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Title of Journal: Infection

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Abbravation: Infection

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Urban and Vogel

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DOI

10.1007/bf00475935

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1439-0973

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Failure of Current Antibiotic FirstLine Regimens

Authors: A Umgelter W Reindl M Miedaner R M Schmid W Huber
Publish Date: 2009/01/23
Volume: 37, Issue: 1, Pages: 2-
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Abstract

Increases in Grampositive infections and infections with Enterobacteriaceae with antimicrobial resistance have been reported in patients with spontaneous bacterial peritonitis SBP This study was performed to investigate the rate of treatment failures of recommended empirical therapies and the impact on mortality17 patients initially received a broader than recommended antibiotic regimen Most of these were treated in the intensive care unit because of severe sepsis/septic shock Hospital mortality in this group was 82 A modification of therapy was necessary in 24 of the 84 patients receiving one of the published firstline therapies cefotaxime ampicillin/clavulanate or ciprofloxacin Mortality was significantly higher in these patients than in those with no change in treatment 667 vs 30 p = 0002 In 29 patients with positive cultures mortality was also higher in those with an ineffective firstline treatment 90 vs 45 p = 0032 In the multivariable analysis a modification of antibiotic treatment was an independent risk factor for mortality odds ratio 5876 95 confidence interval 1826–18910 p = 0003 In 41 culturepositive cases the most commonly cultured pathogens were Escherichia coli n = 17 and Enterococcus faecium n = 10 Of the encountered bacterial microorganisms 14 333 were resistant to cefotaxime 17 386 were resistant to amoxicillin/clavulanate and 19 452 were resistant to ciprofloxacin 29 644 of the isolates were resistant to one of the recommended firstline antibiotic regimens and 11 244 of the isolates were resistant to all three


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  4. Increasing Occurrence of Multidrug-Resistance in Acinetobacter baumannii Isolates From Four German University Hospitals, 2002–2006
  5. Antineutrophil cytoplasmic antibody-associated vasculitis associated with Epstein–Barr virus infection: a case report and review of the literature
  6. Zur Diffusion von Cefotaxim in verschiedene Gewebe des urologischen Bereichs
  7. Validation of a multiplex reverse transcriptase PCR ELISA for the detection of 19 respiratory tract pathogens
  8. Interferon-γ releasing assay versus tuberculin skin testing for latent tuberculosis infection in targeted screening programs for high risk immigrants
  9. Complicated Community-Acquired Soft Tissue Infection by MRSA from Porcine Origin
  10. Human metapneumovirus infection after allogeneic hematopoietic stem cell transplantation
  11. Reasons for not starting antiretroviral therapy in HIV-1-infected individuals: a changing landscape
  12. Serum Citrate Levels, Haptoglobin Haplotypes and Transferrin Receptor (CD71) in Patients With HIV-1 Infection
  13. Immune-Mediated Severe Hemolytic Crisis with a Hemoglobin Level of 1.6 g/dl Caused by Anti-Piperacillin Antibodies in a Patient with Cystic Fibrosis
  14. Combination of Quinupristin/Dalfopristin and Glycopeptide in Severe Methicillin-Resistant Staphylococcal Infections Failing Previous Glycopeptide Regimens
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