Effect of colistin combined with sulbactam: 9 g versus 12 g per day on mortality in the treatment of carbapenems resistant Acinetobacter baumannii pneumonia: A randomized controlled trial.

Background: The current treatment recommendation involves administering a high dose of sulbactam alongside at least one additional agent. However, there remains a lack of data regarding the optimal dosage of sulbactam. We investigated whether administering sulbactam at a dosage of 12 g/day decreases the mortality rate among patients with CRAB pneumonia compared to 9 g/day.

Impact of Inappropriate Empirical Antibiotic on Outcomes in Community-acquired Third Generation Cephalosporin Resistant Bacteremia.

Background: Currently, third generation cephalosporin resistant (3GCRE) are becoming more common in community-acquired infection, leading to increasing consumption of carbapenems. Because community-acquired 3GCRE infections are generally less severe and of lower pathogenicity, the impact of inappropriate empirical antibiotics among patients with community-acquired 3GCRE bacteremia remains unknown.

Materials And Methods: This prospective cohort study included adult patients with 3GCRE bacteremia from April 2018 to December 2021.

Clinical Impact of Vancomycin Treatment in Ampicillin-Susceptible Enterococci Bloodstream Infections.

Enterococci are major causes of bacteremia. Although the mortality rate of ampicillin- susceptible enterococci (ASE) bloodstream infections (BSI) is lower, compared with that of ampicillin-resistant enterococci BSI, the role of treatment regimens in ASE BSI remains to be determined. This retrospective study aimed to evaluate the treatment outcomes and factors associated with mortality among patients with ASE BSI.

A Randomized Controlled Trial of Colistin Combined with Sulbactam: 9 g per Day versus 12 g per Day in the Treatment of Extensively Drug-Resistant Pneumonia: An Interim Analysis.

Extensively drug-resistant (XDRAB) pneumonia has a high mortality rate in hospitalized patients. One of the recommended treatments is colistin combined with sulbactam; however, the optimal dosage of sulbactam is unclear. In an open-label, superiority, randomized controlled trial, patients diagnosed with XDRAB pneumonia were randomly assigned (1:1) to receive colistin in combination with sulbactam at either 9 g/day or 12 g/day.

Correction: Nulsopapon et al. The Synergistic Activity and Optimizing Doses of Tigecycline in Combination with Aminoglycosides against Clinical Carbapenem-Resistant Isolates. 2021, , 736.

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Vibrio vulnificus Necrotizing Fasciitis in Upper Limbs and Septicemia Following Pinch Injury by Mud Crab: A Case Report.

necrotizing fasciitis is a rare emergency and has a high mortality rate condition occurring among patients with cirrhosis, iron overload states, chronic renal failure, malignancy, HIV, or immunosuppressive medications. Here, we report a case of nonfoodborne infection caused by presenting as bilateral necrotizing fasciitis on the hands and lower arms after a pinch injury by a mud crab in a 64-year-old man with hypertension presenting with acute fever, bilateral hand swelling, and pain. The patient was treated with emergency fasciotomy and intravenous antibiotics.

Optimizing Doses of Ceftolozane/Tazobactam as Monotherapy or in Combination with Amikacin to Treat Carbapenem-Resistant .

Carbapenem-resistant Pseudomonas aeruginosa (CRPA) is a hospital-acquired pathogen with a high mortality rate and limited treatment options. We investigated the activity of ceftolozane/tazobactam (C/T) and its synergistic effects with amikacin to extend the range of optimal therapeutic choices with appropriate doses. The E-test method is used to determine in vitro activity.

Rare manifestation of ocular immune reconstitution inflammatory syndrome from infection in a patient with AIDS.

Immune reconstitution inflammatory syndrome (IRIS) is a common complication following the initiation of antiretroviral therapy (ART). The most commonly associated pathogens include Mycobacterium tuberculosis and Cryptococcus spp. IRIS following nontuberculosis mycobacteria (NTM) infection is uncommon, particularly, IRIS following NTM conjunctivitis.

Colistin plus Sulbactam or Fosfomycin against Carbapenem-Resistant : Improved Efficacy or Decreased Risk of Nephrotoxicity?

Background: has been recognized as a cause of nosocomial infection. To date, polymyxins, the last-resort therapeutic agents for carbapenem-resistant (CRAB). Thus, the small number of effective antibiotic options against CRAB represents a challenge to human health.

Optimization of Linezolid Dosing Regimens for Treatment of Vancomycin-Resistant Enterococci Infection.

Background: Linezolid, an oxazolidinone antibiotic, is recommended for vancomycin-resistant enterococci (VRE). However, 100% free-drug concentration above the minimum inhibitory concentration (T>MIC) and an area under the curve of free drug to MIC ratio (AUC24/MIC) >100 were associated with favorable clinical outcome with less emerging resistance. A plasma trough concentration (C) of linezolid ≥9 μg/mL was also related to hematologic toxicity.

The Potential Use of Ceftazidime-Avibactam Against Carbapenem Resistant Clinical Isolates Harboring Different Carbapenemase Types in a Thai University Hospital.

Purpose: MBL and OXA-48 genes in carbapenem-resistant Enterobacterales (CRE) have emerged as a major public health problem worldwide, including Thailand. Due to the lack of susceptibility data and dosing regimens of ceftazidime-avibactam (CZA) against CRE in Thailand, especially in colistin-resistant era, we aimed to demonstrate in vitro susceptibility data of CZA and optimal dose based on Monte Carlo simulation of CZA to expand the treatment options.

Patients And Methods: We collected 49 carbapenem-resistant (CRKP) clinical isolates from unique patients at Phramongkutklao Hospital (June-October 2020).

The Synergistic Activity and Optimizing Doses of Tigecycline in Combination with Aminoglycosides against Clinical Carbapenem-Resistant Isolates.

Carbapenem-resistant Enterobacteriaceae (CRE), especially carbapenem-resistant (CRKP), are among the largest pathogenic threats to humans. The available antibiotic treatment options for combating CRKP are limited. Colistin-resistant Enterobacteriaceae (CoRE) have also been reported worldwide, including in Thailand.

First-Line Antiretroviral Regimen Failure and Determinants in an Urban HIV Clinic at Phramongkutklao Hospital, Bangkok, Thailand: 20 Years Experience.

Purpose: HIV treatment involves antiretroviral therapy (ART) endeavoring to suppress viral load to an undetectable level. Virologic failure occurs when ART fails to suppress and sustain an individual's viral load to less than 200 copies/mL after 6 months of therapy. In Thailand, the data among first-line antiretroviral regimen failure and determinants remains limited, especially in urban HIV clinics.

Clinical manifestations and prognostic factors for Streptococcus agalactiae bacteremia among nonpregnant adults in Thailand.

Background: Streptococcus agalactiae infection in nonpregnant adults is an emerging disease with increasing burden. This study described epidemiologic, clinical characteristics, and treatment options among patients with S. agalactiae bacteremia, and determined the factors associated with mortality.

Does Vancomycin Resistance Increase Mortality? Clinical Outcomes and Predictive Factors for Mortality in Patients with Infections.

The prevalence of enterococcal infection, especially is increasing, and the issue of the impact of vancomycin resistance on clinical outcomes is controversial. This study aimed to investigate the clinical outcomes of infection caused by and determine the risk factors associated with mortality. This retrospective study was performed at the Phramongkutklao Hospital during the period from 2014 to 2018.

Low serum potassium among patients with COVID-19 in Bangkok, Thailand: Coincidence or clinically relevant?

Our cross-sectional study estimated the prevalence and clinical relevance of hypokalaemia among confirmed COVID-19 cases admitted in three hospitals in Bangkok during the early outbreak in Thailand. Of 36 patients, nine were in the hypokalaemia group (25%) and 27 in the normokalaemia group (75%). All cases were asymptomatic, and 94.

Vancomycin Area under the Curve and Pharmacokinetic Parameters during the First 24 Hours of Treatment in Critically Ill Patients using Bayesian Forecasting.

Background: Currently, the achievement of the target area under the curve (AUC)/minimum inhibitory concentration ratio during the first 24 - 48 h of treatment is associated with reduced 30-day mortality and greater microbiological eradication in patients with methicillin-resistant bacteremia. This study aimed to determine the AUC and pharmacokinetic parameters on the first day of vancomycin administration based on the Bayesian theorem to optimize the dosing regimen in critically ill patients.

Materials And Methods: This retrospective study included participants meeting the following criteria: 1) ≥18 years old; 2) receipt of at least one dose of vancomycin; 3) measurement of 2 vancomycin serum concentrations during the first 24 h of treatment; and 4) an intensive care unit admission, mechanical ventilator use, or an Acute Physiology and Chronic Health Evaluation II score >15 points.

Is Early Monitoring Better? Impact of Early Vancomycin Exposure on Treatment Outcomes and Nephrotoxicity in Patients with Methicillin-Resistant Infections.

Optimal early vancomycin target exposure remains controversial. To clarify the therapeutic exposure range, we investigated the association between vancomycin exposure and treatment outcomes or nephrotoxicity in patients with methicillin-resistant (MRSA) infection. This retrospective study reviewed clinical data obtained from 131 patients with MRSA infections between January 2017 and September 2019.

Optimizing the Dosing Regimens of Tigecycline against Vancomycin-Resistant Enterococci in the Treatment of Intra-abdominal and Skin and Soft Tissue Infections.

Tigecycline was previously considered to have activity against vancomycin-resistant (VRE) isolates, but the optimal dose was not clarified. Thus, this study assessed the activity of tigecycline against clinical VRE isolates to determine its optimal regimens for complicated intra-abdominal (cIAIs) and complicated skin/soft tissue infections (cSSTIs). We used Monte Carlo simulation to calculate the probability of target attainment (PTA) and the cumulative fraction of response for the ratio of the free area under the curve to the minimum inhibitory concentration (MIC) (AUIC), which were 17.

Is Echocardiography Mandatory for All Subsp. Bacteremia?

Background: , formerly known as one of the group, is frequently associated with endocarditis. Current guidelines recommended diagnostic work-up for endocarditis among patients with bacteremia. However, subsp.

Optimizing the Dosing Regimens of Daptomycin Based on the Susceptible Dose-Dependent Breakpoint against Vancomycin-Resistant Enterococci Infection.

Daptomycin, a lipopeptide antibiotic, is one of the therapeutic options used for the treatment of vancomycin-resistant enterococci (VRE). Recently, the Clinical and Laboratory Standards Institute (CLSI) M100 30th edition has removed the susceptibility (S) breakpoint for and replaced it with a susceptible dose-dependent (SDD) breakpoint of ≤4 μg/mL, with a suggested dosage of 8-12 mg/kg/day. Herein, we aimed to determine the minimum inhibitory concentration (MIC) values of daptomycin against clinical VRE isolates and to study the appropriate daptomycin dosing regimens among critically ill patients based on the new susceptibility CLSI breakpoint.

Clinical Outcomes Of Colistin In Combination With Either 6-G Sulbactam Or Carbapenems For The Treatment Of Extensively Drug-Resistant Pneumonia With High MIC To Sulbactam, A Prospective Cohort Study.

Purpose: Extensively drug-resistant (XDRAB) is an important cause of nosocomial pneumonia with limited therapeutic options. Colistin-based regimen is the recommended treatment. Which drugs should be combined with colistin remains uncertain.

Vancomycin-resistant enterococcal infection in a Thai university hospital: clinical characteristics, treatment outcomes, and synergistic effect.

Purpose: The incidence of infections with vancomycin-resistant enterococci (VRE) is increasing, with associated high mortality rates and limited therapeutic choices. We investigated the clinical characteristics and treatment outcomes of VRE infection and also determined the in vitro effect of monotherapy and combined antimicrobials against clinical VRE isolates.

Patients And Methods: Clinical data and bacterial isolates obtained from patients with VRE infections between January 2014 and April 2018 at Phramongkutklao Hospital were reviewed.

Effect of standard dose paracetamol versus placebo as antipyretic therapy on liver injury in adult dengue infection: a multicentre randomised controlled trial.

Background: Dengue is a common cause of acute liver failure in tropical countries. Paracetamol is the recommended antipyretic for dengue. Related observational studies in dengue have suggested that excessive paracetamol intake is related to hepatic injury.

Disseminated Phaeohyphomycosis Caused by Curvularia tuberculata in a Previously Healthy Man.

Disseminated phaeohyphomycosis is an extremely rare clinical syndrome, especially in a host without apparent immunological defect. Here, we report a case of disseminated phaeohyphomycosis in a 22-year-old previously healthy man who showed nonmassive hemoptysis from diffuse lung nodules and cavities, together with a hard palate ulcer and generalized subcutaneous nodules. Histopathology, cultures and subsequent molecular assay from two different sites confirmed Curvularia tuberculata infection.