Presentation title: The Exposure?Response Relationship of Enmetazobactam, Combined with Cefepime
, Is Best Described by fT - CT in a Murine Thigh Infection Model
Preclinical results showed that cefepime/VNRX-5133 showed potent in vitro activity against all Enterobacteriaceae, with an MIC90 of 0.5 mg/L, compared to cefepime
, levofloxacin, meropenem, and piperacillin-tazobactam (MIC90 values >128, >4, 4, >64 mg/L, respectively).
Similarly the Study of Tapan Majumdar, Shibabrata Bhattacharya et al, it was obtained that overall antibiotic resistant pattern of the isolates showed a high degree of resistance towards Amoxycillin, 3rd generation Cephalosporins and Tetracycline whereas Cefepime
, Imipenem Amino Glycosides were showing less resistance.
La figura 1 muestra los diferentes esquemas de tratamiento prescriptos: el 16 % de los pacientes utilizo imipenem/cilastatina 500/500 mg y con el mismo porcentaje la ampicilina/sulbactam 1000/500 mg asociada con claritromicina 500 mg; en menor cantidad, se utilizo la ceftriaxona 1000 mg y la combinacion de cefepime
1000 mg con amikacina 500 mg, ambas con el mismo porcentaje (4 %).
This patient improved after intravenous therapy with cefepime
Serious adverse events occurred in 12% of the combination group and 7% of the cefepime
No resistance was noted for doripenem and cefepime
. MIC50 was 0.094 for Cefpirome, 0.125 Aztreonam, 0.25 imipenem and tigecycline, 2 cefpodoxime and 8 for azithromycin.
As for antibiotic treatment, cefepime
(a fourthgeneration cephalosporin) is often employed as a first-line therapy for agranulocytosis with infection.
The following antibiotic discs were tested: ceftazidime (30 [micro]g), cefepime
(30 [micro]g), piperacillin-tazobactam (100 [micro]g/10 [micro]g), Imipenem (10 [micro]g), Meropenem (10 [micro]g), Gentamicin (10 [micro]g), Amikacin (30 [micro]g), Ampicillin-sulbactam (10 [micro]g/10 [micro]g), Cotrimoxazole (25 [micro]g), aztreonam (30 [micro]g), Ciprofloxacin (5 [micro]g), Norfloxacin (30 [micro]g) (for urinary isolates), Polymyxin B (300 units), and Colistin (10 [micro]g).
Though prospective research demonstrating effectiveness of other therapies has been limited, there is emerging retrospective evidence in support of the use of cefepime
, fluoroquinolones, and piperacillin/tazobactam in certain clinical situations [5-10].
The patient was started empirically on cefepime
, doxycycline, and vancomycin to ensure adequate coverage of suspected marine pathogens.
The different anti-microbials tested were piperacillin (100 ug), ceftazidime (30 ug), amikacin (30 ug), piperacillin-tazobactam (100/10 ug), imipenem (10 ug), ciprofloxacin (5 ug), cefepime
(30 ug), ceftriaxone (30 ug), aztreonam (30 ug) and cefoperazone (30 ug).