Abstract | BACKGROUND: Selecting an appropriate agent for empiric antibiotic therapy for secondary peritonitis is challenging. The pathogens responsible, aerobic gram-negative bacilli in particular, are becoming more resistant to antibiotics. The purpose of this study was to predict the ability of common antimicrobial regimens to achieve optimal pharmacodynamic exposure against aerobic bacteria implicated in secondary peritonitis, while considering current national resistance trends. METHODS: Monte Carlo simulation was used to model pharmacodynamic endpoints and compare the cumulative fraction of response (CFR) for imipenem-cilastatin, meropenem, ertapenem, piperacillin/tazobactam, ceftazidime, ceftriaxone, ciprofloxacin, and levofloxacin against isolates of species associated with secondary peritonitis. Minimum inhibitory concentration (MIC) distributions for isolates collected in North America were obtained from the 2004 MYSTIC database. Pharmacokinetic parameters were derived from the literature; the endpoints evaluated included free drug time above the MIC (fT(>MIC)) and the area under the concentration-time curve to MIC ratio (AUC:MIC). RESULTS: CONCLUSIONS:
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Authors | Kathryn J Eagye, Joseph L Kuti, David P Nicolau |
Journal | Surgical infections
(Surg Infect (Larchmt))
Vol. 8
Issue 2
Pg. 215-26
(Apr 2007)
ISSN: 1096-2964 [Print] United States |
PMID | 17437367
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
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Topics |
- Acinetobacter
(drug effects)
- Anti-Infective Agents
(pharmacokinetics)
- Bacteria, Aerobic
(drug effects, pathogenicity)
- Bacterial Infections
(drug therapy)
- Decision Making, Computer-Assisted
- Empirical Research
- Enterobacteriaceae
(drug effects)
- Forecasting
- Gram-Positive Cocci
(drug effects)
- Humans
- Microbial Sensitivity Tests
- Models, Biological
- Monte Carlo Method
- Peritonitis
(drug therapy, microbiology)
- Pseudomonas aeruginosa
(drug effects)
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