Clin Microbiol Infect
December 2024
Objectives: In this large retrospective cohort analysis, we aimed to determine the incidence of KDIGO-defined acute kidney injury (AKI) within 14 days in patients with Staphylococcus aureus bacteraemia, and the association of AKI with 30-day mortality.
Methods: A retrospective cohort study of adults with S. aureus bacteraemia between 1998 to 2023 admitted to a large regional Australian health service.
Penicillin allergy is a significant burden on patient, prescribing and hospital outcomes. There has been increasing interest in the incorporation of penicillin allergy testing (i.e.
View Article and Find Full Text PDFBackground: Severe cutaneous adverse reactions (SCAR) are a group of delayed presumed T-cell mediated hypersensitivities associated with significant morbidity and mortality. Despite their shared global healthcare burden and impact, the clinical phenotypes, genomic predisposition, drug causality, and treatment outcomes may vary. We describe the establishment and results from the first Australasian registry for SCAR (AUS-SCAR), that via a collaborative network advances strategies for the prevention, diagnosis and treatment of SCAR.
View Article and Find Full Text PDFNephrology (Carlton)
February 2024
Accurate detection of acute kidney injury (AKI) in clinical trials is important. Using a 'baseline' creatinine from trial enrolment may not be ideal for understanding a participant's true baseline kidney function. We aimed to determine if a 'pre-trial baseline creatinine' resulted in comparable creatinine concentrations to a 'trial baseline creatinine', and how the timing of baseline creatinine affected the incidence of AKI in the Combination Antibiotic therapy for MEthicillin Resistant Staphylococcus aureus (CAMERA2) randomised trial.
View Article and Find Full Text PDFCurr Opin Crit Care
October 2023
Purpose Of Review: Staphylococcus aureus is a significant human pathogen, causing a variety of infections, from skin and soft tissue infections to endocarditis, bone and joint infections and deep tissue abscesses. Mortality from S. aureus bacteraemia remains high, without major therapeutic advances in recent decades.
View Article and Find Full Text PDFBackground: The Combination Antibiotic Therapy for Methicillin-Resistant (CAMERA2) trial ceased recruitment in July 2018, noting that a higher proportion of patients in the intervention arm (combination therapy) developed acute kidney injury (AKI) compared to the standard therapy (monotherapy) arm. We analyzed the long-term outcomes of participants in CAMERA2 to understand the impact of combination antibiotic therapy and AKI.
Methods: Trial sites obtained additional follow-up data.
Beta-lactams are an important family of antibiotics used to treat infections and are commonly used in critically ill patients. Optimal use of these drugs in the intensive care unit (ICU) is important because of the serious complications from sepsis. Target beta-lactam antibiotic exposures may be chosen using fundamental principles of beta-lactam activity derived from pre-clinical and clinical studies, although the debate regarding optimal beta-lactam exposure targets is ongoing.
View Article and Find Full Text PDFJ Pediatric Infect Dis Soc
April 2023
This retrospective analysis describes the administration of sotrovimab in 32 children (22 aged 12-16 years old; 10 aged 1-11 years old) who were at high risk of deterioration to severe COVID-19 disease. We provide dosing suggestions and demonstrate the feasibility of sotrovimab use in the younger pediatric population (<12 years old and <40 kg).
View Article and Find Full Text PDFBackground: Clinical risk factors for nephrotoxicity in Staphylococcus aureus bacteraemia remain largely undetermined, despite its common occurrence and clinical significance. In an international, multicentre, prospective clinical trial (CAMERA2), which compared standard therapy (vancomycin monotherapy) to combination therapy (adding an anti-staphylococcal beta-lactam) for methicillin-resistant S. aureus bacteraemia, significantly more people in the combination therapy arm experienced acute kidney injury compared with those in the monotherapy arm (23% vs 6%).
View Article and Find Full Text PDFPurpose: Traditionally meropenem has been considered too unstable in solution for continuous infusion. However, in the era of increasing antimicrobial resistance, use of meropenem is becoming more frequently required, and the ability to facilitate its administration via community-based programs would be beneficial. There are some reassuring data about meropenem stability in solution, but data about actual drug exposure in patients and subsequent clinical outcomes are lacking.
View Article and Find Full Text PDFThe use of ampicillin in the outpatient setting has traditionally been avoided because of the short half-life and instability in solution of this drug. However, recent in vitro data and two case series support the safe and effective administration of ampicillin by continuous infusion in the community. Therapeutic drug monitoring (TDM) of beta-lactam antibiotics can be used to optimise antibiotic exposure and ensure adequate clinical responses.
View Article and Find Full Text PDFSoil-transmitted helminths (STHs), are recognised neglected tropical diseases and have been endemic in patients in tropical Northern Australia. We reviewed the temporal trends in detections of STHs and Hymenolepis nana in faecal samples from Northern Territory (NT) Government Health facilities, representing patients with acute illnesses and comorbidities between 2008 and 2018. Ascaris lumbricoides is not detected in patients in the NT.
View Article and Find Full Text PDF