Detroit Receiving Hospital

About: Detroit Receiving Hospital is a healthcare organization based out in Detroit, Michigan, United States. It is known for research contribution in the topics: Vancomycin & Population. The organization has 877 authors who have published 850 publications receiving 37202 citations. The organization is also known as: Detroit General.

Use of terbinafine in rare and refractory mycoses

Abstract: Terbinafine is the only systemic allylamine antifungal currently available. Its mechanism of action is unique and sets it apart from other agents. Although it is primarily used for dermatophyte infections, such as onychomycosis and tinea pedis, terbinafine has broad in vitro activity against a variety of non-dermatophyte fungal pathogens, including Candida spp. and many molds. In addition, synergistic activity is noted with other antifungals, notably triazoles. Multiple case reports exist of its use for unusual and refractory fungal infections, but no systematic review is available. We review the current literature with regard to in vitro data and clinical experience with terbinafine in the treatment of rare and refractory mycoses.

Activity of Telavancin against Staphylococcus aureus Strains with Various Vancomycin Susceptibilities in an In Vitro Pharmacokinetic/Pharmacodynamic Model with Simulated Endocardial Vegetations

Abstract: We investigated the activity of telavancin, a novel lipoglycopeptide, alone and combined with gentamicin or rifampin (rifampicin) against strains of Staphylococcus aureus with various vancomycin susceptibilities. Strains tested included methicillin (meticillin)-resistant S. aureus (MRSA) 494, methicillin-sensitive S. aureus (MSSA) 1199, heteroresistant glycopeptide-intermediate S. aureus (hGISA) 1629, which was confirmed by a population analysis profile, and glycopeptide-intermediate S. aureus (GISA) NJ 992. Regimens of 10 mg/kg telavancin daily and 1 g vancomycin every 12 h were investigated alone and combined with 5 mg/kg gentamicin daily or 300 mg rifampin every 8 h in an in vitro model with simulated endocardial vegetations over 96 h. Telavancin demonstrated significantly greater killing than did vancomycin (P < 0.01) for all isolates except MRSA 494 (P = 0.07). Telavancin absolute reductions, in log10 CFU/g, at 96 h were 2.8 ± 0.5 for MRSA 494, 2.8 ± 0.3 for MSSA 1199, 4.2 ± 0.2 for hGISA 1629, and 4.1 ± 0.3 for GISA NJ 992. Combinations of telavancin with gentamicin significantly enhanced killing compared to telavancin alone against all isolates (P < 0.001) except MRSA 494 (P = 0.176). This enhancement was most evident against hGISA 1629, where killing to the level of detection (2 log10 CFU/g) was achieved at 48 h (P < 0.001). The addition of rifampin to telavancin resulted in significant (P < 0.001) enhancement of killing against only MSSA 1199. No changes in telavancin susceptibilities were observed. These results suggest that telavancin may have therapeutic potential, especially against strains with reduced susceptibility to vancomycin. Combination therapy, particularly with gentamicin, may improve bacterial killing against certain strains.