Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Piperacillin”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 955 records · Page 53Linked to original sources
PubMedDate not supplied

Comparative activity of newer antibiotics against gram-negative bacilli.

The in vitro activities of cefoperazone, cefotaxime, ceftriaxone, ceftazidime, azlocillin, mezlocillin, piperacillin, ticarcillin/clavulanate, aztreonam, imipenem, and ciprofloxacin were concurrently determined against over 1,000 isolates of gram-negative bacilli from clinical specimens of patients at the Cleveland Clinic. Cephalosporins, penicillins, and aztreonam were active against species of Enterobacteriaceae other than Citrobacter freundii, Enterobacter aerogenes, and Enterobacter cloacae. Ceftazidime was the most active cephalosporin against Pseudomonas aeruginosa. Against the Enterobacteriaceae, the rank order of activity of penicillins was ticarcillin/clavulanate greater than piperacillin greater than mezlocillin greater than azlocillin. Against P. aeruginosa, the rank order of activity of penicillins was piperacillin greater than ticarcillin/clavulanate greater than azlocillin greater than mezlocillin. Aztreonam was less active v P. aeruginosa than ceftazidime, cefoperazone, or piperacillin. The most active antimicrobials against all isolates tested were imipenem and ciprofloxacin.

Aztreonam↗
PubMed1983

Induction of cephalosporinase production by various penicillins in enterobacteriaceae.

The inducer activity of seven penicillins for cephalosporinase (CSase) production and their antibacterial activity against CSase-producing strains were studied using clinical isolates of Proteus morganii, P. rettgeri, P. vulgaris, Enterobacter cloacae, and Serratia marcescens. Piperacillin, apalcillin, and methicillin showed rather low inducer activity for CSase production in all strains tested. On the other hand, ampicillin, carbenicillin, and sulbenicillin showed high inducer activity for CSase production. Piperacillin, apalcillin, and ampicillin were less stable to CSases than were carbenicillin, sulbenicillin, and methicillin, but much more stable than benzylpenicillin. In the growing culture of CSase-producing strains, piperacillin and apalcillin were rather stable. Against CSase-producing strains, piperacillin and apalcillin were more active than other penicillins tested.

Cephalosporinase↗
PubMed1984

Synergistic activity of astromicin and beta-lactam antibiotics against Pseudomonas aeruginosa in vitro and in vivo.

Synergistic activity of astromicin and an antipseudomonal beta-lactam antibiotic such as piperacillin, cefsulodin or carbenicillin against Pseudomonas aeruginosa was demonstrated in vitro and in vivo. Synergy in vitro was observed more often when astromicin was combined with piperacillin or cefsulodin than when it was combined with carbenicillin. The combination of astromicin with piperacillin showed a bactericidal activity against Pseudomonas aeruginosa at a bacteriostatic concentration of each antibiotic alone. The synergy observed in vitro was reproduced against experimental mouse infections, and the astromicin-piperacillin or cefsulodin combination produced significantly greater protective effects than the single use of individual antibiotics.

Aminoglycosides↗
PubMed1999

[In vitro activity of beta-lactam agents and beta-lactamase inhibitors in clinical isolates of Acinetobacter baumannii].

Acinetobacter is a Gram-negative coccobacillus frequently associated with nosocomial infections, especially pneumonia in patients using mechanical ventilators in ICUs. Many of the clinical isolates of Acinetobacter baumannii are now resistant to most antibiotics, including the betalactams, making these infections difficult to treat. We compared the in vitro activity of betalactam agents (ampicillin, piperacillin and ticarcillin), betalactamase inhibitors (clavulanic acid, sulbactam and tazobactam) alone and in combination with betalactam agents (amoxicillin-clavulanic acid, ampicillin-sulbactam, piperacillin-tazobactam and ticarcillin-clavulanic) against 156 clinical isolates of A. baumannii using an agar dilution method. In general, we observed a low susceptibility to the betalactam agents tested (ampicillin: 1.9% susceptibility; piperacillin: 10.2%; ticarcillin: 19.8%). We did not observe a significant reduction of the MIC in the combination of betalactam agents and betalactamase inhibitors; only ampicillin/sulbactam showed a high antimicrobial activity (84.6% compared to 14.1%, 37.8% and 33.9% for amoxicillin-clavulanic acid, piperacillin-tazobactam and ticarcillin-clavulanic acid, respectively). Sulbactam was the only betalactamase inhibitor which showed good in vitro activity, with a low MIC(50) and MIC(90) (8 and 32 mg/l, respectively) similar to ampicillin/sulbactam (2 and 16 mg/l, respectively). Sulbactam could be a good therapeutic alternative for the treatment of multiresistant A. baumannii infections.

Acinetobacter↗
PubMed2003

Current status of drug resistance among gram-negative bacilli isolated from admitted cases in a tertiary care centre.

AIMS: To study the prevalence of drug resistance among gram-negative bacilli and susceptibility to the Cefoperazone + Sulbactam and Piperacillin + Tazobactam combination among the hospital isolates resistant to all other antimicrobial agents. METHODS: A total of 367 gram-negative bacilli isolated from various pathological samples were tested for susceptibility to antimicrobial agent by the disc diffusion technique and 300 isolates of gram-negative bacilli which were resistant to all the other antibiotics were checked for sensitivity to piperacillin + tazobactam and cefoperazone + sulbactam combination. RESULTS: Resistance to ampicillin and amoxicillin + clavulanic acid ranged from (72.1-83.8%) which was highest. Resistance to cotrimoxazole, gentamicin, netilmycin, quinolones and all the generation of cephalsporins was often above 50%. piperacillin + tazobactam combination had the lowest incidence of resistance (14 to 20.5%). CONCLUSION: Drug resistance for most of the antimicrobial agents was greater than 50% including the various generations of cephalosporins. Inefficiency of amoxicillin + clavulanic acid (resistance among 72-79.5% isolates) suggests the presence of extended spectrum beta-lactamases among the isolates. Addition of sulbactam to cefoperazone showed increased activity (resistance 27 to 34%) but piperacillin + tazobactam was the most effective combination in vitro.

Anti-Bacterial Agents↗
PubMed1990

Comparative in vitro activity of several antimicrobial agents against selected clinical isolates.

A comparison between the in vitro activities of ceftazidime, cefotaxime, ceftriaxone, ampicillin, piperacillin, gentamicin, tobramycin and netilmicin was performed on selected clinical isolates. The activity of the agents was assessed by means of minimum inhibitory concentration determinations, and time-kill studies. The third generation cephalosporins were active against all members of the Enterobacteriaceae excluding some Enterobacter species. Their activity against these bacteria was generally comparable and greater than that of piperacillin. Netilmicin was the most active of the aminoglycosides tested against members of the Enterobacteriaceae; however, aminoglycoside-resistant strains were encountered. Ceftazidime was the most active of the third generation cephalosporins against the non-fermenters (e.g. Pseudomonas and Acinetobacter spp), its inhibitory activity also being greater than that of piperacillin. Using a time-kill study, ceftazidime also demonstrated greater bactericidal activity than piperacillin against an isolate of Pseudomonas aeruginosa. The aminoglycoside demonstrating the greatest activity against the non-fermenters was tobramycin.

Anti-Bacterial Agents↗
PubMed1989

[Activity of cefpirome against bacteria isolated from hospitalized patients].

The activity of cefpirome (HR 810) was evaluated against 247 strains isolated from patients developing their infections while in a hospital in Buenos Aires. Its activity against Gram negative bacilli was compared with ceftriaxone, ceftazidime, cephalotin, piperacillin, amikacin, gentamicin and norfloxacin. In terms of MIC50 and MIC90 (mg/l) it was as follows: Klebsiella pneumoniae: less than 0.125, less than 2.0; Pseudomonas aeruginosa: less than 8, less than 16; Escherichia coli: less than 0.016, less than 0.063; Serratia marcescens: less than 0.063, less than 1.0; Enterobacter cloacae: less than 0.125, less than 1.0. Cefpirome was more active than the other cephalosporins against P. aeruginosa: at 16 mg/l, this drug inhibited 95% of strains versus 60% for ceftazidime and 32% for ceftriaxone. Activity of norfloxacine against Gram negative bacilli was similar to cefpirome, while piperacillin and the aminoglycosides were less active. Cefpirome was more active than cepahallotin against Streptococcus faecalis (2.0, 32) although less active than ampicillin, piperacillin, rifampicin and vancomycin. Against methicillin-susceptible Staphylococcus aureus (less than 0.25, less than 1.0) it was more active than cephalotin and the other drugs evaluated (piperacillin, erythromycin, chloranphenicol, aminogycosides). Like cephalotin, the activity of cefpirome against methicillin-resistant strains was variable (1.0, 32).

Anti-Bacterial Agents↗
PubMed1986

[Value of bactericidal curves in the optimal selection of a beta-lactam-aminoglycoside combination on Pseudomonas aeruginosa. In vitro study of 40 strains of Pseudomonas aeruginosa isolated in pediatric intensive care units].

Antimicrobial sensitivity and time-kill curves were determined for ticarcillin, azlocillin, piperacillin, cefsulodin, ceftazidime, gentamicin, tobramycin and amikacin alone or in combination against 40 strains of Pseudomonas aeruginosa isolated from blood cultures and tracheal aspirates in pediatric intensive care units. The antibiotics were used in concentrations obtainable with the usual therapeutic dosage. No bactericidal effect was observed with each of the beta-lactam antibiotics tested alone. For ticarcillin-sensitive strains the most rapid bacterial inoculum size decrease was observed at 2.5 h with the piperacillin-amikacin combination, and a bactericidal effect was obtained within 4.5 h when amikacin was combined with ticarcillin, azlocillin, piperacillin, ceftazidime or cefsulodin. For ticarcillin-resistant strains a bactericidal effect was obtained within 4.5 h when amikacin was combined with piperacillin, azlocillin, ceftazidime or cefsulodin.

Amikacin↗
PubMedDate not supplied

[Antibiotic sensitivity of anaerobic bacteria isolated during one year (1993)].

BACKGROUND: The aim of this study was to determine the antimicrobian susceptibility of the anaerobe bacteria isolated from clinical samples in the authors' department in 1993. METHODS: The minimum inhibitory concentrations of 10 antimicrobians were determined in microgram/ml for 129 anaerobe bacterias by the microdilution in broth method recommended by the NCCLS. RESULTS: All The strains were sensitive to chloramphenicol. Metronidazole inhibited all the isolates except A. meyeri and 50% of other non spored gram-positive bacilli. Imipenen and piperacillin-tazobactam were the most active beta lactamics, with only 1 B. fragilis being resistant to both. Clavulanic amoxycillin presented good activity with only 5% from the B. fragilis group, 1 F. mortiferum and 2 P. anaerobius being resistant. In the B. fragilis group 10% were resistant to cefoxitin and 15% to piperacillin. The remaining isolates were sensitive to both antimicrobians. Resistance to clindamycin in the B. fragilis group was 16.7%. There were also strains resistant to Peptostreptococcus, Prevotella and aerotolerant non spored gram-positive bacilli. Penicillin and amoxycillin were the least active antimicrobians. CONCLUSIONS: Chloramphenicol, metronidazole, imipenem, piperacillin-tazobactam and clavulanic amoxycillin were very effective and showed a wide spectrum of activity versus the strains studied. Cefoxitin, piperacillin and clindamycin maintain good antianaerobe activity.

Anti-Bacterial Agents↗
PubMed2004

Steady-state plasma and intrapulmonary concentrations of piperacillin/tazobactam 4 g/0.5 g administered to critically ill patients with severe nosocomial pneumonia.

OBJECTIVE: To determine the steady-state plasma and epithelial lining fluid (ELF) concentrations of piperacillin/tazobactam (P/T) administered to critically ill patients with severe bacterial pneumonia. DESIGN: Prospective, open-label study. SETTING: An intensive care unit and research ward in a university hospital. PATIENTS: Ten adult patients with severe nosocomial bacterial pneumonia on mechanical ventilation. INTERVENTIONS: All subjects received a 30-min intravenous infusion of P/T 4 g/0.5 g every 8 h. The steady-state plasma and ELF concentrations of P/T were determined by high-performance liquid chromatography. MEASUREMENTS AND MAIN RESULTS: The mean+/-SD steady-state plasma trough, peak, and intermediate concentrations were 8.5+/-4.6 microg/ml, 55.9+/-21.6 microg/ml, and 24.0+/-13.8 microg/ml for piperacillin, and 2.1+/-1.0 microg/ml, 4.8+/-2.1 microg/ml, and 2.4+/-1.2 microg/ml for tazobactam, respectively. The mean+/-SD steady-state intermediate ELF concentrations were 13.6+/-9.4 microg/ml for piperacillin and 2.1+/-1.1 microg/ml for tazobactam, respectively, showing a mean percentage penetration of piperacillin and tazobactam into ELF of 56.8% and 91.3 %, respectively, with a P/T ratio of 6.5:1. CONCLUSION: Our results show that during the treatment of severe nosocomial pneumonia, a regimen of P/T 4 g/0.5 g every 8 h might provide insufficient concentrations into lung tissue to exceed the MIC of many causative pathogens. This suggests that higher doses of P/T should be administered in order to maximize the antibiotic concentration at the site of infection, or that a second antimicrobial agent should be used in association.

Cross Infection↗
PubMed2001

Efficacy and tolerability of piperacillin/tazobactam versus ceftazidime in association with amikacin for treating nosocomial pneumonia in intensive care patients: a prospective randomized multicenter trial.

OBJECTIVE: To compare clinical and bacteriological efficacy as well as tolerability of two regimens of broad-spectrum antibiotics (ceftazidime versus piperacillin/tazobactam) combined with amikacin in the treatment of nosocomial pneumonia in intensive care patients. DESIGN: Open label, prospective, multicenter, and randomized phase III clinical trial. SETTING: Medical or surgical intensive care units (ICUs) of nine acute-care teaching hospitals in Spain. PATIENTS AND PARTICIPANTS: One hundred and twenty-four ICU patients with nosocomial pneumonia and requiring mechanical ventilation were included. They were randomized to receive amikacin (15 mg/day divided into two doses) combined with either piperacillin (4 g every 6 h) and tazobactam (0.5 g every 6 h) (n = 88) or ceftazidime (2 g every 8 h) (n = 36). MEASUREMENTS AND RESULTS: The causative pathogen was determined in 60.2% of patients in the group of amikacin plus piperacillin/tazobactam and in 76.9% in the group of amikacin plus ceftazidime. A total of 94 bacterial organisms were isolated among which gram-negative bacilli predominated, Pseudomonas aeruginosa being the most frequent. Clinical response at the end of antibiotic therapy was considered satisfactory (cure and/or improvement) in 63.9% of patients in the amikacin plus piperacillin/tazobactam group and in 61.5% in the amikacin plus ceftazidime (odds ratio 1.1; 95% confidence interval 0.44-2.75). Eradication or presumptive eradication rates for each pathogen and for either gram-negative or gram-positive bacteria were similar in both antibiotic combinations (odds ratio 1.2; 95% confidence interval 0.39-3.66). A total of 21 adverse effects (23.9%) occurred in the amikacin plus piperacillin and tazobactam group and six (16.7%) in the amikacin plus ceftazidime group, thrombocytosis, renal dysfunction, and hepatic cytolysis being the most common. The efficacy and tolerability of the two therapeutic regimens were similar not only in the whole study population, but also in the subset of P. aeruginosa-related pneumonia (odds ratio 1; 95% confidence interval 0.08-13.37). CONCLUSIONS: Amikacin associated with either ceftazidime or piperacillin and tazobactam has shown comparable efficacy and tolerability in the treatment of ICU patients with nosocomial pneumonia.

Aged↗
PubMed2005

Bowel colonization with resistant gram-negative bacilli after antimicrobial therapy of intra-abdominal infections: observations from two randomized comparative clinical trials of ertapenem therapy.

The selection of resistant gram-negative bacilli by broad-spectrum antibiotic use is a major issue in infection control. The aim of this comparative study was to assess the impact of different antimicrobial regimens commonly used to treat intra-abdominal infections on the susceptibility patterns of gram-negative bowel flora after completion of therapy. In two international randomized open-label trials with laboratory blinding, adults with complicated intra-abdominal infection requiring surgery received piperacillin-tazobactam (OASIS 1) or ceftriaxone/metronidazole (OASIS II) versus ertapenem for 4-14 days. Rectal swabs were obtained at baseline, end of therapy, and 2 weeks post-therapy. Escherichia coli and Klebsiella spp. were tested for production of extended-spectrum beta-lactamase (ESBL). Enterobacteriaceae resistant to the agent used were recovered from 19 of 156 (12.2%) piperacillin-tazobactam recipients at the end of therapy compared to 1 (0.6%) patient at baseline (p<0.001) in OASIS I, and from 33 of 193 (17.1%) ceftriaxone/metronidazole recipients at the end of therapy compared to 5 (2.6%) patients at baseline (p<0.001) in OASIS II. Ertapenem-resistant Enterobacteriaceae were recovered from 1 of 155 and 1 of 196 ertapenem recipients at the end of therapy versus 0 and 1 ertapenem recipients at baseline in OASIS I and II, respectively. Resistant Enterobacteriaceae emerged significantly less often during treatment with ertapenem than with the comparator in both OASIS I (p<0.001) and OASIS II (p<0.001). The prevalence of ESBL-producers increased significantly during therapy in OASIS II among 193 ceftriaxone/metronidazole recipients (from 4 [2.1%] to 18 [9.3%]) (p<0.001), whereas no ertapenem recipient was colonized with an ESBL-producer at the end of therapy in either study. Selection for imipenem-resistant Pseudomonas aeruginosa was uncommon in all treatment groups. In these studies, the frequency of bowel colonization with resistant Enterobacteriaceae substantially increased in patients treated with either piperacillin-tazobactam or ceftriaxone/metronidazole, but not in patients treated with ertapenem.

Adolescent↗
PubMed1998

In vitro activity of piperacillin/tazobactam versus other broad-spectrum antibiotics against nosocomial gram-negative pathogens isolated from burn patients.

Burn patients are at high risk for nosocomial infections due to multiresistant bacteria, a large proportion of which are gram-negative. Tazobactam, a potent inhibitor of beta-lactamases, extends the spectrum of piperacillin to include many beta-lactamase producing bacteria. Consequently, it was decided to evaluate the activity of piperacillin/tazobactam in comparison with that of eight other antibiotics that are usually used for therapy against gram-negative bacterial infections in our burn unit. All consecutive gram-negative isolates from wounds, blood, respiratory tract, urine etc. from burn patients considered to be clinically significant were tested for their susceptibility to piperacillin/tazobactam, piperacillin, ceftazidime, cefotaxime, ceftriaxone, ciprofloxacin, gentamicin, amikacin and imipenem, determined by disk diffusion test. The zone inhibition was interpreted according to NCCLS recommendations. A total of 948 strains, isolated during the period of July, 1994 to September, 1995, made up of Pseudomonas spp (326), Acinetobacter spp (268) and Enterobacteriaceae (354), were tested. Overall piperacillin/tazobactam showed superior activity over the other antibiotics except for imipenem. Of the 948 isolates, 87% were susceptible to the combination, 56% to the three third generation cephalosporins, 69% to ciprofloxacin, 59% to the aminoglycosides and 97% to imipenem. Piperacillin/tazobactam showed strikingly superior activity over piperacillin alone against Acinetobacter spp followed by Enterobacteriaceae and the least against Pseudomonas. The emergence of Acinetobacter spp as a dominant gram-negative pathogen in burn patients and its high level of resistance against most of the antibiotics tested except piperacillin/tazobactam (87%) and imipenem (100%) were significant in light of the epidemiology of burn infections and treatment. This study suggests that piperacillin/tazobactam holds good promise against gram-negative infections in burn patients.

Burns↗
PubMed2002

Penetration of piperacillin/tazobactam (4 g/500 mg) into synovial tissue.

The degree of penetration of an antibiotic into the infected site is an important criterion for therapeutic success. This is particularly true for bone and joint infections. The association of piperacillin and tazobactam has been widely used in the treatment of serious infections including bone infections, but no study has been devoted to the subject of its diffusion into synovial tissue. Our objective was to quantify piperacillin/tazobactam synovial tissue penetration and to estimate the efficacy of the association against the microorganisms usually encountered in joint infections. In an open-label study, 6 subjects with similar age, weight, height and creatinine clearance, who were undergoing elective total hip replacement, received a single, parenteral, 4 g/500 mg dose of piperacillin/tazobactam. Plasma and synovial tissue samples were collected and analyzed by a validated HPLC method. The mean concentrations of piperacillin and tazobactam 1.5 h after the initiation of infusion were 69.9 +/- 4.9 microg/mL and 7.7 +/- 0.3 microg/mL, respectively, in plasma and 37.1 +/- 2.1 microg/g and 2.8 +/- 0.4 microg/g, respectively, in synovial tissue. The synovial tissue/plasma ratios were 0.5 +/- 0.0 for piperacillin and 0.4 +/- 0.0 for tazobactam. The piperacillin/tazobactam ratios were 9.1:1 in plasma and 13.5:1 in synovial tissue. The concentrations achieved in synovial tissue are above the MICs of most of the susceptible pathogens usually involved in joint infections, which suggests that the piperacillin/tazobactam combination should be effective in the treatment of most joint infections caused by susceptible microorganisms.

Aged↗
PubMed2002

In vitro activity of ertapenem against common clinical isolates in relation to human pharmacokinetics.

The in vitro activity of ertapenem against bacterial pathogens isolated from patients with moderate to severe complicated intra-abdominal, complicated skin/skin structure, acute pelvic, or complicated urinary tract infection or community acquired pneumonia was compared to ceftriaxone and piperacillin-tazobactam and related to known plasma concentrations of the three agents. Ertapenem was more potent against methicillin-susceptible Staphylococcus aureus (MSSA) than ceftriaxone and piperacillin-tazobactam and was more potent and more active than both of these agents against Enterobacteriaceae and anaerobes. Piperacillin-tazobactam was the most active agent against enterococci and Pseudomonas aeruginosa. All isolates of Enterobacteriaceae (n=1088), Streptococcus pyogenes (n=37), Streptococcus agalactiae (n=48), MSSA (n=187), Haemophilus influenzae (n=59), and Moraxella catarrhalis (n=9) were susceptible to ertapenem; < 1% of 1284 anaerobes and only 1 of 113 Streptococcus pneumoniae (a penicillin-resistant isolate) were resistant to ertapenem. The MIC value at which 90% of all Enterobacteriaceae, streptococci, MSSA, H. influenzae, M. catarrhalis, and anaerobes were inhibited (MIC90) was < or = 1 microg/ml and below the mean plasma concentration of total ertapenem following a 1 g intravenous infusion for at least 24 hours, i.e., the entire recommended dosing interval, and below the free drug concentration for at least 8 h.

Anti-Bacterial Agents↗
PubMed2006

Antibiotic prophylaxis in hernia repair and breast surgery: a prospective randomized study comparing piperacillin/tazobactam versus placebo.

Although antibiotic prophylaxis is not explicitly indicated for hernia repair and breast surgery, its use for these clean procedures is widely adopted, albeit to a different extent in different countries, often on the personal decision of the individual surgeon. The present study was carried out to compare the efficacy of a single pre-operative dose of piperacillin-tazobactam with placebo in preventing surgical wound infections and to determine the main risk factors associated with infections following two main elective surgical clean procedures such as hernia repair and breast surgery.A total of 501 patients undergoing elective inguinal/femoral hernia repair or breast surgery were enrolled in this prospective randomized clinical study. Patients were randomly assigned to receive preoperative antibiotic prophylaxis or placebo. One dose of piperacillin-tazobactam 2.250 g or placebo was administered i.v. 30 minutes prior to the surgical procedure. Using statistical univariate analysis, the following variables were correlated with a higher infection risk: age >40 years, concomitant disease, WBC <3500, surgical wound size >9cm, use of drainages, non-prophylaxis. Using multivariate analysis, no antibiotic pre-operative prophylaxis, concurrent chronic diseases, especially diabetes (risk 15 times higher), and length of intervention >45 min (risk 6 times higher) were independent predictors of infection. Finally, patients with postoperative infections had a significantly longer hospitalisation. One pre-operative dose of piperacillin-tazobactam 2.250 g is more effective than placebo in preventing postoperative infections in breast surgery and hernia repair.

Age Factors↗
PubMedDate not supplied

[Antimicrobial susceptibility of phenotypically extended spectrum beta-lactamase producing Pseudomonas aeruginosa and Acinetobacter baumannii isolates].

The aim of this study was to investigate the antimicrobial susceptibilities of Pseudomonas aeruginosa and Acinetobacter baumannii strains that were identified as producers of extended spectrum beta-lactamases (ESBL) phenotypically. Fifty three P. aeruginosa and 53 A. baumannii strains that were isolated from patients with hospital infections followed-up by Infectious Diseases Unit of Hacettepe University Adult Hospital in 2002-2004, were included in the study. The susceptibilities of the isolates to ceftazidime, cefotaxime, cefepime, tobramycin, ciprofloxacin, piperacillin-tazobactam, imipenem and meropenem were determined by Etest (AB Biodisk, Solna, Sweden) method. The susceptibility rates of A. baumannii isolates against tobramycin and carbapenem group were 54.7% and 49.1%, respectively; whereas for the rest of the antimicrobial agents tested, these rates were lower than 25 percent. The susceptibility rates of P. aeruginosa isolates against ciprofloxacin, carbapenem group, piperacillin-tazobactam and tobramycin differed between 35-38 percent. Of the P. aeruginosa isolates, 37.5%, and of the A. baumannii isolates 37.7% were resistant against imipenem/meropenem, piperacillin-tazobactam, ciprofloxacin and tobramycin simultaneously. As a result, phenotypically ESBL producing P. aeruginosa and A. baumannii isolates were found highly resistant not only against the third and fourth generation cephalosporins, but also to the antibiotics currently used in the therapy including carbapenemes.

Acinetobacter baumannii↗
PubMedDate not supplied

Neonatal sepsis in an intensive care unit and results of treatment.

Incidence and fatality of neonatal sepsis in intensive care units have been relatively high despite progress in the management of very ill neonates and combined treatment of sepsis with antibiotics. Between 1985 and 1989 944 children (632 premature babies and 312 term babies) were treated in the intensive care unit of the University Children's Hospital of Kiel. The incidence of sepsis was 5% (congenital sepsis 4%, sepsis acquired after birth 1%). Pneumonia occurred in 4% (congenital pneumonia in 2%, postnatal pneumonia in 2%). Early diagnosis and treatment with piperacillin plus cefotaxime reduced the mortality rate of sepsis to 2%. Sepsis never developed under treatment with piperacillin plus cefotaxime. Early recognition of neonatal sepsis by a good blood culture technique and beginning of treatment on first suspicion of sepsis with cefotaxime and piperacillin can improve the results especially in intensive care patients.

Cefotaxime↗