AI Article Synopsis
- The study investigates the effectiveness of various antibiotics against a multidrug-resistant Gram-negative bacillus in critically ill patients, using a pharmacokinetic/pharmacodynamic (PK/PD) framework.
- Antibiotics evaluated included cotrimoxazole, levofloxacin, minocycline, tigecycline, cefiderocol, and a new combination of aztreonam/avibactam, with Monte Carlo simulations used to assess treatment probabilities and outcomes.
- Findings suggested that cefiderocol, minocycline, tigecycline, and aztreonam/avibactam were promising treatments, but revealed inconsistencies between established PK/PD breakpoints and clinical guidelines, especially depending on isolation location.
Article Abstract
is an opportunistic, multidrug-resistant non-fermentative Gram-negative bacillus, posing a significant challenge in clinical treatment due to its numerous intrinsic and acquired resistance mechanisms. This study aimed to evaluate the adequacy of antibiotics used for the treatment of infections in critically ill patients using a pharmacokinetic/pharmacodynamic (PK/PD) approach. The antibiotics studied included cotrimoxazole, levofloxacin, minocycline, tigecycline, cefiderocol, and the new combination aztreonam/avibactam, which is not yet approved. By Monte Carlo simulations, the probability of target attainment (PTA), the PK/PD breakpoints, and the cumulative fraction of response (CFR) were estimated. PK parameters and MIC distributions were sourced from the literature, the European Committee on Antimicrobial Susceptibility Testing (EUCAST), and the SENTRY Antimicrobial Surveillance Program collection. Cefiderocol 2 g q8h, minocycline 200 mg q12h, tigecycline 100 mg q12h, and aztreonam/avibactam 1500/500 mg q6h were the best options to treat empirically infections due to . Cotrimoxazole provided a higher probability of treatment success for the U.S. isolates than for European isolates. For all antibiotics, discrepancies between the PK/PD breakpoints and the clinical breakpoints defined by EUCAST (or the ECOFF) and CLSI were detected.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11201243 | PMC |
| http://dx.doi.org/10.3390/antibiotics13060553 | DOI Listing |
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