The relative inhibitory activities of diazabicyclooctanes (avibactam, relebactam, zidebactam, nacubactam, durlobactam), boronic acid derivatives (vaborbactam, taniborbactam, xeruborbactam), and penicillin-based sulfone derivative enmetazobactam were evaluated against several intrinsic and acquired class C β-lactamases. By contrast to vaborbactam and enmetazobactam, taniborbactam, xeruborbactam, and all diazabicyclooctanes demonstrated effective activities against most AmpC enzymes. Notably, durlobactam exhibited the most pronounced inhibitory effect. Interstingly, the chromosomal AmpC of Acinetobacter baumannii was the least sensitive enzyme to the newly developed β-lactamase inhibitors.
- MeSH
- Acinetobacter baumannii * drug effects enzymology MeSH
- Anti-Bacterial Agents * pharmacology chemistry MeSH
- Azabicyclo Compounds * pharmacology chemistry MeSH
- Bacterial Proteins * antagonists & inhibitors metabolism MeSH
- beta-Lactamases * metabolism MeSH
- Bridged Bicyclo Compounds, Heterocyclic pharmacology chemistry MeSH
- Cyclooctanes MeSH
- beta-Lactamase Inhibitors * pharmacology chemistry MeSH
- Boronic Acids * pharmacology chemistry MeSH
- Lactams MeSH
- Microbial Sensitivity Tests * MeSH
- Penicillins pharmacology chemistry MeSH
- Piperidines MeSH
- Sulfones pharmacology chemistry MeSH
- Publication type
- Journal Article MeSH
- Keywords
- Zaficefta,
- MeSH
- Anti-Bacterial Agents administration & dosage therapeutic use MeSH
- Drug Resistance, Microbial drug effects MeSH
- Pneumonia, Bacterial * diagnosis drug therapy MeSH
- Ceftazidime administration & dosage therapeutic use MeSH
- COVID-19 diagnosis MeSH
- Drug Combinations MeSH
- beta-Lactamase Inhibitors administration & dosage therapeutic use MeSH
- Lung Abscess diagnosis drug therapy MeSH
- Stenotrophomonas maltophilia isolation & purification MeSH
- MeSH
- Anti-Bacterial Agents classification therapeutic use MeSH
- Drug Resistance, Microbial * drug effects MeSH
- Gram-Negative Bacteria enzymology MeSH
- Cross Infection * MeSH
- beta-Lactamase Inhibitors therapeutic use MeSH
- Carbapenems therapeutic use MeSH
- Humans MeSH
- Microbial Sensitivity Tests MeSH
- Communicable Diseases, Emerging MeSH
- Drug Synergism MeSH
- Check Tag
- Humans MeSH
Predkladaný článok popisuje využitie rezervného karbapenemového antibiotika imipeném v kombinácii s novým inhibítorom b-laktamázy relebaktámom v liečbe ventilátorovej pneumónie vznikajúcej v teréne infekcie SARS-CoV-2 u mladej gravidnej pacientky. V úvode stručne popisuje mechanizmus a spektrum účinku antibiotika, vrátane jeho dávkovania.
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- Keywords
- relebaktam,
- MeSH
- Anti-Bacterial Agents administration & dosage MeSH
- Cesarean Section MeSH
- COVID-19 complications therapy MeSH
- COVID-19 Drug Treatment MeSH
- Drug Combinations MeSH
- beta-Lactamase Inhibitors administration & dosage pharmacology MeSH
- Cilastatin, Imipenem Drug Combination * administration & dosage pharmacology MeSH
- Pregnancy Complications drug therapy therapy MeSH
- Humans MeSH
- Young Adult MeSH
- Pneumonia etiology drug therapy therapy MeSH
- Pregnancy MeSH
- Pneumonia, Ventilator-Associated * etiology drug therapy therapy MeSH
- Check Tag
- Humans MeSH
- Young Adult MeSH
- Pregnancy MeSH
- Female MeSH
- Publication type
- Case Reports MeSH
Between 2014 and 2017, 6,662 Enterobacterales and 1,953 P. aeruginosa isolates were collected by 19 centers in four central European countries and Israel. A further 2,585 Enterobacterales and 707 P. aeruginosa isolates were collected in 2018 by 28 centers in seven European countries and Israel as part of the Antimicrobial Testing Leadership and Surveillance (ATLAS) study. A central laboratory performed antimicrobial susceptibility testing using broth microdilution panels according to Clinical Laboratory Standards Institute (CLSI) guidelines. Susceptibility rates among Enterobacterales were highest to ceftazidime-avibactam (≥98.5%), colistin (≥97.3%), and meropenem (≥95.8%). Ceftazidime-resistant and multidrug-resistant (MDR) Enterobacterales subsets were highly susceptible to ceftazidime-avibactam (≥94.9%) and colistin (≥94.7%). Susceptibility rates to colistin among all P. aeruginosa were ≥97.4% and were ≥96.3% among ceftazidime-resistant and MDR subsets. Susceptibility rates to ceftazidime-avibactam were 91.9% (2014-2017), 86.3% (2018) and, in common with comparator agents, were lower among ceftazidime-resistant (≥51.7%) and MDR isolates (≥57.1%).
- MeSH
- Anti-Bacterial Agents pharmacology MeSH
- Azabicyclo Compounds pharmacology MeSH
- Drug Resistance, Bacterial drug effects MeSH
- Ceftazidime pharmacology MeSH
- Enterobacteriaceae drug effects isolation & purification MeSH
- Enterobacteriaceae Infections microbiology MeSH
- Drug Combinations MeSH
- beta-Lactamase Inhibitors pharmacology MeSH
- Humans MeSH
- Microbial Sensitivity Tests MeSH
- Pseudomonas Infections microbiology MeSH
- Pseudomonas aeruginosa drug effects isolation & purification MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Geographicals
- Europe MeSH
- Israel MeSH
Ceftolozan/tazobaktam je antibiotikum kombinující nového zástupce cefalosporinů s inhibitorem betalaktamázy. Základní indikací pro použití tohoto antibiotika jsou komplikované nitrobřišní infekce a komplikované infekce močového systému. Postupně se také dokumentuje vysoká efektivita ceftolozan/tazobaktamu v případě terapie infekčních komplikací v jiných kompartmentech, zejména pokud se jedná o infekce rezistentními kmeny Pseudomonas aeruginosa. Terapie infekčních kom‑ plikací způsobených tímto patogenem jsou velmi komplikované a mnohdy vyžadují zásadní kompromis mezi schválenou indikací a efektivitou. V kazuistice prezentujeme případ těžce popáleného mladého muže s multifokální infekcí způsobenou multirezistentní Pseudomonas aeruginosa.
Ceftolozane/tazobactam is an antibiotic combining a novel cephalosporin with a beta-lactamase inhibitor. Complicated intra-ab‑ dominal infections and complicated urinary tract infections are basic indications for the use of this antibiotic. There has also been increasing evidence of high efficacy of ceftolozane/tazobactam in treating infectious complications in other compartments, par‑ ticularly in the case of infections with resistant Pseudomonas aeruginosa strains. Treatment of infectious complications caused by this pathogen is very challenging, often requiring a major compromise between an approved indication and efficacy. The case report presents a severely burned young man with a multifocal infection caused by multiresistant Pseudomonas aeruginosa.
- Keywords
- ceftolozan/tazobaktam,
- MeSH
- Anti-Bacterial Agents * administration & dosage MeSH
- Cephalosporins administration & dosage therapeutic use MeSH
- Infections etiology drug therapy MeSH
- beta-Lactamase Inhibitors administration & dosage therapeutic use MeSH
- Drug Therapy, Combination MeSH
- Comorbidity MeSH
- Humans MeSH
- Burns, Electric * diagnosis drug therapy complications therapy MeSH
- Pseudomonas Infections etiology drug therapy MeSH
- Pseudomonas aeruginosa pathogenicity drug effects MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Publication type
- Case Reports MeSH
Komplikované nitrobřišní infekce (cIAI) jsou častou příčinou nemocnosti na jednotkách intenzivní péče. Stále častěji jsou vyvolány multirezistentními kmeny enterobakterií či Pseudomonas aeruginosa. V souboru 592 pacientů z 1. chirurgické kliniky VFN v Praze v letech 2014–2017 byl zaznamenán alarmující nárůst rezistence u kmenů Escherichia coli k potencovaným aminopenicilinům, piperacilinu/tazobaktamu a cefalosporinům třetí generace (z 28,7 % v roce 2014 na 37,5 % v roce 2017, z 25 % na 32 % a z 2,3 % na 5,6 % resp.). Ceftolozan/tazobaktam a ceftazidim/avibaktam patří mezi nová cefalosporinová antibiotika s indikací na léčbu komplikovaných nitrobřišních infekcí. Ceftolozan/tazobaktam vykazuje vysokou účinnost vůči multirezistentním kmenům P. aeruginosa včetně karbapenem rezistentních izolátů. Nový nebeta-laktamové inhibitor beta-laktamáz avibaktam v kombinaci s ceftazidimem je účinný na kmeny enterobakterií produkujících karbapenemázy. Obě antibiotika jsou součástí nových WSES doporučených postupů pro terapii komplikovaných nitrobřišních infekcí.
Complicated intra-abdominal infections (cIAI) are a substantial cause of morbidity at intensive care units. cIAI are frequently caused by multidrug- resistant strains of Enterobacteriaceae and Pseudomonas aeruginosa. In 592 cIAI patients from the First Department of Surgery, General University Hospital in Prague, we found an alarming increase in resistance of Escherichia coli to amoxicillin/clavulanic acid, piperacillin/tazobactam and third-generation cephalosporins in 2014–2017 (from 28.7% in 2014 to 37.5% in 2017, from 25% to 32% and from 2.3% to 5.6%, respectively). Ceftolozane/tazobactam and ceftazidime/avibactam are novel cephalosporins available for the treatment of cIAI. Ceftolozane/tazobactam is highly active against multidrug-resistant strains of P. aeruginosa, including carbapenem-resistant isolates. The new non-b-lactam b-lactamase inhibitor avibactam plus ceftazidime is active against carbapenemases-producing strains of Enterobacteriaceae. Both antibiotics are included in the new WSES guidelines for the management of cIAI.
- Keywords
- ceftolozan/tazobaktam, ceftazidim/avibaktam,
- MeSH
- Anti-Bacterial Agents pharmacology therapeutic use MeSH
- Azabicyclo Compounds pharmacology therapeutic use MeSH
- Drug Resistance, Bacterial MeSH
- Cephalosporins pharmacology therapeutic use MeSH
- Drug Combinations MeSH
- beta-Lactamase Inhibitors pharmacology therapeutic use MeSH
- Humans MeSH
- Intraabdominal Infections * drug therapy MeSH
- Tazobactam pharmacology therapeutic use MeSH
- Check Tag
- Humans MeSH
- Publication type
- Review MeSH
