Search Our Scientific Publications & Authors

PLoS One 2018 29;13(11):e0207413. Epub 2018 Nov 29.

Division of Infectious Diseases, Shizuoka Cancer Center Hospital, Sunto-gun, Shizuoka, Japan.

The most common complication in cancer patients is catheter-related bloodstream infection (CRBSI), of which Staphylococcus aureus is a common pathogen. Although S. aureus CRBSI patients are recommended for prolonged intravenous therapy, this is often not feasible. Read More

J Antimicrob Chemother 2018 Nov 9. Epub 2018 Nov 9.

Anti-Infective Research Laboratory, College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI, USA.

Background: Published guidelines call for prolonged courses of intravenous (iv) antibiotics for the treatment of MRSA bloodstream infection (BSI) to ensure eradication of deep foci and decrease relapse risk. Sequential iv-to-oral antibiotic therapy has been successfully applied to other serious infections but has not been evaluated for MRSA BSI.

Objectives: To compare outcomes in adults completing MRSA BSI therapy with oral versus parenteral antibiotics in the outpatient setting [oral outpatient antibiotic therapy (OOAT) versus outpatient parenteral antibiotic therapy (OPAT)]. Read More

Clin Chest Med 2018 Dec;39(4):853-869

Infectious Diseases Clinic, Department of Medicine, University of Udine, Azienda Sanitaria Universitaria, Presidio Ospedaliero Universitario Santa Maria della Misericordia, Colugna Street, Udine 33100, Italy.

Delayed antimicrobial prescriptions and inappropriate treatment can lead to poor outcomes in pneumonia. In nosocomial infections, especially in countries reporting high rates of antimicrobial resistance, the presence of multidrug-resistant gram-negative and gam-positive bacteria can limit options for adequate antimicrobial treatment. New antibiotics, belonging to known classes of antimicrobials or characterized by novel mechanisms of actions, have recently been approved or are under development. Read More

Eur J Drug Metab Pharmacokinet 2018 Oct 15. Epub 2018 Oct 15.

Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, Room 3-142D, 11,361-87 Ave, Edmonton, AB, T6G 2E1, Canada.

Delafloxacin has recently received approval by the US Food and Drug Administration for the treatment of acute bacterial skin and skin structure infections. This article provides a balanced and comprehensive systematic critique of the literature in order to provide an up-to-date summary of its clinical pharmacology. Oral delafloxacin is rapidly absorbed and exhibits comparable exposure characteristics (300 mg intravenous versus 450 mg oral) between the two formulations, allowing easy transition from intravenous to oral therapy. Read More

Ann Pharm Fr 2018 Oct 6. Epub 2018 Oct 6.

Service pharmaceutique, hospices Civils de Lyon, hôpital de la Croix-Rousse, groupement hospitalier Nord, 103, grande rue de la Croix-Rousse, 69317 Lyon cedex 04, France. Electronic address:

Introduction: Potassium is used to treat or prevent hypokalemia and exhibits all the characteristics of an intravenous to oral therapy conversion program. Despite this, the intravenous route for potassium replacement seems frequently unjustified.

Objectives: To determine the impact of a conversion program on the use of intravenous and oral galenic forms in a university tertiary care hospital. Read More

Front Chem 2018 21;6:386. Epub 2018 Sep 21.

Tianjin Key Laboratory of Molecular Drug Research, State Key Laboratory of Elemento-organic Chemistry, College of Pharmacy, Nankai University, Tianjin, China.

Physiological characteristics of human malignancies are increased glycolysis and overexpression of glucose transporters (GLUTs). Flurodeoxyglucose-positron emission tomography (FDG-PET) has successfully developed as clinical modality for the diagnosis and staging of many cancers based on the Warburg effect. To leverage this glucose transporter mediated metabolic disparity between normal and malignant cells, in the current report, protected, and de-protected glucose, mannose, galactose, rhamnose, maltose, and lactose-conjugated platinum(IV) complexes were designed and synthesized. Read More

Eur J Drug Metab Pharmacokinet 2018 Oct 3. Epub 2018 Oct 3.

Faculty of Medical Sciences, University of Kragujevac, Zmaj Jovina Street, 30, Kragujevac, 34000, Serbia.

Second-generation triazoles were developed in response to the quest for more efficacious and safer therapeutic options for the treatment of severe systemic aspergillosis and candidiasis. These agents include voriconazole, posaconazole, isavuconazole, and ravuconazole. The aim of this review was to present and compare the pharmacokinetic characteristics of second-generation triazoles for the treatment of invasive aspergillosis and candidiasis, emphasizing their clinical implications. Read More

J Antimicrob Chemother 2018 Dec;73(12):3496-3504

Scientific Center for Quality of Healthcare (IQ healthcare), Radboud Institute for Health Sciences, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, The Netherlands.

Background: Stewardship guidelines define three essential building blocks for successful hospital antimicrobial stewardship programmes (ASPs): stewardship prerequisites, stewardship objectives and improvement strategies.

Objectives: We systematically developed a survey, based on these building blocks, to evaluate the current state of antimicrobial stewardship in hospitals. We tested this survey in 64 Dutch acute care hospitals. Read More

N Engl J Med 2018 Aug 28. Epub 2018 Aug 28.

From the Department of Cardiology, Herlev-Gentofte University Hospital (K.I., M.S., C.F.K.), Department of Cardiology, the Heart Center, Rigshospitalet, Copenhagen University Hospital (N.I., D.E.H., E.L.F., L.K., H.B.), the Departments of Infectious Diseases (J.H.-L.) and Clinical Microbiology (C.M.), Rigshospitalet, the Department of Cardiology, Hillerød Hospital (N.T.), and the Department of Clinical Microbiology, Slagelse Hospital and Institute of Clinical Medicine (J.J.C.), University of Copenhagen, Copenhagen, the Departments of Cardiology (S.U.G.) and Clinical Microbiology (F.R.), Odense University Hospital, Odense, the Departments of Cardiology (T.M.) and Cardiology and Epidemiology and Biostatistics (C.T.-P.), Aalborg University Hospital, the Department of Clinical Microbiology, Aalborg University Hospital, Aalborg University (H.C.S.), and the Department of Health Science and Technology, Aalborg University (C.T.-P.), Aalborg, the Department of Cardiology, Zealand University Hospital, Roskilde (H.E.), the Department of Cardiology, Aarhus University Hospital, Aarhus (K.T.J.), the Department of Cardiology, University Hospital of Copenhagen, Gentofte (N.E.B.), and the Department of Bacteria, Parasites and Fungi, Statens Serum Institut, Copenhagen (K.F.) - all in Denmark.

Background Patients with infective endocarditis on the left side of the heart are typically treated with intravenous antibiotic agents for up to 6 weeks. Whether a shift from intravenous to oral antibiotics once the patient is in stable condition would result in efficacy and safety similar to those with continued intravenous treatment is unknown. Methods In a randomized, noninferiority, multicenter trial, we assigned 400 adults in stable condition who had endocarditis on the left side of the heart caused by streptococcus, Enterococcus faecalis, Staphylococcus aureus, or coagulase-negative staphylococci and who were being treated with intravenous antibiotics to continue intravenous treatment (199 patients) or to switch to oral antibiotic treatment (201 patients). Read More

Hosp Pharm 2018 Jun 6;53(3):188-193. Epub 2017 Nov 6.

University of Arkansas for Medical Sciences, Little Rock, USA.

Medication cost is frequently overlooked when treating critically ill patients. Stewardship of health care resources in high-utilization settings is imperative. This study was conducted to determine nonpharmacist health care providers' knowledge and perceptions of medication costs in a medical intensive care unit (MICU). Read More

Pharm Pract (Granada) 2018 Apr-Jun;16(2):855. Epub 2018 Jun 17.

Clinical Pharmacist. Pharmacy Department, Sibu Hospital. Sibu (Malaysia).

Background: Early intravenous to oral (IV-PO) antibiotics switch, which is one of the important elements in antimicrobial stewardship (AMS) is not well implemented in Malaysian district hospitals. A systematic interventional strategy is required to facilitate IV-PO antibiotic switch.

Objective: This study aimed to evaluate the impact of printed AMS recommendations on early IV-PO antibiotics switch practice in district hospitals. Read More

Pharmacotherapy 2018 Sep 2;38(9):947-966. Epub 2018 Aug 2.

Center for Anti-Infective Research and Development, Hartford Hospital, Hartford, Connecticut.

Acute hematogenous osteomyelitis (AHO), often occurring in young children, is the most frequently diagnosed type of osteomyelitis in pediatric patients. Optimizing antibiotics is essential as delays to receipt of appropriate therapy can lead to chronic osteomyelitis, as well as impairments in bone growth and development. Antimicrobial stewardship programs (ASPs) are in a key position to help improve the care of patients with AHO as they contain a pharmacist with expertise in antibiotic drug selection, optimization of dosing, and microbiologic test review. Read More

Emerg Med J 2018 Aug 18;35(8):492-498. Epub 2018 Jun 18.

Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia, Canada.

Objective: The purpose of our study was to determine if cephalexin 500 mg orally four times daily was non-inferior to cefazolin 2 g intravenously daily plus probenecid 1 g orally daily in the management of patients with uncomplicated mild-moderate skin and soft tissue infection (SSTI) presenting to the ED.

Methods: This was a prospective, multicentre, double dummy-blind, randomised controlled non-inferiority trial conducted at two tertiary care teaching hospitals in Canada. Patients were enrolled if they presented to the ED with an uncomplicated SSTI, and randomly assigned in a 1:1 fashion to oral cephalexin or intravenous cefazolin plus oral probenecid for up to 7 days. Read More

Infect Control Hosp Epidemiol 2018 Aug 12;39(8):941-946. Epub 2018 Jun 12.

1Public Health Ontario,Toronto,Canada.

Objectives: Antibiotic use varies widely between hospitals, but the influence of antimicrobial stewardship programs (ASPs) on this variability is not known. We aimed to determine the key structural and strategic aspects of ASPs associated with differences in risk-adjusted antibiotic utilization across facilities.

Design: Observational study of acute-care hospitals in Ontario, Canada METHODS: A survey was sent to hospitals asking about both structural (8 elements) and strategic (32 elements) components of their ASP. Read More

J Antimicrob Chemother 2018 Aug;73(8):2201-2206

Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, CA Rotterdam, The Netherlands.

Objectives: To evaluate a clinical decision support system (CDSS) based on consensus-based intravenous to oral switch criteria, which identifies intravenous to oral switch candidates.

Methods: A three-step evaluation study of a stand-alone CDSS with electronic health record interoperability was performed at the Erasmus University Medical Centre in the Netherlands. During the first step, we performed a technical validation. Read More

Antimicrob Agents Chemother 2018 Jun 25;62(6). Epub 2018 May 25.

Department of Microbiology, Daiichi Sankyo India Pharma Private Limited, Gurgaon, Haryana, India

DS-2969b is a novel GyrB inhibitor under clinical development. In this study, the activity of DS-2969b and the activities of DS-2969b and its water-soluble prodrug, DS11960558, against methicillin-resistant (MRSA) were evaluated. DS-2969b inhibited the supercoiling activity of DNA gyrase and the decatenation activity of its topoisomerase IV. Read More

Pharmazie 2018 04;73(4):234-240

Vitamin (V) K deficiency may cause severe bleeding tendencies, which necessitates extreme caution. We report a case of a 30-year-old man diagnosed with VK deficiency of unknown etiology. He was treated with intravenous menatetrenone three times a week in an outpatient setting for about 1 year and 9 months. Read More

Eur J Clin Pharmacol 2018 Jun 2;74(6):767-773. Epub 2018 Mar 2.

Department of Hospital Pharmacy, Erasmus Medical Center, PO Box 2040 3000, CA, Rotterdam, The Netherlands.

Purpose: Cyclosporine A (CsA) is the most widely used immunosuppressive agent after a hematopoietic stem cell transplantation (HSCT). Although recommendations for CsA dose conversion from intravenous to oral administration differ from 1:1 to 1:3, most studies did not consider the role of azole antifungals as an important confounder. Therefore, we assess the optimal conversion rate of CsA from intravenous to oral administration in HSCT recipients, taking into account the concomitant use of azole antifungals. Read More

J Pediatric Infect Dis Soc 2018 Feb 8. Epub 2018 Feb 8.

Department of Pharmacy, Children's Minnesota, Minneapolis.

Background: Hospital practice patterns vary for switching from intravenous to oral antibiotics for community-acquired pneumonia in pediatric patients, but it is unknown how these practice patterns affect hospital lengths of stay and costs.

Methods: We conducted a retrospective study of 78673 pediatric patients (aged 3 months to 17 years) hospitalized for community-acquired pneumonia. Analyses were performed with data from the Pediatric Health Information System between 2007 and 2016, including discharge data from 48 freestanding children's hospitals. Read More

Curr Opin Infect Dis 2018 04;31(2):163-169

Azienda Sanitaria Universitaria Integrata, Presidio Ospedaliero Universitario Santa Maria della Misericordia.

Purpose Of Review: Skin and soft tissue infections prevalence is increasing and represent a frequent cause of hospital admission. New guidelines have become available in order to better define these infections and their response to antimicrobial treatment. Gram-positive bacteria, in particular Staphylococcus aureus, remain the most frequently isolated pathogens in skin and soft tissue infections. Read More

Int J Antimicrob Agents 2018 May 5;51(5):794-798. Epub 2018 Jan 5.

Université de Lorraine, CHRU-Nancy, Infectious Diseases Department, F-54000 Nancy, France; Université de Lorraine, APEMAC, F-54000 Nancy, France. Electronic address:

Bloodstream infections (BSIs) are common, however international guidelines are available only for methicillin-resistant Staphylococcus aureus (MRSA) bacteraemia and candidaemia. This international ESCMID cross-sectional survey, open from December 2016 to February 2017, explored the management of BSIs by infection specialists. All infection specialists (senior or trainees) giving at least weekly advice on positive blood cultures could participate. Read More

Stud Health Technol Inform 2017 ;245:1251

Research Center for Medical Informatics, University Hospital Zurich & University of Zurich, Switzerland.

Advantages of early intravenous (IV) to oral (PO) switches of antimicrobials are well known. Yet, little data have been published on reasonable IV-to-PO switches of other drug classes, although interventions to promote early IV-to-PO conversions may further increase patient safety and decrease costs. We therefore analyzed IV-to-PO switches of non-antimicrobials. Read More

Hosp Pharm 2017 Jul 26;52(7):508-513. Epub 2017 Jul 26.

Medical University of South Carolina, Charleston, USA.

Focus on antimicrobial use and infection prevention from accrediting or regulatory bodies such as the Joint Commission, as well as regulatory agencies such as the Centers for Medicare and Medicaid Services and the Centers for Disease Control, has highlighted the need for continuing development of antimicrobial stewardship programs at healthcare facilities across the country. Our institution utilized the 2007 Infectious Diseases Society of America and the Society for Healthcare Epidemiology guidelines to direct the evaluation of its antimicrobial use and develop a successful antimicrobial stewardship program. Three baseline evaluations were conducted. Read More

Clin Med (Lond) 2017 Dec;17(6):504-507

Division of Public Health and Epidemiology, University of Nottingham.

We hypothesised that delays in providing non-urgent medication step-downs at weekends to medical management may be associated with increased length of stay.In a novel use of electronic prescribing data, we analysed emergency admissions from a busy acute medical hospital over 52 weeks from November 2014 to October 2015. The main outcomes of interest were switching from intravenous antibiotics to oral antibiotics and stopping nebulised bronchodilators. Read More

J Eval Clin Pract 2018 04 28;24(2):454-455. Epub 2017 Nov 28.

School of Clinical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Australia.

Antimicrob Agents Chemother 2018 Feb 25;62(2). Epub 2018 Jan 25.

Paratek Pharmaceuticals, Inc., King of Prussia, Pennsylvania, USA.

Omadacycline, a first-in-class aminomethylcycline antibiotic, is related to tetracyclines but is structurally modified to circumvent mechanisms of resistance to tetracyclines. Omadacycline demonstrates potent activity against a broad range of pathogens, including drug-resistant strains, and is in late-stage development for treatment of acute bacterial skin and skin structure infections and community-acquired bacterial pneumonia. Previous studies support an intravenous-to-oral transition regimen with 300-mg once-daily oral dosing. Read More

J Infect Chemother 2018 Jan 16;24(1):40-44. Epub 2017 Nov 16.

Department of Pediatrics, School of Medicine, University of Occupational and Environmental Health Japan, Kitakyushu, Japan.

An early switch from intravenous to oral antimicrobial therapy is useful for reducing the duration of the hospitalization in adult patients with community acquired-pneumonia, whereas the efficacy of switch therapy for pediatric patients with community acquired (CA)-lower respiratory tract infection (LRTI) is uncertain. The aim of this study is to investigate the efficacy of switch therapy for LRTI in patients with severe motor intellectual disabilities (SMID). This retrospective study was performed on 92 patients with SMID who were admitted to the Department of Pediatrics at the Hospital of University of Occupational and Environmental Health, Japan from April 1, 2010 to March 31, 2017 for the suspicion of bacterial LRTI and were initially treated with an intravenous antimicrobial agent. Read More

Pharmacotherapy 2018 01 23;38(1):108-121. Epub 2017 Nov 23.

College of Pharmacy, Nova Southeastern University, Fort Lauderdale, Florida.

Delafloxacin is a new fluoroquinolone antimicrobial approved for the treatment of acute bacterial skin and skin structure infections (ABSSSIs) in adults using dosage regimens of 300 mg intravenously every 12 hours, 450 mg orally every 12 hours, or switching from intravenous to oral regimens for a 5- to 14-day treatment duration. Dosage adjustments in patients with severe renal dysfunction (estimated glomerular filtration rate [eGFR] = 15-29 ml/min/1.73 m ) are not required for oral doses but should be decreased to 200 mg intravenously every 12 hours in patients requiring parenteral therapy. Read More

Pharmacotherapy 2017 Nov 23;37(11):1479-1483. Epub 2017 Oct 23.

Department of Pharmacy Services, Medical University of South Carolina, Charleston, South Carolina.

Objectives: To characterize antibiotic regimens utilized for bacteremic Enterobacteriaceae urinary tract infections and assess treatment failure associated with intravenous-only compared to intravenous transitioned to oral antibiotic treatment.

Design: Retrospective cohort.

Settings: Tertiary care academic medical center. Read More

Asia Pac J Clin Oncol 2018 Apr 28;14(2):e129-e137. Epub 2017 Aug 28.

Department of Medical Oncology, Tata Memorial Hospital, Parel, Mumbai, Maharashtra, India.

Aim: We aimed to find the optimal route of iron supplementation in patients with malignancy and iron deficiency (true or functional) anemia not receiving erythropoiesis stimulating agents (ESA).

Methods: Adult patients with malignancy requiring chemotherapy, hemoglobin (Hb) <12 g/dL and serum ferritin <100 mcg/mL, transferrin saturation <20% or hypochromic red blood cells >10% were randomized to intravenous (IV) iron sucrose or oral ferrous sulfate. The primary endpoint was change in Hb from baseline to 6 weeks. Read More

Antimicrob Resist Infect Control 2017 15;6:81. Epub 2017 Aug 15.

Department of Internal Medicine, Canisius-Wilhelmina Hospital, Nijmegen, the Netherlands.

Background: Timely switch from intravenous (iv) antibiotics to oral therapy is a key component of antimicrobial stewardship programs in order to improve patient safety, promote early discharge and reduce costs. We have introduced a time-efficient and easily implementable intervention that relies on a computerized trigger tool, which identifies patients who are candidates for an iv to oral antibiotic switch.

Methods: The intervention was introduced on all internal medicine wards in a teaching hospital. Read More

PLoS One 2017 21;12(7):e0181803. Epub 2017 Jul 21.

Kantar Health s.r.o., Praha, Czech Republic.

Objectives: Adjuvant cisplatin-based chemotherapy is recommended for routine use in patients with Stage IIA, IIB or IIIA non-small cell lung cancer (NSCLC) after complete resection. Results obtained for Stage IB were not conclusive. While vinorelbine plus cisplatin is the preferred choice after resection, combining vinorelbine with carboplatin promises improved compliance and delivery of drugs due to lower toxicity. Read More

Future Microbiol 2017 08 7;12:847-851. Epub 2017 Jul 7.

Zydus Research Center, Cadila Health Care Ltd, Sarkhej-Bavla NH No 8A, Moraiya, Ahmedabad 382 210, Gujarat, India.

J Paediatr Child Health 2017 Jul;53(7):722

Children's Hospital at Westmead, Sydney.

Eur Heart J Acute Cardiovasc Care 2017 Jun 1:2048872617707960. Epub 2017 Jun 1.

2 Brigham and Women's Hospital Heart & Vascular Center, Harvard Medical School, Boston, USA.

Cangrelor, the first and currently only available intravenous P2Y receptor antagonist, has been approved and is now being used in patients with coronary artery disease requiring percutaneous coronary intervention. The rationale for cangrelor use is most robust in patients requiring an immediate, profound, and predictable level of P2Y inhibition - especially in patients with acute coronary syndromes. Herein we summarize the drug development program and reflect on practical considerations for clinicians on cangrelor use in the acute setting surrounding percutaneous coronary intervention, including selection of patients, concomitant administration of glycoprotein IIb/IIIa inhibitors and transition strategies from intravenous to oral P2Y receptor antagonists. Read More

J Med Chem 2017 May 24;60(9):3755-3775. Epub 2017 Apr 24.

Actelion Pharmaceuticals Ltd. , Gewerbestrasse 16, CH-4123 Allschwil, Switzerland.

Our strategy to combat resistant bacteria consisted of targeting the GyrB/ParE ATP-binding sites located on bacterial DNA gyrase and topoisomerase IV and not utilized by marketed antibiotics. Screening around the minimal ethyl urea binding motif led to the identification of isoquinoline ethyl urea 13 as a promising starting point for fragment evolution. The optimization was guided by structure-based design and focused on antibacterial activity in vitro and in vivo, culminating in the discovery of unprecedented substituents able to interact with conserved residues within the ATP-binding site. Read More

Infect Chemother 2017 Mar 22;49(1):87-89. Epub 2017 Mar 22.

Department of Internal Medicine, Kyungpook National University, School of Medicine, Daegu, Korea.

Infect Chemother 2017 Mar 13;49(1):31-37. Epub 2017 Mar 13.

Division of Infectious Diseases, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.

Background: Early conversion from intravenous to oral antibiotics plays an important role in lowering the risk of catheter-associated infections, reducing the workload of nurses, decreasing direct and indirect costs, and shortening hospital stays. In August 2015, an antimicrobial stewardship program (ASP) was implemented to facilitate conversion from intravenous to oral administration of fluoroquinolones in our institute. This study evaluated the clinical and economic impact of the intervention. Read More

J Eval Clin Pract 2017 Aug 7;23(4):848-852. Epub 2017 Mar 7.

Department of Pharmacy, Groupe Hospitalier Paris Saint-Joseph, Paris, France.

Rationale, Aims, And Objectives: Intravenous (IV) to oral (PO) drug switch is a challenge for tertiary care institutions for several reasons: catheter-related infections, patient's pain and discomfort or higher costs, and overuse of IV drugs considered as an irrational use of medicines. The objective was to evaluate yearly acetaminophen and proton-pump inhibiters' (PPIs) IV/PO ratios from 2011 to 2015 and to determine their correlation with all drugs IV/PO ratios and their relevance as drug tracers. A secondary objective was to estimate costs savings associated with a IV to PO switch improvement. Read More

Enferm Infecc Microbiol Clin 2017 Jan;35 Suppl 1:41-45

Servicio de Farmacia, Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, España. Electronic address:

The economic cost of treating an infection can be influenced by multiple factors related to patient characteristics, the type of infection, the isolated microorganism and some mechanisms of bacterial resistance. Of these, the factor generating the largest number of studies is bacterial resistance but many of these studies show major limitations. Antimicrobial stewardship has been proposed as a means to reduce the economic cost of treating infections. Read More

Expert Rev Anti Infect Ther 2017 04 27;15(4):351-359. Epub 2016 Dec 27.

b Infectious Disease Department, Hospital Universitari de Bellvitge, IDIBELL, Spanish Network for Research in Infectious Diseases (REIPI), and Clinical Science Department, Faculty of Medicine , University of Barcelona , Barcelona , Spain.

Introduction: Community-acquired pneumonia (CAP) continues to be associated with significant mortality and morbidity. As with other infectious diseases, in recent years there has been a marked increase in resistance to the antibiotics commonly used against the pathogens that cause CAP. Antimicrobial stewardship denotes coordinated interventions to improve and measure the appropriate use of antibiotics by encouraging the selection of optimal drug regimens. Read More

J Antimicrob Chemother 2017 02 20;72(2):543-546. Epub 2016 Dec 20.

Department of Medical Microbiology and Infectious Diseases, Erasmus MC University Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands.

Objectives: Despite huge overlap in suggested criteria for a safe intravenous (iv)-to-oral antibiotic switch, there is considerable variation in their operationalization. The objective of this study was to develop a set of measurable conditions that should be met in adult hospitalized patients for a safe iv-to-oral switch.

Methods: A RAND-modified Delphi procedure was performed to develop a set of operationalized iv-to-oral switch criteria. Read More

Drugs 2016 Dec;76(18):1737-1757

Department of Medical Microbiology, Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada.

Solithromycin is a novel fluoroketolide developed in both oral and intravenous formulations to address increasing macrolide resistance in pathogens causing community-acquired bacterial pneumonia (CABP). When compared with its macrolide and ketolide predecessors, solithromycin has several structural modifications which increase its ribosomal binding and reduce its propensity to known macrolide resistance mechanisms. Solithromycin, like telithromycin, affects 50S ribosomal subunit formation and function, as well as causing frame-shift errors during translation. Read More

Int J Hematol 2017 Mar 7;105(3):361-368. Epub 2016 Nov 7.

Department of Pharmacy, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.

The aim of this retrospective study was to identify variable factors affecting tacrolimus blood concentration during the switch from continuous intravenous infusion to twice-daily oral administration in allogeneic hematopoietic stem cell transplant recipients (n = 73). The blood concentration/dose ratio of tacrolimus immediately before the change from continuous infusion (C/Div) was compared with that between 3 and 5 days after the change to oral administration (C/Dpo). Median (C/Dpo)/(C/Div) was 0. Read More

Int J Antimicrob Agents 2016 Nov 20;48(5):498-503. Epub 2016 Aug 20.

Department of Medicine, Division of Infectious Diseases, University of South Carolina School of Medicine, Columbia, SC, USA. Electronic address:

There is paucity of data evaluating intravenous-to-oral antibiotic switch options for Gram-negative bloodstream infections (BSIs). This retrospective cohort study examined the effectiveness of oral antibiotics for definitive treatment of Gram-negative BSI. Patients with Gram-negative BSI hospitalised for <14 days at Palmetto Health Hospitals in Columbia, SC, from 1 January 2010 through 31 December 2013 and discharged on oral antibiotics were included in this study. Read More

J Pharm Policy Pract 2016 28;9:35. Epub 2016 Oct 28.

Division of Pharmacy, Ehime University Hospital, 454 Shitsukawa, Toon, Ehime 791-0295 Japan.

Background: High oral bioavailability of antimicrobial agents can result in the replacement of intravenous (IV) therapy with oral therapy when a patient meets defined clinical criteria. However, few studies have evaluated the effects of switching antibiotic administration route in Japan, especially for linezolid. This study evaluated an IV-to-oral antibiotic switching program for linezolid treatment at a university hospital in Japan. Read More

J Thorac Dis 2016 Sep;8(9):2473-2484

Respiratory Department of Chinese PLA General Hospital, Beijing 100853, China.

Background: To compare 5-day regimen of levofloxacin 750 mg IV daily with 7-14-day conventional regimen of levofloxacin 500 mg intravenous to oral (IV/PO) daily for treatment of community-acquired pneumonia (CAP) in Chinese population.

Methods: This was a non-inferiority study to assess the difference of clinical efficacy at the end of treatment (EOT) between two regimens. Adult CAP patients with CURB-65 score 0-2 were enrolled from 17 hospitals in China from November 2012 to July 2014. Read More

Ann Am Thorac Soc 2017 Feb;14(2):200-205

2 Division of Infectious Diseases, Intermountain Healthcare, Murray, Utah.

Rationale: Guidelines recommend a switch from intravenous to oral antibiotics once patients who are hospitalized with pneumonia achieve clinical stability. However, little evidence guides the selection of an oral antibiotic for patients with health care-associated pneumonia, especially where no microbiological diagnosis is made.

Objectives: To compare outcomes between patients who were transitioned to broad- versus narrow-spectrum oral antibiotics after initially receiving broad-spectrum intravenous antibiotic coverage. Read More

World J Clin Pediatr 2016 Aug 8;5(3):244-50. Epub 2016 Aug 8.

Nathan Batchelder, Tsz-Yin So, Department of Pharmacy, Moses H. Cone Memorial Hospital, Greensboro, NC 27401, United States.

Osteomyelitis is a bone infection that requires prolonged antibiotic treatment and potential surgical intervention. If left untreated, acute osteomyelitis can lead to chronic osteomyelitis and overwhelming sepsis. Early treatment is necessary to prevent complications, and the standard of care is progressing to a shorter duration of intravenous (IV) antibiotics and transitioning to oral therapy for the rest of the treatment course. Read More