TY - JOUR
AU1 - Hirsch, Elizabeth, B.
AU2 - Cottreau, Jessica, M.
AU3 - Ikwuagwu, Judy, O.
AU4 - Lusardi, Katherine, T.
AU5 - Mohr, John, F.
AU6 - Rodriguez, Sarah, M.
AU7 - Shah, Dhara, N.
AU8 - Tran, Truc, T.
AB - Abstract Purpose Important articles on topics pertinent to infectious diseases (ID) pharmacotherapy published in prominent peer-reviewed journals in 2010 are summarized. Summary At the end of 2010, pharmacists, physicians, and researchers in the Houston Infectious Diseases Network were asked to nominate articles published from January through December 2010 that they perceived as having a significant impact in the field of ID pharmacotherapy. The resulting list, comprising 27 articles relating to human immunodeficiency virus (HIV) disease or acquired immune deficiency syndrome (AIDS) and 52 articles on a broad range of other ID-related topics, was sent to members of the Society of Infectious Diseases Pharmacists (SIDP) for evaluation via an Internet survey. The survey participants were asked to select from the list 10 articles unrelated to HIV or AIDS and 1 HIV- or AIDS-related article that in their view had the most significant impact in the field. Of the 380 SIDP members surveyed, 105 (27.6%) ranked the non-HIV-related papers and 45 (11.8%) ranked the HIV-related papers. The 11 highest-ranked publications—including 2 articles presenting updated practice guidelines—are summarized here. Conclusion Due to the increasing number of articles published each year, it is difficult to maintain a current knowledge of significant publications in the field of ID pharmacotherapy. This review of key publications in 2010 may be helpful to the nonspecialist clinician by lessening this burden. Acquired immunodeficiency syndrome, Antinfective agents, Communicable diseases, Data collection, HIV infections, Journals, Organizations, Peer review, Pharmacists, Protocols, Publications Each year, the volume of information published in peer-reviewed journals makes it challenging for many clinicians to stay updated on key publications. A PubMed search conducted in February 2011 found that in 2010 alone, 897,926 articles were cited. Specific keyword searches for the terms infectious diseases and HIV yielded 10,104 and 13,464 articles, respectively; those figures reflect substantial increases from the numbers of articles on those topics identified in 2009 (9,435 and 12,596, respectively). Rising antimicrobial resistance rates, strategies aimed at combating increased resistance, and investigations of novel antimicrobials may add to the growing body of publications in this field. The Houston Infectious Diseases Network (HIDN) is a group of about 40 infectious diseases (ID) clinicians (pharmacists and physicians), microbiologists, and researchers, the majority of whom practice at more than 17 institutions in the greater Houston area. HIDN meets regularly and aims to foster collaborative research and education and the sharing of best-practice models. The network hosts presentations by national ID experts and mentors residents and fellows with an interest in ID. To build on previous efforts to identify and summarize important ID pharmacotherapy-oriented publications of the previous year,1–3 HIDN members were asked to serve as an expert panel in nominating articles published in 2010 that they believe had a significant impact in the area of ID pharmacotherapy, including the management of human immunodeficiency virus (HIV) infection or acquired immune deficiency syndrome (AIDS). All nominated manuscripts were published from January 1 through December 31, 2010, in prominent peer-reviewed journals (e.g., The New England Journal of Medicine, Lancet, Clinical Infectious Diseases, Antimicrobial Agents and Chemotherapy, and Journal of Acquired Immune Deficiency Syndrome). In late December 2010, the list of nominated articles was compiled and sent to members of the Society of Infectious Diseases Pharmacists (SIDP) for voting via an Internet survey (www.surveymonkey.com). SIDP members were asked to select the top 10 papers (in nonranked fashion) that made the most significant contributions to the field of ID pharmacotherapy from a list of 52 publications, as well as the single most significant paper from a list of 27 articles related to HIV disease or AIDS. In an effort to minimize responses from SIDP members who may not have been up to date with publications in both general and HIV-focused ID pharmacotherapy, the survey respondents were given the opportunity to opt out of voting in either area. Respondents were also allowed to nominate articles not included in the survey; each write-in nomination was counted as a single vote. The total survey response counts were used to determine the final article rankings. Of the 380 SIDP members surveyed, 105 (27.6%) and 45 (11.8%) members voted for non-HIV-related articles and HIV-related articles, respectively. Interestingly, the majority of top articles selected from the non-HIV-related category pertained to major practice guideline updates or research on gram-negative bacteria or sepsis or septic shock, perhaps reflecting the continued and alarming emergence of resistance within gram-negative bacterial species. There were three write-in nominations of articles in the non-HIV-related category and no write-in nominations of HIV-related articles. The 11 highest-ranked papers (10 non-HIV-related articles and 1 HIV-related article) are cited and summarized below; the selected papers are listed alphabetically by the lead author’s name. A ranked summary of the top 25 non-HIV-related articles appears in Table 1, and the top 10 HIV-related articles are listed in Table 2. Table 2 Surveyed Ranking Results of Top 10 Publications on HIV or AIDS in 2010a Ranking Reference No. (%) Individuals Ranking Article (n = 45) 1 Abdool Karim Q, Abdool Karim SS, Frohlich JA et al. Effectiveness and safety of tenofovir gel, an antiretroviral microbicide, for the prevention of HIV infection in women. Science. 2010; 329:1168–74. 11 (24) 2 Grant RM, Lama JR, Anderson PL et al. Preexposure chemoprophylaxis for HIV prevention in men who have sex with men. N Engl J Med. 2010; 363:2587–99. 8 (18) 3 Severe P, Juste MA, Ambroise A et al. Early versus standard antiretroviral therapy for HIV-infected adults in Haiti. N Engl J Med. 2010; 363:257–65. 4 (9) 4 Hamill RJ, Sobel JD, El-Sadr W et al. Comparison of 2 doses of liposomal amphotericin B and conventional amphotericin B deoxycholate for treatment of AIDS-associated acute cryptococcal meningitis: a randomized, double-blind clinical trial of efficacy and safety. Clin Infect Dis. 2010; 51:225–32. 3 (7) 5 Perfect JR, Dismukes WE, Dromer F et al. Clinical practice guidelines for the management of cryptococcal disease: 2010 update by the Infectious Diseases Society of America. Clin Infect Dis. 2010; 50:291–322. 3 (7) 6 Thompson MA, Aberg JA, Cahn P et al. Antiretroviral treatment of adult HIV infection: 2010 recommendations of the International AIDS Society-USA panel. JAMA. 2010; 304:321–33. 3 (7) 7 Arribas JR, Horban A, Gerstoft J et al. The MONET trial: darunavir/ritonavir with or without nucleoside analogues, for patients with HIV RNA below 50 copies/ml. AIDS. 2010; 24:223–30. 2 (4) 8 German P, Warren D, West S et al. Pharmacokinetics and bioavailability of an integrase and novel pharmacoenhancer-containing single-tablet fixed-dose combination regimen for the treatment of HIV. J Acquir Immune Defic Syndr. 2010; 55:323–9. 2 (4) 9 Gill VS, Lima VD, Zhang W et al. Improved virological outcomes in British Columbia concomitant with decreasing incidence of HIV type 1 drug resistance detection. Clin Infect Dis. 2010; 50:98–105. 2 (4) 10 Lennox JL, Dejesus E, Berger DS et al. Raltegravir versus efavirenz regimens in treatment-naive HIV-1-infected patients: 96-week efficacy, durability, subgroup, safety, and metabolic analyses. J Acquir Immune Defic Syndr. 2010; 55:39–48. 2 (4) Ranking Reference No. (%) Individuals Ranking Article (n = 45) 1 Abdool Karim Q, Abdool Karim SS, Frohlich JA et al. Effectiveness and safety of tenofovir gel, an antiretroviral microbicide, for the prevention of HIV infection in women. Science. 2010; 329:1168–74. 11 (24) 2 Grant RM, Lama JR, Anderson PL et al. Preexposure chemoprophylaxis for HIV prevention in men who have sex with men. N Engl J Med. 2010; 363:2587–99. 8 (18) 3 Severe P, Juste MA, Ambroise A et al. Early versus standard antiretroviral therapy for HIV-infected adults in Haiti. N Engl J Med. 2010; 363:257–65. 4 (9) 4 Hamill RJ, Sobel JD, El-Sadr W et al. Comparison of 2 doses of liposomal amphotericin B and conventional amphotericin B deoxycholate for treatment of AIDS-associated acute cryptococcal meningitis: a randomized, double-blind clinical trial of efficacy and safety. Clin Infect Dis. 2010; 51:225–32. 3 (7) 5 Perfect JR, Dismukes WE, Dromer F et al. Clinical practice guidelines for the management of cryptococcal disease: 2010 update by the Infectious Diseases Society of America. Clin Infect Dis. 2010; 50:291–322. 3 (7) 6 Thompson MA, Aberg JA, Cahn P et al. Antiretroviral treatment of adult HIV infection: 2010 recommendations of the International AIDS Society-USA panel. JAMA. 2010; 304:321–33. 3 (7) 7 Arribas JR, Horban A, Gerstoft J et al. The MONET trial: darunavir/ritonavir with or without nucleoside analogues, for patients with HIV RNA below 50 copies/ml. AIDS. 2010; 24:223–30. 2 (4) 8 German P, Warren D, West S et al. Pharmacokinetics and bioavailability of an integrase and novel pharmacoenhancer-containing single-tablet fixed-dose combination regimen for the treatment of HIV. J Acquir Immune Defic Syndr. 2010; 55:323–9. 2 (4) 9 Gill VS, Lima VD, Zhang W et al. Improved virological outcomes in British Columbia concomitant with decreasing incidence of HIV type 1 drug resistance detection. Clin Infect Dis. 2010; 50:98–105. 2 (4) 10 Lennox JL, Dejesus E, Berger DS et al. Raltegravir versus efavirenz regimens in treatment-naive HIV-1-infected patients: 96-week efficacy, durability, subgroup, safety, and metabolic analyses. J Acquir Immune Defic Syndr. 2010; 55:39–48. 2 (4) a Rank listed from 1 (most highly rated) to 10 (least highly rated). HIV = human immunodeficiency virus, AIDS = acquired immune deficiency syndrome. Open in new tab Table 2 Surveyed Ranking Results of Top 10 Publications on HIV or AIDS in 2010a Ranking Reference No. (%) Individuals Ranking Article (n = 45) 1 Abdool Karim Q, Abdool Karim SS, Frohlich JA et al. Effectiveness and safety of tenofovir gel, an antiretroviral microbicide, for the prevention of HIV infection in women. Science. 2010; 329:1168–74. 11 (24) 2 Grant RM, Lama JR, Anderson PL et al. Preexposure chemoprophylaxis for HIV prevention in men who have sex with men. N Engl J Med. 2010; 363:2587–99. 8 (18) 3 Severe P, Juste MA, Ambroise A et al. Early versus standard antiretroviral therapy for HIV-infected adults in Haiti. N Engl J Med. 2010; 363:257–65. 4 (9) 4 Hamill RJ, Sobel JD, El-Sadr W et al. Comparison of 2 doses of liposomal amphotericin B and conventional amphotericin B deoxycholate for treatment of AIDS-associated acute cryptococcal meningitis: a randomized, double-blind clinical trial of efficacy and safety. Clin Infect Dis. 2010; 51:225–32. 3 (7) 5 Perfect JR, Dismukes WE, Dromer F et al. Clinical practice guidelines for the management of cryptococcal disease: 2010 update by the Infectious Diseases Society of America. Clin Infect Dis. 2010; 50:291–322. 3 (7) 6 Thompson MA, Aberg JA, Cahn P et al. Antiretroviral treatment of adult HIV infection: 2010 recommendations of the International AIDS Society-USA panel. JAMA. 2010; 304:321–33. 3 (7) 7 Arribas JR, Horban A, Gerstoft J et al. The MONET trial: darunavir/ritonavir with or without nucleoside analogues, for patients with HIV RNA below 50 copies/ml. AIDS. 2010; 24:223–30. 2 (4) 8 German P, Warren D, West S et al. Pharmacokinetics and bioavailability of an integrase and novel pharmacoenhancer-containing single-tablet fixed-dose combination regimen for the treatment of HIV. J Acquir Immune Defic Syndr. 2010; 55:323–9. 2 (4) 9 Gill VS, Lima VD, Zhang W et al. Improved virological outcomes in British Columbia concomitant with decreasing incidence of HIV type 1 drug resistance detection. Clin Infect Dis. 2010; 50:98–105. 2 (4) 10 Lennox JL, Dejesus E, Berger DS et al. Raltegravir versus efavirenz regimens in treatment-naive HIV-1-infected patients: 96-week efficacy, durability, subgroup, safety, and metabolic analyses. J Acquir Immune Defic Syndr. 2010; 55:39–48. 2 (4) Ranking Reference No. (%) Individuals Ranking Article (n = 45) 1 Abdool Karim Q, Abdool Karim SS, Frohlich JA et al. Effectiveness and safety of tenofovir gel, an antiretroviral microbicide, for the prevention of HIV infection in women. Science. 2010; 329:1168–74. 11 (24) 2 Grant RM, Lama JR, Anderson PL et al. Preexposure chemoprophylaxis for HIV prevention in men who have sex with men. N Engl J Med. 2010; 363:2587–99. 8 (18) 3 Severe P, Juste MA, Ambroise A et al. Early versus standard antiretroviral therapy for HIV-infected adults in Haiti. N Engl J Med. 2010; 363:257–65. 4 (9) 4 Hamill RJ, Sobel JD, El-Sadr W et al. Comparison of 2 doses of liposomal amphotericin B and conventional amphotericin B deoxycholate for treatment of AIDS-associated acute cryptococcal meningitis: a randomized, double-blind clinical trial of efficacy and safety. Clin Infect Dis. 2010; 51:225–32. 3 (7) 5 Perfect JR, Dismukes WE, Dromer F et al. Clinical practice guidelines for the management of cryptococcal disease: 2010 update by the Infectious Diseases Society of America. Clin Infect Dis. 2010; 50:291–322. 3 (7) 6 Thompson MA, Aberg JA, Cahn P et al. Antiretroviral treatment of adult HIV infection: 2010 recommendations of the International AIDS Society-USA panel. JAMA. 2010; 304:321–33. 3 (7) 7 Arribas JR, Horban A, Gerstoft J et al. The MONET trial: darunavir/ritonavir with or without nucleoside analogues, for patients with HIV RNA below 50 copies/ml. AIDS. 2010; 24:223–30. 2 (4) 8 German P, Warren D, West S et al. Pharmacokinetics and bioavailability of an integrase and novel pharmacoenhancer-containing single-tablet fixed-dose combination regimen for the treatment of HIV. J Acquir Immune Defic Syndr. 2010; 55:323–9. 2 (4) 9 Gill VS, Lima VD, Zhang W et al. Improved virological outcomes in British Columbia concomitant with decreasing incidence of HIV type 1 drug resistance detection. Clin Infect Dis. 2010; 50:98–105. 2 (4) 10 Lennox JL, Dejesus E, Berger DS et al. Raltegravir versus efavirenz regimens in treatment-naive HIV-1-infected patients: 96-week efficacy, durability, subgroup, safety, and metabolic analyses. J Acquir Immune Defic Syndr. 2010; 55:39–48. 2 (4) a Rank listed from 1 (most highly rated) to 10 (least highly rated). HIV = human immunodeficiency virus, AIDS = acquired immune deficiency syndrome. Open in new tab Table 1 Surveyed Ranking Results of the Top 25 Significant Publications in Infectious Diseases Pharmacotherapy in 2010a Rank Reference No. (%) Individuals Ranking Article in Top 10 (n = 105) 1 Cohen SH, Gerding DN, Johnson S et al. Clinical practice guidelines for Clostridium difficile infection in adults: 2010 update by the Society for Healthcare Epidemiology of America (SHEA) and the Infectious Diseases Society of America (IDSA). Infect Control Hosp Epidemiol. 2010; 31:431–55. 72 (68.6) 2 Patel N, Scheetz MH, Drusano GL et al. Identification of optimal renal dosage adjustments for traditional and extended-infusion piperacillin– tazobactam dosing regimens in hospitalized patients. Antimicrob Agents Chemother. 2010; 54:460–5. 52 (49.5) 3 Kofteridis DP, Alexopoulou C, Valachis A et al. Aerosolized plus intravenous colistin versus intravenous colistin alone for the treatment of ventilator-associated pneumonia: a matched case-control study. Clin Infect Dis. 2010; 51:1238–44. 44 (41.9) 4 Solomkin JS, Mazuski JE, Bradley JS et al. Diagnosis and management of complicated intra-abdominal infection in adults and children: guidelines by the Surgical Infection Society and the Infectious Diseases Society of America. Clin Infect Dis. 2010; 50:133–64. 41 (39.0) 5 Tam VH, Rogers CA, Chang KT et al. Impact of multidrug-resistant Pseudomonas aeruginosa bacteremia on patient outcomes. Antimicrob Agents Chemother. 2010; 54:3717–22. 40 (38.1) 6 Micek ST, Welch EC, Khan J et al. Empiric combination antibiotic therapy is associated with improved outcome against sepsis due to gram- negative bacteria: a retrospective analysis. Antimicrob Agents Chemother. 2010; 54:1742–8. 38 (36.2) 7 Kumarasamy KK, Toleman MA, Walsh TR et al. Emergence of a new antibiotic resistance mechanism in India, Pakistan, and the UK: a molecular, biological, and epidemiological study. Lancet Infect Dis. 2010; 10:597–602. 36 (34.3) 8 Falagas ME, Rafailidis PI, Ioannidou E et al. Colistin therapy for microbiologically documented multidrug-resistant gram-negative bacterial infections: a retrospective cohort study of 258 patients. Int J Antimicrob Agents. 2010; 35:194–9. 35 (33.3) 9 Gaieski DF, Mikkelsen ME, Band RA et al. Impact of time to antibiotics on survival in patients with severe sepsis or septic shock in whom early goal-directed therapy was initiated in the emergency department. Crit Care Med. 2010; 38:1045–53. 35 (33.3) 10 Kumar A, Zarychanski R, Light B et al. Early combination antibiotic therapy yields improved survival compared with monotherapy in septic shock: a propensity-matched analysis. Crit Care Med. 2010; 38:1773–85. 35 (33.3) 11 Hirsch EB, Tam VH. Detection and treatment options for Klebsiella pneumoniae carbapenemases (KPCs): an emerging cause of multidrug-resistant infection. J Antimicrob Chemother. 2010; 65:1119–25. 34 (32.4) 12 Vesga O, Agudelo M, Salazar BE et al. Generic vancomycin products fail in vivo despite being pharmaceutical equivalents of the innovator. Antimicrob Agents Chemother. 2010; 54:3271–9. 34 (32.4) 13 Goldberg E, Paul M, Talker O et al. Co-trimoxazole versus vancomycin for the treatment of methicillin-resistant Staphylococcus aureus bacteraemia: a retrospective cohort study. J Antimicrob Chemother. 2010; 65:1779–83. 29 (27.6) 14 Kalil AC, Murthy MH, Hermsen ED et al. Linezolid versus vancomycin or teicoplanin for nosocomial pneumonia: a systematic review and meta-analysis. Crit Care Med. 2010; 38:1802–8. 27 (25.7) 15 Kim PW, Wu YT, Cooper C et al. Meta-analysis of a possible signal of increased mortality associated with cefepime use. Clin Infect Dis. 2010; 51:381–9. 27 (25.7) 16 Lowy I, Molrine DC, Leav BA et al. Treatment with monoclonal antibodies against Clostridium difficile toxins. N Engl J Med. 2010; 362:197–205. 26 (24.8) 17 Sexually transmitted diseases treatment guidelines, 2010. MMWR Recomm Rep. 2010; 59(RR-12):1–110. 26 (24.8) 18 Bhavnani SM, Rubino CM, Ambrose PG et al. Daptomycin exposure and the probability of elevations in the creatine phosphokinase level: data from a randomized trial of patients with bacteremia and endocarditis. Clin Infect Dis. 2010; 50:1568–74. 25 (23.8) 19 Yoon YK, Kim JY, Park DW et al. Predictors of persistent methicillin-resistant Staphylococcus aureus bacteraemia in patients treated with vancomycin. J Antimicrob Chemother. 2010; 65:1015–8. 23 (21.9) 20 Caffrey AR, Quilliam BJ, LaPlante KL. Comparative effectiveness of linezolid and vancomycin among a national cohort of patients infected with methicillin-resistant Staphylococcus aureus. Antimicrob Agents Chemother. 2010; 54:4394–400. 22 (21.0) 21 Crandon JL, Bulik CC, Kuti JL et al. Clinical pharmacodynamics of cefepime in patients infected with Pseudomonas aeruginosa. Antimicrob Agents Chemother. 2010; 54:1111–6. 22 (21.0) 22 Jenkins TC, Sabel AL, Sarcone EE et al. Skin and soft-tissue infections requiring hospitalization at an academic medical center: opportunities for antimicrobial stewardship. Clin Infect Dis. 2010; 51:895–903. 21 (20.0) 23 Jung YJ, Koh Y, Hong SB et al. Effect of vancomycin plus rifampicin in the treatment of nosocomial methicillin-resistant Staphylococcus aureus pneumonia. Crit Care Med. 2010; 38:175–80. 21 (20.0) 24 Nucci M, Anaissie E, Betts RF et al. Early removal of central venous catheter in patients with candidemia does not improve outcome: analysis of 842 patients from 2 randomized clinical trials. Clin Infect Dis. 2010; 51:295–303. 21 (20.0) 25 Beibei L, Yun C, Mengli C et al. Linezolid versus vancomycin for the treatment of gram-positive bacterial infections: meta-analysis of randomised controlled trials. Int J Antimicrob Agents. 2010; 35:3–12. 19 (18.1) Rank Reference No. (%) Individuals Ranking Article in Top 10 (n = 105) 1 Cohen SH, Gerding DN, Johnson S et al. Clinical practice guidelines for Clostridium difficile infection in adults: 2010 update by the Society for Healthcare Epidemiology of America (SHEA) and the Infectious Diseases Society of America (IDSA). Infect Control Hosp Epidemiol. 2010; 31:431–55. 72 (68.6) 2 Patel N, Scheetz MH, Drusano GL et al. Identification of optimal renal dosage adjustments for traditional and extended-infusion piperacillin– tazobactam dosing regimens in hospitalized patients. Antimicrob Agents Chemother. 2010; 54:460–5. 52 (49.5) 3 Kofteridis DP, Alexopoulou C, Valachis A et al. Aerosolized plus intravenous colistin versus intravenous colistin alone for the treatment of ventilator-associated pneumonia: a matched case-control study. Clin Infect Dis. 2010; 51:1238–44. 44 (41.9) 4 Solomkin JS, Mazuski JE, Bradley JS et al. Diagnosis and management of complicated intra-abdominal infection in adults and children: guidelines by the Surgical Infection Society and the Infectious Diseases Society of America. Clin Infect Dis. 2010; 50:133–64. 41 (39.0) 5 Tam VH, Rogers CA, Chang KT et al. Impact of multidrug-resistant Pseudomonas aeruginosa bacteremia on patient outcomes. Antimicrob Agents Chemother. 2010; 54:3717–22. 40 (38.1) 6 Micek ST, Welch EC, Khan J et al. Empiric combination antibiotic therapy is associated with improved outcome against sepsis due to gram- negative bacteria: a retrospective analysis. Antimicrob Agents Chemother. 2010; 54:1742–8. 38 (36.2) 7 Kumarasamy KK, Toleman MA, Walsh TR et al. Emergence of a new antibiotic resistance mechanism in India, Pakistan, and the UK: a molecular, biological, and epidemiological study. Lancet Infect Dis. 2010; 10:597–602. 36 (34.3) 8 Falagas ME, Rafailidis PI, Ioannidou E et al. Colistin therapy for microbiologically documented multidrug-resistant gram-negative bacterial infections: a retrospective cohort study of 258 patients. Int J Antimicrob Agents. 2010; 35:194–9. 35 (33.3) 9 Gaieski DF, Mikkelsen ME, Band RA et al. Impact of time to antibiotics on survival in patients with severe sepsis or septic shock in whom early goal-directed therapy was initiated in the emergency department. Crit Care Med. 2010; 38:1045–53. 35 (33.3) 10 Kumar A, Zarychanski R, Light B et al. Early combination antibiotic therapy yields improved survival compared with monotherapy in septic shock: a propensity-matched analysis. Crit Care Med. 2010; 38:1773–85. 35 (33.3) 11 Hirsch EB, Tam VH. Detection and treatment options for Klebsiella pneumoniae carbapenemases (KPCs): an emerging cause of multidrug-resistant infection. J Antimicrob Chemother. 2010; 65:1119–25. 34 (32.4) 12 Vesga O, Agudelo M, Salazar BE et al. Generic vancomycin products fail in vivo despite being pharmaceutical equivalents of the innovator. Antimicrob Agents Chemother. 2010; 54:3271–9. 34 (32.4) 13 Goldberg E, Paul M, Talker O et al. Co-trimoxazole versus vancomycin for the treatment of methicillin-resistant Staphylococcus aureus bacteraemia: a retrospective cohort study. J Antimicrob Chemother. 2010; 65:1779–83. 29 (27.6) 14 Kalil AC, Murthy MH, Hermsen ED et al. Linezolid versus vancomycin or teicoplanin for nosocomial pneumonia: a systematic review and meta-analysis. Crit Care Med. 2010; 38:1802–8. 27 (25.7) 15 Kim PW, Wu YT, Cooper C et al. Meta-analysis of a possible signal of increased mortality associated with cefepime use. Clin Infect Dis. 2010; 51:381–9. 27 (25.7) 16 Lowy I, Molrine DC, Leav BA et al. Treatment with monoclonal antibodies against Clostridium difficile toxins. N Engl J Med. 2010; 362:197–205. 26 (24.8) 17 Sexually transmitted diseases treatment guidelines, 2010. MMWR Recomm Rep. 2010; 59(RR-12):1–110. 26 (24.8) 18 Bhavnani SM, Rubino CM, Ambrose PG et al. Daptomycin exposure and the probability of elevations in the creatine phosphokinase level: data from a randomized trial of patients with bacteremia and endocarditis. Clin Infect Dis. 2010; 50:1568–74. 25 (23.8) 19 Yoon YK, Kim JY, Park DW et al. Predictors of persistent methicillin-resistant Staphylococcus aureus bacteraemia in patients treated with vancomycin. J Antimicrob Chemother. 2010; 65:1015–8. 23 (21.9) 20 Caffrey AR, Quilliam BJ, LaPlante KL. Comparative effectiveness of linezolid and vancomycin among a national cohort of patients infected with methicillin-resistant Staphylococcus aureus. Antimicrob Agents Chemother. 2010; 54:4394–400. 22 (21.0) 21 Crandon JL, Bulik CC, Kuti JL et al. Clinical pharmacodynamics of cefepime in patients infected with Pseudomonas aeruginosa. Antimicrob Agents Chemother. 2010; 54:1111–6. 22 (21.0) 22 Jenkins TC, Sabel AL, Sarcone EE et al. Skin and soft-tissue infections requiring hospitalization at an academic medical center: opportunities for antimicrobial stewardship. Clin Infect Dis. 2010; 51:895–903. 21 (20.0) 23 Jung YJ, Koh Y, Hong SB et al. Effect of vancomycin plus rifampicin in the treatment of nosocomial methicillin-resistant Staphylococcus aureus pneumonia. Crit Care Med. 2010; 38:175–80. 21 (20.0) 24 Nucci M, Anaissie E, Betts RF et al. Early removal of central venous catheter in patients with candidemia does not improve outcome: analysis of 842 patients from 2 randomized clinical trials. Clin Infect Dis. 2010; 51:295–303. 21 (20.0) 25 Beibei L, Yun C, Mengli C et al. Linezolid versus vancomycin for the treatment of gram-positive bacterial infections: meta-analysis of randomised controlled trials. Int J Antimicrob Agents. 2010; 35:3–12. 19 (18.1) a Rank listed from 1 (most highly rated) to 25 (least highly rated). Open in new tab Table 1 Surveyed Ranking Results of the Top 25 Significant Publications in Infectious Diseases Pharmacotherapy in 2010a Rank Reference No. (%) Individuals Ranking Article in Top 10 (n = 105) 1 Cohen SH, Gerding DN, Johnson S et al. Clinical practice guidelines for Clostridium difficile infection in adults: 2010 update by the Society for Healthcare Epidemiology of America (SHEA) and the Infectious Diseases Society of America (IDSA). Infect Control Hosp Epidemiol. 2010; 31:431–55. 72 (68.6) 2 Patel N, Scheetz MH, Drusano GL et al. Identification of optimal renal dosage adjustments for traditional and extended-infusion piperacillin– tazobactam dosing regimens in hospitalized patients. Antimicrob Agents Chemother. 2010; 54:460–5. 52 (49.5) 3 Kofteridis DP, Alexopoulou C, Valachis A et al. Aerosolized plus intravenous colistin versus intravenous colistin alone for the treatment of ventilator-associated pneumonia: a matched case-control study. Clin Infect Dis. 2010; 51:1238–44. 44 (41.9) 4 Solomkin JS, Mazuski JE, Bradley JS et al. Diagnosis and management of complicated intra-abdominal infection in adults and children: guidelines by the Surgical Infection Society and the Infectious Diseases Society of America. Clin Infect Dis. 2010; 50:133–64. 41 (39.0) 5 Tam VH, Rogers CA, Chang KT et al. Impact of multidrug-resistant Pseudomonas aeruginosa bacteremia on patient outcomes. Antimicrob Agents Chemother. 2010; 54:3717–22. 40 (38.1) 6 Micek ST, Welch EC, Khan J et al. Empiric combination antibiotic therapy is associated with improved outcome against sepsis due to gram- negative bacteria: a retrospective analysis. Antimicrob Agents Chemother. 2010; 54:1742–8. 38 (36.2) 7 Kumarasamy KK, Toleman MA, Walsh TR et al. Emergence of a new antibiotic resistance mechanism in India, Pakistan, and the UK: a molecular, biological, and epidemiological study. Lancet Infect Dis. 2010; 10:597–602. 36 (34.3) 8 Falagas ME, Rafailidis PI, Ioannidou E et al. Colistin therapy for microbiologically documented multidrug-resistant gram-negative bacterial infections: a retrospective cohort study of 258 patients. Int J Antimicrob Agents. 2010; 35:194–9. 35 (33.3) 9 Gaieski DF, Mikkelsen ME, Band RA et al. Impact of time to antibiotics on survival in patients with severe sepsis or septic shock in whom early goal-directed therapy was initiated in the emergency department. Crit Care Med. 2010; 38:1045–53. 35 (33.3) 10 Kumar A, Zarychanski R, Light B et al. Early combination antibiotic therapy yields improved survival compared with monotherapy in septic shock: a propensity-matched analysis. Crit Care Med. 2010; 38:1773–85. 35 (33.3) 11 Hirsch EB, Tam VH. Detection and treatment options for Klebsiella pneumoniae carbapenemases (KPCs): an emerging cause of multidrug-resistant infection. J Antimicrob Chemother. 2010; 65:1119–25. 34 (32.4) 12 Vesga O, Agudelo M, Salazar BE et al. Generic vancomycin products fail in vivo despite being pharmaceutical equivalents of the innovator. Antimicrob Agents Chemother. 2010; 54:3271–9. 34 (32.4) 13 Goldberg E, Paul M, Talker O et al. Co-trimoxazole versus vancomycin for the treatment of methicillin-resistant Staphylococcus aureus bacteraemia: a retrospective cohort study. J Antimicrob Chemother. 2010; 65:1779–83. 29 (27.6) 14 Kalil AC, Murthy MH, Hermsen ED et al. Linezolid versus vancomycin or teicoplanin for nosocomial pneumonia: a systematic review and meta-analysis. Crit Care Med. 2010; 38:1802–8. 27 (25.7) 15 Kim PW, Wu YT, Cooper C et al. Meta-analysis of a possible signal of increased mortality associated with cefepime use. Clin Infect Dis. 2010; 51:381–9. 27 (25.7) 16 Lowy I, Molrine DC, Leav BA et al. Treatment with monoclonal antibodies against Clostridium difficile toxins. N Engl J Med. 2010; 362:197–205. 26 (24.8) 17 Sexually transmitted diseases treatment guidelines, 2010. MMWR Recomm Rep. 2010; 59(RR-12):1–110. 26 (24.8) 18 Bhavnani SM, Rubino CM, Ambrose PG et al. Daptomycin exposure and the probability of elevations in the creatine phosphokinase level: data from a randomized trial of patients with bacteremia and endocarditis. Clin Infect Dis. 2010; 50:1568–74. 25 (23.8) 19 Yoon YK, Kim JY, Park DW et al. Predictors of persistent methicillin-resistant Staphylococcus aureus bacteraemia in patients treated with vancomycin. J Antimicrob Chemother. 2010; 65:1015–8. 23 (21.9) 20 Caffrey AR, Quilliam BJ, LaPlante KL. Comparative effectiveness of linezolid and vancomycin among a national cohort of patients infected with methicillin-resistant Staphylococcus aureus. Antimicrob Agents Chemother. 2010; 54:4394–400. 22 (21.0) 21 Crandon JL, Bulik CC, Kuti JL et al. Clinical pharmacodynamics of cefepime in patients infected with Pseudomonas aeruginosa. Antimicrob Agents Chemother. 2010; 54:1111–6. 22 (21.0) 22 Jenkins TC, Sabel AL, Sarcone EE et al. Skin and soft-tissue infections requiring hospitalization at an academic medical center: opportunities for antimicrobial stewardship. Clin Infect Dis. 2010; 51:895–903. 21 (20.0) 23 Jung YJ, Koh Y, Hong SB et al. Effect of vancomycin plus rifampicin in the treatment of nosocomial methicillin-resistant Staphylococcus aureus pneumonia. Crit Care Med. 2010; 38:175–80. 21 (20.0) 24 Nucci M, Anaissie E, Betts RF et al. Early removal of central venous catheter in patients with candidemia does not improve outcome: analysis of 842 patients from 2 randomized clinical trials. Clin Infect Dis. 2010; 51:295–303. 21 (20.0) 25 Beibei L, Yun C, Mengli C et al. Linezolid versus vancomycin for the treatment of gram-positive bacterial infections: meta-analysis of randomised controlled trials. Int J Antimicrob Agents. 2010; 35:3–12. 19 (18.1) Rank Reference No. (%) Individuals Ranking Article in Top 10 (n = 105) 1 Cohen SH, Gerding DN, Johnson S et al. Clinical practice guidelines for Clostridium difficile infection in adults: 2010 update by the Society for Healthcare Epidemiology of America (SHEA) and the Infectious Diseases Society of America (IDSA). Infect Control Hosp Epidemiol. 2010; 31:431–55. 72 (68.6) 2 Patel N, Scheetz MH, Drusano GL et al. Identification of optimal renal dosage adjustments for traditional and extended-infusion piperacillin– tazobactam dosing regimens in hospitalized patients. Antimicrob Agents Chemother. 2010; 54:460–5. 52 (49.5) 3 Kofteridis DP, Alexopoulou C, Valachis A et al. Aerosolized plus intravenous colistin versus intravenous colistin alone for the treatment of ventilator-associated pneumonia: a matched case-control study. Clin Infect Dis. 2010; 51:1238–44. 44 (41.9) 4 Solomkin JS, Mazuski JE, Bradley JS et al. Diagnosis and management of complicated intra-abdominal infection in adults and children: guidelines by the Surgical Infection Society and the Infectious Diseases Society of America. Clin Infect Dis. 2010; 50:133–64. 41 (39.0) 5 Tam VH, Rogers CA, Chang KT et al. Impact of multidrug-resistant Pseudomonas aeruginosa bacteremia on patient outcomes. Antimicrob Agents Chemother. 2010; 54:3717–22. 40 (38.1) 6 Micek ST, Welch EC, Khan J et al. Empiric combination antibiotic therapy is associated with improved outcome against sepsis due to gram- negative bacteria: a retrospective analysis. Antimicrob Agents Chemother. 2010; 54:1742–8. 38 (36.2) 7 Kumarasamy KK, Toleman MA, Walsh TR et al. Emergence of a new antibiotic resistance mechanism in India, Pakistan, and the UK: a molecular, biological, and epidemiological study. Lancet Infect Dis. 2010; 10:597–602. 36 (34.3) 8 Falagas ME, Rafailidis PI, Ioannidou E et al. Colistin therapy for microbiologically documented multidrug-resistant gram-negative bacterial infections: a retrospective cohort study of 258 patients. Int J Antimicrob Agents. 2010; 35:194–9. 35 (33.3) 9 Gaieski DF, Mikkelsen ME, Band RA et al. Impact of time to antibiotics on survival in patients with severe sepsis or septic shock in whom early goal-directed therapy was initiated in the emergency department. Crit Care Med. 2010; 38:1045–53. 35 (33.3) 10 Kumar A, Zarychanski R, Light B et al. Early combination antibiotic therapy yields improved survival compared with monotherapy in septic shock: a propensity-matched analysis. Crit Care Med. 2010; 38:1773–85. 35 (33.3) 11 Hirsch EB, Tam VH. Detection and treatment options for Klebsiella pneumoniae carbapenemases (KPCs): an emerging cause of multidrug-resistant infection. J Antimicrob Chemother. 2010; 65:1119–25. 34 (32.4) 12 Vesga O, Agudelo M, Salazar BE et al. Generic vancomycin products fail in vivo despite being pharmaceutical equivalents of the innovator. Antimicrob Agents Chemother. 2010; 54:3271–9. 34 (32.4) 13 Goldberg E, Paul M, Talker O et al. Co-trimoxazole versus vancomycin for the treatment of methicillin-resistant Staphylococcus aureus bacteraemia: a retrospective cohort study. J Antimicrob Chemother. 2010; 65:1779–83. 29 (27.6) 14 Kalil AC, Murthy MH, Hermsen ED et al. Linezolid versus vancomycin or teicoplanin for nosocomial pneumonia: a systematic review and meta-analysis. Crit Care Med. 2010; 38:1802–8. 27 (25.7) 15 Kim PW, Wu YT, Cooper C et al. Meta-analysis of a possible signal of increased mortality associated with cefepime use. Clin Infect Dis. 2010; 51:381–9. 27 (25.7) 16 Lowy I, Molrine DC, Leav BA et al. Treatment with monoclonal antibodies against Clostridium difficile toxins. N Engl J Med. 2010; 362:197–205. 26 (24.8) 17 Sexually transmitted diseases treatment guidelines, 2010. MMWR Recomm Rep. 2010; 59(RR-12):1–110. 26 (24.8) 18 Bhavnani SM, Rubino CM, Ambrose PG et al. Daptomycin exposure and the probability of elevations in the creatine phosphokinase level: data from a randomized trial of patients with bacteremia and endocarditis. Clin Infect Dis. 2010; 50:1568–74. 25 (23.8) 19 Yoon YK, Kim JY, Park DW et al. Predictors of persistent methicillin-resistant Staphylococcus aureus bacteraemia in patients treated with vancomycin. J Antimicrob Chemother. 2010; 65:1015–8. 23 (21.9) 20 Caffrey AR, Quilliam BJ, LaPlante KL. Comparative effectiveness of linezolid and vancomycin among a national cohort of patients infected with methicillin-resistant Staphylococcus aureus. Antimicrob Agents Chemother. 2010; 54:4394–400. 22 (21.0) 21 Crandon JL, Bulik CC, Kuti JL et al. Clinical pharmacodynamics of cefepime in patients infected with Pseudomonas aeruginosa. Antimicrob Agents Chemother. 2010; 54:1111–6. 22 (21.0) 22 Jenkins TC, Sabel AL, Sarcone EE et al. Skin and soft-tissue infections requiring hospitalization at an academic medical center: opportunities for antimicrobial stewardship. Clin Infect Dis. 2010; 51:895–903. 21 (20.0) 23 Jung YJ, Koh Y, Hong SB et al. Effect of vancomycin plus rifampicin in the treatment of nosocomial methicillin-resistant Staphylococcus aureus pneumonia. Crit Care Med. 2010; 38:175–80. 21 (20.0) 24 Nucci M, Anaissie E, Betts RF et al. Early removal of central venous catheter in patients with candidemia does not improve outcome: analysis of 842 patients from 2 randomized clinical trials. Clin Infect Dis. 2010; 51:295–303. 21 (20.0) 25 Beibei L, Yun C, Mengli C et al. Linezolid versus vancomycin for the treatment of gram-positive bacterial infections: meta-analysis of randomised controlled trials. Int J Antimicrob Agents. 2010; 35:3–12. 19 (18.1) a Rank listed from 1 (most highly rated) to 25 (least highly rated). Open in new tab Cohen SH, Gerding DN, Johnson S et al. Clinical practice guidelines for Clostridium difficile infection in adults: 2010 update by the Society for Healthcare Epidemiology of America (SHEA) and the Infectious Diseases Society of America (IDSA). Infect Control Hosp Epidemiol. 2010; 31:431–55 The 2010 update on C. difficile infection (CDI) addresses clinical questions with a focus on the literature published since the last SHEA position paper on CDI in 1995.4 Unlike the 1995 position paper, the 2010 update was jointly created by SHEA and IDSA. The 2010 guidelines are organized according to clinical questions in the areas of epidemiology, diagnosis, infection control and prevention, and treatment. An executive summary provides several statements addressing each clinical question. Each question is followed by several detailed recommendations and a summary highlighting relevant evidence-based information. A “research gaps” section at the end of the document identifies a list of unanswered research questions in various areas. Regarding CDI epidemiology, the experts recommended using the surveillance definitions health care facility (HCF) onset, HCF-associated; community-onset, HCF-associated; and community-associated CDI when describing the type of exposure. It is also essential to report HCF-associated CDI cases per 10,000 patient-days, they advised. Standardization is essential in studying CDI epidemiology, including the identification of CDI outbreaks. With respect to diagnosis, an enzyme-linked immunosorbent assay for the C. difficile toxin is currently the most commonly used diagnostic tool due to a rapid turnaround time, but the test’s utility is limited by low sensitivity. One alternative testing method for which the expert panel made an interim recommendation is glutamate dehydrogenase (GDH) detection followed by confirmation with a C. difficile toxin assay or toxigenic culture for GDH-positive samples. Another promising option is a polymerase chain reaction (PCR) technique, but the panel declined to recommend its routine use until more supportive data are available. Proper infection control practices, hand hygiene, and management of antimicrobial agents through antimicrobial stewardship programs are emphasized as prevention strategies. Probiotics are not recommended for the primary prevention of CDI. For the treatment of CDI, the guidelines recommend selecting a treatment for a first or second occurrence of CDI according to a determination of severity of illness based on the white blood cell (WBC) count and the serum creatinine (SCr) concentration; previously published studies used other factors to determine the severity of illness.5,6 Under the new guidelines, the first occurrence of CDI is classified as severe if the patient has a WBC of ≥15,000 cells/≤L or a SCr concentration of ≥1.5 times the premorbid SCr concentration; CDI is considered to be severe and complicated if hypotension, shock, megacolon, or ileus is present. For a first occurrence of CDI, metronidazole is recommended for mild or moderate cases, and oral vancomycin is recommended for severe cases; a combination of oral vancomycin and i.v. metronidazole is suggested for severe and complicated disease. For a first recurrence of CDI, either metronidazole or vancomycin may be used depending on the severity of illness. The use of metronidazole after the first recurrence is discouraged due to a risk of neuro-toxicity; oral vancomycin given as a tapered or pulsed regimen is the preferred alternative. The expert panel provided no recommendations on strategies to prevent recurrent CDI. This comprehensive update may serve as a valuable tool to guide the diagnosis and management of CDI. Falagas ME, Rafailidis PI, Ioannidou E et al. Colistin therapy for microbiologically documented multidrug-resistant gram-negative bacterial infections: a retrospective cohort study of 258 patients. Int J Antimicrob Agents. 2010; 35:194–9 A recent increase in the use of colistin for the treatment of multi-drug-resistant (MDR) gram-negative infections has reignited the need for information regarding the appropriate use and efficacy of this older antimicrobial agent. Falagas et al. performed a retrospective, single-center cohort study to evaluate the effectiveness of colistin in treating cases of MDR gram-negative infections in Greece over a seven-year period. Patients were included in the study if they received colistin for at least 72 hours and had an MDR infection. Of the 258 patients identified, pneumonia accounted for the majority (60%) of infections, followed by bacteremia (13%), abdominal infections (9%), and central venous catheter-related infections (6%). Acinetobacter baumannii was the most common organism identified (65.9% of cases), followed by Pseudomonas aeruginosa (26.4%), Klebsiella pneumoniae (7.0%), Stenotrophomonas maltophilia (0.4%), and Enterobacter cloacae (0.4%). Polymyxin-only-susceptible pathogens accounted for 52.3% of the isolates evaluated. Combination therapy with colistin and piperacillin–tazobactam, ampicillin–sulbactam, or other agents was associated with significantly lower cure rates (64.7%, 75%, and 61.3%, respectively) than colistin alone or combination colistin– meropenem (83.3% cure rate for both; p = 0.05 and p = 0.003, respectively). All-cause mortality was 34.9%. Multivariate analysis revealed that variables associated with increased survival were higher daily colistin doses (adjusted odds ratio [OR], 1.22; 95% confidence interval (CI), 1.05–1.42; p = 0.009) and cure of infection (adjusted OR, 9; 95% CI, 3.6–23.1; p < 0.001). The use of colistin (alone or colistin–meropenem regimens) and the presence of pneumonia were independent predictors of cure (p = 0.01 and p < 0.001, respectively). Factors associated with decreased survival were a higher Acute Physiology and Chronic Health Evaluation (APACHE) II score (adjusted OR, 0.89; 95% CI, 0.84–0.95; p < 0.001), a proportional increase in SCr levels (adjusted OR, 0.21; 95% CI, 0.1–0.45; p < 0.001), and hematologic disease (adjusted OR, 0.23; 95% CI, 0.08–0.66; p = 0.006). Neither the colistin dose nor any other factors evaluated were independently associated with nephrotoxicity. In a subset of patients with polymyxin-only-susceptible infections, the use of colistin alone and the use of colistin–meropenem regimens were found to be independent predictors of cure (p = 0.017), whereas the presence of malignancy and infections other than pneumonia were associated with treatment failure (p = 0.008 and p = 0.006, respectively); similar findings were reported for the overall population. Based on the findings of this study, both colistin-only and colistin– meropenem regimens were demonstrated to produce favorable outcomes without considerable nephrotoxicity. The efficacy of treatment depends strongly on the colistin dose and the site of infection. While this study gives further information on the use of colistin, larger prospective trials are needed to better define the drug’s role in the treatment of MDR infections. Gaieski DF, Mikkelsen ME, Band RA et al. Impact of time to antibiotics on survival in patients with severe sepsis or septic shock in whom early goal-directed therapy was initiated in the emergency department. Crit Care Med. 2010; 38:1045–53 Antimicrobial therapy has been a mainstay for the treatment of severe sepsis or septic shock, and previous studies have shown that a delay in appropriate antimicrobial therapy is an important determinant of inhospital mortality.7,8 Unfortunately, there are limited published data on the role of the time of antibiotic administration on survival among patients receiving early goal-directed therapy (EGDT). Gaieski et al. conducted a retrospective analysis of a single-center cohort study to determine the impact of time to administration of antibiotics on survival in patients who received EGDT initiated in the emergency department. The investigators examined mortality in relation to the time from triage to administration of antibiotics, the time from qualification for EGDT to administration of antibiotics, the time from triage to administration of appropriate antibiotics, and the time from qualification for EGDT to administration of appropriate antibiotics. A total of 261 evaluable patients who received EGDT were included. The median time from triage to antibiotic administration was 119 minutes; the median time from qualification for EGDT to antibiotic administration was 42 minutes. Overall, inhospital mortality in the cohort was 31%, with no significant difference in mortality between culture-positive and culture-negative patients. No association was seen between in hospital mortality and the time from triage or EGDT qualification to the administration of any antibiotic therapy. However, mortality was significantly lower when appropriate antibiotics were given within one hour of triage (19.5% versus 33.2%, p = 0.02) and EGDT qualification (25% versus 38.5%, p = 0.03). These findings suggest that the prompt administration of appropriate antibiotics is a priority in patients with severe sepsis or septic shock who qualify for resuscitation with EGDT in the emergency department. Appropriate antibiotics should be initiated within one hour of EGDT qualification. Therefore, the authors recommend the timely delivery of appropriate antibiotics and the use of an institution’s severe sepsis and septic shock antibiogram to guide drug selection and prevent delays in drug administration. Improvements in assessment and triage practices in the emergency department may help to minimize inadequate antimicrobial treatment of these life-threatening disorders. Kofteridis DP, Alexopoulou C, Valachis A et al. Aerosolized plus intravenous colistin versus intravenous colistin alone for the treatment of ventilator-associated pneumonia: a matched case-control study. Clin Infect Dis. 2010; 51:1238–44 Ventilator-associated pneumonia (VAP) caused by MDR gram-negative pathogens is a considerable problem for which there are limited treatment options. Due to the toxicity and questionable lung penetration of i.v. colistin, aerosolized colistin is a desirable adjunct to systemic therapy. This retrospective, case–control matching study examined patients with documented VAP caused by MDR A. baumannii, P. aeruginosa, or K. pneumoniae. The study compared outcomes in patients who received six or more doses of aerosolized colistin in combination with three or more days of i.v. colistin therapy and those who received i.v. colistin alone for three or more days. Patients were matched based on age, APACHE II score on the day of colistin introduction, and the date of admission to the intensive care unit. The primary study endpoint was the clinical outcome of infection, with clinical cure or improvement considered to indicate treatment success. Secondary endpoints included microbiological outcome, VAP-related mortality, all-cause mortality, and the occurrence of adverse events related to colistin therapy. Of the 86 VAP cases included in the study, the majority (77%) were caused by A. baumannii. The evaluated outcomes did not differ significantly according to group characteristics such as the reason for hospital admission, comorbid conditions, the pathogen isolated, and the duration of therapy. Patients in the group receiving a combination of aerosolized and i.v. colistin had improved rates of clinical cure relative to those who received i.v. colistin alone (54% versus 32.5%), but the difference was not statistically significant (p = 0.05). There were no significant differences between the two groups in clinical success, mortality, bacteriologic outcome, or adverse events related to colistin therapy. While the study was limited by a small sample size and retrospective design, it appears that adding aerosolized colistin to systemic treatment may have little effect on clinical outcomes in patients with VAP caused by MDR gram-negative pathogens. While this finding is supported by evidence from other recent studies,9,10 including one small, randomized, controlled trial,9 a large controlled trial is still needed to determine the role of aerosolized colistin in this setting. Kumar A, Zarychanski R, Light B et al. Early combination antibiotic therapy yields improved survival compared with monotherapy in septic shock: a propensity-matched analysis. Crit Care Med. 2010; 38:1773–85 While there is a clear benefit from early appropriate antimicrobial therapy in patients with septic shock,11 the role of combination therapy remains controversial.12,13 The Cooperative Antimicrobial Therapy of Septic Shock Database Research Group performed a retrospective, propensity-matched cohort study to examine the impact of early combination therapy in patients with confirmed bacterial septic shock. Patients were excluded from the analysis if culture results were negative or indicated fungal, anaerobic, or atypical pathogens or if they died before receiving effective antimicrobial therapy. Monotherapy was defined as the use of any single appropriate i.v. antibiotic and, when possible, a bactericidal agent. The use of aminoglycosides was not considered appropriate monotherapy despite the organism’s susceptibility. Combination therapy was defined as the use of at least two agents with different mechanisms of action for at least 24 hours after the onset of shock. Each patient in the cohort who received combination therapy was matched to a patient receiving monotherapy using a propensity score to eliminate bias with respect to antimicrobial selection. The baseline patient characteristics were similar in the mono-therapy and combination therapy groups (n = 1223 for each group). The combination therapy group had significantly lower 28-day mortality than the monotherapy group (29% versus 36.3%; hazard ratio [HR], 0.77; 95% CI, 0.67–0.88; p = 0.0002). In patients who received combination therapy, the absolute mortality reduction was 10.1% when the second drug was administered within 1 hour of the first (HR, 0.68; 95% CI, 0.53–0.89; p = 0.004) and 2.5% when the administration of the second drug was delayed 24 hours (HR, 0.89; 95% CI, 0.69–1.15; p = 0.37). The rate of successful extubation was higher in the combination therapy group than in the monotherapy group (67.8% versus 61.8%, p = 0.001), as was the rate of discontinuation of vasopressor and inotrope support (80.1% versus 75.3%, p = 0.005). The median length of hospital stay was shorter in the combination therapy group than in the monotherapy group (22 days versus 26 days, p = 0.01); however, the median length of stay in the intensive care unit did not differ significantly (about 7 days for both groups, p = 0.29). Favorable effects were seen when β-lactams were given as the primary therapy in combination with aminoglycosides, fluoroquinolones, macrolides, or clindamycin, as compared with the use of β-lactams alone. A mortality benefit with combination therapy was demonstrated in patients with infections due to gram-positive and gram-negative bacteria, particularly Streptococcus pneumoniae and Enterobacteriaceae species. The results of this large retrospective study suggest that early combination therapy may improve outcomes in patients with bacterial septic shock, especially when a second agent is administered within an hour of the first. Kumarasamy KK, Toleman MA, Walsh TR et al. Emergence of a new antibiotic resistance mechanism in India, Pakistan, and the UK: a molecular, biological, and epidemiological study. Lancet Infect Dis. 2010; 10:597–602 MDR gram-negative pathogens are becoming a major public health problem in various settings.14–16 The discovery and characterization of a New Delhi metallo-β-lactamase (NDM-1), encoded by the blaNDM-1 gene on a plasmid, have sparked fears of antibiotic resistance worldwide.17 However, molecular epidemiologic studies have not yet been conducted to evaluate the prevalence of the blaNDM-1 gene among clinical isolates. Kumarasamy et al. analyzed the prevalence of NDM-1 in carbapenem-resistant Enterobacteriaceae isolates obtained in India, Pakistan, and the United Kingdom from 2003 to 2009. Isolates were evaluated for antibiotic susceptibilities, the presence of the blaNDM-1 gene (as demonstrated by PCR assay), and clonality (as demonstrated by pulsed-field gel electrophoresis). Seventy isolates from the Chennai and Haryana regions of India and 37 isolates from the United Kingdom (collectively accounting for 41% of the carbapenem-resistant isolates evaluated) tested positive for NDM-1. The analysis also included NDM-1-positive isolates from other sites in Bangladesh, Pakistan, and India; 82% of those isolates were K. pneumoniae and Escherichia coli, which are highly resistant to many antibiotic classes. Most isolates evaluated in the study were found to be susceptible to tigecycline and colistin; only a few were susceptible to individual aminoglycosides and aztreonam (by European Committee for Antimicrobial Susceptibility Testing criteria). These isolates were identified as the cause of multiple types of infections, including community-acquired urinary tract infections, bloodstream infections, and pneumonia. The electrophoretic profiles of isolates from Haryana suggested clonal spread, while isolates from Chennai and the United Kingdom were clonally diverse. History-taking indicated that many of the patients from whom the U.K. isolates were obtained had traveled to India or Pakistan. These data highlight the threat of MDR Enterobacteriaceae and the potential for dissemination of NDM-1 worldwide. Although this report emphasized the link between NDM-1 and India, the extent of the geographic distribution of NDM-1 remains unknown. Continued international surveillance of NDM-1-producing isolates is needed. Furthermore, clinicians should be cognizant of this emerging resistance mechanism and the few remaining active treatment options. Micek ST, Welch EC, Khan J et al. Empiric combination antibiotic therapy is associated with improved outcome against sepsis due to gram-negative bacteria: a retrospective analysis. Antimicrob Agents Chemother. 2010; 54:1742–8 This retrospective cohort study by Micek et al. evaluated the appropriateness of initial antimicrobial therapy in patients with severe sepsis and septic shock associated with gram-negative bacteremia. The primary goal of the study was to determine whether combination antimicrobial therapy directed against gram-negative bacteria was associated with lower hospital mortality; secondary outcomes included the evaluation of renal toxicity and the incidence of C. difficile-associated diarrhea. Antimicrobial therapy was considered appropriate if at least one agent was active against the identified pathogen or pathogens (as demonstrated by in vitro susceptibility testing) and was administered within 24 hours of blood culture collection. For polymicrobial infections, only initial antimicrobial regimens that were active against each pathogen isolated were considered appropriate. Of the 760 patients meeting the criteria for severe sepsis or septic shock, 522 (68.7%) received initially appropriate antimicrobial treatment and 238 (31.3%) received inappropriate therapy. E. coli was the most frequently isolated organism; however, patients who received inappropriate initial antimicrobial therapy (IIAT) were likely to be infected with extended-spectrum β-lactamase (ESBL) producing bacteria, K. pneumoniae, Achromobacter species, Acinetobacter species, and S. maltophilia. The rate of IIAT was higher among patients who received monotherapy than in those who had initial combination therapy (36% versus 22.2%, p < 0.001). The investigators noted that the addition of an aminoglycoside or fluoroquinolone to carbapenem, cefepime, or piperacillin–tazobactam therapy would have resulted in an incremental overall increase in the rate of appropriate therapy, with the addition of an aminoglycoside offering a small benefit over adjunctive fluoroquinolone therapy. Inhospital mortality was significantly higher among patients who received IIAT than among those who received initially appropriate treatment (51.7% versus 36.4%, p < 0.001). Hospital mortality was significantly higher among patients infected with Acinetobacter spp., P. aeruginosa, and S. maltophilia who received IIAT. There were no significant differences in rates of CDAD or nephrotoxicity between the monotherapy and combination therapy groups. However, a higher rate of nephrotoxicity was observed with the use of regimens that included aminoglycosides. Logistic regression analysis identified two independent predictors of inhospital mortality: IIAT (adjusted OR, 2.30; 95% CI, 1.89–2.80) and increasing (in 1-point increments) APACHE II scores (adjusted OR, 1.11; 95% CI, 1.09–1.13). The authors concluded that combination antimicrobial therapy, especially when an aminoglycoside is used, is associated with more appropriate initial therapy for patients with severe sepsis and septic shock caused by gram-negative bacteremia. Thus, it appears reasonable to use this approach, but local susceptibility patterns should also be considered. Patel N, Scheetz MH, Drusano GL et al. Identification of optimal renal dosage adjustments for traditional and extended-infusion piperacillin–tazobactam dosing regimens in hospitalized patients. Antimicrob Agents Chemother. 2010; 54:460–5 Studies describing the pharmacokinetic modeling and clinical benefits of extended-interval piperacillin–tazobactam regimens have emphasized that the time (t) the free drug concentration (f) exceeds the minimum inhibitory concentration (MIC) must be at least 50% of the dosing interval for bacterial killing activity to occur (i.e., 50% ft>MIC is necessary for maximum bactericidal effect). Previous research in this area has been limited by the exclusion of patients on dialysis and little discussion of the effect of renal function.18 Patel et al. modeled the effect of renal function on the pharmacokinetics of the Food and Drug Administration (FDA)-approved dosage regimen and extended-interval infusions of piperacillin–tazobactam. The objectives of the study were to evaluate the effect of renal impairment on the probability of achieving a 50% ft>MIC and to calculate appropriate dosing regimens for patients with renal impairment. Pharmacokinetic data were collected from 105 hospitalized patients and used in a Monte Carlo simulation. To identify an optimal regimen for patients with renal dysfunction, the probability of target attainment (PTA) for traditional and extended-interval infusion regimens was simulated and stratified by estimated creatinine clearance (CLcr); for purposes of the simulation, estimated CLcr values were fixed at logical dosage adjustment thresholds (e.g., 20, 40, 60, 80, and 100 mL/min). Traditional dosing of piperacillin–tazobactam was defined as a 30-minute i.v. infusion of 4.5 g (4 g of piperacillin and 0.5 g of tazobactam) every 6 hours for an estimated CLcr of 100 mL/min or an i.v. infusion of 3.375 g (3 g of piperacillin and 0.375 g of tazobactam) every 6 hours for estimated CLcr values of 20 or 40 mL/min. Extended-interval infusion dosing was modeled as a 4-hour i.v. infusion at a piperacillin–tazobactam dosage of 3.375 g (3 g of piperacillin and 0.375 g of tazobactam) every 8 hours for an estimated CLcr of 100 mL/min or an i.v. infusion of 3.375 values g i.v. every 12 hours for CLcr of 20 or 40 mL/min. For traditional and extended-interval infusion dosing, the PTAs (i.e., 50% ft>MIC) for MICs of 8, 16, and 32 mg/L at differing CLcr values are presented in Table 3. Both the regimen from FDA-approved labeling and the extended-interval infusion regimen were associated with suboptimal PTA values for an MIC of ≥32 mg/L. Table 3 Probability of Target Attainment for Two Piperacillin–Tazobactam Dosing Regimens, by Renal Clearance and Organism MIC19,a Creatinine Clearance Model % Probability of Target Attainmentb Traditional Infusionc Extended-Interval Infusiond MIC = 8 mg/L MIC = 16 mg/L MIC = 32 mg/L MIC = 8 mg/L MIC = 16 mg/L MIC = 32 mg/L 100 mL/min 67 46 19 97 73 17 40 mL/min 90 77 50 79 52 16 20 mL/min 95 88 73 90 74 40 Creatinine Clearance Model % Probability of Target Attainmentb Traditional Infusionc Extended-Interval Infusiond MIC = 8 mg/L MIC = 16 mg/L MIC = 32 mg/L MIC = 8 mg/L MIC = 16 mg/L MIC = 32 mg/L 100 mL/min 67 46 19 97 73 17 40 mL/min 90 77 50 79 52 16 20 mL/min 95 88 73 90 74 40 a MIC = minimum inhibitory concentration. b Target attainment achieved when free antibiotic concentration is greater than the MIC for 50% of the dosing interval (50% ft>MIC). c 4.5 g (4 g of piperacillin and 0.5 g of tazobactam) i.v. every six hours as a 30-minute infusion. d 3.375 g (3 g of piperacillin and 0.375 g of tazobactam) i.v. every eight hours as a four-hour infusion. Open in new tab Table 3 Probability of Target Attainment for Two Piperacillin–Tazobactam Dosing Regimens, by Renal Clearance and Organism MIC19,a Creatinine Clearance Model % Probability of Target Attainmentb Traditional Infusionc Extended-Interval Infusiond MIC = 8 mg/L MIC = 16 mg/L MIC = 32 mg/L MIC = 8 mg/L MIC = 16 mg/L MIC = 32 mg/L 100 mL/min 67 46 19 97 73 17 40 mL/min 90 77 50 79 52 16 20 mL/min 95 88 73 90 74 40 Creatinine Clearance Model % Probability of Target Attainmentb Traditional Infusionc Extended-Interval Infusiond MIC = 8 mg/L MIC = 16 mg/L MIC = 32 mg/L MIC = 8 mg/L MIC = 16 mg/L MIC = 32 mg/L 100 mL/min 67 46 19 97 73 17 40 mL/min 90 77 50 79 52 16 20 mL/min 95 88 73 90 74 40 a MIC = minimum inhibitory concentration. b Target attainment achieved when free antibiotic concentration is greater than the MIC for 50% of the dosing interval (50% ft>MIC). c 4.5 g (4 g of piperacillin and 0.5 g of tazobactam) i.v. every six hours as a 30-minute infusion. d 3.375 g (3 g of piperacillin and 0.375 g of tazobactam) i.v. every eight hours as a four-hour infusion. Open in new tab The authors’ conclusions are similar to those of other researchers whose work has demonstrated the difficulty of attaining 50% ft>MIC with piperacillin–tazobactam when the MIC is ≥32 mg/L.18,20 This study was the first to examine the dosage regimens stratified by CLcr and attempt to identify optimal dosing regimens in the context of renal impairment. The authors suggested using a CLcr of 20 mL/min as the decision point for determining whether to use an 8- or a 12-hour dosing interval for extended-interval piperacillin–tazobactam infusion. However, this recommendation is based on a simulated model and remains to be validated in clinical practice. Solomkin JS, Mazuski JE, Bradley JS et al. Diagnosis and management of complicated intra-abdominal infection in adults and children: guidelines by the Surgical Infection Society and the Infectious Diseases Society of America. Clin Infect Dis. 2010; 50:133–64 This update to guidelines published in 2002 and 2003 incorporates information from studies performed during the period 2003–08. The guideline addresses 16 clinical questions related to the management of complicated intraabdominal infections and includes a brief up-front summary, making the guideline relatively simple to navigate. Major updates include a new section on the management of infections in children, the discouragement of antibiotic prophylaxis in patients with necrotizing pancreatitis but no established infection, an emphasis on percutaneous drainage of well-localized fluid collections in lieu of surgery, and a call for the development of pathways to guide appendicitis management. In adults, recommendations for the treatment of mild-to-moderate community-acquired infections include ticarcillin–clavulanate, cefoxitin, ertapenem, moxifloxacin, tigecycline, and a combination of metronidazole with a cephalosporin, levofloxacin, or ciprofloxacin. Antipseudomonal carbapenems, piperacillin–tazobactam, or the combination of metronidazole with cefepime or ceftazidime should be reserved for community-acquired infections considered to be severe or posing a high risk of treatment failure. Health care-associated infections are treated similarly, but therapy should be tailored to the local antimicrobial susceptibilities of common pathogens. The new recommendations for pediatric patients advise an aminoglycoside-based regimen, carbapenems, a β-lactam–β-lactamase inhibitor combination, or an advanced-generation cephalosporin in combination with metronidazole. Antibiotic therapy should be limited to four to seven days unless establishing control over the source of infection is delayed. Several changes to the treatment guidelines have been made in response to patterns of antimicrobial resistance. Resistance in E. coli has led to the removal of ampicillin–sulbactam as a treatment option and the addition of a statement that fluoroquinolones should not be considered unless greater than 90% of local isolates are susceptible. Due to resistance in community-acquired Bacteroides fragilis, both cefotetan use and clindamycin use are discouraged; cefoxitin is recommended for mild-to-moderate infections. In addition to updated recommendations on standard therapy, the guidelines provide direction on when to consider the addition of coverage for Enterococcus, methicillin-resistant Staphylococcus aureus, and yeasts. Tam VH, Rogers CA, Chang KT et al. Impact of multidrug-resistant Pseudomonas aeruginosa bacteremia on patient outcomes. Antimicrob Agents Chemother. 2010; 54:3717–22 P. aeruginosa is the eighth most commonly isolated pathogen in nosocomial bloodstream infections, yet the associated mortality rate is second only to that of Candida-related bloodstream infections.21 In recent years, increasing rates of MDR P. aeruginosa infection have been reported.22 There are conflicting data as to whether MDR strains maintain their virulence.23,24 This retrospective cohort study by Tam et al. examined the impact of multidrug resistance on outcomes in patients with P. aeruginosa bacteremia; 109 episodes of P. aeruginosa bacteremia were identified and classified as MDR or multidrug sensitive (MDS). The primary endpoint was 30-day all-cause mortality. At baseline, the MDR cohort had a significantly higher incidence of underlying disease (respiratory or renal disease and diabetes) and a higher mean APACHE II score. In comparison to the patients in the MDS cohort (n = 84), the patients infected with MDR organisms (n = 25) also had a longer mean ± S.D. hospital stay before positive blood cultures (32.6 ± 37.3 days versus 14.4 ± 43.6 days, p = 0.046) and were more likely to have received inappropriate empirical therapy (44% versus 6%, p < 0.001). Overall 30-day mortality was 18.3%, with mortality of 11.9% and 40.0% in the MDS and MDR cohorts, respectively (p = 0.003). To adjust for the heterogeneity of the patient population, multivariate analysis and propensity-score matching were used. Kaplan-Meier analysis showed that the time to death was shorter in patients with MDR isolates (p = 0.011). Of the MDR isolates, 17 unique clonal isolates were identified and all were resistant to antipseudomonal carbapenems and fluoroquinolones. Secondary analyses identified three independent risk factors for 30-day mortality: multidrug resistance (OR, 6.829; 95% CI, 1.945–23.984; p = 0.003), immunosuppression (OR, 5.001; 95% CI, 1.430–17.495; p = 0.012), and an APACHE II score of ≥ 22 (OR, 29.034; 95% CI, 5.012–168; p < 0.001). This study confirmed that MDR P. aeruginosa is an independent risk factor for mortality in patients with bacteremia and emphasizes the need for aggressive strategies to prevent and treat infections caused by MDR bacteria. Abdool Karim Q, Abdool Karim SS, Frohlich JA et al. Effectiveness and safety of tenofovir gel, an antiretroviral microbicide, for the prevention of HIV infection in women. Science. 2010; 329:1168–74 The options for HIV prevention, especially in women, remain limited. Oral tenofovir, a nucleoside reverse transcriptase inhibitor, is commonly used for HIV disease treatment. Tenofovir, as a 1% vaginal gel formulation, is the first antiretroviral with demonstrated utility as a microbicide in initial studies.25 Abdool Karim et al. conducted a double-blind, randomized, placebo-controlled trial to evaluate the effectiveness and safety of tenofovir gel in HIV prevention among women from selected areas of South Africa. Prior feasibility studies determined that the rates of HIV infection in the selected rural and urban areas were approximately 11% and 16%, respectively. In this intent-to-treat study, a total of 889 sexually active, HIV-negative women 18–40 years of age were assigned to tenofovir and placebo groups. The women were instructed to use tenofovir gel—40 mg of 9-(R)-2-(phosphonomethoxypropyl) adenine monohydrate in a solution of purified water with edetate disodium, citric acid, glycerin, methylparaben, propylparaben, and hydroxyethycellulose—or placebo gel in a coitally related dosing regimen: one dose of gel within 12 hours prior to sexual intercourse and a second dose as soon as possible but up to 12 hours after sex. Enrolled women were regularly interviewed, counseled, and assessed for adherence and safety during 30 months of follow-up; they were also asked to return used and unused gel applicators during follow-up visits. The investigators reported a 39% reduction in the HIV incidence rate in the tenofovir group (incidence rate ratio [IRR], 0.61; 95% CI, 0.40–0.95; p = 0.017). The peak effect of tenofovir occurred 12 months after the initiation of gel use, and a decrease in effect was observed at 18 months. In the tenofovir group, the reduction in HIV incidence rate was 54% among women with adherence to gel use of >80% (IRR, 0.46; 95% CI, 0.20–094; p = 0.025), 38% among those with adherence of 50–80% (p = not significant), and 28% among those with gel adherence of <50% (p = not significant). Notably, women with gel adherence of >80% reported the least number of coital episodes. The number of serious adverse events was similar in the tenofovir and the placebo groups (23 and 16 events, respectively; p = not significant). The occurrence of diarrhea was higher in the tenofovir group relative to the placebo group (16.9% versus 11.0%, p = 0.02). Adverse events led to the discontinuation of gel use in 5 women. Furthermore, no tenofovir resistance mutations were detected in 35 women who underwent HIV seroconversion during the study and were exposed to tenofovir gel. This trial was essential in establishing the effectiveness and safety of tenofovir vaginal gel in preventing HIV infection in women. The external validity of this trial is limited due to the population enrolled and the study locations selected. Further studies are warranted. Conclusion Due to the increasing number of articles published each year, it is difficult to maintain a current knowledge of significant publications in the field of ID pharmacotherapy. This review of key publications in 2010 may be helpful to the nonspecialist clinician by lessening this burden. Footnotes Dr. Hirsch has received research funding from Ortho-McNeil-Janssen Pharmaceuticals. Dr. Mohr is an employee of Cubist Pharmaceuticals. The other authors have declared no potential conflicts of interest. The contributions of Patrick G. Clay, Pharm.D., Rustin D. Crutchley, Pharm.D., Kelly L. Echevarria, Pharm.D., Kristi M. Kuper, Pharm.D., Andrea L. Mora, Pharm.D., Vincent H. Tam, Pharm.D., and Rosa F. Yeh, Pharm.D., are acknowledged. References 1 Yeh RF Kuper KM Coyle EA et al. . Significant publications on infectious diseases pharmacotherapy in 2007 . Am J Health-Syst Pharm. 2008 ; 65 : e72 – 9 . Google Scholar Crossref Search ADS PubMed WorldCat 2 Kuper KM Hirsch EB Tam VH . Significant publications on infectious diseases pharmacotherapy in 2008 . Am J Health-Syst Pharm. 2009 ; 66 : 1726 – 34 . Google Scholar Crossref Search ADS PubMed WorldCat 3 Palmer HR Cottreau JM Garey KW et al. . Significant publications on infectious diseases pharmacotherapy in 2009 . Am J Health-Syst Pharm. 2010 ; 67 : e34 – 42 . Google Scholar Crossref Search ADS PubMed WorldCat 4 Gerding DN Johnson S Peterson LR et al. . Clostridium difficile-associated diarrhea and colitis . Infect Control Hosp Epidemiol. 1995 ; 16 : 459 – 77 . Google Scholar Crossref Search ADS PubMed WorldCat 5 Zar FA Bakkanagari SR Moorthi KM et al. . 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Initiation of inappropriate antimicrobial therapy results in a fivefold reduction of survival in human septic shock . Chest. 2009 ; 136 : 1237 – 48 . Google Scholar Crossref Search ADS PubMed WorldCat 12 Safdar N Handelsman J Maki DG . Does combination antimicrobial therapy reduce mortality in gram-negative bacteremia? A meta-analysis . Lancet Infect Dis. 2004 ; 4 : 519 – 27 . Google Scholar Crossref Search ADS PubMed WorldCat 13 Paul M Benuri-Silbiger I Soares-Weiser K et al. . Beta lactam monotherapy versus beta lactam-aminoglycoside combination therapy for sepsis in immunocompetent patients: systematic review and meta-analysis of randomised trials . BMJ. 2004 ; 328 : 884 . Google Scholar Crossref Search ADS WorldCat 14 Canton R Coque TM . The CTX-M beta-lactamase pandemic . Curr Opin Microbiol. 2006 ; 9 : 466 – 75 . Google Scholar Crossref Search ADS PubMed WorldCat 15 Harish BN Menzes GA Shekatkar S et al. . Extended-spectrum beta-lactamase-producing Klebsiella pneumoniae from blood culture . J Med Microbiol. 2007 ; 56 : 999 – 1000 . Google Scholar Crossref Search ADS PubMed WorldCat 16 Nordmann P Cuzon G Naas T . The real threat of Klebsiella pneumoniae carbapenemase-producing bacteria . Lancet Infect Dis. 2009 ; 9 : 228 – 36 . Google Scholar Crossref Search ADS PubMed WorldCat 17 Yong D Toleman MA Giske CG et al. . Characterization of a new metallo-β-lactamase gene, bla(NDM-1), and a novel erythromycin esterase gene carried on a unique genetic structure in Klebsiella pneumoniae sequence type 14 from India . Antimicrob Agents Chemother. 2009 ; 53 : 5046 – 54 . Google Scholar Crossref Search ADS PubMed WorldCat 18 Lodise TP Jr Lomaestro B Drusano GL . Piperacillin-tazobactam for Pseudomonas aeruginosa infection: clinical implications of an extended-infusion dosing strategy . Clin Infect Dis. 2007 ; 44 : 357 – 63 . Google Scholar Crossref Search ADS PubMed WorldCat 19 Patel N Scheetz MH Drusano GL et al. . Identification of optimal renal dosage adjustments for traditional and extended-infusion piperacillin-tazobactam dosing regimens in hospitalized patients . Antimicrob Agents Chemother. 2010 ; 54 : 460 – 5 . Google Scholar Crossref Search ADS PubMed WorldCat 20 Kim A Sutherland CA Kuti JL et al. . Optimal dosing of piperacillin-tazobactam for the treatment of Pseudomonas aeruginosa infections: prolonged or continuous infusion? Pharmacotherapy. 2007 ; 27 : 1490 – 7 . Google Scholar Crossref Search ADS PubMed WorldCat 21 Wisplinghoff H Bischoff T Tallent SM et al. . Nosocomial bloodstream infections in US hospitals: analysis of 24,179 cases from a prospective nationwide surveillance study . Clin Infect Dis. 2004 ; 39 : 309 – 17 . Google Scholar Crossref Search ADS PubMed WorldCat 22 Hirsch EB Tam VH . Impact of multi-drug-resistant Pseudomonas aeruginosa infection on patient outcomes . Expert Rev Pharmacoecon Outcome Res. 2010 ; 10 : 441 – 51 . Google Scholar Crossref Search ADS WorldCat 23 Kugelberg E Lofmark S Wretlind B et al. . Reduction of the fitness burden of quinolone resistance in Pseudomonas aeruginosa . J Antimicrob Chemother. 2005 ; 55 : 22 – 30 . Google Scholar Crossref Search ADS PubMed WorldCat 24 Hocquet D Berthelot P Roussel-Delvallez M et al. . Pseudomonas aeruginosa may accumulate drug resistance mechanisms without losing its ability to cause bloodstream infections . Antimicrob Agents Chemother. 2007 ; 51 : 3531 – 6 . Google Scholar Crossref Search ADS PubMed WorldCat 25 Rohan LC Moncla BJ Kunjara Na Ayudhya RP et al. . In vitro and ex vivo testing of tenofovir shows it is effective as an HIV-1 microbicide . PLoS One. 2010 ; 5 : e931 . Google Scholar Crossref Search ADS WorldCat Copyright © 2011, American Society of Health-System Pharmacists, Inc. All rights reserved.
TI - Significant publications on infectious diseases pharmacotherapy in 2010
JF - American Journal of Health-System Pharmacy
DO - 10.2146/ajhp110125
DA - 2011-11-01
UR - https://www.deepdyve.com/lp/oxford-university-press/significant-publications-on-infectious-diseases-pharmacotherapy-in-CJMO0EN4BZ
SP - 2075
VL - 68
IS - 21
DP - DeepDyve
ER -