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Quinupristin-Dalfopristin

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141. Intravenous linezolid administered orally: a novel desensitization strategy. (Abstract)

Intravenous linezolid administered orally: a novel desensitization strategy. A 41-year-old woman with a history of myasthenia gravis was admitted to a local hospital because of severe muscle weakness, ptosis, shortness of breath, nausea and vomiting, and fever. Blood cultures revealed Enterococcus faecium resistant to several antimicrobial agents. The organism had minimum inhibitory concentrations above 16 microg/ml for vancomycin and above 2 microg/ml for quinupristin-dalfopristin

2006 Pharmacotherapy

142. Emerging options for treatment of invasive, multidrug-resistant Staphylococcus aureus infections. (Abstract)

acquired in the community setting. Newer treatment options for MRSA include linezolid, quinupristin-dalfopristin, daptomycin, and tigecycline. With the exception of linezolid, these newer agents require intravenous administration. Combination therapy may be considered in select invasive diseases refractory to standard monotherapies. These diseases include infections such as endocarditis, meningitis, and prosthetic device infections. Additional alternatives to vancomycin are under clinical investigation

2007 Pharmacotherapy

143. Antimicrobial dosing considerations in obese adult patients. (Abstract)

concentrations as those of patients who are not obese. Fluoroquinolone pharmacokinetics are variably altered by obesity, which prevents a uniform approach. Data on the pharmacokinetics of drugs that have activity against gram-positive organisms-quinupristin-dalfopristin, linezolid, and daptomycin-reveal that they are altered in the presence of obesity, but more data are needed to solidify dosing recommendations. Limited data are available on nonantibacterials. An understanding of the physiologic changes

2007 Pharmacotherapy

144. Methicillin-resistant Staphylococcus aureus prosthetic aortic valve endocarditis with paravalvular abscess treated with daptomycin. (Abstract)

-resistant S. aureus (MRSA) strains, are the most frequent pathogens causing prosthetic valve endocarditis (PVE). Vancomycin has been the cornerstone of therapy for serious MRSA infections including bacteremia and endocarditis. Clinicians have noted that MRSA bacteremias treated with vancomycin often fail to clear even with prolonged therapy. Persistent or prolonged MRSA bacteremia unresponsive to vancomycin therapy has led to the treatment of these infections by other agents, that is, quinupristin (...) , dalfopristin, linezolid, or daptomycin. These antibiotics have been found particularly useful in treating MRSA bacteremias unresponsive to vancomycin therapy. We report a case of a patient who presented with MRSA PVE complicated by perivalvular aortic abscess with persistent MRSA bacteremia unresponsive to vancomycin therapy. The patient's MRSA bacteremia was cleared with daptomycin therapy (6 mg/kg/d). Because the patient refused surgery, daptomycin therapy was continued in hopes of curing

2005 Heart & Lung

145. In vitro activities of 28 antimicrobial agents against methicillin-resistant Staphylococcus aureus (MRSA) from a clinical setting in Malaysia. (Abstract)

. Twenty-five of 26 erythromycin-resistant MRSA isolates exhibited an inducible MLS(B) resistance phenotype while one showed an MS phenotype. More than half the isolates (68.75%) were resistant to at least one of the six aminoglycosides tested, with netilmicin as the most susceptible. The most effective antistaphylococcal agents were linezolid, vancomycin, teicoplanin and quinupristin/dalfopristin exhibited 100% susceptibility. Since MRSA is under continuous pressure of acquiring multiple drug

2008 Southeast Asian Journal of Tropical Medicine and Public Health

146. Bacteremia caused by group g streptococci, taiwan. Full Text available with Trip Pro

Bacteremia caused by group g streptococci, taiwan. A retrospective observational study in Taiwan, 1998-2004, identified 92 patients with group G streptococcal bacteremia; 86 had Streptococcus dysgalactiae subspecies equisimilis. The most common diagnosis was cellulitis (48 cases), followed by primary bacteremia (34 cases). Infection recurred in 9 patients. Mortality rate was low (3.3%); resistance to quinupristin-dalfopristin was high.

2008 Emerging Infectious Diseases

147. In vitro antibacterial activity of CE-156811: A novel analog derived from Hygromycin A. Full Text available with Trip Pro

In vitro antibacterial activity of CE-156811: A novel analog derived from Hygromycin A. We evaluated a novel truncated hygromycin A analog in which the furanose ring was replaced with a 2-fluoro-2-cyclopropylethyl substituent for its activity against multidrug resistant gram-positive bacteria and compared its activity to the activities of linezolid, quinupristin-dalfopristin, and vancomycin. CE-156811 demonstrated robust in vitro activity against gram-positive bacteria that was comparable

2008 Antimicrobial Agents and Chemotherapy

148. Analysis of meticillin-susceptible and meticillin-resistant biofilm-forming Staphylococcus aureus from catheter infections isolated in a large Italian hospital. Full Text available with Trip Pro

, telithromycin, gentamicin, ciprofloxacin, quinupristin/dalfopristin, rifampicin, vancomycin and linezolid), and the presence of genetic determinants of antibiotic resistance and biofilm formation. All strains but three (92 %) were able to grow on a plastic surface as a biofilm. An almost complete association was found between phenotypes and genotypic traits of antibiotic resistance, whilst PFGE profiling showed the highly polyclonal composition of the set of strains under study. Sixteen isolates (43 %) were

2008 Journal of Medical Microbiology

149. New antimicrobial agents for the treatment of Gram-positive bacterial infections. Full Text available with Trip Pro

. There is a continuing effort in the pharmaceutical industry to develop new antimicrobial agents for the treatment of resistant infections. Linezolid, quinupristin-dalfopristin, daptomycin, tigecyline, new glycopeptides and ceftobiprole are the main agents recently introduced or under clinical development. This review summarises their major properties, the results of recent studies with these agents, and future treatment possibilities.

2008 Clinical Microbiology and Infection

150. Linezolid resistance in Staphylococcus aureus: gene dosage effect, stability, fitness costs, and cross-resistances. Full Text available with Trip Pro

Linezolid resistance in Staphylococcus aureus: gene dosage effect, stability, fitness costs, and cross-resistances. Linezolid resistance in Staphylococcus aureus is typically associated with mutations in the 23S rRNA gene. Here we show that the accumulation of a single point mutation, G2576T, in the different copies of this gene causes stepwise increases in resistance, impairment of the biological fitness, and cross-resistance to quinupristin-dalfopristin and chloramphenicol.

2008 Antimicrobial Agents and Chemotherapy

151. Current and emerging serious Gram-positive infections. Full Text available with Trip Pro

with newer antimicrobial agents such as linezolid and quinupristin/dalfopristin are also emerging. Consequently, there is a clinical need for new antimicrobial agents that have suitable pharmacokinetic properties and safety profiles, with activity against these Gram-positive pathogens.

2005 Clinical Microbiology and Infection

152. The need for new therapeutic agents: what is the pipeline? (Abstract)

The need for new therapeutic agents: what is the pipeline? There is a clinical need for new treatment options for serious Gram-positive infections. Recently introduced agents such as the newer fluoroquinolones and the ketolide telithromycin have limited use as they do not cover methicillin-resistant Staphylococcus aureus (MRSA) or glycopeptide-resistant enterococci (GRE). The clinical use of the streptogramin combination quinupristin/dalfopristin, which has activity against MRSA and vancomycin

2005 Clinical Microbiology and Infection

153. Rapid genotyping of methicillin-resistant Staphylococcus aureus (MRSA) isolates using miniaturised oligonucleotide arrays. Full Text available with Trip Pro

macrolide resistance genes were found in 40% and 32% of the isolates, respectively. The most prevalent aminoglycoside resistance gene was aphA3 (57% of the isolates), followed by aacA-aphD (29%) and aadD (29%); tet genes, mupR and dfrA were rare. There were no isolates with van genes or genes involved in resistance to quinupristin-dalfopristin. Enterotoxins were detected in 27% of the isolates. Genes encoding Panton-Valentine leukocidin, toxic shock syndrome toxin and exfoliative toxins were not found

2005 Clinical Microbiology and Infection

154. Incidence of inducible clindamycin resistance in staphylococci: first results from Turkey. Full Text available with Trip Pro

-sensitive CoNS isolates. All MRSA isolates that were erythromycin-resistant and clindamycin-susceptible were positive by the D-test. The same results were obtained with an azithromycin instead of an erythromycin disk. All isolates were susceptible to quinupristin-dalfopristin. The cost-benefit of the d-test should be evaluated locally after determining the incidence of the different resistance phenotypes.

2005 Clinical Microbiology and Infection

155. Methicillin-resistant Staphylococcus aureus: clinical manifestations and antimicrobial therapy. (Abstract)

valve/prosthetic valve). There is a discrepancy between in-vitro sensitivity and in-vivo effectiveness with MRSA. To treat MRSA infections, clinicians should select an MRSA drug with proven in-vivo effectiveness, i.e., daptomycin. Linezolid, quinupristin/dalfopristin, minocycline, or vancomycin, and not rely on in-vitro susceptibility data. For MRSA, doxycycline cannot be substituted for minocycline. Linezolid and minocycline are available for oral administration and both are also effective

2005 Clinical Microbiology and Infection

156. Antimicrobial resistance among faecal enterococci from healthy individuals in Portugal. Full Text available with Trip Pro

Antimicrobial resistance among faecal enterococci from healthy individuals in Portugal. Analysis of 247 faecal enterococcal isolates from 99 healthy Portuguese individuals during 2001 revealed the presence of enterococci resistant to vancomycin (5%) and highly resistant to streptomycin (52%), kanamycin (40%) or gentamicin (11%). Most isolates were also resistant to tetracycline, erythromycin, ciprofloxacin and quinupristin-dalfopristin. The vanA (two Tn1546 types), vanC1, erm(B), aac(6')-aph(2

2006 Clinical Microbiology and Infection

157. Invasive Streptococcus pneumoniae from Portugal: implications for vaccination and antimicrobial therapy. Full Text available with Trip Pro

for their susceptibility to penicillin, cefuroxime, cefotaxime, vancomycin, erythromycin, clindamycin, levofloxacin, gatifloxacin, moxifloxacin, linezolid, quinupristin-dalfopristin, tetracycline, chloramphenicol and trimethoprim-sulphamethoxazole. Most isolates collected from children aged < 6 years had decreased susceptibility to at least one antibiotic class, whereas isolates from patients aged > or = 6 years were mostly susceptible to all antimicrobial agents tested. Overall, 23% of isolates showed reduced

2004 Clinical Microbiology and Infection

158. Antistaphylococcal activity of CG400549, a new experimental FabI inhibitor, compared with that of other agents. Full Text available with Trip Pro

Antistaphylococcal activity of CG400549, a new experimental FabI inhibitor, compared with that of other agents. Among 203 strains of Staphylococcus aureus, the MICs of CG400549 were 0.06 to 1.0 microg/ml, with MIC(50) and MIC(90) values of 0.25 microg/ml each. All strains were susceptible to linezolid and quinupristin-dalfopristin (MICs, 0.25 to 2.0 microg/ml). The daptomycin MICs were 0.25 to 2.0 microg/ml for methicillin-susceptible and 0.25 to 4.0 microg/ml against methicillin-resistant

2007 Antimicrobial Agents and Chemotherapy

159. Alternatives to vancomycin for the treatment of methicillin-resistant Staphylococcus aureus infections. Full Text available with Trip Pro

for invasive MRSA infections include linezolid, daptomycin, tigecycline, and quinupristin/dalfopristin. Additionally, a number of new anti-MRSA compounds are in development, including novel glycopeptides (dalbavancin, telavancin, and oritavancin), ceftobiprole, and iclaprim. The present article will review clinical issues surrounding the newly marketed and investigational agents with activity against MRSA.

2007 Clinical Infectious Diseases

160. Emergence of a 23S rRNA mutation in Mycoplasma hominis associated with a loss of the intrinsic resistance to erythromycin and azithromycin. Full Text available with Trip Pro

macrolides and related antibiotics.Selection of macrolide-resistant mutants was performed by serial passages of M. hominis PG21 in broth medium containing subinhibitory concentrations of clindamycin, pristinamycin, quinupristin/dalfopristin and telithromycin. Stepwise selection of josamycin-resistant mutants was performed onto agar medium containing increasing inhibitory concentrations of josamycin. Resistant mutants were characterized by PCR amplification and DNA sequencing of 23S rRNA, L4 and L22 (...) ribosomal protein genes.Various mutations in domain II or V of 23S rRNA were selected in the presence of each selector antibiotic and were associated with several resistance phenotypes. Josamycin was the sole antibiotic that selected for single amino acid changes in ribosomal proteins L4 and L22. Unexpectedly, the C2611U transition selected in the presence of clindamycin and the quinupristin/dalfopristin combination was associated with decreased MICs of erythromycin, azithromycin and telithromycin

2006 Journal of Antimicrobial Chemotherapy

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