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Gatti M, Virgili G, Viale P, Pea F. Is intrathecal or intraventricular therapy with polymyxins or aminoglycosides still needed to improve the outcome of post-neurosurgical extensively/multidrug-resistant Gram-negative bacteria-related meningitis/ventriculitis in the current era of novel beta-lactams and beta-lactam/beta-lactamase inhibitor combinations? Int J Antimicrob Agents 2024; 63:107177. [PMID: 38643849 DOI: 10.1016/j.ijantimicag.2024.107177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 02/02/2024] [Accepted: 03/15/2024] [Indexed: 04/23/2024]
Affiliation(s)
- Milo Gatti
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy; Clinical Pharmacology Unit, Department for Integrated Infectious Risk Management, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
| | - Giulio Virgili
- Infectious Diseases Unit, Department for Integrated Infectious Risk Management, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Pierluigi Viale
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy; Infectious Diseases Unit, Department for Integrated Infectious Risk Management, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Federico Pea
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy; Clinical Pharmacology Unit, Department for Integrated Infectious Risk Management, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
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Pipitone G, Di Bella S, Maraolo AE, Granata G, Gatti M, Principe L, Russo A, Gizzi A, Pallone R, Cascio A, Iaria C. Intravenous Fosfomycin for Systemic Multidrug-Resistant Pseudomonas aeruginosa Infections. Antibiotics (Basel) 2023; 12:1653. [PMID: 38136687 PMCID: PMC10741068 DOI: 10.3390/antibiotics12121653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 11/21/2023] [Accepted: 11/22/2023] [Indexed: 12/24/2023] Open
Abstract
Human Pseudomonas infections have high morbidity and mortality rates. Pseudomonas bacteria can cause sepsis or septic shock; they produce biofilm and commonly exhibit a multidrug-resistant phenotype. The choice of antimicrobial therapy in many cases is challenging, and deep knowledge of clinical, microbiological, and pharmacological issues is required. Intravenous fosfomycin is being repurposed in a combination given its favorable pharmacokinetic/pharmacodynamic properties (a small molecule with favorable kinetic both in bloodstream infection and in deep-seated infections), antibiofilm activity, and its interesting synergistic effects with other antimicrobials. Recent literature on epidemiological, microbiological, pharmacological, and clinical data on intravenous fosfomycin therapy against Pseudomonas is herein reviewed and discussed.
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Affiliation(s)
- Giuseppe Pipitone
- Infectious Diseases Unit, ARNAS Civico-Di Cristina Hospital, 90127 Palermo, Italy; (G.P.)
| | - Stefano Di Bella
- Clinical Department of Medical, Surgical and Health Sciences, Trieste University, 34127 Trieste, Italy
| | - Alberto Enrico Maraolo
- First Division of Infectious Diseases, Cotugno Hospital, Azienda Ospedaliera dei Colli, 80131 Naples, Italy
| | - Guido Granata
- Clinical and Research Department for Infectious Diseases, National Institute for Infectious Diseases L. Spallanzani, IRCCS, 00149 Rome, Italy
| | - Milo Gatti
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy
- Clinical Pharmacology Unit, IRCCS University Hospital of Bologna, 40138 Bologna, Italy
| | - Luigi Principe
- Microbiology and Virology Unit, Great Metropolitan Hospital “Bianchi-Melacrino-Morelli”, 89133 Reggio Calabria, Italy
| | - Alessandro Russo
- Infectious and Tropical Diseases Unit, Department of Medical and Surgical Sciences, ‘Magna Graecia’ University of Catanzaro, 88100 Catanzaro, Italy
| | - Andrea Gizzi
- Infectious Diseases Unit, ARNAS Civico-Di Cristina Hospital, 90127 Palermo, Italy; (G.P.)
- Infectious Diseases Unit, University Hospital P. Giaccone, 90127 Palermo, Italy
| | - Rita Pallone
- Infectious and Tropical Diseases Unit, University Hospital “Renato Dulbecco”, 88100 Catanzaro, Italy
| | - Antonio Cascio
- Infectious Diseases Unit, University Hospital P. Giaccone, 90127 Palermo, Italy
| | - Chiara Iaria
- Infectious Diseases Unit, ARNAS Civico-Di Cristina Hospital, 90127 Palermo, Italy; (G.P.)
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