1- Monday Infectious Disease News – 2nd August 

1 – Perioperative administration of cefazolin and metronidazole in obese and non-obese patients: a pharmacokinetic study in plasma and interstitial fluid

• This study aims to assess plasma and tissue pharmacokinetics of cefazolin and metronidazole in obese patients undergoing bariatric surgery and non-obese patients undergoing intra-abdominal surgery.
• During the time of surgery, cefazolin concentrations in plasma and ISF of subcutaneous tissue were lower in obese patients, but not clinically relevant.
• Regarding metronidazole, the respective differences were higher, and may influence dosing of metronidazole for perioperative prophylaxis in obese patients.

Source: Oxford Academic

2 – In vitro and in vivo synergistic effects of tigecycline combined with aminoglycosides on carbapenem-resistant Klebsiella pneumoniae

• Carbapenem-resistant Klebsiella pneumoniae (CR-KP) infections represent severe threats to public health worldwide.
• The aim of this study was to assess potential synergistic interaction between tigecycline and aminoglycosides via in vitro and in vivo studies.
• Compared with single drugs, tigecycline combined with aminoglycosides could exert synergistic effects and reduce the emergence of tigecycline resistance.
• Such a combination might be an effective alternative when treating CR-KP infections in clinical practice.

Source: Oxford Academic

3 – Activity of plazomicin against carbapenem-intermediate or -resistant Escherichia coli isolates from the United States and international sites in relation to clonal background, resistance genes, co-resistance, and region

• Emerging carbapenem resistance in Escherichia coli, including sequence type 131 (ST131), threatens therapeutic efficacy.
• Plazomicin (PLZ), a semisynthetic aminoglycoside approved by the FDA in 2018, overcomes the most common aminoglycoside resistance mechanisms and maintains activity against many carbapenem-intermediate or -resistant (CIR) E. coli strains.
• This study aims to assess plazomicin susceptibility among CIR E. coli in relation to region and multiple bacterial characteristics.
• The likely utility of plazomicin against CIR E. coli is high overall, but varies with region and multiple bacterial characteristics.

Source: Oxford Academic

4- Variation in approaches to antimicrobial use surveillance in high-income secondary care settings: a systematic review

• In secondary care, antimicrobial use (AMU) must be monitored to reduce the risk of antimicrobial resistance and infection-related complications.
• However, there is variation in how hospitals address this challenge, partly driven by each site’s level of digital maturity, expertise and resources available.
• This systematic review investigated approaches to measuring AMU to explore how these structural differences may present barriers to engagement with AMU surveillance.
• Even in regions with access to electronic datasets, hospitals rely on manual data extraction for this work.
• Data extraction is undertaken by healthcare professionals, who may have conflicting priorities.
• Reducing barriers to engagement in AMU surveillance requires investment in methods, resources and training so that hospitals can extract and analyse data already contained within electronic patient records.

Source: Oxford Academic

5 – Clinical efficacy and safety of remdesivir in patients with COVID-19: a systematic review and network meta-analysis of randomized controlled trials

• They performed a systematic review and network meta-analysis of randomized controlled trials (RCTs) to provide updated information regarding the clinical efficacy of remdesivir in treating coronavirus disease 2019 (COVID-19).
• Remdesivir can help improve the clinical outcome of hospitalized patients with COVID-19 and a 5 day regimen, instead of a 10 day regimen, may be sufficient for treatment.
• Moreover, remdesivir appears as tolerable as other comparators or placebo.

Source: Oxford Academic

6 – Comparative macrolide use in humans and animals: should macrolides be moved off the World Health Organisation’s critically important antimicrobial list?

• Macrolide antibiotics are categorized by the WHO as Highest Priority, Critically Important Antimicrobials due to their recommendation as treatment for severe cases of campylobacteriosis in humans; a self-limiting, rarely life-threatening, zoonotic foodborne infection.
• Low rates of macrolide resistance in Campylobacter jejuni and the availability of alternative treatments have prompted some regulatory schemes to assign macrolides to a lower importance category.
• Apart from rare, specific infections, macrolides largely play a supportive role to other drug classes in human medicine.
• Whilst acknowledging that ongoing surveillance is required to reduce the spread of recently emerged, transferable macrolide resistance among Campylobacter, this article recommends that macrolides should be moved to the WHO Highly Important category.

Source: Oxford Academic

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