepspace head and neck infections from the University Hospital of Maxillofacial Surgery, Sofia, Bulgaria Journal of Medical Microbiology (2006), 55, 1285 1289 DOI 10.1099/jmm.0.46512-0 Anaerobic bacteria in 118 patients with deepspace head and neck infections from the University Hospital of Maxillofacial

More information

Give the Right Antibiotics in Trauma Mitchell J Daley, PharmD, BCPS

Give the Right Antibiotics in Trauma Mitchell J Daley, PharmD, BCPS Give the Right Antibiotics in Trauma Mitchell J Daley, PharmD, BCPS Clinical Pharmacy Specialist, Critical Care Dell Seton Medical Center at the University of Texas and Seton Healthcare Family Clinical

More information

ESCMID Online Lecture Library. by author

ESCMID Online Lecture Library. by author Anaerobic Bacteria in Intra-Abdominal Infections and Bacteremia Maria Hedberg, Umeå University, Umeå, Sweden Anaerobic Bacteria: Next Generation Technology Meets Anaerobic Diagnostics ESCMID Postgraduate

More information

Other Beta - lactam Antibiotics

Other Beta - lactam Antibiotics Other Beta - lactam Antibiotics Assistant Professor Dr. Naza M. Ali Lec 5 8 Nov 2017 Lecture outlines Other beta lactam antibiotics Other inhibitors of cell wall synthesis Other beta-lactam Antibiotics

More information

General Approach to Infectious Diseases

General Approach to Infectious Diseases General Approach to Infectious Diseases 2 The pharmacotherapy of infectious diseases is unique. To treat most diseases with drugs, we give drugs that have some desired pharmacologic action at some receptor

More information

The prevalence of antibiotic resistance in anaerobic bacteria isolated from patients with skin infections Research Article

The prevalence of antibiotic resistance in anaerobic bacteria isolated from patients with skin infections Research Article Gene Therapy and Molecular Biology Vol 9, page 263 Gene Ther Mol Biol Vol 9, 263-268, 2005 The prevalence of antibiotic resistance in anaerobic bacteria isolated from patients with skin infections Research

More information

USA Product Label CLINTABS TABLETS. Virbac. brand of clindamycin hydrochloride tablets. ANADA # , Approved by FDA DESCRIPTION

USA Product Label CLINTABS TABLETS. Virbac. brand of clindamycin hydrochloride tablets. ANADA # , Approved by FDA DESCRIPTION VIRBAC CORPORATION USA Product Label http://www.vetdepot.com P.O. BOX 162059, FORT WORTH, TX, 76161 Telephone: 817-831-5030 Order Desk: 800-338-3659 Fax: 817-831-8327 Website: www.virbacvet.com CLINTABS

More information

NON-SPORING ANAEROBES

NON-SPORING ANAEROBES 36 NON-SPORING ANAEROBES 36.1 INTRODUCTION Anaerobic bacteria are widespread and very important. They do not require oxygen for growth, which is often toxic for them. They lack the enzymes superoxide dismutase,

More information

In Vitro Activities of OPT-80 and Comparator Drugs against Intestinal Bacteria

In Vitro Activities of OPT-80 and Comparator Drugs against Intestinal Bacteria ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, Dec. 2004, p. 4898 4902 Vol. 48, No. 12 0066-4804/04/$08.00 0 DOI: 10.1128/AAC.48.12.4898 4902.2004 Copyright 2004, American Society for Microbiology. All Rights

More information

Chapter Anaerobic infections (individual fields): intraperitoneal infections (acute peritonitis, hepatobiliary infections, etc.

Chapter Anaerobic infections (individual fields): intraperitoneal infections (acute peritonitis, hepatobiliary infections, etc. J Infect Chemother (2011) 17 (Suppl 1):84 91 DOI 10.1007/s10156-010-0146-5 GUIDELINES Chapter 2-5-4. Anaerobic infections (individual fields): intraperitoneal infections (acute peritonitis, hepatobiliary

More information

Antimicrobial Stewardship Strategy: Antibiograms

Antimicrobial Stewardship Strategy: Antibiograms Antimicrobial Stewardship Strategy: Antibiograms A summary of the cumulative susceptibility of bacterial isolates to formulary antibiotics in a given institution or region. Its main functions are to guide

More information

2016 Antibiotic Susceptibility Report

2016 Antibiotic Susceptibility Report Fairview Northland Medical Center and Elk River, Milaca, Princeton and Zimmerman Clinics 2016 Antibiotic Susceptibility Report GRAM-NEGATIVE ORGANISMS 2016 Gram-Negative Non-Urine The number of isolates

More information

Intrinsic, implied and default resistance

Intrinsic, implied and default resistance Appendix A Intrinsic, implied and default resistance Magiorakos et al. [1] and CLSI [2] are our primary sources of information on intrinsic resistance. Sanford et al. [3] and Gilbert et al. [4] have been

More information

Scottish Medicines Consortium

Scottish Medicines Consortium Scottish Medicines Consortium tigecycline 50mg vial of powder for intravenous infusion (Tygacil ) (277/06) Wyeth 9 June 2006 The Scottish Medicines Consortium (SMC) has completed its assessment of the

More information

2015 Antibiotic Susceptibility Report

2015 Antibiotic Susceptibility Report Citrobacter freundii Enterobacter aerogenes Enterobacter cloacae Escherichia coli Haemophilus influenzenza Klebsiella oxytoca Klebsiella pneumoniae Proteus mirabilis Pseudomonas aeruginosa Serratia marcescens

More information

number Done by Corrected by Doctor

number Done by Corrected by Doctor number 32 Done by Nazek Hyasat Corrected by Doctor مالك الزحلف In this sheet we will talk about two cute drugs and a group of drugs, wish you a pleasant study... First of all, we will talk about clindamycin,which

More information

Concise Antibiogram Toolkit Background

Concise Antibiogram Toolkit Background Background This toolkit is designed to guide nursing homes in creating their own antibiograms, an important tool for guiding empiric antimicrobial therapy. Information about antibiograms and instructions

More information

General Infectious Disease Concepts/Resources

General Infectious Disease Concepts/Resources General Infectious Disease Concepts/Resources Learning Objectives: 1. Distinguish between foundational infectious disease concepts including gram positive and negative bacteria, bacteriostatic and bactericidal

More information

ESBL Producers An Increasing Problem: An Overview Of An Underrated Threat

ESBL Producers An Increasing Problem: An Overview Of An Underrated Threat ESBL Producers An Increasing Problem: An Overview Of An Underrated Threat Hicham Ezzat Professor of Microbiology and Immunology Cairo University Introduction 1 Since the 1980s there have been dramatic

More information

Diabetic Foot Infection. Dr David Orr Consultant Microbiologist Lancashire Teaching Hospitals

Diabetic Foot Infection. Dr David Orr Consultant Microbiologist Lancashire Teaching Hospitals Diabetic Foot Infection Dr David Orr Consultant Microbiologist Lancashire Teaching Hospitals History of previous amputation [odds ratio (OR)=19.9, P=.01], Peripheral vascular disease (OR=5.5, P=.007)

More information

Medicinal Chemistry 561P. 2 st hour Examination. May 6, 2013 NAME: KEY. Good Luck!

Medicinal Chemistry 561P. 2 st hour Examination. May 6, 2013 NAME: KEY. Good Luck! Medicinal Chemistry 561P 2 st hour Examination May 6, 2013 NAME: KEY Good Luck! 2 MDCH 561P Exam 2 May 6, 2013 Name: KEY Grade: Fill in your scantron with the best choice for the questions below: 1. Which

More information

CONTAGIOUS COMMENTS Department of Epidemiology

CONTAGIOUS COMMENTS Department of Epidemiology VOLUME XXIX NUMBER 3 November 2014 CONTAGIOUS COMMENTS Department of Epidemiology Bugs and Drugs Elaine Dowell SM MLS (ASCP), Marti Roe SM MLS (ASCP), Sarah Parker MD, Jason Child PharmD, and Samuel R.

More information

Antimicrobial Susceptibility Testing: Advanced Course

Antimicrobial Susceptibility Testing: Advanced Course Antimicrobial Susceptibility Testing: Advanced Course Cascade Reporting Cascade Reporting I. Selecting Antimicrobial Agents for Testing and Reporting Selection of the most appropriate antimicrobials to

More information

جداول میکروارگانیسم های بیماریزای اولویت دار و آنتی بیوتیک های تعیین شده برای آزمایش تعیین حساسیت ضد میکروبی در برنامه مهار مقاومت میکروبی

جداول میکروارگانیسم های بیماریزای اولویت دار و آنتی بیوتیک های تعیین شده برای آزمایش تعیین حساسیت ضد میکروبی در برنامه مهار مقاومت میکروبی جداول میکروارگانیسم های بیماریزای اولویت دار و آنتی بیوتیک های تعیین شده برای آزمایش تعیین حساسیت ضد میکروبی در برنامه مهار مقاومت میکروبی ویرایش دوم بر اساس ed., 2017 CLSI M100 27 th تابستان ۶۹۳۱ تهیه

More information

Clinical Features and Prognostic Factors of Anaerobic Infections: A 7-Year Retrospective Study

Clinical Features and Prognostic Factors of Anaerobic Infections: A 7-Year Retrospective Study ORIGINAL ARTICLE DOI: 10.3904/kjim.2009.24.1.13 Clinical Features and Prognostic Factors of Anaerobic Infections: A 7-Year Retrospective Study Yoonseon Park 1, Jun Young Choi 1, Dongeun Yong 2, Kyungwon

More information

Basic principles of antibiotic use

Basic principles of antibiotic use Basic principles of antibiotic use Michal Holub Department of Infectious Diseases First Faculty of Medicine Charles University and Military University Hospital, Prague 1. Is antibiotical treatment indicated

More information

See Important Reminder at the end of this policy for important regulatory and legal information.

See Important Reminder at the end of this policy for important regulatory and legal information. Clinical Policy: Reference Number: CP.HNMC.24 Effective Date: 07.01.17 Last Review Date: 02.18 Line of Business: Medicaid - HNMC Revision Log See Important Reminder at the end of this policy for important

More information

Patterns of Susceptibility to Fluoroquinolones Among Anaerobic Bacterial Isolates in the United States

Patterns of Susceptibility to Fluoroquinolones Among Anaerobic Bacterial Isolates in the United States S377 Patterns of Susceptibility to Fluoroquinolones Among Anaerobic Bacterial Isolates in the United States Ellie J. C. Goldstein From R. M. Alden Research Laboratory, Santa Monica Hospital Medical Center,

More information

Moxifloxacin resistance is prevalent among Bacteroides and Prevotella species in Greece

Moxifloxacin resistance is prevalent among Bacteroides and Prevotella species in Greece Journal of Antimicrobial Chemotherapy (2008) 62, 137 141 doi:10.1093/jac/dkn134 Advance Access publication 1 April 2008 Moxifloxacin resistance is prevalent among Bacteroides and Prevotella species in

More information

Performance Information. Vet use only

Performance Information. Vet use only Performance Information Vet use only Performance of plates read manually was measured in three sites. Each centre tested Enterobacteriaceae, streptococci, staphylococci and pseudomonas-like organisms.

More information

11/10/2016. Skin and Soft Tissue Infections. Disclosures. Educational Need/Practice Gap. Objectives. Case #1

11/10/2016. Skin and Soft Tissue Infections. Disclosures. Educational Need/Practice Gap. Objectives. Case #1 Disclosures Selecting Antimicrobials for Common Infections in Children FMR-Contemporary Pediatrics 11/2016 Sean McTigue, MD Assistant Professor of Pediatrics, Pediatric Infectious Diseases Medical Director

More information

BactiReg3 Event Notes Module Page(s) 4-9 (TUL) Page 1 of 21

BactiReg3 Event Notes Module Page(s) 4-9 (TUL) Page 1 of 21 www.wslhpt.org 2601 Agriculture Drive Madison, WI 53718 (800) 462-5261 (608) 265-1111 2015-BactiR Reg3 Shipment Date: September 14, 2015 Questions or comments should be directed to Amanda Weiss at 800-462-5261

More information

National Clinical Guideline Centre Pneumonia Diagnosis and management of community- and hospital-acquired pneumonia in adults

National Clinical Guideline Centre Pneumonia Diagnosis and management of community- and hospital-acquired pneumonia in adults National Clinical Guideline Centre Antibiotic classifications Pneumonia Diagnosis and management of community- and hospital-acquired pneumonia in adults Clinical guideline 191 Appendix N 3 December 2014

More information

Epidemiology and Microbiology of Surgical Wound Infections

Epidemiology and Microbiology of Surgical Wound Infections JOURNAL OF CLINICAL MICROBIOLOGY, Feb. 2000, p. 918 922 Vol. 38, No. 2 0095-1137/00/$04.00 0 Copyright 2000, American Society for Microbiology. All Rights Reserved. Epidemiology and Microbiology of Surgical

More information

3/20/2011. Code 215 of Hammurabi: If a physician performed a major operation on

3/20/2011. Code 215 of Hammurabi: If a physician performed a major operation on The Good Antibiotics: the Good, the Bad and the Ugly John P. Cello, MD Professor of Medicine and Surgery, University of California, San Francisco Most organisms can be readily identified by culture, special

More information

Antimicrobial susceptibility

Antimicrobial susceptibility Antimicrobial susceptibility PATTERNS Microbiology Department Canterbury ealth Laboratories and Clinical Pharmacology Department Canterbury District ealth Board March 2011 Contents Preface... Page 1 ANTIMICROBIAL

More information

number Done by Corrected by Doctor

number Done by Corrected by Doctor number 28 Done by Dina Yaseen Corrected by حسام أبو عوض Doctor مالك الزحلف Cephalosporins -Cephalosporins are β-lactam antibiotics isolated from a strain of Streptomyces. -They are bactericidal and work

More information

Pharmacology Week 6 ANTIMICROBIAL AGENTS

Pharmacology Week 6 ANTIMICROBIAL AGENTS Pharmacology Week 6 ANTIMICROBIAL AGENTS Mechanisms of antimicrobial action Mechanisms of antimicrobial action Bacteriostatic - Slow or stop bacterial growth, needs an immune system to finish off the microbe

More information

Detection and Quantitation of the Etiologic Agents of Ventilator Associated Pneumonia in Endotracheal Tube Aspirates From Patients in Iran

Detection and Quantitation of the Etiologic Agents of Ventilator Associated Pneumonia in Endotracheal Tube Aspirates From Patients in Iran Letter to the Editor Detection and Quantitation of the Etiologic Agents of Ventilator Associated Pneumonia in Endotracheal Tube Aspirates From Patients in Iran Mohammad Rahbar, PhD; Massoud Hajia, PhD

More information

Appropriate antimicrobial therapy in HAP: What does this mean?

Appropriate antimicrobial therapy in HAP: What does this mean? Appropriate antimicrobial therapy in HAP: What does this mean? Jaehee Lee, M.D. Kyungpook National University Hospital, Korea KNUH since 1907 Presentation outline Empiric antimicrobial choice: right spectrum,

More information

Piperacillin-Tazobactam, and Cefoxitin

Piperacillin-Tazobactam, and Cefoxitin ANTiMICROBLAL AGENTS AND CHEMOTHERAPY, Aug. 1993, p. 1649-1654 0066-4804/93/081649-06$00/0 Copyright 1993, American Society for Microbiology Vol. 37, No. 8 Susceptibilities of 428 Gram-Positive and -Negative

More information

Antimicrobial Susceptibility Testing: The Basics

Antimicrobial Susceptibility Testing: The Basics Antimicrobial Susceptibility Testing: The Basics Susan E. Sharp, Ph.D., DABMM, FAAM Director, Airport Way Regional Laboratory Director, Regional Microbiology and Molecular Infectious Diseases Laboratories

More information

Pinni Meedha Mojutho Ammanu Dengina Koduku Part 1 Kama Kathalu

Pinni Meedha Mojutho Ammanu Dengina Koduku Part 1 Kama Kathalu Search for: Search Search Does levaquin cover anaerobes Pinni Meedha Mojutho Ammanu Dengina Koduku Part 1 Kama Kathalu Levofloxacin, sold under the trade names Levaquin among others, is an antibiotic.

More information

Canadian practice guidelines for surgical intra-abdominal infections

Canadian practice guidelines for surgical intra-abdominal infections AMMI CAnAdA guidelines Canadian practice guidelines for surgical intra-abdominal infections Co-Chairs (listed alphabetically): Anthony W Chow MD FACP FRCPC 1, Gerald A Evans MD FRCPC 2, Avery B Nathens

More information

Rational use of antibiotics

Rational use of antibiotics Rational use of antibiotics Uga Dumpis MD, PhD,, DTM Stradins University Hospital Riga, Latvia ugadumpis@stradini.lv BALTICCARE CONFERENCE, PSKOV, 16-18.03, 18.03, 2006 Why to use antibiotics? Prophylaxis

More information

Anaerobic and microaerophilic gram-positive cocci Peptococcus species, Peptostreptococcus species, Microaerophilic streptococci

Anaerobic and microaerophilic gram-positive cocci Peptococcus species, Peptostreptococcus species, Microaerophilic streptococci CLINDACIN Composition Each capsule contains Clindamycin (as hydrochloride) 150 mg Capsule Action Clindamycin bind exclusively to the 50S subunit of bacterial ribosomes and suppress protein synthesis. Clindamycin

More information

Antimicrobial Susceptibility Patterns

Antimicrobial Susceptibility Patterns Antimicrobial Susceptibility Patterns KNH SURGERY Department Masika M.M. Department of Medical Microbiology, UoN Medicines & Therapeutics Committee, KNH Outline Methodology Overall KNH data Surgery department

More information

a. 379 laboratories provided quantitative results, e.g (DD method) to 35.4% (MIC method) of all participants; see Table 2.

a. 379 laboratories provided quantitative results, e.g (DD method) to 35.4% (MIC method) of all participants; see Table 2. AND QUANTITATIVE PRECISION (SAMPLE UR-01, 2017) Background and Plan of Analysis Sample UR-01 (2017) was sent to API participants as a simulated urine culture for recognition of a significant pathogen colony

More information

Antibiotics. Antimicrobial Drugs. Alexander Fleming 10/18/2017

Antibiotics. Antimicrobial Drugs. Alexander Fleming 10/18/2017 Antibiotics Antimicrobial Drugs Chapter 20 BIO 220 Antibiotics are compounds produced by fungi or bacteria that inhibit or kill competing microbial species Antimicrobial drugs must display selective toxicity,

More information

Who should read this document? 2. Key practice points 2. Background/ Scope/ Definitions 2. What is new in this version? 3

Who should read this document? 2. Key practice points 2. Background/ Scope/ Definitions 2. What is new in this version? 3 Neurosurgical infections (adult only) Antibiotic Guidelines Classification: Clinical Guideline Lead Author: Antibiotic Steering Committee Additional author(s): as above Authors Division: DCSS & Tertiary

More information

Similar to Penicillins: -Chemically. -Mechanism of action. -Toxicity.

Similar to Penicillins: -Chemically. -Mechanism of action. -Toxicity. Similar to Penicillins: -Chemically. -Mechanism of action. -Toxicity. Cephalosporins are divided into Generations: -First generation have better activity against gram positive organisms. -Later compounds

More information

Mercy Medical Center Des Moines, Iowa Department of Pathology. Microbiology Department Antibiotic Susceptibility January December 2016

Mercy Medical Center Des Moines, Iowa Department of Pathology. Microbiology Department Antibiotic Susceptibility January December 2016 Mercy Medical Center Des Moines, Iowa Department of Pathology Microbiology Department Antibiotic Susceptibility January December 2016 These statistics are intended solely as a GUIDE to choosing appropriate

More information

Prevalence of Metallo-Beta-Lactamase Producing Pseudomonas aeruginosa and its antibiogram in a tertiary care centre

Prevalence of Metallo-Beta-Lactamase Producing Pseudomonas aeruginosa and its antibiogram in a tertiary care centre International Journal of Current Microbiology and Applied Sciences ISSN: 2319-7706 Volume 4 Number 9 (2015) pp. 952-956 http://www.ijcmas.com Original Research Article Prevalence of Metallo-Beta-Lactamase

More information

Objectives. Basic Microbiology. Patient related. Environment related. Organism related 10/12/2017

Objectives. Basic Microbiology. Patient related. Environment related. Organism related 10/12/2017 Basic Microbiology Vaneet Arora, MD MPH D(ABMM) FCCM Associate Director of Clinical Microbiology, UK HealthCare Assistant Professor, Department of Pathology and Laboratory Medicine University of Kentucky

More information

PRACTIC GUIDELINES for APPROPRIATE ANTIBIOTICS USE

PRACTIC GUIDELINES for APPROPRIATE ANTIBIOTICS USE PRACTIC GUIDELINES for APPROPRIATE ANTIBIOTICS USE Global Alliance for Infection in Surgery World Society of Emergency Surgery (WSES) and not only!! Aims - 1 Rationalize the risk of antibiotics overuse

More information

Meropenem for all? Midge Asogan ICU Fellow (also ID AT)

Meropenem for all? Midge Asogan ICU Fellow (also ID AT) Meropenem for all? Midge Asogan ICU Fellow (also ID AT) Infections Common reason for presentation to ICU Community acquired - vs nosocomial - new infection acquired within hospital environment Treatment

More information

Safe Patient Care Keeping our Residents Safe Use Standard Precautions for ALL Residents at ALL times

Safe Patient Care Keeping our Residents Safe Use Standard Precautions for ALL Residents at ALL times Safe Patient Care Keeping our Residents Safe 2016 Use Standard Precautions for ALL Residents at ALL times #safepatientcare Do bugs need drugs? Dr Deirdre O Brien Consultant Microbiologist Mercy University

More information

Susceptibility of Respiratory Tract Anaerobes to Orally Administered Penicillins and Cephalosporins

Susceptibility of Respiratory Tract Anaerobes to Orally Administered Penicillins and Cephalosporins ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, Oct. 1976, p. 713-720 Copyright 0 1976 American Society for Microbiology Vol. 10, No. 4 Printed in U.S.A. Susceptibility of Respiratory Tract Anaerobes to Orally

More information

2010 ANTIBIOGRAM. University of Alberta Hospital and the Stollery Children s Hospital

2010 ANTIBIOGRAM. University of Alberta Hospital and the Stollery Children s Hospital 2010 ANTIBIOGRAM University of Alberta Hospital and the Stollery Children s Hospital Medical Microbiology Department of Laboratory Medicine and Pathology Table of Contents Page Introduction..... 2 Antibiogram

More information

OBSTETRICS & GYNAECOLOGY. Penicillin G 5 million units IV ; followed by 2.5 million units 4hourly upto delivery

OBSTETRICS & GYNAECOLOGY. Penicillin G 5 million units IV ; followed by 2.5 million units 4hourly upto delivery OBSTETRICS & GYNAECOLOGY A.OBSTETRICS Infection/Condition/likely organism Intrapartum Group B Streptococcal (GBS) infection; positive mothers Suggested treatment Preferred Penicillin G 5 million units

More information

Classification of Bacteria

Classification of Bacteria Classification of Bacteria MICROBIOLOGY -TAXONOMY Taxonomy is the system to classify living organisms Seven groups kingdom, phylum or div, class, order, family, genus, species Binomial system of nomenclature

More information

Beta-lactams 1 รศ. พญ. มาล ยา มโนรถ ภาคว ชาเภส ชว ทยา. Beta-Lactam Antibiotics. 1. Penicillins 2. Cephalosporins 3. Monobactams 4.

Beta-lactams 1 รศ. พญ. มาล ยา มโนรถ ภาคว ชาเภส ชว ทยา. Beta-Lactam Antibiotics. 1. Penicillins 2. Cephalosporins 3. Monobactams 4. Beta-lactams 1 รศ. พญ. มาล ยา มโนรถ ภาคว ชาเภส ชว ทยา จ ดประสงค การศ กษา เม อส นส ดการเร ยนการสอน และการศ กษาด วยตนเองเพ มเต ม น กศ กษาสามารถ 1. อธ บายกลไกการออกฤทธ และกลไกการด อยาของยากล ม penicillins

More information

Perichondritis: Source: UpToDate Ciprofloxacin 10 mg/kg/dose PO (max 500 mg/dose) BID Inpatient: Ceftazidime 50 mg/kg/dose q8 hours IV

Perichondritis: Source: UpToDate Ciprofloxacin 10 mg/kg/dose PO (max 500 mg/dose) BID Inpatient: Ceftazidime 50 mg/kg/dose q8 hours IV Empiric Antibiotics for Pediatric Infections Seen in ED NOTE: Choice of empiric antibiotic therapy must take into account local pathogen frequency and resistance patterns, individual patient characteristics,

More information

Routine internal quality control as recommended by EUCAST Version 3.1, valid from

Routine internal quality control as recommended by EUCAST Version 3.1, valid from Routine internal quality control as recommended by EUCAST Version.1, valid from 01-01-01 Escherichia coli Pseudomonas aeruginosa Staphylococcus aureus Enterococcus faecalis Streptococcus pneumoniae Haemophilus

More information

Suggestions for appropriate agents to include in routine antimicrobial susceptibility testing

Suggestions for appropriate agents to include in routine antimicrobial susceptibility testing Suggestions for appropriate agents to include in routine antimicrobial susceptibility testing These suggestions are intended to indicate minimum sets of agents to test routinely in a diagnostic laboratory

More information

Surveillance of susceptibility patterns in 1297 European and US anaerobic and capnophilic isolates to co-amoxiclav and five other antimicrobial agents

Surveillance of susceptibility patterns in 1297 European and US anaerobic and capnophilic isolates to co-amoxiclav and five other antimicrobial agents Journal of Antimicrobial Chemotherapy (2004) 53, 1039 1044 DOI: 10.1093/jac/dkh248 Advance Access publication 5 May 2004 Surveillance of susceptibility patterns in 1297 European and US anaerobic and capnophilic

More information

after trauma in children

after trauma in children 6 Department of Pediatrics, Navy Hospital, Bethesda, Maryland, USA Brook Correspondence to: Dr tzhak Brook, PO Box 704, Chevy Chase, MD 08-04, USA. Accepted for publication November 997 Table JAccid Emerg

More information

Aerobic bacterial infections in a burns unit of Sassoon General Hospital, Pune

Aerobic bacterial infections in a burns unit of Sassoon General Hospital, Pune Original article Aerobic bacterial infections in a burns unit of Sassoon General Hospital, Pune Patil P, Joshi S, Bharadwaj R. Department of Microbiology, B.J. Medical College, Pune, India. Corresponding

More information

Multicenter Study of In Vitro Susceptibility of the Bacteroides fragilis Group, 1995 to 1996, with Comparison of Resistance Trends from 1990 to 1996

Multicenter Study of In Vitro Susceptibility of the Bacteroides fragilis Group, 1995 to 1996, with Comparison of Resistance Trends from 1990 to 1996 ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, Oct. 1999, p. 2417 2422 Vol. 43, No. 10 0066-4804/99/$04.00 0 Copyright 1999, American Society for Microbiology. All Rights Reserved. Multicenter Study of In Vitro

More information

Principles of Anti-Microbial Therapy Assistant Professor Naza M. Ali. Lec 1

Principles of Anti-Microbial Therapy Assistant Professor Naza M. Ali. Lec 1 Principles of Anti-Microbial Therapy Assistant Professor Naza M. Ali Lec 1 28 Oct 2018 References Lippincott s IIIustrated Reviews / Pharmacology 6 th Edition Katzung and Trevor s Pharmacology / Examination

More information

Pathogens commonly isolated from selected diseases

Pathogens commonly isolated from selected diseases Pathogens commonly isolated from selected diseases Equine pneumonia/pleuropneumonia -hemolytic Strep. Clostridium Pasteurella E. coli Klebsiella pneumoniae Bacteroides Equine enteric pathogens Salmonella

More information