Antimicrobial resistance among Past

Antimicrobial resistance among Pasteurella isolates is rarely reported in humans. Tetracyclines, erythromycin, and penicillin are most commonly associated with resistance. Penicillin-resistant strains have been isolated only from respiratory tract infections. Most animal-bite injuries can be treated with oral antimicrobials on an outpatient basis. Severe or partially responding infections may necessitate hospitalization and parenteral antimicrobial administration, along with surgical intervention.

Most Pasteurella isolates are susceptible to oral antimicrobials such as amoxicillin, amoxicillin/clavulanic acid, minocycline, fluoroquinolones (ciprofloxacin, ofloxacin, levofloxacin, moxifloxacin), and trimethoprim-sulfamethoxazole. Based on in vitro susceptibility data, several antimicrobials should not be used empirically for P multocida infections, including dicloxacillin, vancomycin, cephalexin, cefaclor, cefadroxil, erythromycin, and clindamycin. Macrolide resistance is usually encountered with erythromycin. Other macrolides, including azithromycin, clarithromycin, and telithromycin (in order of decreasing susceptibility), retain in vitro activity against most Pasteurella strains. Aminoglycosides have poor activity against P multocida.

More-severe infections may require parenteral antibiotics. Intravenous ampicillin-sulbactam, ticarcillin-clavulanate, piperacillin-tazobactam, cefoxitin, and carbapenems (imipenem-cilastatin, meropenem, ertapenem) are excellent empiric options for animal-bite injuries, providing gram-positive, gram-negative, and anaerobic coverage. The new tetracycline-derivative tigecycline also has excellent in vitro activity against P multocida and other pathogens encountered in animal and bite injuries. If P multocida is the only isolated organism, therapy may be changed to intravenous penicillin G. Once clinical improvement is noted, oral penicillin VK is an option. Patients with penicillin allergies can receive minocycline, doxycycline, fluoroquinolones, trimethoprim-sulfamethoxazole, or azithromycin.

The duration of therapy for P multocida infections has not been well established and can be tailored to clinical response. Milder soft-tissue infections usually require 7-10 days of oral therapy. More-severe cases can be treated for 10-14 days. Deep-tissue infections often require 4-6 weeks of treatment, usually with intravenous therapy initially

Kết quả (Việt) 1:

Kháng kháng sinh trong số Pasteurella chủng hiếm khi được báo cáo trong con người. Tetracycline, erythromycin, và penicillin được phổ biến nhất kết hợp với sức đề kháng. Các chủng kháng penicillin đã được phân lập từ các nhiễm trùng đường hô hấp. Hầu hết động vật-cắn chấn thương có thể được điều trị bằng miệng antimicrobials trên cơ sở ngoại trú. Nhiễm trùng nghiêm trọng hoặc đáp ứng một phần có thể đòi hỏi phải nằm viện và quản lý các chế phẩm kháng biện, cùng với sự can thiệp phẫu thuật.Hầu hết Pasteurella chủng được nhạy cảm để uống antimicrobials như amoxicillin, amoxicillin/clavulanic axit, minocycline, fluoroquinolones (ciprofloxacin, ofloxacin, levofloxacin, moxifloxacin), và trimethoprim-sulfamethoxazole. Dựa trên dữ liệu nhạy cảm trong ống nghiệm, một số antimicrobials không nên được sử dụng empirically P multocida bệnh nhiễm trùng, bao gồm cả dicloxacillin, tiêm, cephalexin, cefaclor, cefadroxil, erythromycin và clindamycin. Macrolide kháng thường gặp phải với erythromycin. Khác macrolide, Azithromycin., clarithromycin và telithromycin (theo thứ tự giảm dần tính nhạy cảm), Giữ lại các hoạt động trong ống nghiệm chống lại hầu hết Pasteurella chủng. Aminoglycosides có các hoạt động kém chống lại P multocida.More-severe infections may require parenteral antibiotics. Intravenous ampicillin-sulbactam, ticarcillin-clavulanate, piperacillin-tazobactam, cefoxitin, and carbapenems (imipenem-cilastatin, meropenem, ertapenem) are excellent empiric options for animal-bite injuries, providing gram-positive, gram-negative, and anaerobic coverage. The new tetracycline-derivative tigecycline also has excellent in vitro activity against P multocida and other pathogens encountered in animal and bite injuries. If P multocida is the only isolated organism, therapy may be changed to intravenous penicillin G. Once clinical improvement is noted, oral penicillin VK is an option. Patients with penicillin allergies can receive minocycline, doxycycline, fluoroquinolones, trimethoprim-sulfamethoxazole, or azithromycin.The duration of therapy for P multocida infections has not been well established and can be tailored to clinical response. Milder soft-tissue infections usually require 7-10 days of oral therapy. More-severe cases can be treated for 10-14 days. Deep-tissue infections often require 4-6 weeks of treatment, usually with intravenous therapy initially