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Pharmacodynamic profiling of imipenem, meropenem and ertapenem against clinical isolates of extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella spp. from Brazil.
Int J Antimicrob Agents. 2006 Oct; 28(4):340-4.IJ

Abstract

The pharmacodynamic potency of imipenem, meropenem and ertapenem against extended-spectrum beta-lactamase (ESBL)-producing isolates was investigated. Minimal inhibitory concentration (MIC) determination, confirmation of ESBLs by Etest and the disk approximation test were performed for 133 ESBL-producing isolates of Escherichia coli and Klebsiella spp. Pharmacodynamic exposure, measured as percent of the dosing interval during which free drug was above the MIC (% fT>MIC), was modelled via a 5000-subject Monte Carlo simulation. Bactericidal cumulative fraction of response (CFR), defined as 40% fT>MIC, was calculated against each bacterial population. All agents achieved high bactericidal CFR against all ESBL isolates as a group, but ertapenem (96.26%) was slightly less effective than imipenem (99.96%) and meropenem (99.90%) (P<0.05). Similar results were observed against Klebsiella spp. only (P<0.05). Against E. coli, CFRs were close to 100%. Ertapenem is probably an effective agent against ESBL-producing bacteria, although its ability to achieve bactericidal pharmacodynamic exposures will depend on the bacterial susceptibility.

Authors+Show Affiliations

Fleury Institute, São Paulo, Brazil. carlos.kiffer@fleury.com.brNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16930951

Citation

Kiffer, Carlos R V., et al. "Pharmacodynamic Profiling of Imipenem, Meropenem and Ertapenem Against Clinical Isolates of Extended-spectrum Beta-lactamase-producing Escherichia Coli and Klebsiella Spp. From Brazil." International Journal of Antimicrobial Agents, vol. 28, no. 4, 2006, pp. 340-4.
Kiffer CR, Kuti JL, Eagye KJ, et al. Pharmacodynamic profiling of imipenem, meropenem and ertapenem against clinical isolates of extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella spp. from Brazil. Int J Antimicrob Agents. 2006;28(4):340-4.
Kiffer, C. R., Kuti, J. L., Eagye, K. J., Mendes, C., & Nicolau, D. P. (2006). Pharmacodynamic profiling of imipenem, meropenem and ertapenem against clinical isolates of extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella spp. from Brazil. International Journal of Antimicrobial Agents, 28(4), 340-4.
Kiffer CR, et al. Pharmacodynamic Profiling of Imipenem, Meropenem and Ertapenem Against Clinical Isolates of Extended-spectrum Beta-lactamase-producing Escherichia Coli and Klebsiella Spp. From Brazil. Int J Antimicrob Agents. 2006;28(4):340-4. PubMed PMID: 16930951.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pharmacodynamic profiling of imipenem, meropenem and ertapenem against clinical isolates of extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella spp. from Brazil. AU - Kiffer,Carlos R V, AU - Kuti,Joseph L, AU - Eagye,Kathryn J, AU - Mendes,Caio, AU - Nicolau,David P, Y1 - 2006/08/22/ PY - 2006/05/03/received PY - 2006/05/15/revised PY - 2006/05/19/accepted PY - 2006/8/26/pubmed PY - 2007/1/11/medline PY - 2006/8/26/entrez SP - 340 EP - 4 JF - International journal of antimicrobial agents JO - Int J Antimicrob Agents VL - 28 IS - 4 N2 - The pharmacodynamic potency of imipenem, meropenem and ertapenem against extended-spectrum beta-lactamase (ESBL)-producing isolates was investigated. Minimal inhibitory concentration (MIC) determination, confirmation of ESBLs by Etest and the disk approximation test were performed for 133 ESBL-producing isolates of Escherichia coli and Klebsiella spp. Pharmacodynamic exposure, measured as percent of the dosing interval during which free drug was above the MIC (% fT>MIC), was modelled via a 5000-subject Monte Carlo simulation. Bactericidal cumulative fraction of response (CFR), defined as 40% fT>MIC, was calculated against each bacterial population. All agents achieved high bactericidal CFR against all ESBL isolates as a group, but ertapenem (96.26%) was slightly less effective than imipenem (99.96%) and meropenem (99.90%) (P<0.05). Similar results were observed against Klebsiella spp. only (P<0.05). Against E. coli, CFRs were close to 100%. Ertapenem is probably an effective agent against ESBL-producing bacteria, although its ability to achieve bactericidal pharmacodynamic exposures will depend on the bacterial susceptibility. SN - 0924-8579 UR - https://www.unboundmedicine.com/medline/citation/16930951/Pharmacodynamic_profiling_of_imipenem_meropenem_and_ertapenem_against_clinical_isolates_of_extended_spectrum_beta_lactamase_producing_Escherichia_coli_and_Klebsiella_spp__from_Brazil_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0924-8579(06)00261-5 DB - PRIME DP - Unbound Medicine ER -