CRAB Infections: β-Lactam β-Lactamase Inhibitors
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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% (B)</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 (C)</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% (A)</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 (C)</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 (B)</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) (B)</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 (A)</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 (B)</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 (A)</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 (B)</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 (B)</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 (A)</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 (D)</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 (C)</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 (D)</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 (D)</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 (D)</p> Signup and view all the answers

What type of enzymes does Avibactam inhibit?

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

What is Sulbactam a substrate for?

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

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

<p>Agar dilution (B)</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 (A)</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 (D)</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 (B)</p> Signup and view all the answers

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

<p>20% (C)</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 (A)</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 (C)</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 (A)</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 (B)</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 (C)</p> Signup and view all the answers

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

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

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

<p>Worse clinical response (D)</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 (C)</p> Signup and view all the answers

What is the advantage of using Colistin over Tigecycline?

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

What is the limitation of small-scale clinical investigations?

<p>Limited population size (C)</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 (B)</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 (C)</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 (C)</p> Signup and view all the answers

What is the inactive form of Polymyxin B?

<p>Colistimethate (A)</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 (D)</p> Signup and view all the answers

What is a benefit of using Polymyxin B over Colistin?

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

What is the aim of optimizing antimicrobial treatment?

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

What is the result of progressive elevation of Colistin concentrations?

<p>Accelerated Polymyxin resistance (B)</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 (C)</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 (D)</p> Signup and view all the answers

What is the global concern related to antibiotic resistance?

<p>The worldwide incidence of antibiotic resistance (A)</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 (D)</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 (D)</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 (A)</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 (B)</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 (C)</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 (D)</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 (A)</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 (A)</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 (A)</p> Signup and view all the answers

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

<p>Colistin (D)</p> Signup and view all the answers

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