The injectable agent daptomycin, when prescribed according to approved guidelines, can be a welcome option for treating some multiresistant, gram-positive infections that have become increasingly prevalent.
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Therapeutic drug monitoring versus Bayesian AUC-based dosing for vancomycin in routine practice: a cost-benefit analysis.
J Antimicrob Chemother
January 2025
Pharmacy Department, Ghent University Hospital, Corneel Heymanslaan 10, 9000 Ghent, Belgium.
Background: AUC-based dosing with validated Bayesian software is recommended as a good approach to guide bedside vancomycin dosing.
Objectives: To compare treatment and vancomycin-associated acute kidney injury (AKI) costs between Bayesian AUC-based dosing and conventional therapeutic drug monitoring (TDM) using steady-state plasma concentrations of vancomycin administered as continuous infusion in hospitalized non-critically ill patients with severe Gram-positive infection.
Methods: A cost-benefit analysis presented as a return on investment (ROI) analysis from a hospital perspective was conducted using a decision tree model (TDM versus AUC-based dosing) to simulate treatment cost (personnel, serum sampling and drug cost), vancomycin-associated AKI risk and cost up to 14 days.
A Rare Case of Infective Endocarditis Caused by .
J Community Hosp Intern Med Perspect
January 2025
Department of Cardiology, Long Island Community Hospital, United States.
is an alpha-hemolytic gram-positive catalase-negative coccus that typically causes urinary tract infections. It has been rarely implicated in other invasive infections such as endocarditis, bacteremia, peritonitis, meningitis, and vertebral osteomyelitis. There are approximately 50 reported cases of infective endocarditis in literature.
View Article and Find Full Text PDF: An Unlikely Device-related Infection.
J Community Hosp Intern Med Perspect
January 2025
Department of Medicine, West Virginia University, House Staff 4Floor HSC-N Morgantown, PO Box 9168, Morgantown, WV, USA.
Implantable cardiac devices, including cardiac pacemakers, are not without risk for infection, carrying a mortality and morbidity of around 5-15%. Gram positive organisms are most common in 91% of cases, whereas gram negative organisms are less common, found in 2% of cases secondary to gram negative organisms other than . Here, we present a rare case of the gram-negative organism leading to a pacemaker site infection.
View Article and Find Full Text PDFPoor Outcome of Rare Lactobacillus Bacteremia and Endocarditis in a Patient With Frequent Consumption of Live Culture Yogurts.
J Community Hosp Intern Med Perspect
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Division of Infectious Disease, Department of Internal Medicine, Naples Comprehensive Health, Naples, FL, USA.
is a gram-positive bacterium commonly found in dairy products and used as a probiotic due to its resistance to acid and bile. While generally considered safe, rare cases of bacteremia and endocarditis have been reported, primarily in individuals with significant risk factors. This report discusses an elderly male with a history of cardiovascular diseases, diabetes, and asthma, who developed bacteremia and endocarditis after consuming large quantities of Greek yogurt.
View Article and Find Full Text PDFEffects of polymyxin B haemoperfusion on septic shock caused by Gram-positive bacteria.
Anaesth Intensive Care
January 2025
Department of Intensive Care Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan.
Polymyxin B haemoperfusion is commonly used to adsorb endotoxins in septic shock caused by Gram-negative bacterial infections. Polymyxin B haemoperfusion has been reported to improve hypotension in Gram-positive bacterial infections; however, its efficacy and mechanism in treating such cases are unclear. We hypothesised that polymyxin B haemoperfusion would be equally effective in improving haemodynamics during Gram-positive bacterial infections as in Gram-negative bacterial infections.
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