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Retrospective Analysis of Ceftriaxone 1 Gram or 2 Grams for Bacteremia.

J Pharm Pract

January 2025

Emergency Medicine, Department of Pharmacy, Long Island Jewish Valley Stream, Valley Stream, NY, USA.

Ceftriaxone is a third-generation cephalosporin commonly used for treating bacteremia caused by gram-positive organisms such as and gram-negative organisms such as Enterobacterales. The typical doses for treating bacteremia are either 1 gram or 2 grams daily. Despite its widespread use, there are limited data on the optimal treatment dose for bacteremia.

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Background/objectives: is the third most common sexually transmitted infection (STI), which may become untreatable soon if resistance continues to drastically increase. Due to increases in resistance to recommended antibiotics, alternative sources of novel compounds to combat this threat are being explored. Interestingly, marine sponges have proven to produce a plethora of bioactive compounds that display anticancer, antiviral, antifungal, and antibacterial activity.

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β-Lactams are the most widely used antibiotics for the treatment of bacterial infections because of their proven track record of safety and efficacy. However, susceptibility to β-lactam antibiotics is continually eroded by resistance mechanisms. Emerging multidrug-resistant (MDR) strains possessing altered alleles (encoding PBP2) pose a global health emergency as they threaten the utility of ceftriaxone, the last remaining outpatient antibiotic.

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Article Synopsis
  • A six-month-old girl showed signs of feeding intolerance, fever, and leg swelling, leading to the discovery of multiple fractures, which raised suspicions of non-accidental trauma.
  • Blood tests indicated an infection with a ceftriaxone-resistant bacteria, requiring a 10-day antibiotic treatment.
  • The case emphasizes the need for careful assessment of potential abuse in infants who have unexplained fractures and infections.
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Importance: The results of prediction models that stratify patients with sepsis and risk of resistant gram-negative bacilli (GNB) infections inform treatment guidelines. However, these models do not extrapolate well across hospitals.

Objective: To assess whether patient case mix and local prevalence rates of resistance contributed to the variable performance of a general risk stratification GNB sepsis model for community-onset and hospital-onset sepsis across hospitals.

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