1,721,681 research outputs found
Fungal pulmonary infections: the conservative approach,
No full textInvasive fungal infections have increased worldwide and represent a threat for immunocompromised patients, including those who are HIV infected, recipients of solid organ and stem cell transplants, and patients receiving immunosuppressive therapies. High mortality rates and difficulties in early diagnosis characterise pulmonary fungal infections. In this chapter, invasive pulmonary aspergillosis, cryptococcosis and Pneumocystis jirovecii pneumonia have been reviewed, focusing on clinical aspects and therapeutic management. Although new compounds have become available in recent years (e.g. amphotericin B lipid formulations, third-generation azoles and echinocandins), new diagnostic tools and careful therapeutic management are mandatory to ensure an early appropriate targeted treatment, which is the key to a successful conservative approach in respiratory fungal infections
Infezioni delle vie urinarie: appropriatezza in antibioticoterapia
No full textAdequacy of antimicrobial therapy in urinary tract infections (UTI)Urinary tract infections are one of the most common reasons for antimicrobial prescriptions, however urine cultures are often unavailable and the choice of antibiotics is therefore empiric. The ideal antimicrobial agent must have specific pharmacokinetic and pharmacodynamic characteristics and an adequate spectrum of activity in order to obtain the potential eradication of the pathogen from the site of infection, minimizing the risk of recurrences and ensuring the best safety profile. There are several factors to be considered in the therapy choice: the type of infection, the increasing presence of extended-spectrum beta-lactamase (ESBL) producing bacteria showing resistance to most antibiotics and the problem of the bacterial internalization, that is a frequent cause of treatment failure and early recurrences. Prulifloxacin is a recent oral fluoroquinolone antibiotic approved in several European countries for the treatment of lower urinary tract infections and shows some interesting advantages in comparison with other antibiotics
Bacterial and fungal infections in kidney transplant recipients
No full textDespite advances in the scientific knowledge related to organ transplantation, kidney transplant recipients remain patients who must take immunosuppressive therapy for the rest of their lives to prevent graft rejection. This situation, coupled with the possible need for medical care, whether invasive or noninvasive, and higher hospitalization rates than in the general population, puts the patient with a transplanted kidney at risk of developing infectious diseases. An important threat are bacterial infections of the urinary tract at different levels of severity (from asymptomatic bacteriuria to urinary septicemia), which in recent years have included infections by multidrug-resistant bacteria. Careful attention must be paid therefore to the overall management of kidney transplant recipients with infections and to the "ecological" use of antibiotic therapy, which aims at preventing antibiotic resistance according to the recent concept of antibiotic stewardship. Among the fungal infections candida infections require special consideration. As with bacterial infections, there may be different degrees of severity ranging from candiduria (where some see no indication for treatment) to pyelonephritis and candidemia, conditions that may lead to vascular complications and the possible rupture of blood vessels. The key to success in the fight against infections after kidney transplant lies in the multidisciplinary approach to their management, with the involvement of the nephrologist, transplant surgeon, infectiologist, clinical microbiologist and clinical pharmacologist
Innovative β-lactam/β-lactamase inhibitor combinations for carbapenem-resistant Gram-negative bacteria
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Cefepime-taniborbactam and CERTAIN-1: Can we treat carbapenem-resistant infections?
No full textWagenlehner and colleagues 1 demonstrated non-inferiority and superiority with respect to a primary endpoint of composite success (microbiological plus clinical) of cefepime/taniborbactam vs. meropenem in treating complicated urinary tract infections and acute pyelonephritis caused by carbapenem-susceptible gram-negative bacteria in adults. A major area of interest in real-world application of cefepime/taniborbactam is its potential role in treating carbapenem-resistant infections, which deserves further investigation
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