Urinary tract infection vancomycin

Vancomycin + (gentamicin or streptomycin), linezolid, daptomycin, tigecydine Urinary tract infection (UTI)... 

There is no regimen that is reliably bactericidal for vancomycin-resistant enterococcus for which there is extensive clinical experience daptomycin has bactericidal activity in vitro. Regimens that have been reported to be efficacious include nitrofurantoin (for urinary tract infection) potential regimens for bacteremia include daptomycin, linezolid, and dalfopristin/quinupristin. 

Septicaemia related to urinary tract infection usually involves Escherichia coli (or other Gramnegative bacteria), enterococci gentamicin plus benzylpenicillin or cefotaxime alone (ciprofloxacin plus vancomycin). 

A 47-year-old white man with a cadaveric liver transplant took chloramphenicol for a urinary tract infection due to a vancomycin-resistant Enterococcus and inadvertently received 1850 mg qds (roughly twice the maximum recommended dose). On day 4 he had a 12-hour trough tacrolimus concentration of over 60 ng/ml. 

A) AmpiciUin and tobramycin Cefipime and vancomycin Ciprofloxacin and ampicillin Tobramycin and ticarciUin Trimethoprim and sulfamethoxazole A 24-year-old mother of a young infant is to be treated with ciprofloxacin for a urinary tract infection. In providing the patient with information about the ciprofloxacin which one of the following statements is false ... 

Fosfomycin is one of a few natural products containing a carbon-phosphorus (C— P) bond isolated from Streptomyces fradiae, Streptomyces viridochromogenes, and Streptomyces wedmorensis [73]. It was also isolated from Pseudomonas syringae and Pseudomonas viridiflava [74, 75], Fosfomycin is a highly effective antibiotic of low toxicity clinically utilized for the treatment of lower urinary tract infections [76] as well as methicillin-resistant [77] and vancomycin-resistant [78] strains of S. aureus. Moreover, fosfomycin is effective for the treatment of cephalosporin- and penicillin-resistant Streptococcus pneumonia [79] and ciprofloxacin-resistant E. coli [80], The antimicrobial activity of fosfomycin has been ascribed to the inactivation of UDP-GlcAAc-3-O-enolpyruvyltransferase (MurA), an essential enzyme that catalyzes the first committed step in the biosynthesis of peptidoglycan, the main component of the cell wall, by covalent alkylation of an active site cysteine [81]. 

Fraimow HS. Jungkind DL, Landers DW, Desio DR, Dean JL. Urinary tract infections with an Enterococcus fwcalis isolate that requires vancomycin for growth. Ann Incetn Med 1994 121 22-26. 

Linezolid is FDA approved for treatment of infections caused by vancomycin-resistant E. faecium nosocomial pneumonia caused by methicillin-susceptible and methicillin-resistant strains of S. aureus community-acquired pneumonia caused by penicillin-susceptible strains of S. pneumoniae complicated skin and skin-structure infections caused by streptococci and methicillin-susceptible and -resistant strains of S. aureus and uncomplicated skin and skin-structure infections. In noncomparative studies, linezolid (600 mg twice daily) has had clinical and miaobiological cure rates in the range of 85 to 90% in treatment of a variety of infections (soft tissue, urinary tract, and bacteremia) caused by vancomycin-resistant E. faecium. A 200-mg, twice-daily dose was less effective, with clinical and microbiological cure rates of approximately 75 and 59%, respectively. The 600-mg, twice-daily dose, therefore, should be used for treatment of infections caused by enterococci. A 400-mg, twice-daily dosage regimen is recommended only for treatment of uncomplicated skin and skin-structure infections. 

Enterococci are responsible for urinary tract, wound, intra abdominal, and pelvic infections (Barsby et al., 2001). The increase of vancomycin-resistant enterococci (VRE) as important agents of nosocomial infections is cause of great concern (Perl, 1999). It is thought that a selective pressure favoring the survival and spread of VRE was the consequence of the use of... 

Chloramphenicol, isolated in 1947, is a broad spectiarm antibiotic. It is rapidly absorbed from the gastrointestinal tract and hence can be given orally in case of typhoid, dysentery, acute fever, certain form of urinary infections, meningitis and pneumonia. Vancomycin and ofloxacin are the other important broad spectr-um antibiotics. The antibiotic dysidazirine is supposed to be toxic towards certain strains of cancer cells. 

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