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Related Concept Videos

Pneumonia IV: Management01:28

Pneumonia IV: Management

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.
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care01:30

Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care

A healthcare provider can diagnose a urinary tract infection (UTI) through several methods:Medical History and Symptoms: The provider will take a detailed medical history and ask about symptoms such as frequent urination, burning sensation during urination, and lower abdominal pain.Urinalysis: A clean-catch urine sample is collected in a sterile container and tested for the presence of bacteria, white blood cells (leukocytes), nitrites, blood, and protein. The presence of leukocytes and...
Urinary Tract Infection IV: Nursing Management01:17

Urinary Tract Infection IV: Nursing Management

In managing urinary tract infections (UTIs) in nursing, a comprehensive assessment is essential. Begin by gathering subjective data, such as the patient’s complaints of dysuria (painful urination), urinary frequency, urgency, suprapubic pain, and any lower abdominal discomfort. This information can be complemented by questions regarding previous UTIs, sexual activity, and personal hygiene practices, which can provide insight into risk factors. Objective assessment should focus on signs like...
Acute Pyelonephritis II: Diagnostic Studies and Management01:28

Acute Pyelonephritis II: Diagnostic Studies and Management

Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...
Antimicrobial Effectiveness01:28

Antimicrobial Effectiveness

The effectiveness of antimicrobial agents depends on various factors influencing their ability to eliminate microbial populations. Larger microbial populations require more time for complete eradication, emphasizing the importance of population size analysis when evaluating antimicrobial efficacy.Microbial resistance to antimicrobial agents varies significantly. Highly resilient microorganisms include endospores, gram-negative bacteria, and non-enveloped viruses, while prions are exceptionally...
Clinical Significance of Antibiotic Resistance01:25

Clinical Significance of Antibiotic Resistance

Methicillin-resistant Staphylococcus aureus (MRSA) presents a critical public health threat, arising from its capacity to resist β-lactam antibiotics due to acquisition of the mecA gene within the staphylococcal cassette chromosome mec (SCCmec). This gene encodes penicillin-binding protein 2a (PBP2a), which impairs binding efficacy of methicillin and other β-lactams. MRSA has evolved into distinct clonal lineages impacting humans and animals alike, reinforcing its significance within the One...

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Related Experiment Video

Updated: May 10, 2026

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
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Ceftazidime-Avibactam in Critically Ill Patients: A Multicenter Observational Study.

Olivieri Silvia1, Sara Mazzanti2, Gabriele Gelo Signorino2,3

  • 1Infectious Diseases, Via Murri, 15, 63023 Fermo, Italy.

Antibiotics (Basel, Switzerland)
|August 28, 2025
PubMed
Summary

Ceftazidime-avibactam (CAZ-AVI) shows moderate efficacy in critically ill patients, with a 58% positive outcome rate. However, rapid resistance development necessitates careful antimicrobial stewardship to optimize CAZ-AVI use in intensive care units.

Keywords:
ceftazidime/avibactamcritically ill patientsliver transplantation

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Area of Science:

  • Infectious Diseases
  • Critical Care Medicine
  • Pharmacology

Background:

  • Ceftazidime-avibactam (CAZ-AVI) is an important intravenous antibiotic for Gram-negative bacterial infections.
  • Limited data exist on CAZ-AVI's effectiveness and safety in critically ill patient populations.
  • This study addresses the need for more evidence in intensive care unit (ICU) settings.

Purpose of the Study:

  • To evaluate 30-day clinical outcomes in critically ill patients treated with CAZ-AVI.
  • To identify risk factors associated with 30-day clinical failure, including death and recurrence.
  • To assess the efficacy and safety of CAZ-AVI in an ICU cohort.

Main Methods:

  • A multicenter, retrospective, observational cohort study was conducted in four ICUs.
  • Included were 161 adult critically ill patients receiving CAZ-AVI for at least 72 hours.
  • Patients were treated for confirmed or suspected Gram-negative bacterial infections.

Main Results:

  • CAZ-AVI achieved positive clinical outcomes in 58% of patients, with a 24% overall mortality rate.
  • Relapse or persistent infection occurred in 25% of patients, with 26% developing acquired resistance.
  • Treatment failure was higher in immunosuppressed patients, especially liver transplant recipients.

Conclusions:

  • CAZ-AVI mortality rates in ICU patients are comparable to other studies.
  • Rapid emergence of CAZ-AVI resistance highlights the need for antimicrobial stewardship.
  • Optimizing pharmacokinetic/pharmacodynamic (PK/PD) properties is crucial for effective CAZ-AVI use in critically ill patients.