Review
Microbiology
Pedro Povoa, Patricia Moniz, Joao Goncalves Pereira, Luis Coelho
Summary: Choosing and managing antimicrobial dosing in critically ill patients is a significant challenge. The unstable pharmacokinetic status and rapidly changing clinical condition of these patients require consideration of multiple factors to maximize treatment effectiveness.
Article
Pharmacology & Pharmacy
Chao-Yang Chen, Min Xie, Jun Gong, Ning Yu, Ran Wei, Li-Li Lei, Si-Miao Zhao, Ruo-Ming Li, Xiu Dong, Xiang-Lin Zhang, Ying Zhou, Shuang-Ling Li, Yi-Min Cui
Summary: This study aimed to investigate the population pharmacokinetics (PPK) characteristics of teicoplanin in adult sepsis patients and provide recommendations for optimal teicoplanin dosing regimens. The study found that current standard doses may result in undertherapeutic concentrations and area under the curve (AUC), and a single dose of at least 12 mg/kg may be needed. Model-based simulations revealed the optimal dosing regimens for different renal functions. The importance of monitoring teicoplanin trough concentrations and AUC was emphasized.
FRONTIERS IN PHARMACOLOGY
(2023)
Article
Infectious Diseases
Lisa F. Amann, Rawan Alraish, Astrid Broeker, Magnus Kaffarnik, Sebastian G. Wicha
Summary: This study investigated tigecycline exposure in critically ill patients from a population pharmacokinetic perspective and found that liver impairment significantly reduced tigecycline clearance. The study suggests dose adjustments based on liver function scores.
Article
Infectious Diseases
Letao Li, Sebastiaan D. T. Sassen, Tim M. J. Ewoldt, Alan Abdulla, Nicole G. M. Hunfeld, Anouk E. Muller, Brenda C. M. de Winter, Henrik Endeman, Birgit C. P. Koch
Summary: The suitability of published meropenem pharmacokinetic models for clinical practice was evaluated using real-world ICU data, and two models were found to perform well when using two to three plasma concentrations for therapeutic drug monitoring, while the other models performed poorly.
Article
Critical Care Medicine
Luca F. Roggeveen, Tingjie Guo, Lucas M. Fleuren, Ronald Driessen, Patrick Thoral, Reinier M. van Hest, Ron A. A. Mathot, Eleonora L. Swart, Harm-Jan de Grooth, Bas van den Bogaard, Armand R. J. Girbes, Rob J. Bosman, Paul W. G. Elbers
Summary: This study evaluated the feasibility, safety, and efficacy of a decision support system, AutoKinetics, for personalized antibiotic dosing in critically ill patients. The results showed that personalized dosing significantly improved target attainment for ciprofloxacin but not for other antibiotics. Clinical endpoints were not significantly different.
Article
Pharmacology & Pharmacy
Danhong Liang, Zhi Liang, Guoliang Deng, Anfen Cen, Dandan Luo, Chen Zhang, Suiqin Ni
Summary: The use of Polymyxin B is increasing due to the global spread of multidrug-resistant gram-negative bacteria. However, unsatisfactory therapeutic effects have been observed in critically ill patients. This study aims to determine the pharmacokinetic characteristics of polymyxin B, identify influencing factors, and optimize dosing regimens for clinical effectiveness.
FRONTIERS IN PHARMACOLOGY
(2023)
Article
Infectious Diseases
Romain Garreau, Benoit Falquet, Lisa Mioux, Laurent Bourguignon, Tristan Ferry, Michel Tod, Florent Wallet, Arnaud Friggeri, Jean-Christophe Richard, Sylvain Goutelle
Summary: This study conducted population pharmacokinetic analysis to identify optimal loading and maintenance doses of vancomycin administered by continuous infusion in ICU patients. The model-driven approach suggested loading dose of 27.5 mg/kg of ideal body weight and maintenance dose ranging from 17.5 to 30 mg/kg depending on renal function. Simulations showed that approximately 55.8% of patients would achieve the target exposure with the suggested dosages.
Article
Chemistry, Medicinal
Sha He, Zeneng Cheng, Feifan Xie
Summary: This study developed a population pharmacokinetic (PK) model of gentamicin in continuous renal replacement therapy (CRRT) patients, and inferred the optimal dosing regimen for gentamicin. The results indicated that a combination of 7 mg/kg gentamicin q24h and 40 mL/kg/h CRRT dose might be considered as a starting treatment option for CRRT patients, and drug monitoring is required to manage toxicity.
DRUG DESIGN DEVELOPMENT AND THERAPY
(2022)
Article
Infectious Diseases
Sha He, Zeneng Cheng, Feifan Xie
Summary: This study evaluated the pharmacokinetic/pharmacodynamic (PK/PD) of the Hartford nomogram and its influence on gentamicin dosing in critically ill patients. The study found that the Hartford nomogram provided adequate gentamicin exposure in patients with MIC<=1 mg/L.
INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTS
(2022)
Article
Microbiology
Erin F. Barreto, Jack Chang, Andrew D. Rule, Kristin C. Mara, Laurie A. Meade, Johar Paul, Paul J. Jannetto, Arjun P. Athreya, Marc H. Scheetz, BLOOM Study Group
Summary: A population pharmacokinetic model for cefepime was developed and validated for critically ill patients. The study highlighted the importance of using cystatin C in predicting cefepime clearance.
ANTIMICROBIAL AGENTS AND CHEMOTHERAPY
(2023)
Article
Pharmacology & Pharmacy
Nan Yang, Jing Wang, Yueliang Xie, Junjie Ding, Cuifang Wu, Jingjing Liu, Qi Pei
Summary: This study evaluated the adequacy and predictive capabilities of various meropenem models on routine data, showing that Bayesian forecasting outperformed a priori prediction in predictability.
FRONTIERS IN PHARMACOLOGY
(2022)
Review
Critical Care Medicine
Brian L. Erstad, Jeffrey F. Barletta
Summary: This paper discusses the impact of pharmacokinetic changes in obese patients on medication dosing in the intensive care unit. For hemodynamic support medications, a similar dosing strategy as in non-obese patients can be used. Medications for stress ulcer prophylaxis typically do not need dose adjustments. Anticoagulants for venous thromboembolism prophylaxis, however, require individualized dosing with higher doses in obese patients.
Article
Infectious Diseases
Noemie de Cacqueray, Deborah Hirt, Yi Zheng, Emmanuelle Bille, Pierre Louis Leger, Jerome Rambaud, Julie Toubiana, Anais Chosidow, Sophie Vimont, Delphine Callot, Laurent Chouchana, Agathe Beranger, Jean Marc Treluyer, Sihem Benaboud, Mehdi Oualha
Summary: The study aimed to build a population pharmacokinetic (PK) model for cefepime in critically ill children and optimize individual initial dosing regimens. The results showed that body weight and estimated glomerular filtration rate were associated with drug clearance. According to the simulations, continuous intravenous infusion of cefepime was more likely to achieve the PK target in patients with renal failure, while intermittent intravenous infusion was adequate for patients with normal or augmented renal clearance. Close therapeutic drug monitoring is necessary for cefepime treatment.
CLINICAL MICROBIOLOGY AND INFECTION
(2022)
Article
Pharmacology & Pharmacy
Shamir Kalaria, Sarah Williford, Dong Guo, Yan Shu, Christopher Medlin, Matthew Li, Siu Yan Amy Yeung, Farhan Ali, Wisna Jean, Mathangi Gopalakrishnan, Mojdeh Heavner
Summary: This study aimed to characterize the pharmacokinetics of ceftaroline in critically ill patients undergoing CRRT and to provide individualized dosing recommendations. Results showed that ceftaroline clearance is mainly influenced by non-renal pathways in these patients, impacting the achievement of pharmacodynamic targets.
Article
Biochemistry & Molecular Biology
Maria Della Giovampaola, Irene Cavalli, Luciana Mascia
Summary: Sepsis and septic shock are significant global burdens of disease, with sepsis-associated neurological consequences having a profound impact on patients. Sepsis-associated encephalopathy is a severe brain dysfunction that can lead to long-term cognitive impairment. Its pathophysiology involves neuroinflammation and hemodynamic impairment. Clinical manifestations vary, ranging from agitation and restlessness to delirium and coma. Definite diagnosis is challenging, but clinical management focuses on early detection of the infection source, maintenance of hemodynamic stability, and avoidance of metabolic disturbances or neurotoxic drugs.
Letter
Virology
Giancarlo Ceccarelli, Gabriele d'Ettorre, Alessandro Russo, Silvia Fabris, Massimo Ciccozzi, Gabriella d'Ettorre
JOURNAL OF MEDICAL VIROLOGY
(2023)
Article
Microbiology
Francesco Alessandri, Giancarlo Ceccarelli, Giuseppe Migliara, Valentina Baccolini, Alessandro Russo, Carolina Marzuillo, Mariateresa Ceparano, Giovanni Giordano, Pierfrancesco Tozzi, Gioacchini Galardo, Giammarco Raponi, Claudio Mastroianni, Mario Venditti, Francesco Pugliese, Gabriella d'Ettorre
Summary: This study analyzed the incidence of bloodstream infections (BSI) due to Candida in COVID-19 patients supported with ECMO, and found that the incidence of candidemia was significantly higher in the ECMO group compared to the control group. This result was confirmed by survival analysis and multivariable analyses.
Article
Infectious Diseases
Lorenzo Volpicelli, Mario Venditti, Alessandra Oliva
Summary: Acute bacterial skin and skin structure infections (ABSSSIs) are common in children and increasingly associated with multidrug resistance. Dalbavancin, a long-acting molecule, has shown promise in treating adult ABSSSIs, but its use in pediatric patients is limited. However, emerging evidence suggests that dalbavancin can be safe and effective in treating children with ABSSSIs.
EXPERT REVIEW OF ANTI-INFECTIVE THERAPY
(2023)
Review
Infectious Diseases
Alessandra Oliva, Sergio Carbonara, Vito Cianci, Massimo Crapis, Enea Gino Di Domenico, Marco Falcone, Gioacchino Galardo, Emanuele Durante-Mangoni, Mario Venditti
Summary: Acute Bacterial Skin and Skin Structure Infections (ABSSSIs) commonly result in Emergency Department (ED) access and hospital admissions, causing a significant economic burden. Long-acting lipoglycopeptides (LALs) allow for outpatient management of ABSSSI patients who require parenteral therapy but do not need hospitalization. This article discusses the microbiological activity, efficacy, and safety of dalbavancin, critical steps for ABSSSI management in the ED, and the potential advantage of direct/early discharge with dalbavancin.
EXPERT REVIEW OF ANTI-INFECTIVE THERAPY
(2023)
Review
Biochemistry & Molecular Biology
Nadia Marascio, Giuseppe Guido Maria Scarlata, Francesco Romeo, Claudia Cicino, Enrico Maria Trecarichi, Angela Quirino, Carlo Torti, Giovanni Matera, Alessandro Russo
Summary: Sepsis, a life-threatening condition caused by an abnormal host response to infection, results in multiple organ dysfunction and has a high global mortality rate, with 11 million deaths per year in high-income countries. Studies have shown that septic patients often have dysbiotic gut microbiota, which is associated with increased mortality. This narrative review examines original articles, clinical trials, and pilot studies to evaluate the potential benefits of manipulating the gut microbiota in clinical practice, starting with early sepsis diagnosis and in-depth analysis of the gut microbiota.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2023)
Editorial Material
Biochemistry & Molecular Biology
Alessandro Russo, Rita Pallone, Enrico Maria Trecarichi, Carlo Torti
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2023)
Article
Infectious Diseases
Giancarlo Ceccarelli, Beatrice Perciballi, Alessandro Russo, Paolo Martini, Francesco Marchetti, Marco Rivano Capparuccia, Giancarlo Iaiani, Silvia Fabris, Massimo Ciccozzi, Ciro Villani, Mario Venditti, Gabriella D'Ettorre, Daniele De Meo
Summary: Prosthetic joint infection (PJI) and fracture-related infection (FRI) are challenging conditions in high-risk patients. For those not eligible for standard treatment, combination therapy of debridement, long-term antibiotics, and chronic oral antimicrobial suppression (COAS) can be a reasonable option. This study retrospectively analyzed 16 patients who underwent COAS after debridement and antibiotic treatment, with a median follow-up of 15 months. The monitoring of patients included clinical evaluation, laboratory tests, and radiolabeled leukocyte scintigraphy (LS). The results showed that 62.5% of patients had no relapse after cure at the last evaluation, while side effects led to COAS discontinuation in 50% of the patients who experienced a relapse.
Letter
Immunology
Maurizio Guastalegname, Enrico Maria Trecarichi, Alessandro Russo
CLINICAL INFECTIOUS DISEASES
(2023)
Review
Infectious Diseases
Alessandra Oliva, Francesco Giuseppe De Rosa, Malgorzata Mikulska, Federico Pea, Maurizio Sanguinetti, Carlo Tascini, Mario Venditti
Summary: Invasive Candida Infections (ICIs) have experienced significant changes in epidemiology, pathophysiology, and clinical manifestations in recent decades, including a shift towards non-albicans species and an increase in exogenous infections. The long-acting echinocandin rezafungin has shown potent in-vitro activity against Candida spp., including azole-resistant strains and C.auris.
EXPERT REVIEW OF ANTI-INFECTIVE THERAPY
(2023)
Editorial Material
Medicine, General & Internal
Sara Palma Gulli, Alessandro Russo
INTERNAL AND EMERGENCY MEDICINE
(2023)
Article
Infectious Diseases
A. Russo, A. Bruni, S. Gulli, C. Borrazzo, A. Quirino, R. Lionello, F. Serapide, E. Garofalo, R. Serraino, F. Romeo, N. Marascio, G. Matera, F. Longhini, E. M. Trecarichi, C. Torti
Summary: This study observed VAP and concurrent bloodstream infections caused by CRAB, finding that chronic obstructive pulmonary disease and age were independently associated with 30-day mortality, while cefiderocol-containing regimens and cefiderocol + fosfomycin in combination were independently associated with 30-day survival.
INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTS
(2023)
Article
Medicine, General & Internal
Giancarlo Ceccarelli, Francesco Alessandri, Giuseppe Migliara, Valentina Baccolini, Giovanni Giordano, Gioacchino Galardo, Carolina Marzuillo, Corrado De Vito, Alessandro Russo, Massimo Ciccozzi, Paolo Villari, Mario Venditti, Claudio M. Mastroianni, Francesco Pugliese, Gabriella d'Ettorre
Summary: The study aimed to assess the accuracy of procalcitonin levels as a diagnostic tool and found that elevated levels may not always indicate bacterial superinfections or coinfections in severe COVID-19 cases.
JOURNAL OF CLINICAL MEDICINE
(2023)
Review
Medicine, General & Internal
Ferdinando Carmelo Pio Lionello, Salvatore Rotundo, Gabriele Bruno, Gabriella Marino, Helen Linda Morrone, Paolo Fusco, Chiara Costa, Alessandro Russo, Enrico Maria Trecarichi, Anna Beltrame, Carlo Torti
Summary: Among infectious diseases, zoonoses are becoming more important worldwide, particularly in the Mediterranean region. This study reports clinical cases from a hospital in Southern Italy and provides a review of the epidemiological and clinical features of these diseases. The review also highlights the pathogenic mechanisms used by pathogens to evade the host immune system.