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Article ; Online: Unneeded antibiotics for acute respiratory infections in primary care: stop as early as possible.

Rodríguez-Baño, Jesús / Retamar, Pilar

Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases

2021 Volume 28, Issue 2, Page(s) 147–148

MeSH term(s)	Anti-Bacterial Agents/therapeutic use ; Humans ; Primary Health Care ; Respiratory Tract Infections/drug therapy
Chemical Substances	Anti-Bacterial Agents
Language	English
Publishing date	2021-11-23
Publishing country	England
Document type	Journal Article ; Comment
ZDB-ID	1328418-6
ISSN	1469-0691 ; 1470-9465 ; 1198-743X
ISSN (online)	1469-0691
ISSN	1470-9465 ; 1198-743X
DOI	10.1016/j.cmi.2021.11.009
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Zs.MO 284: Show issues

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Article ; Online: A step forward in the definition of antimicrobial stewardship indicators: Better measurements, better work.

Retamar, Pilar / Rodríguez-Baño, Jesús

Farmacia hospitalaria : organo oficial de expresion cientifica de la Sociedad Espanola de Farmacia Hospitalaria

2019 Volume 43, Issue 3, Page(s) 77–78

Title translation	Un paso adelante en la definición de indicadores PROA: Medir bien para trabajar mejor.
MeSH term(s)	Anti-Infective Agents ; Antimicrobial Stewardship ; Hospitals
Chemical Substances	Anti-Infective Agents
Language	English
Publishing date	2019-05-01
Publishing country	Spain
Document type	Editorial ; Comment
ZDB-ID	1122680-8
ISSN	2171-8695 ; 1130-6343
ISSN (online)	2171-8695
ISSN	1130-6343
DOI	10.7399/fh.11238
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Zs.A 3450: Show issues

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Article: Cefalea y visión borrosa en una mujer de 26 años.

Hernández Quero, José / Retamar, Pilar

Medicina clinica

2010 Volume 134, Issue 13, Page(s) 600–604

Title translation	Headache and blurred vision in a 26-year-old woman.
MeSH term(s)	Adult ; Brain Abscess/complications ; Brain Abscess/diagnosis ; Brain Edema/diagnosis ; Brain Edema/etiology ; Candidiasis, Oral/complications ; Cerebellum/microbiology ; Cerebellum/pathology ; Colitis, Ulcerative/complications ; Colitis, Ulcerative/drug therapy ; Diagnosis, Differential ; Emergencies ; Female ; Frontal Lobe/microbiology ; Frontal Lobe/pathology ; Headache/etiology ; Humans ; Immunocompromised Host ; Immunosuppressive Agents/adverse effects ; Immunosuppressive Agents/therapeutic use ; Intracranial Hypertension/diagnosis ; Intracranial Hypertension/etiology ; Magnetic Resonance Imaging ; Nocardia Infections/complications ; Nocardia Infections/diagnosis ; Occipital Lobe/microbiology ; Occipital Lobe/pathology ; Parietal Lobe/microbiology ; Parietal Lobe/pathology ; Vision Disorders/etiology
Chemical Substances	Immunosuppressive Agents
Language	Spanish
Publishing date	2010-05-08
Publishing country	Spain
Document type	Case Reports ; Clinical Conference ; Journal Article
ZDB-ID	411607-0
ISSN	1578-8989 ; 0025-7753
ISSN (online)	1578-8989
ISSN	0025-7753
DOI	10.1016/j.medcli.2009.10.015
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Ua VI Zs.279: Show issues

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Article ; Online: Opportunities for antibiotic optimisation and outcome improvement in patients with negative blood cultures: study protocol for a cluster-randomised crossover trial, the NO-BACT study.

Jiménez-Jorge, Silvia / Palacios-Baena, Zaira R / Rosso-Fernández, Clara M / Girón-Ortega, José A / Rodriguez-Baño, Jesús / Retamar, Pilar

BMJ open

2019 Volume 9, Issue 12, Page(s) e030062

Abstract: Introduction: Patients with negative blood cultures (BCx) represent 85%-90% of all patients with BCx taken during hospital admission. This population usually includes a heterogeneous group of patients admitted with infectious diseases or febrile ... ...

Abstract	Introduction: Patients with negative blood cultures (BCx) represent 85%-90% of all patients with BCx taken during hospital admission. This population usually includes a heterogeneous group of patients admitted with infectious diseases or febrile syndromes that require a blood culture. There is very little evidence of the clinical characteristics and antibiotic treatment given to these patients. Methods and analysis: In a preliminary exploratory prospective cohort study of patients with BCx taken, the clinical/therapeutic characteristics and outcomes/antimicrobial stewardship opportunities of a population of patients with negative BCx will be analysed. In the second phase, using a cluster randomised crossover design, the implementation of an antimicrobial stewardship intervention targeting patients with negative BCx will be evaluated in terms of quality of antimicrobial use (duration and de-escalation), length of hospital stay and mortality. Ethics and dissemination: This study has been and registered with clinicaltrials.gov. The findings of our study may support the implementation in clinical practice of an antimicrobial stewardship intervention to optimise the use of antibiotics in patients with negative BCx. The results of this study will be published in peer-reviewed journals and disseminated at national and international conferences. Trial registration number: NCT03535324.
MeSH term(s)	Anti-Bacterial Agents/administration & dosage ; Anti-Bacterial Agents/adverse effects ; Antimicrobial Stewardship/methods ; Blood Culture ; Cluster Analysis ; Cross-Over Studies ; Humans ; Infections/drug therapy ; Infections/mortality ; Length of Stay ; Multicenter Studies as Topic ; Practice Patterns, Physicians'/statistics & numerical data ; Randomized Controlled Trials as Topic
Chemical Substances	Anti-Bacterial Agents
Language	English
Publishing date	2019-12-18
Publishing country	England
Document type	Clinical Trial Protocol ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2599832-8
ISSN	2044-6055 ; 2044-6055
ISSN (online)	2044-6055
ISSN	2044-6055
DOI	10.1136/bmjopen-2019-030062
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Article ; Online: Catheter-related bloodstream infections: predictive factors for Gram-negative bacteria aetiology and 30 day mortality in a multicentre prospective cohort.

Calò, Federica / Retamar, Pilar / Martínez Pérez-Crespo, Pedro María / Lanz-García, Joaquín / Sousa, Adrian / Goikoetxea, Josune / Reguera-Iglesias, José María / León, Eva / Armiñanzas, Carlos / Mantecón, Maria Angeles / Rodríguez-Baño, Jesús / López-Cortés, Luis Eduardo

The Journal of antimicrobial chemotherapy

2020 Volume 75, Issue 10, Page(s) 3056–3061

Abstract: Background: Catheter-related bloodstream infections (CRBSIs) increase morbidity and mortality, prolong hospitalization and generate considerable medical costs. Recent guidelines for CRBSI recommend empirical therapy against Gram-positive bacteria (GPB) ... ...

Abstract	Background: Catheter-related bloodstream infections (CRBSIs) increase morbidity and mortality, prolong hospitalization and generate considerable medical costs. Recent guidelines for CRBSI recommend empirical therapy against Gram-positive bacteria (GPB) and restrict coverage for Gram-negative bacteria (GNB) only to specific circumstances. Objectives: To investigate predictors of GNB aetiology in CRBSI and to assess the predictors of outcome in patients with CRBSI. Methods: Patients with CRBSI were selected from the PROBAC cohort, a prospective, observational, multicentre national cohort study including patients with bloodstream infections consecutively admitted to 26 Spanish hospitals in a 6 month period (October 2016-March 2017). Outcome variables were GNB aetiology and 30 day mortality. Adjusted analyses were performed by logistic regression. Results: Six hundred and thirty-one episodes of CRBSI were included in the study. Risk factors independently related to GNB aetiology were central venous catheter (CVC) [OR 1.60 (95% CI: 1.05-2.44), P = 0.028], sepsis/septic shock [OR: 1.76 (95% CI: 1.11-2.80), P = 0.016], antibiotic therapy in the previous 30 days [OR: 1.56 (95% CI: 1.02-2.36), P = 0.037], neutropenia <500/μL [OR: 2.01 (95% CI: 1.04-3.87), P = 0.037] and peripheral vascular disease [OR: 2.04 (95% CI: 1.13-3.68), P = 0.018]. GNB were not associated with increased mortality in adjusted analysis, while removal of catheter [OR: 0.24 (95% CI: 0.09-0.61), P = 0.002] and adequate empirical treatment [OR: 0.37 (95% CI: 0.18-0.77), P = 0.008] were strong protective factors. Conclusions: Our study reinforces the recommendation that empirical coverage should cover GNB in patients presenting with sepsis/septic shock and in neutropenic patients. Catheter removal and adequate empirical treatment were both protective factors against mortality in patients with CRBSI.
MeSH term(s)	Bacteremia/epidemiology ; Catheter-Related Infections/epidemiology ; Catheters ; Cohort Studies ; Gram-Negative Bacteria ; Humans ; Prospective Studies ; Sepsis/epidemiology
Language	English
Publishing date	2020-07-20
Publishing country	England
Document type	Journal Article ; Multicenter Study ; Observational Study ; Research Support, Non-U.S. Gov't
ZDB-ID	191709-2
ISSN	1460-2091 ; 0305-7453
ISSN (online)	1460-2091
ISSN	0305-7453
DOI	10.1093/jac/dkaa262
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Zs.A 1197: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MO 124: Show issues

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Article ; Online: Evaluating the quality of antimicrobial prescribing: is standardisation possible?

Retamar, Pilar / Martín, M Luisa / Molina, José / del Arco, Alfonso

Enfermedades infecciosas y microbiologia clinica

2013 Volume 31 Suppl 4, Page(s) 25–30

Abstract: The quality of antimicrobial prescribing refers to the optimal way to use antibiotics in regard to their benefits, safety (e.g., resistance generation and toxicity) and cost. Evaluating the quality of antimicrobial prescribing in a way that focuses not ... ...

Abstract	The quality of antimicrobial prescribing refers to the optimal way to use antibiotics in regard to their benefits, safety (e.g., resistance generation and toxicity) and cost. Evaluating the quality of antimicrobial prescribing in a way that focuses not only on reducing antimicrobial consumption but also on using them in a more optimal way allows us to understand patterns of use and to identify targets for intervention. The lack of standardisation is the primary problem to be addressed when planning an evaluation of antimicrobial prescribing. There is little information specifically describing an evaluation methodology. Information related to prescription evaluation can be obtained from the guidelines of Antimicrobial Stewardship Programs (ASPs) and from local and international experience. The criteria used to evaluate the quality of prescription should include the indication for antimicrobial therapy, the timeliness of initiation, the correct antibiotic choice (according to local guidelines), the dosing, the duration, the route of administration and the time at which to switch to oral administration. A locally developed guideline on antimicrobial therapy should preferably be the gold standard by which to evaluate the appropriatenes of prescriptions. Various approaches used to carry out the evaluations have been described in the literature. Repeated point-prevalence surveys (PPS) have been proven to be effective in identifying targets for quality improvement. Continuous prospective monitoring allows the identification of more precise intervention points at different times during prescription. The design of the study chosen to perform the evaluation should be adapted according to the resources available in each centre. Evaluating the quality of antimicrobial prescribing should be the first step to designing ASPs, as well as to evaluating their impact and the changes in prescribing trends over time.
MeSH term(s)	Anti-Bacterial Agents/therapeutic use ; Drug Prescriptions/standards ; Drug Resistance, Bacterial ; Humans ; Quality Control
Chemical Substances	Anti-Bacterial Agents
Language	English
Publishing date	2013-09
Publishing country	Spain
Document type	Journal Article
ZDB-ID	1070941-1
ISSN	1578-1852 ; 0213-005X
ISSN (online)	1578-1852
ISSN	0213-005X
DOI	10.1016/S0213-005X(13)70129-0
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Zs.A 3204: Show issues

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Article ; Online: Author Correction: A nonlinear time-series analysis approach to identify thresholds in associations between population antibiotic use and rates of resistance.

López-Lozano, José-María / Lawes, Timothy / Nebot, César / Beyaert, Arielle / Bertrand, Xavier / Hocquet, Didier / Aldeyab, Mamoon / Scott, Michael / Conlon-Bingham, Geraldine / Farren, David / Kardos, Gábor / Fésűs, Adina / Rodríguez-Baño, Jesús / Retamar, Pilar / Gonzalo-Jiménez, Nieves / Gould, Ian M

Nature microbiology

2020 Volume 5, Issue 11, Page(s) 1449

Abstract: An amendment to this paper has been published and can be accessed via a link at the top of the paper. ...

Abstract	An amendment to this paper has been published and can be accessed via a link at the top of the paper.
Language	English
Publishing date	2020-09-21
Publishing country	England
Document type	Published Erratum
ISSN	2058-5276
ISSN (online)	2058-5276
DOI	10.1038/s41564-020-00796-6
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Article ; Online: Temocillin versus meropenem for the targeted treatment of bacteraemia due to third-generation cephalosporin-resistant

Marín-Candón, Alicia / Rosso-Fernández, Clara M / Bustos de Godoy, Natalia / López-Cerero, Lorena / Gutiérrez-Gutiérrez, Belén / López-Cortés, Luis Eduardo / Barrera Pulido, Lydia / Borreguero Borreguero, Irene / León, María José / Merino, Vicente / Camean-Fernández, Manuel / Retamar, Pilar / Salamanca, Elena / Pascual, Alvaro / Rodriguez-Baño, Jesús

BMJ open

2021 Volume 11, Issue 9, Page(s) e049481

Abstract: Introduction: Alternatives to carbapenems are needed in the treatment of third-generation cephalosporin-resistant : Methods and analysis: Multicentre, open-label, randomised, controlled, pragmatic phase 3 trial. Patients with bacteraemia due to 3GCR- ... ...

Abstract	Introduction: Alternatives to carbapenems are needed in the treatment of third-generation cephalosporin-resistant Methods and analysis: Multicentre, open-label, randomised, controlled, pragmatic phase 3 trial. Patients with bacteraemia due to 3GCR-E will be randomised to receive intravenously temocillin (2 g three times a day) or carbapenem (meropenem 1 g three times a day or ertapenem 1 g once daily). The primary endpoint will be clinical success 7-10 days after end of treatment with no recurrence or death at day 28. Adverse events will be collected; serum levels of temocillin will be investigated in a subset of patients. For a 10% non-inferiority margin, 334 patients will be included (167 in each study arm). For the primary analysis, the absolute difference with one-sided 95% CI in the proportion of patients reaching the primary endpoint will be compared in the modified intention-to-treat population. Ethics and dissemination: The study started after approval of the Spanish Regulatory Agency and the reference institutional review board. Data will be published in peer-reviewed journals. Trial registration number: NCT04478721.
MeSH term(s)	Bacteremia/drug therapy ; Cephalosporins/pharmacology ; Clinical Trials, Phase III as Topic ; Enterobacteriaceae/drug effects ; Humans ; Meropenem/therapeutic use ; Multicenter Studies as Topic ; Penicillins/therapeutic use ; Pragmatic Clinical Trials as Topic ; Randomized Controlled Trials as Topic
Chemical Substances	Cephalosporins ; Penicillins ; temocillin (03QB156W6I) ; Meropenem (FV9J3JU8B1)
Language	English
Publishing date	2021-09-27
Publishing country	England
Document type	Clinical Trial Protocol ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2599832-8
ISSN	2044-6055 ; 2044-6055
ISSN (online)	2044-6055
ISSN	2044-6055
DOI	10.1136/bmjopen-2021-049481
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Article ; Online: Impact of the MIC of piperacillin-tazobactam on the outcome of patients with bacteremia due to extended-spectrum-β-lactamase-producing Escherichia coli.

Retamar, Pilar / López-Cerero, Lorena / Muniain, Miguel Angel / Pascual, Álvaro / Rodríguez-Baño, Jesús

Antimicrobial agents and chemotherapy

2013 Volume 57, Issue 7, Page(s) 3402–3404

Abstract: We investigated the impact of the piperacillin-tazobactam MIC in the outcome of 39 bloodstream infections due to extended-spectrum-β-lactamase-producing Escherichia coli. All 11 patients with urinary tract infections survived, irrespective of the MIC. ... ...

Abstract	We investigated the impact of the piperacillin-tazobactam MIC in the outcome of 39 bloodstream infections due to extended-spectrum-β-lactamase-producing Escherichia coli. All 11 patients with urinary tract infections survived, irrespective of the MIC. For other sources, 30-day mortality was lower for isolates with a MIC of ≤ 2 mg/liter than for isolates with a higher MIC (0% versus 41.1%; P = 0.02).
MeSH term(s)	Aged ; Anti-Bacterial Agents/therapeutic use ; Bacteremia/drug therapy ; Bacteremia/mortality ; Cohort Studies ; Drug Therapy, Combination ; Enzyme Inhibitors/therapeutic use ; Escherichia coli/drug effects ; Escherichia coli Infections/drug therapy ; Humans ; Microbial Sensitivity Tests ; Penicillanic Acid/analogs & derivatives ; Penicillanic Acid/therapeutic use ; Piperacillin/therapeutic use ; Piperacillin, Tazobactam Drug Combination ; Tazobactam ; Treatment Outcome ; Urinary Tract Infections/drug therapy ; beta-Lactamases/metabolism
Chemical Substances	Anti-Bacterial Agents ; Enzyme Inhibitors ; Piperacillin, Tazobactam Drug Combination (157044-21-8) ; Penicillanic Acid (87-53-6) ; beta-Lactamases (EC 3.5.2.6) ; Tazobactam (SE10G96M8W) ; Piperacillin (X00B0D5O0E)
Language	English
Publishing date	2013-04-22
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	217602-6
ISSN	1098-6596 ; 0066-4804
ISSN (online)	1098-6596
ISSN	0066-4804
DOI	10.1128/AAC.00135-13
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Zs.A 809: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
Einzelsignatur: Show issues

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Article ; Online: European Society of Clinical Microbiology and Infectious Diseases (ESCMID) guidelines for the treatment of infections caused by multidrug-resistant Gram-negative bacilli (endorsed by European society of intensive care medicine).

Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases

2021 Volume 28, Issue 4, Page(s) 521–547

Abstract: Scope: These ESCMID guidelines address the targeted antibiotic treatment of third-generation cephalosporin-resistant Enterobacterales (3GCephRE) and carbapenem-resistant Gram-negative bacteria, focusing on the effectiveness of individual antibiotics and ...

Abstract	Scope: These ESCMID guidelines address the targeted antibiotic treatment of third-generation cephalosporin-resistant Enterobacterales (3GCephRE) and carbapenem-resistant Gram-negative bacteria, focusing on the effectiveness of individual antibiotics and on combination versus monotherapy. Methods: An expert panel was convened by ESCMID. A systematic review was performed including randomized controlled trials and observational studies, examining different antibiotic treatment regimens for the targeted treatment of infections caused by the 3GCephRE, carbapenem-resistant Enterobacterales, carbapenem-resistant Pseudomonas aeruginosa and carbapenem-resistant Acinetobacter baumannii. Treatments were classified as head-to-head comparisons between individual antibiotics and between monotherapy and combination therapy regimens, including defined monotherapy and combination regimens only. The primary outcome was all-cause mortality, preferably at 30 days and secondary outcomes included clinical failure, microbiological failure, development of resistance, relapse/recurrence, adverse events and length of hospital stay. The last search of all databases was conducted in December 2019, followed by a focused search for relevant studies up until ECCMID 2021. Data were summarized narratively. The certainty of the evidence for each comparison between antibiotics and between monotherapy and combination therapy regimens was classified by the GRADE recommendations. The strength of the recommendations for or against treatments was classified as strong or conditional (weak). Recommendations: The guideline panel reviewed the evidence per pathogen, preferably per site of infection, critically appraising the existing studies. Many of the comparisons were addressed in small observational studies at high risk of bias only. Notably, there was very little evidence on the effects of the new, recently approved, β-lactam/β-lactamase inhibitors on infections caused by carbapenem-resistant Gram-negative bacteria. Most recommendations are based on very-low- and low-certainty evidence. A high value was placed on antibiotic stewardship considerations in all recommendations, searching for carbapenem-sparing options for 3GCephRE and limiting the recommendations of the new antibiotics for severe infections, as defined by the sepsis-3 criteria. Research needs are addressed.
MeSH term(s)	Anti-Bacterial Agents/pharmacology ; Carbapenems/pharmacology ; Communicable Diseases/drug therapy ; Critical Care ; Gram-Negative Bacteria ; Gram-Negative Bacterial Infections/drug therapy ; Humans
Chemical Substances	Anti-Bacterial Agents ; Carbapenems
Language	English
Publishing date	2021-12-16
Publishing country	England
Document type	Journal Article ; Systematic Review
ZDB-ID	1328418-6
ISSN	1469-0691 ; 1470-9465 ; 1198-743X
ISSN (online)	1469-0691
ISSN	1470-9465 ; 1198-743X
DOI	10.1016/j.cmi.2021.11.025
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