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Antibiotics
Special Issues
Optimization of Antibiotic Use in Hospitals: From Bedside to Theory
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Optimization of Antibiotic Use in Hospitals: From Bedside to Theory

A special issue of Antibiotics (ISSN 2079-6382). This special issue belongs to the section "Antibiotics Use and Antimicrobial Stewardship".

Deadline for manuscript submissions: closed (30 April 2023) | Viewed by 2022

Special Issue Editors

Prof. Dr. Yonghong Xiao

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Guest Editor
State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital of Medicine School, Zhejiang University, Hangzhou, China
Interests: infectious disease; basic and clinic research in antimicrobial agents; diagnosis and treatment of drug-resistant bacterial infection; bacterial resistant surveillance and mechanisms; clinical pharmacology and rational use of antibiotics
Dr. Wei Yu

E-Mail
Guest Editor
State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital of Medicine School, Zhejiang University, Hangzhou, China
Interests: infectious disease; pharmacokinetics/pharmacodynamics of antibiotics; bacterial infections and immunity

Special Issue Information

Dear Colleagues,

Antibiotics are the cornerstone of therapy for bacterial infections, especially for critically ill patients. Unreasonable use of antibiotics was associated with unfavorable outcomes, such as longer hospital stay, higher cost, and mortality. An appropriate antibiotic regimen is now recognized as one of the most important determinants of survival for patients with infections. However, rational regimens of antibiotics remain at a continuous exploration phase. Currently, pharmacokinetic/pharmacodynamic (PK/PD) is of value in establishing rational regimens of antibiotics in human. Thus, not only is early empiric antibiotic administration important but the optimization of those agents is crucial as well.

This Special Issue will center on optimization of antibiotic use in hospitals, and aims to optimize therapy in order to maximize efficacy and minimize side effects and emergence of resistance. It will focus on, but is not limited to, the choice of drug, right dosing, timing of treatments, PK/PD of antibiotics, management of special population, and novel models or technologies to determine the optimal regimens. The relationship between antibiotics uses and resistance in hospitalized patients are welcome as well.

Prof. Dr. Yonghong Xiao
Dr. Wei Yu
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Antibiotics is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • antibiotics
  • antimicrobials
  • antibacterial mechanisms
  • antibiotic resistance
  • antimicrobial therapy
  • antimicrobial stewardship
  • pharmacokinetics/pharmacodynamics
  • therapeutic model
  • therapeutic drug monitor
  • anti-infective
  • clinical researches(trials) of infectious diseases

Published Papers (1 paper)

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Research

11 pages, 720 KiB  
Article
Evaluation of Piperacillin/Sulbactam, Piperacillin/Tazobactam and Cefoperazone/Sulbactam Dosages in Gram-Negative Bacterial Bloodstream Infections by Monte Carlo Simulation
by Xueting Wang, Luying Xiong, Wei Yu, Chen Huang, Jinru Ji, Chaoqun Ying, Zhiying Liu, Yunbo Chen and Yonghong Xiao
Antibiotics 2023, 12(2), 363; https://doi.org/10.3390/antibiotics12020363 - 09 Feb 2023
Cited by 2 | Viewed by 1668
Abstract
The optimal regimens of piperacillin/sulbactam (PIS 2:1), piperacillin/tazobactam (PTZ 8:1), and cefoperazone/sulbactam (CSL 2:1) are not well defined in patients based on renal function. This study was conducted to identify optimal regimens of BLBLIs in these patients. The antimicrobial sensitivity test was performed [...] Read more.
The optimal regimens of piperacillin/sulbactam (PIS 2:1), piperacillin/tazobactam (PTZ 8:1), and cefoperazone/sulbactam (CSL 2:1) are not well defined in patients based on renal function. This study was conducted to identify optimal regimens of BLBLIs in these patients. The antimicrobial sensitivity test was performed by a two-fold agar dilution method. Monte Carlo simulation (MCS) was used to simulate the probability of target attainment (PTA) and the cumulative fraction of response (CFR) for various dosing regimens in patients with different renal functions. For strains with an MIC ≤ 8/4 mg/L, PIS 4.5 g q6h achieved 99.03%PTA in the subset of patients with creatinine clearance (CrCL) > 90 mL/min. For patients with CrCL 60–90 mL/min, PIS 4.5 g q6h achieved 81.2% CFR; for those with CrCL 40–59 mL/min, PIS 4.5 g q8h achieved 80.25% CFR. However, for patients infected by ESBL-producing Enterobacteriaceae, PIS 4.5 g q6h achieved a CFR lower than 80%. For patients infected by A. baumannii with a CrCL of 31–60 mL/min, PIS 6.0 g q8h and 4.5 g q6h achieved 81.24% and 82.42% CFR, respectively. For those infected by P. aeruginosa, PIS 4.5 g q6h reached 90% CFR. PIS and PTZ achieved a similar CFR when piperacillin was at the same dose. The CFRs of CSL were much lower than those of the other two agents in Enterobacteriaceae and P. aeruginosa infections. The antibacterial spectrum of PIS is superior to that of PTZ and CSL. Higher dosages and dosing adjustment according to renal function should be considered to treat Gram-negative bacterial BSIs. Full article
(This article belongs to the Special Issue Optimization of Antibiotic Use in Hospitals: From Bedside to Theory)
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