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Métodos Terapêuticos e Terapias MTCI
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1.
Anaerobe ; 69: 102363, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33819627

RESUMO

Bacteroides fluxus is a Gram-negative anaerobic bacillus isolated from human faeces in healthy individuals. Until now, this bacterium had not been involved in human diseases. We report the first case of abdominal infection due to this microorganism in an elderly patient. A 76-year-old man with a history of chronic pulmonary obstructive disease presented with dyspnea, orthopnea and cough. The clinical evolution worsened with both a colonic ischemia and further diffuse peritonitis of pancreatic origin. Peritoneal fluid was obtained and the culture yielded B. fluxus in pure culture. Resistance to penicillin, amoxicillin-clavulanate, clindamycin and moxifloxacin was documented. Treatment with meropenem + linezolid was started, but the patient finally died due to a multiorganic failure.


Assuntos
Antibacterianos/uso terapêutico , Infecções por Bacteroides/tratamento farmacológico , Infecções por Bacteroides/mortalidade , Bacteroides/efeitos dos fármacos , Infecções Intra-Abdominais/tratamento farmacológico , Infecções Intra-Abdominais/mortalidade , Linezolida/uso terapêutico , Meropeném/uso terapêutico , Idoso , Evolução Fatal , Humanos , Masculino , Testes de Sensibilidade Microbiana
2.
Int J Antimicrob Agents ; 44(1): 1-7, 2014 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-24602499

RESUMO

Here we review the effectiveness and safety of high-dose tigecycline (200mg daily). A systematic search was performed in PubMed and Scopus databases as well as of abstracts presented at scientific conferences. Eight studies (263 patients; 58% critically ill) were included, comprising one randomised controlled trial (RCT), four non-randomised cohorts and three case reports. Klebsiella pneumoniae was the most commonly isolated pathogen (reported in seven studies). In the RCT, response in the clinically evaluable patients was 85.0% (17/20) in the 100mg every 12h (q12h) group and 69.6% (16/23) in the 75mg q12h group (P=0.4). More episodes of diarrhoea, treatment-related nausea and vomiting developed in the high-dose group (14.3% vs. 2.8%, 8.6% vs. 2.8% and 5.7% vs. 2.8%, respectively; P>0.05 for all comparisons). Three (8.6%) and 7 (19.6%) patients died in the 200mg and 150mg daily dose groups, respectively. The cohort studies enrolled patients with severe infections, including ventilator-associated pneumonia and complicated intra-abdominal infections. Mortality with high-dose tigecycline (100mg q12h) in the cohort studies ranged from 8.3% to 26%; mortality in the low-dose groups (50mg q12h) ranged from 8% to 61% and depended on the severity of the underlying infection. There are limited available data regarding the effectiveness and safety of high-dose tigecycline. Most of the data come from critically ill patients with difficult-to-treat infections. Pharmacokinetic/pharmacodynamic properties of tigecycline suggest that high-dose regimens may be more effective than low-dose regimens. Candidates for administration of high-dose tigecycline should be also defined.


Assuntos
Antibacterianos/uso terapêutico , Infecções Intra-Abdominais/tratamento farmacológico , Infecções por Klebsiella/tratamento farmacológico , Minociclina/análogos & derivados , Pneumonia Associada à Ventilação Mecânica/tratamento farmacológico , Adulto , Idoso , Antibacterianos/efeitos adversos , Antibacterianos/farmacocinética , Estado Terminal , Esquema de Medicação , Feminino , Humanos , Infecções Intra-Abdominais/microbiologia , Infecções Intra-Abdominais/mortalidade , Infecções Intra-Abdominais/patologia , Infecções por Klebsiella/microbiologia , Infecções por Klebsiella/mortalidade , Infecções por Klebsiella/patologia , Klebsiella pneumoniae/efeitos dos fármacos , Klebsiella pneumoniae/crescimento & desenvolvimento , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Minociclina/efeitos adversos , Minociclina/farmacocinética , Minociclina/uso terapêutico , Pneumonia Associada à Ventilação Mecânica/microbiologia , Pneumonia Associada à Ventilação Mecânica/mortalidade , Pneumonia Associada à Ventilação Mecânica/patologia , Análise de Sobrevida , Tigeciclina , Resultado do Tratamento
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