Ampicillin and Ceftobiprole Combination for the Treatment of <i>Enterococcus faecalis</i> Invasive Infections: “The Times They Are A-Changin”
Background: <i>Enterococcus faecalis</i> is responsible for a large variety of severe infections. This study is a case series reporting our experience in the treatment of <i>E. faecalis</i> invasive infections with ampicillin in combination with ceftobiprole (ABPR). Methods:...
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| Format: | Article |
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MDPI AG
2023-05-01
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| Series: | Antibiotics |
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| Online Access: | https://www.mdpi.com/2079-6382/12/5/879 |
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| author | Simone Giuliano Jacopo Angelini Denise D’Elia Monica Geminiani Roberto Daniele Barison Alessandro Giacinta Assunta Sartor Floriana Campanile Francesco Curcio Menino Osbert Cotta Jason A. Roberts Massimo Baraldo Carlo Tascini |
| author_facet | Simone Giuliano Jacopo Angelini Denise D’Elia Monica Geminiani Roberto Daniele Barison Alessandro Giacinta Assunta Sartor Floriana Campanile Francesco Curcio Menino Osbert Cotta Jason A. Roberts Massimo Baraldo Carlo Tascini |
| author_sort | Simone Giuliano |
| collection | DOAJ |
| description | Background: <i>Enterococcus faecalis</i> is responsible for a large variety of severe infections. This study is a case series reporting our experience in the treatment of <i>E. faecalis</i> invasive infections with ampicillin in combination with ceftobiprole (ABPR). Methods: We retrospectively analyzed all the medical records of patients admitted to the University Hospital of Udine from January to December 2020 with a diagnosis of infective endocarditis or primary or non-primary complicated or uncomplicated bacteremia caused by <i>E. faecalis</i>. Results: Twenty-one patients were included in the final analysis. The clinical success rate was very high, accounting for 81% of patients, and microbiological cure was obtained in 86% of patients. One relapse was recorded in one patient who did not adhere to the partial oral treatment prescribed. Therapeutic drug monitoring (TDM) was always performed for ampicillin and ceftobiprole, and serum concentrations of both drugs were compared to the MICs of the different enterococcal isolates. Conclusions: ABPR is a well-tolerated antimicrobial regimen with anti-<i>E. faecalis</i> activity. TDM can help clinicians optimize medical treatments to achieve the best possible efficacy with fewer side effects. ABPR might be a reasonable option for the treatment of severe invasive infections caused by <i>E. faecalis</i> due to the high level of enterococcal penicillin-binding protein (PBP) saturation. |
| first_indexed | 2024-03-11T04:00:05Z |
| format | Article |
| id | doaj.art-080beb40087647159108bb5a8cfcbf3c |
| institution | Directory Open Access Journal |
| issn | 2079-6382 |
| language | English |
| last_indexed | 2024-03-11T04:00:05Z |
| publishDate | 2023-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Antibiotics |
| spelling | doaj.art-080beb40087647159108bb5a8cfcbf3c2023-11-18T00:12:38ZengMDPI AGAntibiotics2079-63822023-05-0112587910.3390/antibiotics12050879Ampicillin and Ceftobiprole Combination for the Treatment of <i>Enterococcus faecalis</i> Invasive Infections: “The Times They Are A-Changin”Simone Giuliano0Jacopo Angelini1Denise D’Elia2Monica Geminiani3Roberto Daniele Barison4Alessandro Giacinta5Assunta Sartor6Floriana Campanile7Francesco Curcio8Menino Osbert Cotta9Jason A. Roberts10Massimo Baraldo11Carlo Tascini12Infectious Diseases Division, Department of Medicine, University of Udine and Azienda Sanitaria Universitaria Friuli Centrale, 33100 Udine, ItalyClinical Pharmacology and Toxicology Institute, University Hospital Friuli Centrale ASUFC, 33100 Udine, ItalyInfectious Diseases Division, Department of Medicine, University of Udine and Azienda Sanitaria Universitaria Friuli Centrale, 33100 Udine, ItalyInfectious Diseases Division, Department of Medicine, University of Udine and Azienda Sanitaria Universitaria Friuli Centrale, 33100 Udine, ItalyInfectious Diseases Division, Department of Medicine, University of Udine and Azienda Sanitaria Universitaria Friuli Centrale, 33100 Udine, ItalyInfectious Diseases Division, Department of Medicine, University of Udine and Azienda Sanitaria Universitaria Friuli Centrale, 33100 Udine, ItalyMicrobiology Unit, Udine University Hospital, 33100 Udine, ItalyDepartment of Biomedical and Biotechnological Sciences, Section of Microbiology, University of Catania, 95123 Catania, ItalyDepartment of Medicine, University of Udine (UNIUD), 33100 Udine, ItalyFaculty of Medicine, University of Queensland, Centre for Clinical Research (UQCCR), Brisbane, QLD 4029, AustraliaFaculty of Medicine, University of Queensland, Centre for Clinical Research (UQCCR), Brisbane, QLD 4029, AustraliaClinical Pharmacology and Toxicology Institute, University Hospital Friuli Centrale ASUFC, 33100 Udine, ItalyInfectious Diseases Division, Department of Medicine, University of Udine and Azienda Sanitaria Universitaria Friuli Centrale, 33100 Udine, ItalyBackground: <i>Enterococcus faecalis</i> is responsible for a large variety of severe infections. This study is a case series reporting our experience in the treatment of <i>E. faecalis</i> invasive infections with ampicillin in combination with ceftobiprole (ABPR). Methods: We retrospectively analyzed all the medical records of patients admitted to the University Hospital of Udine from January to December 2020 with a diagnosis of infective endocarditis or primary or non-primary complicated or uncomplicated bacteremia caused by <i>E. faecalis</i>. Results: Twenty-one patients were included in the final analysis. The clinical success rate was very high, accounting for 81% of patients, and microbiological cure was obtained in 86% of patients. One relapse was recorded in one patient who did not adhere to the partial oral treatment prescribed. Therapeutic drug monitoring (TDM) was always performed for ampicillin and ceftobiprole, and serum concentrations of both drugs were compared to the MICs of the different enterococcal isolates. Conclusions: ABPR is a well-tolerated antimicrobial regimen with anti-<i>E. faecalis</i> activity. TDM can help clinicians optimize medical treatments to achieve the best possible efficacy with fewer side effects. ABPR might be a reasonable option for the treatment of severe invasive infections caused by <i>E. faecalis</i> due to the high level of enterococcal penicillin-binding protein (PBP) saturation.https://www.mdpi.com/2079-6382/12/5/879enterococcus infectionsinfective endocarditiscombination therapyceftobiprolePBPstherapeutic drug monitoring |
| spellingShingle | Simone Giuliano Jacopo Angelini Denise D’Elia Monica Geminiani Roberto Daniele Barison Alessandro Giacinta Assunta Sartor Floriana Campanile Francesco Curcio Menino Osbert Cotta Jason A. Roberts Massimo Baraldo Carlo Tascini Ampicillin and Ceftobiprole Combination for the Treatment of <i>Enterococcus faecalis</i> Invasive Infections: “The Times They Are A-Changin” Antibiotics enterococcus infections infective endocarditis combination therapy ceftobiprole PBPs therapeutic drug monitoring |
| title | Ampicillin and Ceftobiprole Combination for the Treatment of <i>Enterococcus faecalis</i> Invasive Infections: “The Times They Are A-Changin” |
| title_full | Ampicillin and Ceftobiprole Combination for the Treatment of <i>Enterococcus faecalis</i> Invasive Infections: “The Times They Are A-Changin” |
| title_fullStr | Ampicillin and Ceftobiprole Combination for the Treatment of <i>Enterococcus faecalis</i> Invasive Infections: “The Times They Are A-Changin” |
| title_full_unstemmed | Ampicillin and Ceftobiprole Combination for the Treatment of <i>Enterococcus faecalis</i> Invasive Infections: “The Times They Are A-Changin” |
| title_short | Ampicillin and Ceftobiprole Combination for the Treatment of <i>Enterococcus faecalis</i> Invasive Infections: “The Times They Are A-Changin” |
| title_sort | ampicillin and ceftobiprole combination for the treatment of i enterococcus faecalis i invasive infections the times they are a changin |
| topic | enterococcus infections infective endocarditis combination therapy ceftobiprole PBPs therapeutic drug monitoring |
| url | https://www.mdpi.com/2079-6382/12/5/879 |
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