THE PROFESSIONALISM IN CLINICAL PRACTICE SERIES

This eBook release, titled "PART III" is part of the "PROFESSIONALISM IN CLINICAL PRACTICE SERIES." It specifically addresses the optimisation of antibiotic efficacy and safety for infections caused by multi-drug resistant bacteria. The eBook covers a total of twenty distinct topics. Each topic is divided into two parts: Keypoints and their references. Each topic typically consists of an average of 12 key points that encompass the relevant subject matter. The following topics are entitled as:

1 CEFIDEROCOL AND SULBACTAM-DURLOBACTAM SHOW STRONG ACTIVITY AGAINST A WIDE RANGE OF ISOLATES. BUT UNRESOLVED QUESTIONS REMAIN ABOUT USING THESE AGENTS ALONGSIDE OTHER MEDICATIONS

2 PREVIOUS POLYMYXIN FAILURE FOR INVASIVE INFECTIONS CAUSED BY CARBAPENEM-RESISTANT ACINETOBACTER BAUMANNII, A THREE-DRUG COMBINATION OF AMPICILLIN-SULBACTAM, CARBAPENEMS, AND POLYMYXINS MAY BE NECESSARY

3 THE HYPOTHESIS THAT AMPICILLIN-SULBACTAM IS BETTER THAN COLISTIN FOR TREATING CARBAPENEM-RESISTANT ACINETOBACTER BAUMANNII INFECTIONS, ESPECIALLY PNEUMONIA, HAS LITTLE CLINICAL EVIDENCE

4 TETRACYCLINE-BASED REGIMENS AND ALTERNATIVE TREATMENTS FOR CARBAPENEM-RESISTANT ACINETOBACTER BAUMANNII INFECTIONS ARE LIMITED, WITH MOST CLINICAL DATA ON TIGECYCLINE. MINOCYCLINE AND ERAVACYCLINE LACK DEFINED CLINICAL BREAKPOINTS

5 AMPICILLIN / SULBACTAM DOSING FOR CARBAPENEM-RESISTANT ACINETOBACTER BAUMANNII INFECTIONS IS VARYING, BUT CLINICAL EVIDENCE SUPPORTS HIGH-DOSE OPTIMISATION

6 COMBINED WITH A -LACTAMASE INHIBITOR, SULBACTAM IS MOST EFFECTIVE AGAINST CARBAPENEM-RESISTANT ACINETOBACTER BAUMANII INFECTIONS. TIGECYCLINE IS PROMISING BUT UNCERTAIN AS A STANDALONE THERAPY

7 MINOCYCLINE, A COMBINATION DRUG, HAS SHOWN PROMISE IN TREATING CARBAPENEM-RESISTANT ACINETOBACTER BAUMANII INFECTIONS, DURLOBACTAM, A NOVEL -LACTAMASE INHIBITOR, ENHANCES SULBACTAM'S EFFECTIVENESS

8 IMIPENEM-CILASTATIN'S EFFECT ON SULBACTAM-DURLOBACTAM NEEDS FURTHER STUDY. DEPENDING ON FACTORS, FUTURE TREATMENTS SHOULD INCLUDE SULBACTAM

9 THE GUIDELINE DEVELOPMENT GROUP DEVELOPED CLINICAL PRACTICE GUIDELINES TO ASSESS THE EFFICACY OF MANAGING CARBAPENEM-RESISTANT ACINETOBACTER BAUMANII INFECTIONS USING THE GRADE APPROACH

10 THE GLOBAL GUIDELINES GROUP RECOMMENDS USING MINIMUM INHIBITOR CONCENTRATION VALUES, PHENOTYPIC AND GENOTYPIC TESTS, AND ANTIMICROBIAL SYNERGY TESTING FOR TREATING CARBAPENEM-RESISTANT ACINETOBACTER BAUMANII INFECTION

11 COMBINING POLYMYXIN AND CARBAPENEM TO TREAT CARBAPENEM-RESISTANT GRAM-NEGATIVE BACTERIA IS CONTROVERSIAL. GUIDELINES RECOMMEND THIS COMBINATION FOR MEROPENEM MICS UNDER 8 MG/

12 TIGECYCLINE-BASED AND POLYMYXIN-BASED COMBINATION THERAPIES HAVE ADVANTAGES AND DISADVANTAGES. AMIKACIN OR INTRAVENOUS FOSFOMYCIN MAY BE RECOMMENDED FOR CARBAPENEM-RESISTANT GRAM-NEGATIVE BACTERIA INFECTIONS

13 THERAPEUTIC DRUG MONITORING ENHANCING TREATMENT EFFECTIVENESS. SCREENING AND INTESTINAL DECOLONIZATION FOR CARBAPENEM-RESISTANT ENTEROBACTERIACEAE ARE EFFECTIVE, REDUCING ALL-CAUSE DEATHS AND INCREASING SUCCESSFUL ERADICATION

14 IMPLEMENTING INTERVENTIONS LIKE SINK REMOVAL, WATER-SAFE POLICIES, AND STAFF HAND HYGIENE MAY REDUCE THE ANNUAL INCIDENCE RATE OF MULTI-DRUG RESISTANT GRAM-NEGATIVE BACTERIA

15 COMBINATION THERAPY FOR LONG-TERM RESPIRATORY TRACT INFECTIONS SHOWS CLINICAL RECOVERY AND COMPLETE ELIMINATION AND CEFTAZIDIME/AVIBACTAM IS SUPERIOR IN TREATING COMPLICATED INFECTIONS

16 MEROPENEM / VABORBACTAM IS USED AS A LAST-RESORT TREATMENT FOR CEFTAZIDIME / AVIBACTAM-RESISTANT K BACTERIA AND CEFIDEROCOL IS EFFECTIVE AGAINST MULTIDRUG-RESISTANT GRAM-NEGATIVE BACTERI

17 CLINICAL TRIALS ON ERAVACYCLINE IN LIVER TRANSPLANTATION HAVE LIMITED DATA, WITH FEW POSITIVE OUTCOMES. FIXED-DOSE COMBINATION MAY CAUSE RENAL IMPAIRMEN

18 BETA-LACTAM ANTIBIOTICS KILL TIME-DEPENDENTLY, DEPENDING ON UNBOUND DRUG CONCENTRATION ABOVE THE MINIMUM INHIBITORY CONCENTRATION.

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