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Parenteral Anesthetics: Overview01:24

Parenteral Anesthetics: Overview

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Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
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Synergism is a useful mechanism where combining two or more drugs is more effective than each constituent used alone. Such combinations are also called supra-additive interactions. The drugs collectively enhance the final therapeutic effect by acting on different targets. Another advantage is that the low dose of each constituent drug is sufficient to achieve the desired effect. This helps reduce the duration of therapy and lower the adverse effects of these drugs.
Such synergistic combinations...
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The treatment of pneumonia varies based on its severity and the causative pathogen. Here is a structured approach to managing pneumonia, integrating pharmaceutical and supportive care strategies.
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Routes of Drug Administration: Parenteral01:25

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The administration of drugs via parenteral routes allows for direct drug introduction into the systemic circulation, resulting in high bioavailability because the medication bypasses the harsh conditions of the gastrointestinal tract and hepatic metabolism.
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The parenteral route is a critical method of drug administration. It delivers compounds directly into the systemic circulation and bypasses the gastrointestinal tract. This approach is particularly advantageous for drugs that exhibit poor absorption or instability when administered orally.
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Is less always more? Ceftazidime/avibactam alone or in combination to treat infections caused by Pseudomonas aeruginosa: a retrospective observational multi-centre cohort study.

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Incidental Detection of Respiratory Viruses in Lung Transplant Donor-Recipient Pairs: Exploratory Associations With Clinical Outcomes in a Post Hoc Analysis.

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Real-World Data on the Use of Intravenous Fosfomycin for the Treatment of Central Nervous System Infections: a Subgroup Analysis from the FORTRESS Study.

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Real-World Use, Effectiveness, and Safety of Intravenous Fosfomycin: The FORTRESS Study.

Klaus-Friedrich Bodmann1, Stefan Hagel2, Alessandra Oliva3

  • 1Kliniken Nordoberpfalz AG, Klinikum Weiden, Weiden, Germany.

Infectious Diseases and Therapy
|March 19, 2025
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Summary

Intravenous fosfomycin (FOS) effectively treats severe Gram-positive and Gram-negative infections, including those caused by multi-drug resistant bacteria. This large real-world study confirms its safety and efficacy as a combination therapy partner.

Keywords:
Klebsiella pneumoniaePseudomonas aeruginosaStaphylococcus aureusBacteraemiaCarbapenem-resistant EnterobacteralesFosfomycinInfective endocarditisMDRObservational studySepsis

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Area of Science:

  • Infectious Diseases
  • Pharmacology
  • Clinical Microbiology

Background:

  • Intravenous fosfomycin (FOS) is a broad-spectrum antibiotic used for severe infections.
  • It is often employed in combination therapy against Gram-positive (GP) and Gram-negative (GN) pathogens, including multi-drug resistant (MDR) bacteria.

Purpose of the Study:

  • To evaluate the real-world effectiveness, safety, usage patterns, and patient characteristics of intravenous FOS.
  • This study represents the largest evaluation of FOS to date.

Main Methods:

  • Interim analysis of a prospective, non-interventional, multicentre study.
  • Data collected from 716 patients across five European countries (Germany, Italy, UK, Greece, Austria) between January 2017 and November 2023.

Main Results:

  • Common indications included bacteraemia/sepsis, complicated urinary tract infections, and bone/joint infections.
  • Prevalence of MDR pathogens was 34.6%, with high carbapenem resistance (48.0%) in Klebsiella spp. infections.
  • FOS demonstrated favorable clinical success (75.3%) and microbiological cure (82.4%), including in MDR/CR infections (78.0%). Electrolyte imbalances were the most common adverse drug reactions.

Conclusions:

  • Intravenous fosfomycin is a safe and effective combination therapy agent for severe GP and GN infections.
  • It is particularly valuable for deep-seated infections and those involving MDR bacteria.