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Antibiotics
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Antibiotics Usage in Special Clinical Situations
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Antibiotics Usage in Special Clinical Situations

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 November 2023) | Viewed by 18081

Special Issue Editor

Dr. Stefano Di Bella

E-Mail Website
Guest Editor
Clinical Department of Medical, Surgical and Health Sciences, Trieste University, Trieste, Italy
Interests: antibiotics; synergism; pharmacokinetic; Clostridioides difficile; antimicrobial stewardship
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

This Special Issue aims to collect data on antibiotic use in special situations. Special situations are clinical scenarios not precisely covered by guidelines or standard practice, where novel strategies alongside new data are welcomed.

The list of clinical situations expected to be covered includes but is not limited to:

  • Antibiotics for infections of foreign bodies (orthopedic implants, neurosurgical implants, etc.);
  • New data on CNS penetration of antibiotics;
  • New data on continuous infusion administration of antibiotics (elastomeric pumps for OPAT included);
  • Antibiotics alongside chelators for severe infections;
  • Antibiotics alongside bacteriophages for severe infections;
  • Aerosolized antibiotics and related delivery tools;
  • New antibiotics for off-label indications;
  • Antibiotic combinations for synergy in difficult-to-treat infections;
  • Intra-articular or intrathecal antibiotic administrations.

Dr. Stefano Di Bella
Guest Editor

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
  • special situations
  • severe infections
  • synergism
  • implants
  • off-label
  • novel

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (5 papers)

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Editorial

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4 pages, 184 KiB  
Editorial
Antibiotics Usage in Special Clinical Situations
by Stefano Di Bella
Antibiotics 2024, 13(1), 34; https://doi.org/10.3390/antibiotics13010034 - 29 Dec 2023
Cited by 1 | Viewed by 1376
Abstract
Medicine and the treatment of infectious diseases are increasingly focused on patient-tailored diagnostics and therapy [...] Full article
(This article belongs to the Special Issue Antibiotics Usage in Special Clinical Situations)

Research

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19 pages, 12326 KiB  
Article
Impact of Erythromycin as a Prokinetic on the Gut Microbiome in Children with Feeding Intolerance—A Pilot Study
by Aravind Thavamani, Senthilkumar Sankararaman, Hilmi Al-Shakhshir, Mauricio Retuerto, Sujithra Velayuthan, Thomas J. Sferra and Mahmoud Ghannoum
Antibiotics 2023, 12(11), 1606; https://doi.org/10.3390/antibiotics12111606 - 8 Nov 2023
Viewed by 2320
Abstract
Background: Studies have demonstrated that the gut microbiome changes upon exposure to systemic antibiotics. There is a paucity of literature regarding impact on the gut microbiome by long-term usage of erythromycin ethyl succinate (EES) when utilized as a prokinetic. Methods: Stool samples from [...] Read more.
Background: Studies have demonstrated that the gut microbiome changes upon exposure to systemic antibiotics. There is a paucity of literature regarding impact on the gut microbiome by long-term usage of erythromycin ethyl succinate (EES) when utilized as a prokinetic. Methods: Stool samples from pediatric patients with feeding intolerance who received EES (N = 8) as a prokinetic were analyzed for both bacteriome and mycobiome. Age-matched children with similar clinical characteristics but without EES therapy were included as controls (N = 20). Results: In both groups, Proteobacteria, Firmicutes, and Bacteroidetes were the most abundant bacterial phyla. Ascomycota was the most abundant fungal phyla, followed by Basidiomycota. There were no significant differences in richness between the groups for both bacterial and fungal microbiome. Alpha diversity (at genus and species levels) and beta diversity (at the genus level) were not significantly different between the groups for both bacterial and fungal microbiome. At the species level, there was a significant difference between the groups for fungal microbiota, with a p-value of 0.029. We also noted that many fungal microorganisms had significantly higher p-values in the EES group than controls at both genera and species levels. Conclusions: In this observational case-control study, the prokinetic use of EES was associated with changes in beta diversity between the groups for mycobiome at the species level. Many fungal microorganisms were significantly higher in the EES group when compared to the controls. Confirmation of these results in larger trials will provide further evidence regarding the impact of EES on gut microbiota when utilized as a prokinetic agent. Full article
(This article belongs to the Special Issue Antibiotics Usage in Special Clinical Situations)
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9 pages, 1339 KiB  
Article
In Vitro and In Vivo Studies of Oritavancin and Fosfomycin Synergism against Vancomycin-Resistant Enterococcus faecium
by Cristina Lagatolla, Jai W. Mehat, Roberto Marcello La Ragione, Roberto Luzzati and Stefano Di Bella
Antibiotics 2022, 11(10), 1334; https://doi.org/10.3390/antibiotics11101334 - 29 Sep 2022
Cited by 12 | Viewed by 3100
Abstract
Therapeutic options for infections caused by vancomycin-resistant enterococci are currently suboptimal. Combination regimens where fosfomycin is used alongside existing treatments are emerging given the proven synergistic potential and PK/PD properties. In the studies presented here, we tested five vanA and five vanB clinical [...] Read more.
Therapeutic options for infections caused by vancomycin-resistant enterococci are currently suboptimal. Combination regimens where fosfomycin is used alongside existing treatments are emerging given the proven synergistic potential and PK/PD properties. In the studies presented here, we tested five vanA and five vanB clinical isolates of Enterococcus faecium using a combination of oritavancin + fosfomycin both in vitro (checkerboard, time killing) and in vivo (Galleria mellonella). The combination of oritavancin and fosfomycin increased drug susceptibility, showing a synergistic effect in 80% of isolates and an additive effect in the remaining isolates. The combination restored fosfomycin susceptibility in 85% of fosfomycin-resistant isolates. Time killing on four selected isolates demonstrated that the combination of oritavancin and fosfomycin provided a CFU/mL reduction > 2 log10 compared with the most effective drug alone and prevented the bacterial regrowth seen after 8–24 h at sub-inhibitory drug concentrations. In addition, the combination was also tested in a biofilm assay with two isolates, and a strong synergistic effect was observed in one isolate and an additive effect in the other. Finally, we demonstrated in vivo (Galleria mellonella) a higher survival rate of the larvae treated with the combination therapy compared to monotherapy (fosfomycin or oritavancin alone). Our study provides preclinical evidence to support trials combining oritavancin and fosfomycin for VRE BSI in humans, even when biofilm is involved. Full article
(This article belongs to the Special Issue Antibiotics Usage in Special Clinical Situations)
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Review

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15 pages, 572 KiB  
Review
Systemic Antimicrobial Treatment of Chronic Osteomyelitis in Adults: A Narrative Review
by Rok Besal, Peter Adamič, Bojana Beović and Lea Papst
Antibiotics 2023, 12(6), 944; https://doi.org/10.3390/antibiotics12060944 - 23 May 2023
Cited by 15 | Viewed by 6483
Abstract
Chronic osteomyelitis in adults is a complex condition that requires prolonged and intensive antimicrobial therapy, but evidence on optimal selection and duration of antibiotics is limited. A review of PubMed and Ovid Embase databases was conducted to identify systematic reviews, meta-analyses, retrospective and [...] Read more.
Chronic osteomyelitis in adults is a complex condition that requires prolonged and intensive antimicrobial therapy, but evidence on optimal selection and duration of antibiotics is limited. A review of PubMed and Ovid Embase databases was conducted to identify systematic reviews, meta-analyses, retrospective and randomised controlled trials (RCTs) on antibiotic treatment outcomes in adults with chronic osteomyelitis. Three main areas of interest were investigated: short-term versus long-term antibiotic therapy, oral versus parenteral antibiotic therapy, and combination antibiotic therapy with rifampicin versus without rifampicin. A total of 36 articles were identified and findings were synthesised using a narrative review approach. The available literature suffers from limitations, including a lack of high-quality studies, inconsistent definitions, and varying inclusion/exclusion criteria among studies. Most studies are open-labelled and lack blinding. Limited high-quality evidence exists that oral therapy is non-inferior to parenteral therapy and that shorter antibiotic duration might be appropriate in low-risk patients. Studies on the impact of rifampicin are inconclusive. Further well-designed studies are needed to provide more robust evidence in these areas. Full article
(This article belongs to the Special Issue Antibiotics Usage in Special Clinical Situations)
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Other

16 pages, 1003 KiB  
Systematic Review
Systemic Antimicrobial Therapy for Diabetic Foot Infections: An Overview of Systematic Reviews
by Angela Wright, Stephen Wood, Janath De Silva and J. Simon Bell
Antibiotics 2023, 12(6), 1041; https://doi.org/10.3390/antibiotics12061041 - 12 Jun 2023
Cited by 4 | Viewed by 3853
Abstract
Diabetic foot infections (DFIs) are a common complication of diabetes; however, there is clinical uncertainty regarding the optimal antimicrobial selection. The aim of this review was to critically evaluate the recent systematic reviews on the efficacy and safety of systemic (parenteral or oral) [...] Read more.
Diabetic foot infections (DFIs) are a common complication of diabetes; however, there is clinical uncertainty regarding the optimal antimicrobial selection. The aim of this review was to critically evaluate the recent systematic reviews on the efficacy and safety of systemic (parenteral or oral) antimicrobials for DFI. Medline, Embase, CENTRAL, and CINAHL databases and the PROSPERO register were searched from January 2015 to January 2023. Systematic reviews with or without meta-analyses on systemic antimicrobials for DFI, with outcomes of clinical infection resolution or complications, were included. Of the 413 records identified, 6 systematic reviews of 29 individual studies were included. Heterogeneity of individual studies precluded meta-analysis, except for ertapenem versus piperacillin–tazobactam (RR 1.07, 95% CI [0.96–1.19]) and fluoroquinolones versus piperacillin–tazobactam (RR 1.03, 95% CI [0.89–1.20]) in one review. The application of the AMSTAR-2 tool determined two reviews to be of high quality. There was no statistical difference in the clinical resolution of infections for 24 different antimicrobial regimens (penicillins, cephalosporins, carbapenems, fluoroquinolones, vancomycin, metronidazole, clindamycin, linezolid, daptomycin, and tigecycline). However, tigecycline did not meet non-inferiority against ertapenem ± vancomycin (absolute difference −5.5%, 95% CI [−11.0–0.1]) and was associated with a higher incidence of adverse drug events. There is minimal systematic review evidence to suggest one regimen is superior to another for DFI. Full article
(This article belongs to the Special Issue Antibiotics Usage in Special Clinical Situations)
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