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Quinupristin-Dalfopristin

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121. Catheter removal versus retention in the management of catheter-associated enterococcal bloodstream infections (PubMed)

of 111 patients had an enterococcal CA-BSI. The median age was 58.2 years (range 21 to 94 years). There were 45 (40.5%) infections caused by Entercoccus faecalis (among which 10 [22%] were vancomycin resistant), 61 (55%) by Enterococcus faecium (57 [93%] vancomycin resistant) and five (4.5%) by other Enterococcus species. Patients were treated with linezolid (n=51 [46%]), vancomycin (n=37 [33%]), daptomycin (n=11 [10%]), ampicillin (n=2 [2%]) or quinupristin/dalfopristin (n=2 [2%]); seven (n=6

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2013 The Canadian Journal of Infectious Diseases & Medical Microbiology

122. Macrolide and Tetracycline Resistance in Clinical Strains of Streptococcus agalactiae Isolated in Tunisia. (PubMed)

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

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2012 Journal of Medical Microbiology

123. Twenty-five years of shared life with vancomycin-resistant enterococci: is it time to divorce? (PubMed)

, have facilitated niche adaptation of this distinct E. faecium subpopulation that is multiply resistant to antibiotics. Quinupristin/dalfopristin and linezolid are licensed for the treatment of VREm infections, with linezolid often used as a first-line treatment. However, the emergence of plasmid-mediated resistance to linezolid by production of a Cfr methyltransferase in Enterococcus faecalis is worrying. Daptomycin has not been extensively evaluated for the treatment of VREm infections

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2012 Journal of Antimicrobial Chemotherapy

124. Wild birds as biological indicators of environmental pollution: antimicrobial resistance patterns of Escherichia coli and enterococci isolated from common buzzards (Buteo buteo). (PubMed)

. 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

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2012 Journal of Medical Microbiology

125. The evaluation of antimicrobial susceptibility of urine enterococci with the Vitek 2 automated system in eastern Turkey. (PubMed)

and detect antimicrobial susceptibility to ten antibiotics: ampicillin, imipenem, ciprofloxacin, moxifloxacin, quinupristin-dalfopristin, tetracycline, tigecyclin, linezolid, vancomycin, teicoplanin and high level aminoglycoside resistance (HLAR) against kanamycin, gentamicin and streptomycin. The predominant species was Enterococci faecalis (74.5%) followed by Enterococcus faecium (18.6%). The resistance rates for Enterococcus faecalis and E. faecium, were 54.5%/77.2% for ampicillin, 0/77.2 (...) % for imipenem, 18.1%/72.7% for both ciprofloxacin and moxifloxacin, 10.2%/9.1% for linezolid and 65.1%/5.2% for quinopristine-dalfopristin, respectively. Beta-lactamase production was detected in 54.5% of E. faecalis isolates. HLAR was also found in 54.5% of E. faecalis isolates and 36.3% of E. faecium isolates; kanamycin resistance comprised the highest proportions (39.7% and 9.1%) of these resistance rates. Five strains were resistant to and one had intermediate resistant to vancomycin. The highest

2012 Southeast Asian Journal of Tropical Medicine and Public Health

126. Study of Erlotinib and Metformin in Triple Negative Breast Cancer

CANNOT be receiving enzyme-inducing or enzyme inhibiting agents listed here: Inhibitors: Amiodarone, Amprenavir, Atazanavir, Chloramphenicol, Clarithromycin, Conivaptan, Cyclosporine, Darunavir, Dasatinib, Delavirdine, Diltiazem, Erythromycin, Fluconazole, Fluoxetine, Fluvoxamine, Fosamprenavir, Imatinib, Indinavir, Isoniazid, Itraconazole, Ketoconazole, Lapatinib, Miconazole, Nefazodone, Nelfinavir, Posaconazole, Ritonavir, Quinupristin, Saquinavir, Tamoxifen, Telithromycin, Troleandomycin

2012 Clinical Trials

127. Domperidone for the Treatment of Chronic Nausea and Vomiting Secondary to Gastroparesis

, promethazine, mesoridazine, theiethylperazine, perphazine, dolasetron, dronabinol, droperidol; anti-infective agents: erythromycin, clarithromycin, troleandomycin, norfloxcin, quinine sulfate, quinupristin and dalfopristin, pentamidine, sparfloxacin, grepafloxacin, azithromycin, ofloxacin, levofloxacin; anti-fungal agents: fluconazole, itraconazole, ketoconazole, miconazole, terconazole, ticonazole, butaconazole; antivirals: foscarnet; protease inhibitors: indinavir, amprenavir, ritonavir, nelfinavir

2012 Clinical Trials

128. Molecular characterization of vanA-containing Enterococcus from migratory birds: song thrush (Turdus philomelos) (PubMed)

Molecular characterization of vanA-containing Enterococcus from migratory birds: song thrush (Turdus philomelos) Vancomycin-resistant enterococci (VRE) were detected in two faecal samples (1.3%) of song thrush in Portugal. vanA isolates showed high level vancomycin/teicoplanin resistance, as well as resistance to ciprofloxacin, quinupristin-dalfopristin and cloranfenicol. Thrush can be a reservoir of VRE and transmit these resistant bacteria to other animals including humans.

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2012 Brazilian Journal of Microbiology

129. Bacterial Meningitis Management

with initially Added in adults and in infection Intraventricular shunt antibiotics may be used if shunt not able to be removed Options: Amikacin, , Polymixin E, Tobramycin, , , Quinupristin-Dalf. V. Management: Antibiotics based on CSF Gram Stain Results Diplococci (Pneumococcus) All cases receive for 4 days Antibiotics for 10-14 days AND OR (or Meropenem or ) AND ( ) or or Pencillin G or or or Chloramphenicol Bacilli ( ) AND Gentamycin OR ( or Meropenem) (H. flu, , Pseudomonas) OR Cefepime (or Meropenem

2015 FP Notebook

130. Vancomycin Resistant Enterococcus

disease Cancer ICU care Organ transplant VI. Labs: Culture MIC Susceptible : MIC <4 mcg/ml Vancomycin Resistant Enterococcus: MIC >32 mcg/ml VII. Management: Vancomycin Resistant Enterococcus No single antibiotic is bactericidal Combination therapy is mandatory Susceptible to Antibiotic 1 or /Sulbactam ( ) Antibiotic 2 (increasing resistance) or High resistance to (MIC >64 mg/ml) Quinupristin/dalfopristin ( ) ( ) Combination 1 (three drugs) and and Combination 2 (two drugs) or and Fosfomycin (...) Combination 3 (four drugs) Chloramphenicol and and and Quinupristin/dalfopristin ( ) Antibiotics effective against some strains of VRE (consult infectious disease) Tigecycline (increasing resistance) Imipenem (against E. faecalis only) Telavansin ( s) Quinupristin/dalfopristin or (against E faecium only) Antibiotics effective against UTI with VRE Remove indwelling if possible (may alone, clear VRE) or (UTI) Fosfomycin (UTI) (UTI) Antibiotics for VRE Endocarditis may be needed AND AND VIII. Prevention

2015 FP Notebook

131. Virulence and Resistance Determinants of German Staphylococcus aureus ST398 Isolates from Nonhuman Sources (PubMed)

) 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

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2011 Applied and environmental microbiology

132. Antimicrobial properties of MX-2401, a second generation lipopeptide active in presence of lung surfactant. (PubMed)

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

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2011 Antimicrobial Agents and Chemotherapy

133. Bacteriological findings and antimicrobial resistance in odontogenic and non-odontogenic chronic maxillary sinusitis. (PubMed)

 % of Streptococcus pneumoniae isolates were penicillin-resistant and/or erythromycin-resistant; 21 % of anaerobic Gram-positive bacteria were penicillin-resistant, and 44 % of anaerobic Gram-negative bacteria were β-lactamase-positive. Vancomycin and quinopristin-dalfopristin had the highest in vitro activity against Staphylococcus aureus and Streptococcus species, respectively; amoxicillin-clavulanate and cefotaxime showed the highest in vitro activity against aerobic Gram-negative bacteria; and moxifloxacin

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2011 Journal of Medical Microbiology

134. Pan-European monitoring of susceptibility to human-use antimicrobial agents in enteric bacteria isolated from healthy food-producing animals. (PubMed)

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

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2011 Journal of Antimicrobial Chemotherapy

135. Molecular typing and characterization of macrolide, lincosamide, and streptogramin resistance in Staphylococcus epidermidis strains isolated in a Mexican hospital. (PubMed)

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

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2011 Journal of Medical Microbiology

136. Cross-Resistance to Lincosamides, Streptogramins A, and Pleuromutilins Due to the lsa(C) Gene in Streptococcus agalactiae UCN70. (PubMed)

% identical to Lsa(A), a protein related to intrinsic LS(A) resistance in Enterococcus faecalis. Expression of this novel gene, named lsa(C), in S. agalactiae BM132 after cloning led to an increase in MICs of lincomycin (0.06 to 4 μg/ml), clindamycin (0.03 to 2 μg/ml), dalfopristin (2 to >32 μg/ml), and tiamulin (0.12 to 32 μg/ml), whereas no change in MICs of erythromycin (0.06 μg/ml), azithromycin (0.03 μg/ml), spiramycin (0.25 μg/ml), telithromycin (0.03 μg/ml), and quinupristin (8 μg/ml) was observed

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2011 Antimicrobial Agents and Chemotherapy

137. 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

138. Sirolimus for Advanced Age-Related Macular Degeneration

skin cancer) diagnosed within the past five years Has laboratory values outside normal limits and considered clinically significant by the investigator Is currently taking one of the following drugs: amprenavir, atazanavir, clarithromycin, darunavir, delavirdine, erythromycin, fluconazole (at doses of 200mg or greater), fluvoxamine, indinavir, itraconazole, ketoconazole, nefazodone, nelfinavir, posaconazole, quinupristin, ritonavir, saquinavir, telithromycin, troleandomycin, verapamil

2011 Clinical Trials

140. 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)

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