Modelled target attainment after meropenem infusion in patients with severe nosocomial pneumonia: the PROMESSE study.
FRIPPIAT, Frédéric ; ; Seidel, Laurence et al
in Journal of Antimicrobial Chemotherapy (2015)
OBJECTIVES: The objective of this study was to propose an optimal treatment regimen of meropenem in critically ill patients with severe nosocomial pneumonia. PATIENTS AND METHODS: Among 55 patients in ... [more ▼]
OBJECTIVES: The objective of this study was to propose an optimal treatment regimen of meropenem in critically ill patients with severe nosocomial pneumonia. PATIENTS AND METHODS: Among 55 patients in intensive care treated with 1 g of meropenem every 8 h for severe nosocomial pneumonia, 30 were assigned to intermittent infusion (II; over 0.5 h) and 25 to extended infusion (EI; over 3 h) groups. Based on plasma and epithelial lining fluid (ELF) concentrations determined at steady-state, pharmacokinetic modelling and Monte Carlo simulations were undertaken to assess the probability of attaining drug concentrations above the MIC for 40%-100% of the time between doses (%T > 1-fold and 4-fold MIC), for 1 or 2 g administered by either method. RESULTS: Penetration ratio, measured by the ELF/plasma ratio of AUCs, was statistically higher in the EI group than in the II group (mean ± SEM: 0.29 ± 0.030 versus 0.20 ± 0.033, P = 0.047). Considering a maximum susceptibility breakpoint of 2 mg/L, all dosages and modes of infusions achieved 40%-100% T > 1-fold MIC in plasma, but none did so in ELF, and only the 2 g dose over EI achieved 40%-100% T > 4-fold MIC in plasma. CONCLUSIONS: The optimum regimen to treat severe nosocomial pneumonia was 2 g of meropenem infused over 3 h every 8 h. This regimen achieved the highest pharmacodynamic targets both in plasma and in ELF. [less ▲]Detailed reference viewed: 24 (3 ULg)
Prevention of ventilator-associated pneumonia and ventilator-associated conditions: A randomized controlled trial with subglottic secretion suctioning
DAMAS, Pierre ; FRIPPIAT, Frédéric ; ANCION, Arnaud et al
in Critical Care Medicine (2015), 43(1), 22-30Detailed reference viewed: 48 (20 ULg)
FATAL ALVEOLAR ECHINOCOCCOSIS OF THE LUMBAR SPINE
KEUTGENS, Aurore ; SIMONI, Paolo ; DETREMBLEUR, Nancy et al
in Journal of Clinical Microbiology (2013), 51(2), 688-91
For the last ten years, the southern part of Belgium has been recognized as a low-risk endemic area for alveolar echinococcosis. This infection, caused by Echinococcus multilocularis, usually induces a ... [more ▼]
For the last ten years, the southern part of Belgium has been recognized as a low-risk endemic area for alveolar echinococcosis. This infection, caused by Echinococcus multilocularis, usually induces a severe liver condition, and can sometimes spread to other organs. However, alveolar echinococcosis involving bones has been described only very rarely. Here, a fatal case of spondylodiscitis due to E. multilocularis contracted in southern Belgium is reported. [less ▲]Detailed reference viewed: 68 (18 ULg)
Is extended or continuous infusion of Carbapenems the obvious solution to improve clinical outcomes and reduce mortality?
FRIPPIAT, Frédéric ; VERCHEVAL, Christelle ; LAMBERMONT, Bernard et al
in Clinical Infectious Diseases : An Official Publication of the Infectious Diseases Society of America (2013), 57(2), 324-325Detailed reference viewed: 23 (8 ULg)
Procalcitonin usefulness for the initiation of antibiotic treatment in intensive care unit patients.
LAYIOS, Nathalie ; LAMBERMONT, Bernard ; CANIVET, Jean-Luc et al
in Critical Care Medicine (2012), 40(8), 2304-9
OBJECTIVES: : To test the usefulness of procalcitonin serum level for the reduction of antibiotic consumption in intensive care unit patients. DESIGN: : Single-center, prospective, randomized controlled ... [more ▼]
OBJECTIVES: : To test the usefulness of procalcitonin serum level for the reduction of antibiotic consumption in intensive care unit patients. DESIGN: : Single-center, prospective, randomized controlled study. SETTING: : Five intensive care units from a tertiary teaching hospital. PATIENTS: : All consecutive adult patients hospitalized for > 48 hrs in the intensive care unit during a 9-month period. INTERVENTIONS: : Procalcitonin serum level was obtained for all consecutive patients suspected of developing infection either on admission or during intensive care unit stay. The use of antibiotics was more or less strongly discouraged or recommended according to the Muller classification. Patients were randomized into two groups: one using the procalcitonin results (procalcitonin group) and one being blinded to the procalcitonin results (control group). The primary end point was the reduction of antibiotic use expressed as a proportion of treatment days and of daily defined dose per 100 intensive care unit days using a procalcitonin-guided approach. Secondary end points included: a posteriori assessment of the accuracy of the infectious diagnosis when using procalcitonin in the intensive care unit and of the diagnostic concordance between the intensive care unit physician and the infectious-disease specialist. MEASUREMENTS AND MAIN RESULTS: : There were 258 patients in the procalcitonin group and 251 patients in the control group. A significantly higher amount of withheld treatment was observed in the procalcitonin group of patients classified by the intensive care unit clinicians as having possible infection. This, however, did not result in a reduction of antibiotic consumption. The treatment days represented 62.6 +/- 34.4% and 57.7 +/- 34.4% of the intensive care unit stays in the procalcitonin and control groups, respectively (p = .11). According to the infectious-disease specialist, 33.8% of the cases in which no infection was confirmed, had a procalcitonin value >1microg/L and 14.9% of the cases with confirmed infection had procalcitonin levels <0.25 microg/L. The ability of procalcitonin to differentiate between certain or probable infection and possible or no infection, upon initiation of antibiotic treatment was low, as confirmed by the receiving operating curve analysis (area under the curve = 0.69). Finally, procalcitonin did not help improve concordance between the diagnostic confidence of the infectious-disease specialist and the ICU physician. CONCLUSIONS: : Procalcitonin measuring for the initiation of antimicrobials did not appear to be helpful in a strategy aiming at decreasing the antibiotic consumption in intensive care unit patients. [less ▲]Detailed reference viewed: 76 (9 ULg)
Tables 1, 2, 3 and 4 (1-199)
; MELIN, Pierrette ; et al
in The Sanford Guide to Antimicrobial Therapy 23rd edition of the Belgian/Luxembourg Version 2012-2013 (Adapted for use by the medical profession in Belgium and Luxembourg by the independent Belgian/Luxembourg Working Party on Antimicrobial Therapy (2012)Detailed reference viewed: 144 (1 ULg)
Métastase septique dorsale secondaire d’un abcès rétropharyngé responsable d’une tétraparésie
Kaux, Jean-François ; LENELLE, Jacques ; FRIPPIAT, Frédéric et al
in Revue Neurologique (2011), 167(8-9), 638-640
Introduction: Peri-tonsillar abscess remains one of the most frequent serous complications of oropharyngeal or dental infections. It can evolve to parapharyngeal and/or retropharyngeal spaces. It can be ... [more ▼]
Introduction: Peri-tonsillar abscess remains one of the most frequent serous complications of oropharyngeal or dental infections. It can evolve to parapharyngeal and/or retropharyngeal spaces. It can be life-threatning and, more rarely, neurological complications are described. Observations: We report the case of a 56 year old woman who developed within few days a progressive tetraparesia due to cervical medullary compression. This compression was consecutive to an epidurite which was a complication of a retropharyngeal abscess. The only surgical act was a cervicotomy to drain the abscess and identify the pathological germ. A targeted antibiotherapy was quickly begun. The recovery was obtained rather quickly and the neurological evolution was good. After one year, the cervical spine presents a post-infectious deformation without sign of root or spinal-cord compression. Conclusion: A cervical tetraparesia induced by spondylodiscitis and epiduritis following a retropharyngeal abscess with Staphylococcus aureus is a rare complication. Adequate diagnosis, as fast as possible, is mandatory in order to carry out an adapted antibiotherapy in the hopes of a complete recovery. The place of surgery on the spine remains to be specified. [less ▲]Detailed reference viewed: 252 (17 ULg)
A pauci-symptomatic case of documented Hantavirus (Puumala) infection in a patient under anti-TNF treatment.
; Bourhaba, Maryam ; FRIPPIAT, Frédéric et al
in Journal of Clinical Virology (2011), 50(3), 247-8
We describe the case of an 18-yr-old male under anti-TNF treatment for Crohn's disease for more than 8 months. He developed fever and biological inflammatory syndrome without absolutely no accompanying ... [more ▼]
We describe the case of an 18-yr-old male under anti-TNF treatment for Crohn's disease for more than 8 months. He developed fever and biological inflammatory syndrome without absolutely no accompanying sign or symptom or paraclinical abnormality despite extensive work-up performed in the context of his immunocompromised state. Symptoms disappeared after 10 days and a diagnosis of Puumala infection was made retrospectively on a serological basis. The case illustrates that anti-TNF treatment does not worsen the course of Puumala infection and could even be associated with a milder clinical picture. [less ▲]Detailed reference viewed: 50 (7 ULg)
Syphilis treatment in the human immunodeficiency virus-infected patient: follow the guidelines.
FRIPPIAT, Frédéric ; Moutschen, Michel
in Clinical Infectious Diseases : An Official Publication of the Infectious Diseases Society of America (2011), 53(8), 845Detailed reference viewed: 31 (3 ULg)
Qu’avons-nous appris de la pandémie de grippe de 2009 ?
Vanmeerbeek, Marc ; Burette, Philippe ; Giet, Didier et al
Scientific conference (2010, November 16)Detailed reference viewed: 41 (3 ULg)
Interest of routine dosage of meropenem in difficult to treat infections
Frippiat, Frédéric ; ; Denooz, Raphael et al
Poster (2010, October 23)Detailed reference viewed: 57 (11 ULg)
Simultaneous quantification of five Beta-lactam antibiotics in human plasma by HPLC-DAD: Clinical application for ceftazidime treatment in intensive care units
Denooz, Raphael ; Frippiat, Frédéric ; Charlier, Corinne
in Acta Clinica Belgica (2010), 65(Suppl. 1), 24-30Detailed reference viewed: 51 (16 ULg)
Usefulness of procalcitonin for the decision of antibiotic treatment in ICU patients
LAYIOS, Nathalie ; LAMBERMONT, Bernard ; LEDOUX, Didier et al
in Intensive Care Medicine (2009), 35(Suppl 1), 82Detailed reference viewed: 9 (1 ULg)
Gentamicin in infective endocarditis: how to use it?
Frippiat, Frédéric ; ; Moutschen, Michel
in Clinical Infectious Diseases : An Official Publication of the Infectious Diseases Society of America (2009), 49(2), 320-1321Detailed reference viewed: 27 (1 ULg)
Autoimmune angioneurotic edema in a patient with Helicobacter pylori infection.
; ; Giot, Jean-Baptiste et al
in Helicobacter (2009), 14(1), 9-11
Association of acquired autoimmune angioneurotic edema with other diseases is increasing. However, the precise mechanism by which antibodies to C1-esterase inhibitor (C1-INH) are produced, is not ... [more ▼]
Association of acquired autoimmune angioneurotic edema with other diseases is increasing. However, the precise mechanism by which antibodies to C1-esterase inhibitor (C1-INH) are produced, is not elucidated. We describe a patient with IgA antibodies against C1-INH without other autoimmune markers. Our patient had gastritis and Helicobacter pylori infection, proven by biopsy. This case suggests that H. pylori infection can act as triggering factor for acquired autoimmune angioneurotic edema. [less ▲]Detailed reference viewed: 45 (2 ULg)
Cotrimoxazole induced mixed type II cryoglobulinemia.
Leclercq, Philippe ; Frippiat, Frédéric ; Lambermont, Bernard
in European Journal of Internal Medicine (2008), 19(4),Detailed reference viewed: 34 (8 ULg)
Chronic hepatitis C infection in a patient with bone marrow hypoplasia.
; ; de Leval, Laurence et al
in World Journal of Gastroenterology (2008), 14(26), 4238-40
Chronic hepatitis C virus (HCV) infection is associated with multifarious extra-hepatic manifestations; the most described and discussed being mixed cryoglobulinemia which is strongly related to B-cell ... [more ▼]
Chronic hepatitis C virus (HCV) infection is associated with multifarious extra-hepatic manifestations; the most described and discussed being mixed cryoglobulinemia which is strongly related to B-cell lymphoproliferative disorders (LPDs). We present a case of chronic HCV infection and mixed cryoglobulinemia, with minimal liver involvement. The case is a 53-year-old patient who was diagnosed as having bone marrow hypoplasia at the age of three. She received several blood transfusions to normalize her haemoglobin. At the age of 31, she was diagnosed with rheumatoid arthritis on account of her diffuse joint pain and inflammation, elevated rheumatoid factor (RF) and Raynaud's phenomenon. Twenty years later, monoclonal gammopathy of IgG Lambda (one year later, changed to IgM Kappa) was detected during a routine examination. A bone marrow biopsy showed hypoplasia, Kappa positive B-lymphocytes and low-grade malignant lymphoma cells. PCR of the bone marrow aspirate was not contributory. No treatment was initiated owing to her poor bone marrow function and she is under regular follow-up. [less ▲]Detailed reference viewed: 54 (6 ULg)
Syphilis en 2008: controverses et attitudes pratiques.
Frippiat, Frédéric ; GIOT, Jean-Baptiste ; et al
in Revue Médicale Suisse (2008), 4(168), 1823-7
Rising incidence rate of syphilis is observed in economically advanced countries, particularly among homosexual men and subpopulation with low socioeconomic status. The various clinical presentations are ... [more ▼]
Rising incidence rate of syphilis is observed in economically advanced countries, particularly among homosexual men and subpopulation with low socioeconomic status. The various clinical presentations are divided into early and late stages, including neurosyphilis. The latter can occur during any stage of the disease, leading to the question "when to perform lumbar puncture", particularly in HIV positive patients. Penicillin continues to be the first-line therapy for all stages of syphilis. An alternative treatment should be considered as an exemption, after advice from a specialist. All patients require prolonged clinical and serological follow-up after treatment to rule out relapse or re-infection. The diagnosis of syphilis is an opportunity to search and treat other sexually transmitted diseases in patients and their sexual partner(s). [less ▲]Detailed reference viewed: 93 (9 ULg)
Report of a case of Streptococcus agalactiae mycotic aneurysm and review of the literature.
; Giot, Jean-Baptiste ; de Leval, Laurence et al
in International Journal of Surgical Pathology (2008), 16(3), 314-9
A unique case of mycotic aneurysm of the abdominal aorta caused by Streptococcus agalactiae in an afebrile patient presenting with abdominal pain is described. Although this bacterium is associated with a ... [more ▼]
A unique case of mycotic aneurysm of the abdominal aorta caused by Streptococcus agalactiae in an afebrile patient presenting with abdominal pain is described. Although this bacterium is associated with a variety of infections in human beings, aortitis is uncommon. Chronic alcoholism and diabetes mellitus are the 2 major predisposing conditions for group B Streptococci infection and both were present in this case. The abdominal pain and elevated inflammatory markers in the absence of fever were elusive in presentation; however, the diagnosis of mycotic aneurysm was established by abdominal computed tomography scan. The patient was treated successfully by resection of the diseased aorta and aortic allograft replacement. Culture of the excised tissue grew Streptococcus agalactiae sensitive to penicillin G and (other commonly tested antibiotics) fluoroquinolones. A prolonged course of moxifloxacin (for 6 months) was administered due to the persistence of elevated inflammatory markers and was remarkably well tolerated. Sixteen months after stopping the antibiotics, the patient is doing well, and the control imaging studies are satisfactory. [less ▲]Detailed reference viewed: 98 (12 ULg)