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Cefoxitin-based combination for ESBL-producing Enterobacteriaceae endocarditis

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Titel: Cefoxitin-based combination for ESBL-producing Enterobacteriaceae endocarditis
Autoren: Danneels, P., Rihet, C., Vannier, C., Quinqueneau, C., Courtois, R., Kempf, M., Eveillard, M., Mahieu, R., Dubée, V.
Weitere Verfasser: Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM), Centre Hospitalier de Cholet (CH Cholet), Centre de Recherche en Cancérologie et Immunologie Intégrée Nantes-Angers (CRCI2NA), Université d'Angers (UA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Nantes Université - UFR de Médecine et des Techniques Médicales (Nantes Univ - UFR MEDECINE), Nantes Université - pôle Santé, Nantes Université (Nantes Univ)-Nantes Université (Nantes Univ)-Nantes Université - pôle Santé, Nantes Université (Nantes Univ)-Nantes Université (Nantes Univ), SFR UA 4208 Interactions Cellulaires et Applications Thérapeutiques (ICAT), Université d'Angers (UA)
Quelle: Infectious Diseases Now. 52:408-413
Verlagsinformationen: Elsevier BV, 2022.
Publikationsjahr: 2022
Schlagwörter: 0301 basic medicine, MESH: Endocarditis, MESH: beta-Lactamases, Cilastatin, Imipenem Drug Combination, MESH: Urinary Tract Infections, Microbial Sensitivity Tests, beta-Lactamases, MESH: Carbapenems, MESH: Enterobacteriaceae, Cefoxitin, 03 medical and health sciences, MESH: Fosfomycin, Fosfomycin, Enterobacteriaceae, MESH: Cilastatin, Ciprofloxacin, MESH: Anti-Bacterial Agents, Escherichia coli, Humans, MESH: Cefoxitin, Beta-lactamase, MESH: Ciprofloxacin, Escherichia coli Infections, MESH: Escherichia coli Infections, MESH: Microbial Sensitivity Tests, MESH: Humans, Endocarditis, MESH: Escherichia coli, Anti-Bacterial Agents, 3. Good health, Carbapenems, Urinary Tract Infections, Imipenem Drug Combination, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Beschreibung: Endocarditis due to extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae is a rare but challenging condition. Its treatment relies on carbapenems alone or in combination, and no alternative has been described to date. The cephamycin cefoxitin has been used for treatment of mild ESBL-producing Enterobacteriaceae infections.We report two patients with nosocomial endocarditis due to ESBL-producing Escherichia coli and Klebsiella pneumoniae who underwent clinical failure or adverse event, respectively, during treatment with imipenem-cilastatin. The first patient was subsequently treated with cefoxitin combined with ciprofloxacin with a favorable outcome. In the second patient, the endocarditis relapsed following a 6-week treatment with cefoxitin and fosfomycin. In time-kill assays, the cefoxitin/ciprofloxacin and cefoxitin/fosfomycin combinations showed synergistic effect.These cases illustrate that cefoxitin is an interesting alternative to carbapenems, even in severe infections such as endocarditis. Pharmacokinetic optimization and combination with another synergistic antibiotic should be considered whenever possible.
Publikationsart: Article
Sprache: English
ISSN: 2666-9919
DOI: 10.1016/j.idnow.2022.08.001
Zugangs-URL: https://pubmed.ncbi.nlm.nih.gov/36028145
Rights: Elsevier TDM
Dokumentencode: edsair.doi.dedup.....6d4a5fcb8a94f68a54cd116887b36c54
Datenbank: OpenAIRE
Beschreibung
Abstract:Endocarditis due to extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae is a rare but challenging condition. Its treatment relies on carbapenems alone or in combination, and no alternative has been described to date. The cephamycin cefoxitin has been used for treatment of mild ESBL-producing Enterobacteriaceae infections.We report two patients with nosocomial endocarditis due to ESBL-producing Escherichia coli and Klebsiella pneumoniae who underwent clinical failure or adverse event, respectively, during treatment with imipenem-cilastatin. The first patient was subsequently treated with cefoxitin combined with ciprofloxacin with a favorable outcome. In the second patient, the endocarditis relapsed following a 6-week treatment with cefoxitin and fosfomycin. In time-kill assays, the cefoxitin/ciprofloxacin and cefoxitin/fosfomycin combinations showed synergistic effect.These cases illustrate that cefoxitin is an interesting alternative to carbapenems, even in severe infections such as endocarditis. Pharmacokinetic optimization and combination with another synergistic antibiotic should be considered whenever possible.
ISSN:26669919
DOI:10.1016/j.idnow.2022.08.001