One such practice that the team incorporated into the workflow was the use of the antibiotic piperacillin-tazobactam
to help reduce surgical site infections by tailoring treatment to address the local microbiology of complex appendicitis.
Moderate levels of resistance were seen to piperacillin-tazobactam
(21%), ciprofloxacin (30%), gentamicin (35%) co-amoxiclav (49%) and the 3rd-generation cephalosporins cefotaxime and ceftazidime (49% and 44%, respectively).
The antibiotic susceptibility profiles of P aeruginosa isolated from superficial swab specimens prior to discharge revealed susceptibility to colistin only and resistance to ampicillin, amoxicillin-clavulanic acid, piperacillin-tazobactam
, cefixime, cefuroxime, cefoxitin, cefotaxime, ceftazidime, cefepime, ertapenem, nitrofurantoin, trimethoprim-sulfamethoxazole, imipinem, meropenem, tigecycline, amikacin, gentamycin and ciprofloxacin.
In the process of doing this work, the team has analyzed appendectomy procedure workflow, from diagnosis to after-care, and has come up with a variety of process improvements, including, for example, an evidence-based recommended practice incorporated into the workflow involving the optimal use of the antibiotic piperacillin-tazobactam
to reduce surgical site infections.
Typhi Antimicrobial agent(s) 301812 (donor) Ampicillin >256 Amoxicillin-clavulanate 16 Piperacillin-tazobactam
3 Cefoxitin 12 Ceftazidime >256 Cefotaxime >256 Cefotaxime-clavulanate 0.
An attempt at conservative management with bladder drainage and Piperacillin-Tazobactam
remains the preferred choice for empiric treatment for most Gram-negative infections (GNIs), a high percentage of respondents prefer using carbapenems in empiric therapy, suggesting that these agents, typically reserved for later-line use, are increasingly being prescribed as frontline therapies.
Oselta-mivir 75mg BID was started with piperacillin-tazobactam
Imipenem still remains most effective drug against ESBL producing organisms followed by piperacillin-tazobactam
Antibiotic Class Drug Mechanism of Action Penicillins ticarcillin, penicillin inhibit bacterial cell wall synthesis Penicillin/Beta- ticarcillin-clavulanate, inhibit bacterial cell lactamase piperacillin-tazobactam
wall synthesis inhibitor Cephalosporins ceftazidime, cefepime inhibit bacterial cell wall synthesis Monobactams aztreonam inhibit bacterial cell wall synthesis Carbapenems imipenem-cilastatin, inhibit bacterial cell meropenem wall synthesis Fluoroquinolones ciprofloxacin, block DNA levofloxacin synthesis (DNA gyrase) Aminoglycosides gentamicin, tobramycin inhibition of protein amikacin synthesis Polymyxins colistin disrupts outer cell membrane Table 2.
Cefepime (FEP) and piperacillin-tazobactam
(TZP) are commonly used alternatives for the [beta]-lactam component of broad-spectrum regimens for empiric treatment of sepsis in the critically ill.
She was started empirically on piperacillin-tazobactam
and amikacin for suspected nosocomial sepsis.