Robert C Owens

..With pharmacists and physicians trained in infectious disease and critical care, clear-cut interventions can be focused on beginning or growing a stewardship program, or proposing future studies...

..Several newer therapies are under investigation but it is unclear whether they will be superior to current treatment options...

..In addition, general pharmacokinetic-pharmacodynamic (PK-PD) concepts will be reviewed and specific PK-PD analyses that support the optimal selection, dosing, and duration of therapy for beta-lactam antimicrobials will be provided...

..Additionally, because TdP remains a difficult-to-measure adverse event, we must rely upon multiple data sources to determine the risk versus the benefit for newly approved drugs...

..The components of an effective ASP are described in depth, drawing examples from the literature, as well as from the author's personal experience at the Maine Medical Center, Portland, ME...

..difficile-associated disease. Efforts to combat BI/NAP1 should include good antimicrobial stewardship in addition to effective infection control and environmental intervention...

..Finally, new methods of administration are being evaluated that may influence peak concentration-related antimicrobial adverse events...

..Differences in antimicrobial stewardship program (ASP) strategies, evidences supporting the benefits of ASPs, barriers to implementing ASPs, and suggestions for overcoming the barriers are discussed...

..This review summarizes safety and tolerability data for the quinolones...

..Preferential use of pharmacodynamically potent agents over other alternatives may lead to improved clinical outcomes and decreased selection of fluoroquinolone-resistant pneumococci...

..We review the more recent literature concerning the impact of antimicrobial stewardship programs on costs, outcomes, and resistance and summarize important considerations for implementation of these programs...

..Incorporating information learned regarding QT interval-related adverse effects into the drug selection process may serve to minimise collateral iatrogenic toxicity...

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..For moxifloxacin, levofloxacin, and gatifloxacin, the point must be clear that these agents should not be used in patients with risk factors predisposing them to TdP...

..The maturation of antimicrobial PK-PD as a scientific discipline continues to accelerate and currently impacts clinical practice, drug development, and regulatory decision making...

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..These data suggest that therapeutic use of cefepime and metronidazole as a single intravenous admixture product is feasible and practical...

..10 days, P = 0.002). The results of this study support previously published reports and suggest that daptomycin is effective for the treatment of skin infections due to gram-positive pathogens...

..In this review, we discuss some of the principles required to optimize antimicrobial dosing and recently obtained data regarding its application to the critically ill patient...

..Susceptibility results (reported on day 4) showed resistance to the initially selected regimen...

..To compare the effects of hospital cleaning agents and germicides on the survival of epidemic Clostridium difficile strains...

..Moreover, sufficient clinical outcome data in infected patients exist and support these pharmacodynamic conclusions...

..difficile with increased virulence, resistance, or both...

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..The efficacy of metronidazole or vancomycin prophylaxis to prevent CDI in patients who are receiving other antimicrobials is unproven, and treatment with these agents is ineffective against C. difficile in asymptomatic carriers...

..difficile vaccine...

..We report 4 cases of gatifloxacin-associated cardiac toxicity in patients with known risk factors for this adverse event...