A pharmacodynamic strategy to optimize empirical antibiotic therapy for gram-negative bacteria in a Brazilian Intensive Care Unit
Braz. j. infect. dis
;
11(2): 183-185, Apr. 2007. tab
Article
in English
| LILACS
| ID: lil-454717
ABSTRACT
Pharmacodynamic analyses were proposed to determine optimal empirical antibiotic therapy against Gram-negative bacteria isolated in a Brazilian ICU. Due to high resistance rates, standard regimens of cefepime, ciprofloxacin, meropenem, and piperacillin/tazobactam were not able to attain significant bactericidal CFR. Prolonged infusion of meropenem achieved 88 percent CFR, making it a possible empirical regimen in this ICU until susceptibilities become available. Still, even through administration of high dose prolonged infusions, 12.0 percent of simulated subjects did not achieve bactericidal exposure, suggesting that combination therapy would frequently be required in this setting. In conclusion, we recommend that in the presence of identified resistance problems among Gram-negative bacteria in a unit or hospital, MIC testing of formulary agents should be conducted along with pharmacodynamic simulation to assist in choosing an optimal antibiotic and dosage regimen for empirical use of severe infections until cultures and susceptibilities become available.
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Gram-Negative Bacterial Infections
/
Gram-Negative Bacteria
/
Anti-Bacterial Agents
Type of study:
Health economic evaluation
Limits:
Humans
Country/Region as subject:
South America
/
Brazil
Language:
English
Journal:
Braz. j. infect. dis
Journal subject:
Communicable Diseases
Year:
2007
Type:
Article
Affiliation country:
Brazil
/
United States
Institution/Affiliation country:
Fleury Institute/BR
/
Hartford Hospital/US
/
Hospital Samaritano/BR
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