CRAB Infections: β-Lactam β-Lactamase Inhibitors
62 Questions
0 Views

Choose a study mode

Play Quiz
Study Flashcards
Spaced Repetition
Chat to lesson

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What is a significant obstacle in developing Monoclonal Antibodies for bacterial infections?

  • The high cost of production
  • The lack of funding for research
  • Host-related obstacles and the unique properties of the product (correct)
  • The complexity of the immune system

    • What is the most extensively studied Polymyxin for its effectiveness against CRAB isolates in laboratory conditions?

  • Polymyxin E
  • Ampicillin/Sulbactam
  • Polymyxin B
  • Colistin (correct)

    • What is the primary factor contributing to the death of critically ill patients?

  • Systemic infections
  • Ventilator-associated pneumonia
  • Nosocomial pneumonia (correct)
  • Meningitis

    • What is the minimum percentage of multidrug-resistant (MDR) or extensively drug-resistant (XDR) A. baumannii in recent decades?

    <p>80%</p> Signup and view all the answers

    What is the main reason for the significance of synergy testing in treating infections caused by bacteria resistant to all single-drug treatment choices?

    <p>To determine the efficacy of antimicrobial therapies</p> Signup and view all the answers

    What is the percentage of antibiotics administered by doctors that are believed to be unnecessary?

    <p>Over 50%</p> Signup and view all the answers

    What is the name of the polymyxin that has been established as a prominent treatment option for many illnesses?

    <p>Polymyxin E</p> Signup and view all the answers

    What is the term used to describe the combination of Polymyxin and Rifampicin that demonstrated a significant level of synergism against A. baumannii?

    <p>Synergism</p> Signup and view all the answers

    What is the term used to describe Acinetobacter species that are resistant to all single-drug treatment choices?

    <p>Pan drug-resistant (PDR)</p> Signup and view all the answers

    What is the name of the bacterial strain that is known for its elevated virulence and resistance to antimicrobial agents?

    <p>A. baumannii</p> Signup and view all the answers

    What is the main difference between Zidebactam and Avibactam?

    <p>Avibactam is a 1st generation BLs and Zidebactam is a 2nd generation BLs</p> Signup and view all the answers

    What is the primary target of Sulbactam in the treatment of CRAB infections?

    <p>Penicillin-binding Proteins (PBPs) 1 and 3</p> Signup and view all the answers

    What is the advantage of using Durlobactam with Sulbactam in the treatment of CRAB infections?

    <p>It reduces the dose of Sulbactam required</p> Signup and view all the answers

    What is the current status of the Sulbactam/Durlobactam antibiotic?

    <p>It has completed phase 3 clinical trials but has not been approved by the FDA</p> Signup and view all the answers

    What is the main limitation of using Bacteriophage Therapy (BT) to treat bacterial diseases?

    <p>There is a lack of knowledge regarding human infections</p> Signup and view all the answers

    What is the goal of modifying the composition of Phage strains in Bacteriophage Therapy (BT)?

    <p>To develop more potent and effective treatments for MDR-GNB and MDR-GPB</p> Signup and view all the answers

    What is the primary advantage of using Phage Concoctions containing two Phage Strains in Bacteriophage Therapy (BT)?

    <p>It leads to 'Sanitation of the infected areas' in 54 to 62.5 percent of individuals</p> Signup and view all the answers

    What is the current focus of research on Sulbactam/Zidebactam in other experimental models?

    <p>PDR-CRAB isolates</p> Signup and view all the answers

    What is the main difference between Relebactam and Avibactam when combined with Sulbactam against Sulbactam-resistant CRAB infections?

    <p>Relebactam is less effective than Avibactam</p> Signup and view all the answers

    What is the main goal of developing novel antimicrobial agents?

    <p>To improve the management of Multidrug-resistant Gram-negative and Gram-positive bacteria</p> Signup and view all the answers

    What type of enzymes does Avibactam inhibit?

    <p>Class A, Class C, and some Class D enzymes</p> Signup and view all the answers

    Why do CRAB isolates typically produce other Serine β-Lactamases?

    <p>To reduce the effectiveness of commonly administered β-Lactam Antibiotics</p> Signup and view all the answers

    What happens when Avibactam is combined with Sulbactam against Carbapenem-resistant Acinetobacter clinical isolates?

    <p>The effectiveness of Sulbactam is restored</p> Signup and view all the answers

    What was observed in 89% of the isolates in the May 2021 study when using Sulbactam/Avibactam?

    <p>A decrease in Sulbactam MICs of 2 dilutions</p> Signup and view all the answers

    What is Sulbactam a substrate for?

    <p>Class C and Class D enzymes</p> Signup and view all the answers

    How many CRAB isolates were tested against Sulbactam/Avibactam and Sulbactam/Relebactam combinations in the May 2021 study?

    <p>187 CRAB isolates</p> Signup and view all the answers

    What method was used to determine the minimum inhibitory concentration of Sulbactam and Fosfomycin?

    <p>Agar dilution</p> Signup and view all the answers

    What was the outcome of combining Colistin with Sulbactam or Fosfomycin?

    <p>Decreased MIC of Colistin against CRAB isolates</p> Signup and view all the answers

    What was the result of using Colistin as a monotherapy in treating A. baumannii infection?

    <p>Higher risk of nephrotoxicity</p> Signup and view all the answers

    What was the outcome of combining Colistin with Sulbactam or Fosfomycin in treating A. baumannii infection?

    <p>Increased microbiological response and decreased nephrotoxicity</p> Signup and view all the answers

    What was the percentage of CRAB isolates that showed susceptibility to Sulbactam?

    <p>20%</p> Signup and view all the answers

    What was the range of MIC values for Colistin in the study?

    <p>0.75-2 µg/ml</p> Signup and view all the answers

    What was the focus of the laboratory study evaluating antibiotic combinations against CR-GNB?

    <p>Pharmacokinetic/Pharmacodynamic properties of antibiotics</p> Signup and view all the answers

    What was the outcome of combining Imipenem with Amikacin or Tobramycin in treating P. aeruginosa infection?

    <p>Enhanced bactericidal effectiveness</p> Signup and view all the answers

    What was the result of the network meta-analysis evaluating bactericidal efficacy and re-growth rate in K. pneumoniae?

    <p>Polymyxin/Rifampicin showed superior bactericidal effectiveness</p> Signup and view all the answers

    What was the frequency of triple combinations showing enhanced efficacy in treating pan-drug-resistant A. baumannii?

    <p>Some combinations showed synergistic effects</p> Signup and view all the answers

    What is the main limitation of in vivo PK/PD models?

    <p>Antibiotic PK differences from humans</p> Signup and view all the answers

    What is the consequence of using Tigecycline as a single treatment?

    <p>Worse clinical response</p> Signup and view all the answers

    What is the purpose of MDR GNB animal models?

    <p>To select the dose and dosing interval of antibiotics</p> Signup and view all the answers

    What is the advantage of using Colistin over Tigecycline?

    <p>Higher microbiological success rates</p> Signup and view all the answers

    What is the limitation of small-scale clinical investigations?

    <p>Limited population size</p> Signup and view all the answers

    What is the purpose of the Limited Population Antibacterial Drug pathway?

    <p>To enable regulatory submission for antibiotic approval</p> Signup and view all the answers

    What is a consequence of improper administration of Colistin and inappropriate prescription?

    <p>Proliferation of Colistin-resistant Gram-negative bacteria, including A. baumannii</p> Signup and view all the answers

    How does Polymyxin B differ from Colistin in terms of pharmacokinetics?

    <p>Polymyxin B achieves stable blood levels without dosage adjustments</p> Signup and view all the answers

    What is the inactive form of Polymyxin B?

    <p>Colistimethate</p> Signup and view all the answers

    Why is it essential to provide greater doses of Colistin?

    <p>To compensate for elimination of CMS before activation</p> Signup and view all the answers

    What is a benefit of using Polymyxin B over Colistin?

    <p>Reduced risk of kidney damage</p> Signup and view all the answers

    What is the aim of optimizing antimicrobial treatment?

    <p>To reduce antibiotic resistance</p> Signup and view all the answers

    What is the result of progressive elevation of Colistin concentrations?

    <p>Accelerated Polymyxin resistance</p> Signup and view all the answers

    What is the primary objective of the Monte Carlo simulation study?

    <p>To analyze the most effective dosage regimens of Colistin</p> Signup and view all the answers

    What is the significance of comprehending the AMR profile?

    <p>To provide more precise advice for prescribing suitable antibiotics</p> Signup and view all the answers

    What is the global concern related to antibiotic resistance?

    <p>The worldwide incidence of antibiotic resistance</p> Signup and view all the answers

    What is the primary concern with using Polymyxin monotherapy?

    <p>It may not be sufficient to effectively kill bacteria and may cause kidney damage</p> Signup and view all the answers

    What is the significance of the MIC of Polymyxins exceeding 2 µg/m?

    <p>It reduces the effectiveness of Polymyxins against A. baumannii</p> Signup and view all the answers

    What is the primary reason for the IDSA's preference for Polymyxin B over Colistin?

    <p>Polymyxin B has a more advantageous pharmacokinetic profile</p> Signup and view all the answers

    What is the result of the RCT comparing Ampicillin/Sulbactam with Colistin in treating VAP caused by CRAB?

    <p>There was no significant difference in mortality, clinical failure, or microbiological failure</p> Signup and view all the answers

    What is the outcome of the retrospective cohort study comparing low-dose Colistin with Ampicillin/Sulbactam in treating CRAB VAP?

    <p>Colistin was associated with a higher all-cause death rate and microbiological failure rate</p> Signup and view all the answers

    What is the significance of the ESCMID guidelines' comparison of Ampicillin/Sulbactam with Colistin?

    <p>The guidelines highlight the comparable outcomes between Ampicillin/Sulbactam and Colistin</p> Signup and view all the answers

    What is the significance of the small randomized controlled trial comparing Ampicillin/Sulbactam with Colistin?

    <p>Ampicillin/Sulbactam was associated with a significant benefit in terms of 14-day and 28-day death rates</p> Signup and view all the answers

    What is the primary limitation of using Polymyxins in treating systemic infections?

    <p>The doses required to treat systemic infections are close to the point where kidney damage may occur</p> Signup and view all the answers

    What is the significance of in vitro synergy evaluation in choosing combinations of antibiotics?

    <p>It is necessary to examine the efficacy and safety of various combinations</p> Signup and view all the answers

    What is the preferred treatment for UTIs caused by CRAB, according to the IDSA guidelines?

    <p>Colistin</p> Signup and view all the answers

    More Like This

    Use Quizgecko on...
    Browser
    Open
    Browser
    Browser