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101. Macrolide and Tetracycline Resistance in Clinical Strains of Streptococcus agalactiae Isolated in Tunisia. Full Text available with Trip Pro

to macrolide and tetracycline. All strains were susceptible to penicillin, ampicillin and quinupristin-dalfopristin. They were resistant to chloramphenicol (3.1%), rifampicin (19.1%), erythromycin (40%) and tetracycline (97.3%); 3.1% were highly resistant to streptomycin and 1.3% to gentamicin. Among the erythromycin-resistant isolates, 78.7% showed a constitutive macrolide-lincosamide-streptogramin B (MLS(B)) phenotype with high-level resistance to macrolides and clindamycin (MIC(50) >256 µg ml(-1)), 10 (...) % showed an inducible MLS(B) phenotype with high MICs of macrolides (MIC(50) >256 µg ml(-1)) and low MICs of clindamycin (MIC(50)=8 µg ml(-1)) and 2.2% showed an M phenotype with a low erythromycin-resistance level (MIC range=12-32 µg ml(-1)) and low MICs of clindamycin (MIC range: 0.75-1 µg ml(-1)). All strains were susceptible to quinupristin-dalfopristin and linezolid (MIC(90): 0.75 µg ml(-1) for each). MLS(B) phenotypes were genotypically confirmed by the presence of the erm(B) gene and the M

2012 Journal of Medical Microbiology

102. Wild birds as biological indicators of environmental pollution: antimicrobial resistance patterns of Escherichia coli and enterococci isolated from common buzzards (Buteo buteo). Full Text available with Trip Pro

. The vat(D) and/or vat(E) genes were found in nine of the 17 quinupristin-dalfopristin-resistant isolates. The enterococcal isolates showing high-level resistance for kanamycin, gentamicin and streptomycin contained the aph(3')-IIIa, aac(6')-aph(2″) and ant(6)-Ia genes, respectively. This report reveals that common buzzards seem to represent an important reservoir, or at least a source, of multi-resistant E. coli and enterococci isolates, and consequently may represent a considerable hazard to human

2012 Journal of Medical Microbiology

103. Enterococcal Infections

). When identified, infected patients are strictly isolated. Recommended treatment includes streptogramins ( quinupristin/dalfopristin for E. faecium only) and oxazolidinones ( linezolid , tedizolid ). Daptomycin and tigecycline have in vitro activity against VRE and may be off-label treatment options. Beta-lactamase–producing enterococci are occasionally encountered, particularly when large numbers of organisms are present (eg, in endocarditis vegetation). Resistance may be present clinically even

2013 Merck Manual (19th Edition)

104. Streptococcal Infections

-resistant enterococci: Streptogramins ( quinupristin/dalfopristin ), oxazolidinones ( linezolid ), lipopeptide ( daptomycin ) S. gallolyticus (formerly S. bovis biotype I) Colonic adenomas or carcinomas, endocarditis Viridans* S. mutans , S. sanguis , S. salivarius , S. mitior , S. anginosus (formerly S milleri ), S. constellatus , S. intermedius Alpha or gamma Endocarditis, bacteremia, meningitis, localized infection, abscesses (particularly S. anginosus ) Penicillin, ampicillin , vancomycin (plus

2013 Merck Manual (19th Edition)

105. Staphylococcal Infections

resistance is common, vancomycin or other newer antibiotics may be required. Some strains are partially or totally resistant to all but the newest antibiotics, which include linezolid , tedizolid , quinupristin/dalfopristin , daptomycin , telavancin , dalbavancin , oritavancin , tigecycline , ceftobiprole (not available in the US), and ceftaroline. The ability to clot blood by producing coagulase distinguishes the virulent pathogen, Staphylococcus aureus , from the less virulent coagulase-negative (...) ( daptomycin , linezolid , tedizolid , dalbavancin , oritavancin , tigecycline , quinupristin/dalfopristin , TMP-SMX, possibly ceftaroline) should be considered when treating MRSA strains with a vancomycin MIC of > 1.5 mcg/mL. Vancomycin -resistant S. aureus (VRSA; MIC > 16 mcg/mL) and vancomycin -intermediate-susceptible S. aureus (VISA; MIC 4 to 8 mcg/mL) strains have appeared in the US. These organisms require linezolid , tedizolid , quinupristin/dalfopristin , daptomycin , TMP/SMX, or ceftaroline

2013 Merck Manual (19th Edition)

106. Quinupristin and Dalfopristin

Loading , PharmD, University of Washington School of Pharmacy Click here for Patient Education NOTE: This is the Professional Version. CONSUMERS: Quinupristin and dalfopristin are streptogramin , which, like and , inhibit the synthesis of bacterial proteins. Quinupristin/dalfopristin (Q/D) is given together in a fixed 30/70 combination; this combination has synergistic bactericidal activity against the following: and , including strains resistant to other antibiotic classes Some gram-negative sp

2013 Merck Manual (19th Edition)

107. Overview of Antibacterial Drugs

as a single dose N/A N/A 1200 mg as a single dose Quinupristin/dalfopristin N/A 7.5 mg/kg IV q 8–12 h 7.5 mg/kg IV q 8 h N/A 7.5 mg/kg IV q 12 h for complicated skin or skin structure infection or 7.5 mg/kg q 8 h for serious infections 7.5 mg/kg IV q 8–12 h Rifampin c For TB (as part of a 3- or 4-drug regimen) 0.6 g q 24 h 0.6 g IV q 24 h N/A 5–10 mg/kg q 12 h or 10–20 mg/kg q 24 h 10–20 mg/kg IV q 24 h 0.3–0.6 g IV or po q 24 h For meningococcal exposure 0.6 g q 12 h for 4 doses N/A N/A Age ≥ 1 mo: 10 mg

2013 Merck Manual (19th Edition)

108. Levofloxacin in Preventing Infection in Young Patients With Acute Leukemia Receiving Chemotherapy or Undergoing Stem Cell Transplantation

of true (centrally reviewed) bacteremia among Acute Leukemia (AL) and Hematopoietic stem cell transplantation (HSCT) patients. Secondary Outcome Measures : Comparison of the Percentage of Patients Having Antibiotic Exposures Between Arms [ Time Frame: Up to 60 days after enrollment or receiving levofloxacin ] Exposure to antibiotics was considered during the infection observation period(s) was defined a priori as follows: Gram positive agents = vancomycin, linezolid, daptomycin or quinupristin (...) /dalfopristin; Aminoglycosides = amikacin, gentamicin or tobramycin; Third or fourth generation cephalosporins = cefepime, ceftazidime, ceftriaxone or cefotaxime; Empiric antibiotics for fever and neutropenia = imipenem, meropenem, cefepime, ceftazidime or piperacillin/tazobactam Comparison of the Percentage of Patients Having Incidence of Fever and Febrile Neutropenia Between Arms [ Time Frame: Up to 60 days after enrollment or receiving levofloxacin ] Fever and febrile neutropenia defined as Absolute

2011 Clinical Trials

109. Virulence and Resistance Determinants of German Staphylococcus aureus ST398 Isolates from Nonhuman Sources Full Text available with Trip Pro

) alone or together with tet(K) and/or tet(L)]. In addition, 98% were resistant to other antimicrobials, including macrolide-lincosamine-streptogramin B (70%, encoded by ermA, ermB, and ermC, alone or in combination), trimethoprim (65%, mostly due to dfrK and dfrG), kanamycin and gentamicin [29% and 14%, respectively, mainly related to aac(6')-Ie-aph(2″)-Ia and/or ant(4')-Ia but also to aph(3')-IIIa], chloramphenicol (9%, fexA or cfr), quinupristin-dalfopristin (9%), ciprofloxacin (8

2011 Applied and environmental microbiology

110. Molecular typing and characterization of macrolide, lincosamide, and streptogramin resistance in Staphylococcus epidermidis strains isolated in a Mexican hospital. Full Text available with Trip Pro

and streptogramin type B (MLS(B)) in developing countries, including Mexico. The aim of this study was to investigate the incidence of resistance to MLS(B) antibiotics in isolates of S. epidermidis obtained in the General Hospital of Acapulco in Mexico. Susceptibility to erythromycin, clindamycin and quinupristin-dalfopristin was tested by a diffusion test, and MICs to oxacillin, erythromycin and lincomycin were determined. Differentiation between MLS(B) phenotypes was performed by a double disc diffusion test

2011 Journal of Medical Microbiology

111. Pan-European monitoring of susceptibility to human-use antimicrobial agents in enteric bacteria isolated from healthy food-producing animals. Full Text available with Trip Pro

was resistant to linezolid, but some were resistant to ampicillin or vancomycin. Resistance to quinupristin/dalfopristin was frequent.Resistance patterns varied widely depending on bacterial species, antibiotics, hosts and region. Resistance varied among countries, particularly for older antimicrobials, but clinical resistance to newer antibiotics used to treat foodborne disease in humans was generally very low. In the absence of resistance to newer compounds in E. coli and Salmonella, the apparent

2011 Journal of Antimicrobial Chemotherapy

112. Antimicrobial properties of MX-2401, a second generation lipopeptide active in presence of lung surfactant. Full Text available with Trip Pro

Antimicrobial properties of MX-2401, a second generation lipopeptide active in presence of lung surfactant. MX-2401 is an expanded-spectrum lipopeptide antibiotic selective for Gram-positive bacteria that is a semisynthetic analog of the naturally occurring lipopeptide amphomycin. It was active against Enterococcus spp., including vancomycin-sensitive Enterococcus (VSE), vanA-, vanB-, and vanC-positive vancomycin-resistant Enterococcus (VRE), linezolid- and quinupristin-dalfopristin-resistant

2011 Antimicrobial Agents and Chemotherapy

113. Treatment Algorithm to Reduce the Use of Vancomycin in Adults With Blood Stream Infection

calendar days immediately preceding the calendar day that the initial positive blood culture was drawn: If methicillin susceptibility of the isolate is unknown at the time of enrollment: vancomycin; daptomycin; telavancin; tigecycline; linezolid (in either oral or IV administration); quinupristin/dalfopristin; piperacillin/tazobactam; penicillin; nafcillin; oxacillin; cloxacillin; cefazolin, ceftriaxone, ceftaroline, dalbavancin, oritavancin, tedizolid, and levofloxacin or equivalent fluoroquinolone (...) (in either oral or IV administration) Note: ciprofloxacin is not an exclusion criteria. If the staphylococcal isolate is known to be methicillin resistant: vancomycin; daptomycin; telavancin; tigecycline; linezolid (in either oral or IV administration), quinupristin/dalfopristin, dalbavancin, oritavancin, tedizolid, and ceftaroline. Note: patients who have developed bacteremia after at least 7 days of prophylaxis with oral antibiotics have by definition failed prophylaxis and the oral antibiotic can

2010 Clinical Trials

114. Dose-finding Study of New Tolvaptan Formulation in Subjects With ADPKD

taking CYP3A4 inhibitors, with the exception of amiodarone, taken within 30 days of dosing (eg, amprenavir, atorvastatin, aprepitant, chloramphenicol [not eye drops], cimetidine, clarithromycin, clotrimazole [if used orally], danazol, delavirdine, diltiazem, erythromycin, fluconazole, fluvoxamine, indinavir, isoniazid, itraconazole, josamycin, ketoconazole, nelfinavir, nefazadone, quinupristin/dalfopristin, ritonavir, saquinavir, troleandomycin, verapamil) Subjects taking CYP3A4 inducers taken within

2010 Clinical Trials

115. Comparison of Antimicrobial Agents as Therapy for Experimental Endocarditis Caused by Methicillin-Resistant Staphylococcus aureus Full Text available with Trip Pro

Comparison of Antimicrobial Agents as Therapy for Experimental Endocarditis Caused by Methicillin-Resistant Staphylococcus aureus We used an experimental rat model to compare the therapeutic efficacy of teicoplanin, linezolid, and quinupristin/dalfopristin with that of vancomycin as standard therapy for infective endocarditis.Aortic endocarditis was induced in rats by insertion of a polyethylene catheter into the left ventricle, followed by intravenous inoculation of 106 colony-forming units (...) of methicillin-resistant Staphylococcus aureus 24 hours later. Forty-eight hours after bacterial challenge, intravenous antibiotic therapies were initiated. There were 6 groups of 8 rats each: uninfected control; infected, untreated control; vancomycin-treated (40 mg/kg twice daily); teicoplanin-treated (20 mg/kg twice daily after a loading dose of 40 mg/kg); linezolid-treated (75 mg/kg 3 times daily for 1 day, then 75 mg/kg twice daily); and quinupristin/dalfopristin-treated (30 mg/kg twice daily

2010 Texas Heart Institute Journal

116. Antibacterial Susceptibility Patterns and Cross-Resistance of Methicillin Resistant and Sensitive Staphyloccus Aureus Isolated from the Hospitalized Patients in Shiraz, Iran Full Text available with Trip Pro

wound samples. All of 200 MSSA isolates were sensitive to oxacillin, vancomycin, tecoplanin, rifampin, linezolid, quinupristin/dalfopristin, mupirocin and fusidic acid. A gradient of reduced susceptibility of MSSA to cephalexin, co-trimoxazole, ciprofloxacin, clindamycin, tetracycline, erythromycin and gentamicin were evident. MRSA isolates were sensitive to vancomycin, tecoplanin, linezolid, quinupristin/dalfopristin, mupirocin and fusidic acid, while reduced susceptibility of them to rifampin, co

2010 Brazilian Journal of Microbiology

117. Assessment of linezolid resistance mechanisms among Staphylococcus epidermidis causing bacteraemia in Rome, Italy. Full Text available with Trip Pro

and/or Ala157Arg appeared responsible for the elevated linezolid MIC, since adjacent alterations have been associated with resistance. L4 Asn158Ser has been reported in a linezolid-susceptible isolate and Lys68Arg detected here did not seem to provide an additive effect. Acquisition of cfr markedly increased (8- to 16-fold) the linezolid MICs. vga(A) was associated with higher MICs of quinupristin/dalfopristin and retapamulin.

2010 Journal of Antimicrobial Chemotherapy

118. Telavancin activity against Gram-positive bacteria isolated from respiratory tract specimens of patients with nosocomial pneumonia. Full Text available with Trip Pro

enterococci non-susceptible to vancomycin (all Enterococcus faecium), telavancin was active against isolates exhibiting a VanB phenotype (MIC, 0.06-0.12 mg/L), but less potent against VanA strains (MIC, ≥ 2 mg/L).Telavancin demonstrated equal or greater potency than the comparators (vancomycin, teicoplanin, daptomycin, linezolid and quinupristin/dalfopristin) against Gram-positive pathogens implicated in NP. Telavancin showed elevated MIC values only against enterococcus isolates showing a VanA phenotype

2010 Journal of Antimicrobial Chemotherapy

119. DNA methylase modifications and other linezolid resistance mutations in coagulase-negative staphylococci in Italy. Full Text available with Trip Pro

expressed methylase activity at position A2503 mediated by the cfr gene. Overall, the isolates showed reduced susceptibility to vancomycin (MICs 1-2 mg/L) and 11 of the 33 isolates showed no susceptibility to teicoplanin. These strains were also resistant to chloramphenicol (28 of 33), lincomycin (24 of 33), erythromycin (17 of 33) and quinupristin/dalfopristin (13 of 33). S. epidermidis isolates, showing mutations or methylase modifications, belonged to different PFGE profiles and to two different

2010 Journal of Antimicrobial Chemotherapy

120. Characterization of two new genes, vgaD and vatG, conferring resistance to streptogramin A in Enterococcus faecium. Full Text available with Trip Pro

Characterization of two new genes, vgaD and vatG, conferring resistance to streptogramin A in Enterococcus faecium. We characterized two new streptogramin A resistance genes from quinupristin-dalfopristin-resistant Enterococcus faecium JS79, which was selected from 79 E. faecium isolates lacking known genes encoding streptogramin A acetyltransferase. A 5,650-bp fragment of HindIII-digested plasmid DNA from E. faecium JS79 was cloned and sequenced. The fragment contained two open reading frames (...) vgaD. vgaD is located 65 bp upstream from vatH, [corrected] was detected together with vatH [corrected] in 12 of 179 quinupristin-dalfopristin-resistant E. faecium isolates, and was located on the same plasmid. Also, the 5.6-kb HindIII-digested fragment which was observed in JS79 was detected in nine vgaD- and vatH-containing [corrected] E. faecium isolates by Southern hybridization. Therefore, it was expected that these two genes were strongly correlated with each other and that they may

2010 Antimicrobial Agents and Chemotherapy

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