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I would like to discuss “Fluoroquinolone (FQ) or TMP-SMX vs beta-lactam (BLs) after initial IV course for gram negative bacteremia (GNR) “
Systemic review was conducted and eight retrospective studies met the inclusion criteria
@IdVilchez
I would like to discuss “Fluoroquinolone (FQ) or TMP-SMX vs beta-lactam (BLs) after initial IV course for gram negative bacteremia (GNR) “
Systemic review was conducted and eight retrospective studies met the inclusion criteria
@IdVilchez
There was 2289 patients 65% transitioned to FQ , 7.7 % transitioned to TMP-SMX, and 27.2 % to BLs.
Follow up ranged between 21 and 90 days .
All cause mortality was not different but recurrent of bacteremia or infection at the primary site was more noted in BLs vs FQs
Follow up ranged between 21 and 90 days .
All cause mortality was not different but recurrent of bacteremia or infection at the primary site was more noted in BLs vs FQs
(OR, 2.05; 95% CI, 1.17–3.61).
The argument for BLs is the dose was suboptimal , BLs exhibit time dependent inhibition and killing and it is generally recommended to target a free drug concentration time greater than the minimum inhibitory concentration
The argument for BLs is the dose was suboptimal , BLs exhibit time dependent inhibition and killing and it is generally recommended to target a free drug concentration time greater than the minimum inhibitory concentration
(MIC; fT > MIC) of >50% for penicillins and 60% for cephalosporins.Some BLs have excellent bioavailability include amoxicillin has up to 92%, amoxicillin/clavulanate 60%, cephalexin up to 100%, and cefaclor up to 95% bioavailability,
whereas ciprofloxacin has 85% and TMP-SMX has 90% bioavailability .
Dosing regimen recommended include
amoxicillin be dosed at 1 g every 8 hours, and cephalexin at 1 g every 6 hours, high-dose amoxicillin and
Dosing regimen recommended include
amoxicillin be dosed at 1 g every 8 hours, and cephalexin at 1 g every 6 hours, high-dose amoxicillin and
amoxicillin/clavulanate should be used and dosed every 8 hours for treating serious infections.
What is your experience with the BLs regimens mentioned above ?
Would you even give higher doses on morbidly obese patients ?
Thank you
Would you even give higher doses on morbidly obese patients ?
Thank you
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