A5050301397- Antibiotics Pharmacokinetics and Efficacy
- Pneumonia and Respiratory Infections
- Tuberculosis Research and Epidemiology
- Antibiotic Use and Resistance
- Antibiotic Resistance in Bacteria
- Pneumocystis jirovecii pneumonia detection and treatment
- HIV/AIDS drug development and treatment
- Sepsis Diagnosis and Treatment
- Pharmacological Effects and Toxicity Studies
- Epilepsy research and treatment
- Antimicrobial Resistance in Staphylococcus
- Cancer therapeutics and mechanisms
- Pharmaceutical studies and practices
- Atrial Fibrillation Management and Outcomes
- Bacterial Identification and Susceptibility Testing
- Acute Kidney Injury Research
- Mycobacterium research and diagnosis
- Hepatitis C virus research
- Neutropenia and Cancer Infections
- Bacterial Infections and Vaccines
- Infectious Diseases and Tuberculosis
- Drug-Induced Hepatotoxicity and Protection
- Pharmaceutical Practices and Patient Outcomes
- Escherichia coli research studies
- Venous Thromboembolism Diagnosis and Management
University of Florida
2017-2024
Florida College
2017-2024
Zagazig University
2020-2024
Ibero American University
2020
Hamad Medical Corporation
2014-2017
King Hussein Cancer Center
2012-2014
Abstract Intravenous β‐lactam antibiotics remain a cornerstone in the management of bacterial infections due to their broad spectrum activity and excellent tolerability. β‐lactams are well established display time‐dependent bactericidal activity, where reductions burden directly associated with time that free drug concentrations above minimum inhibitory concentration (MIC) pathogen during dosing interval. In an effort take advantage these characteristics, prolonged (extended continuous)...
Abstract Background In the ICU, early and appropriate antimicrobial therapy is important to lower infection-related mortality. Objectives Assess whether achieving β-lactam free concentration above MIC 100% of time (fT>MIC) associated with positive outcomes in ICU. Methods This retrospective study was conducted ICU patients admitted UF Health Shands Hospital between 2016 2018. Adult who received had drug measured were included. Data collected included demographics, regimens...
The 4-drug regimen of rifampin, isoniazid, pyrazinamide, and ethambutol is an inexpensive, reliable option for treating patients with drug-susceptible tuberculosis (TB). Its efficacy could be further improved by determining the free drug concentrations in plasma, knowing that only unbound can freely penetrate to tissues. Using ultrafiltration technique, we determined protein binding (PB) extent variability first-line anti-TB drugs when given simultaneously TB patients, representing a...
The prolonged treatment duration for multidrug-resistant tuberculosis (MDR-TB) makes linezolid dosing difficult because of adverse effects associated with long-term use. We sought to find the optimal regimen across different MIC values. Pharmacokinetic (PK) data from TB patients were included Brazil, Georgia, and two U.S. sites. Population PK modeling simulation performed. used an fAUC (area under unbound drug concentration-time curve)/MIC ratio >119 as PK/pharmacodynamic (PD) target minimum...
Background: The mortality rate of patients with a drug-resistant bacterial infection is high, as are the associated treatment costs. To overcome these issues, optimization available therapeutic options required. Beta-lactams time-dependent antibiotics and their efficacy determined by amount time free concentration remains above minimum inhibitory concentration. Therefore, aim this study was to assess extent variability protein binding for meropenem, cefepime, piperacillin. Methods: Plasma...
Abstract Background The ability of antituberculosis drugs to cross the blood–brain barrier and reach central nervous system is critical their effectiveness in treating tuberculosis meningitis (TBM). We sought fill a knowledge gap by providing data on new repurposed penetrate into cerebrospinal fluid (CSF). Methods conducted clinical pharmacology study among patients treated for TBM Tbilisi, Georgia, from January 2019 until 2020. Serial serum CSF samples were collected while hospitalized. was...
Abstract According to the World Health Organization (WHO), tuberculosis is leading cause of death attributed a single microbial pathogen worldwide. In addition large number patients affected by tuberculosis, emergence Mycobacterium drug‐resistance complicating control in many high‐burden countries. During past 5 years, global identified with multidrug‐resistant (MDR‐TB), defined as bacillary resistance at least against rifampicin and isoniazid, two most active drugs treatment regimen, has...
Limited pharmacokinetic/pharmacodynamic (PK/PD) data exist on cycloserine in tuberculosis (TB) patients. We pooled several studies into a large PK set to estimate the population parameters for TB
Cefepime is commonly used in the intensive care unit (ICU) to treat bacterial infections. The time during which free cefepime concentration above MIC ( f T >MIC ) should be optimized increase efficacy of regimen. We aim optimize exposure ICU patients by using population pharmacokinetic (PK) modeling and simulations. Two data sets were included this study. first was a prospective study pediatric who received at 50 mg/kg body weight had extensive PK sampling.
Hospital-acquired pneumonia (HAP) and ventilator-associated (VAP) are the most common intensive care unit (ICU) infections. We aimed to evaluate association of early cumulative beta-lactam pharmacokinetic/pharmacodynamic (PK/PD) parameters with therapy outcomes in pneumonia. Adult ICU patients who received cefepime, meropenem, or piperacillin-tazobactam for HAP VAP had its concentration measured were included. Beta-lactam exposure was generated every patient entire duration therapy, time...
Data evaluating cefepime thresholds associated with neurotoxicity remain limited. The objectives of this study were to evaluate the incidence cefepime-related (CRN) in patients plasma concentrations, assess relationship between exposure and CRN, investigate clinical factors describe electroencephalogram (EEG) abnormalities CRN.This was a retrospective adult inpatients admitted 2016 2018 who received therapeutic drug monitoring (TDM). Potential CRN cases identified utilizing standard...
Background: Tuberculosis meningitis (TBM) is the most lethal form of TB. It difficult to treat in part due poor or uncertain drug penetration into central nervous system (CNS). To help fill this knowledge gap, we evaluated cerebrospinal fluid (CSF) concentrations fluoroquinolones and carbapenems patients being treated for TBM. Methods: Serial serum CSF samples were collected from hospitalized was routine lumbar punctures between alternating timepoints 2 6 h after administration capture early...
Individual pharmacokinetic variability is a driver of poor tuberculosis (TB) treatment outcomes. We developed method for measurement rifampin concentrations by urine colorimetry and mobile phone photographic application to predict clinically important serum measurements in children treated TB.
Abstract Background Pharmacokinetic data are needed for newly implemented anti-tuberculosis drugs to help optimize their use. Objectives To fill existing knowledge gaps, we evaluated the pharmacokinetic parameters of novel and repurposed among patients with drug-resistant pulmonary tuberculosis. Methods A prospective cohort study ≥16 years confirmed TB was conducted in Tbilisi, Georgia. Patients receiving bedaquiline, delamanid and/or clofazimine were included. Blood samples collected 4–6...
To describe the implementation and operationalization of a β-lactam (BL) therapeutic drug monitoring (TDM) program at large academic center.BLs are most used class antibiotics. Suboptimal antibiotic exposure is significant concern in hospitalized patients, particularly those with altered pharmacokinetics. BL-TDM provides clinicians opportunity to optimize concentrations ensure maximal efficacy while minimizing toxicity. However, has not been widely adopted due lack access assays. The...
Beta-lactam therapeutic drug monitoring (BL TDM; level testing) can facilitate improved outcomes in critically ill patients. However, only 10%-20% of hospitals have implemented BL TDM. This study aimed to characterize provider perceptions and key considerations for successfully implementing
Fluoroquinolones are group A drugs in tuberculosis guidelines. We aim to compare the culture conversion between new-generation (levofloxacin and moxifloxacin) old-generation (ciprofloxacin ofloxacin) fluoroquinolones, develop pharmacokinetic models, calculate target attainment for levofloxacin moxifloxacin. included three U.S. centers. Patients admitted 1984 2015, infected with drug-resistant tuberculosis, who had received fluoroquinolones ≥28 days were included. Demographics, sputum...
Although linezolid is effective for multidrug-resistant TB (MDR-TB) tuberculosis treatment, it associated with cytopenias after 4 weeks of administration. Data on toxicities long-term use and drug pharmacodynamics in MDR-TB treatment are limited, concerns about toxicity present barriers to wider implementation. This was a secondary analysis prospective cohort study patients treated the country Georgia from 2015 2017. Intensive blood sampling 6 initiation 600 mg daily performed...