PMID: 9635914Jun 23, 1998Paper

Clinical strategies for serious infection: a North American perspective

Diagnostic Microbiology and Infectious Disease
J P Quinn

Abstract

In the United States, as in Europe, clinical strategies for serious infection are being increasingly driven by growing numbers of cephalosporin-resistant and multiresistant gram-negative bacilli. In a survey of nearly 400 hospital intensive care units in North America, resistance rates of Klebsiella to third-generation cephalosporins increased (from 3.6 to 14.4%) between 1990 and 1993. Resistance rates in Enterobacter are even higher, approaching 40%. Much of this resistance, which is due mainly to production of type-1 and extended spectrum beta-lactamases, appears to have arisen through overuse of third-generation cephalosporins and from poor hand-washing practices. In some American cities, a major reservoir of resistant organisms are nursing homes, where there is evidence of overuse of oral antibiotics. Currently, the most reliable agents available for the treatment of resistant gram-negative pathogens are the carbapenems, imipenem/cilastatin and meropenem, and the aminoglycoside, amikacin. A recent clinical study of meropenem monotherapy in patients with nosocomial pneumonia showed statistically significantly better clinical and microbiologic outcome compared with a standard regimen of ceftazidime plus tobramycin. The enhanc...Continue Reading

References

Jan 1, 1992·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·R P Gaynes, D H Culver
Jan 1, 1991·Antimicrobial Agents and Chemotherapy·F BellidoR E Hancock
Jul 1, 1988·Reviews of Infectious Diseases·J P QuinnS A Lerner
Jul 1, 1995·The Journal of Antimicrobial Chemotherapy·J R Edwards
Sep 1, 1996·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·W E SandersR E Kessler
Oct 1, 1996·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·G S ItokazuR A Weinstein
Jan 1, 1997·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·G H MillerK J Shaw
Feb 1, 1997·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·J P IaconisH L Nadler
Feb 1, 1997·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·D H PitkinH L Nadler
Aug 1, 1997·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·A P LimayeT R Fritsche

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Citations

Dec 8, 2010·Proceedings of the National Academy of Sciences of the United States of America·Seungil HanVeerabahu Shanmugasundaram
May 17, 2001·Antimicrobial Agents and Chemotherapy·D M LivermoreD L Shungu
Mar 30, 2004·Antimicrobial Agents and Chemotherapy·Michael R MulveyUNKNOWN Canadian Hospital Epidemiology Committee, Canadian Nosocomial Infection Surveillance Program, Health Canada
Feb 26, 2010·Journal of Clinical Microbiology·Kenneth S Thomson
Jan 17, 2002·Pharmacotherapy·Allison E EinhornSusan L Pendland
Jun 5, 2004·Clinics in Laboratory Medicine·Andrea M HujerRobert A Bonomo
Sep 3, 2008·Journal of the American Chemical Society·Michiyosi NukagaRobert A Bonomo
Nov 5, 2011·Journal of the American Chemical Society·Seungil HanVeerabahu Shanmugasundaram

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Antifungals (ASM)

An antifungal, also known as an antimycotic medication, is a pharmaceutical fungicide or fungistatic used to treat and prevent mycosis such as athlete's foot, ringworm, candidiasis, cryptococcal meningitis, and others. Discover the latest research on antifungals here.

Antifungals

An antifungal, also known as an antimycotic medication, is a pharmaceutical fungicide or fungistatic used to treat and prevent mycosis such as athlete's foot, ringworm, candidiasis, cryptococcal meningitis, and others. Discover the latest research on antifungals here.

Aminoglycosides

Aminoglycoside is a medicinal and bacteriologic category of traditional Gram-negative antibacterial medications that inhibit protein synthesis and contain as a portion of the molecule an amino-modified glycoside. Discover the latest research on aminoglycoside here.

Carbapenems

Carbapenems are members of the beta lactam class of antibiotics and are used for the treatment of severe or high-risk bacterial infections. Discover the latest research on carbapenems here.

Aminoglycosides (ASM)

Aminoglycoside is a medicinal and bacteriologic category of traditional Gram-negative antibacterial medications that inhibit protein synthesis and contain as a portion of the molecule an amino-modified glycoside. Discover the latest research on aminoglycoside here.

Carbapenems (ASM)

Carbapenems are members of the beta lactam class of antibiotics and are used for the treatment of severe or high-risk bacterial infections. Discover the latest research on carbapenems here.