Staphylococcus epidermidis is a gram-positive bacteria that utilizes a glycocalyx/biofilm to adhere to orthopedic implants and other surfaces and resist phagocytosis.
The biofilm creates a well-protected environment where bacteria can proliferate and thrive essentially undetected by the host immune system. This leads to chronic infections of orthopedic implants that can go undetected for years.
Arciola et al note that S. epidermidis can colonize surfaces in a self-generated viscous biofilm composed of polysaccharides and that the ica genes found in 56% of S. epidermidis isolates were associated with their ability to produce biofilm.
Olson et al discuss the importance of polysaccharide intercellular adhesin (PIA), a substance produced by 50-60% of S. epidermidis strains, in the adherence of S. epidermidis to biomaterials through biofilm creation. PIA plays a critical role in initial adherence of S. epidermidis to biomaterials, biofilm maturation and aggregation.
Illustration A shows microscopy of Staphylococcus epidermidis, which is a gram-positive, coagulase-negative cocci. Illustration B is an overview of the different classes of organisms in microbiology.
Answer 1,2,4,5: Efflux pump production, hydrolysis of B-lactam drugs with beta-lactamase, alteration in cell wall permeability, and ribosomal alteration are mechanisms that Staphylococcus uses to resists antibiotics.
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The review shows no clinically important difference between third generation cephalosporins (ceftriaxone or cefotaxime) and conventional antibiotics (ampicillin-chloramphenicol combination, or chloramphenicol alone). Therefore the choice of antibiotic will depend on cost and availability. The antimicrobial resistance pattern against various antibiotics needs to be closely monitored in low- to middle-income countries as well as high-income countries.
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Data collection and analysis:
Two review authors independently applied the study selection criteria, assessed methodological quality and extracted data.
Antibacterial drugs are constantlyAre improved, as microorganisms tend to develop resistance to the effects of drugs and destroy their molecules. Cephalosporins of 3 generations are the most used medicines from bacterial infections to date.
Cephalosporins 3 generations in tablets
Features of the group of antibiotics are:
- High activity against streptococcal and pneumococcal infections;
- devastating impact on enterobacteria, and non-fermentative Gram-negative organisms;
- Absence of significant effect on staphylococci.
Cephalosporins have a fairly wide rangeActions, due to which they are actively used for the treatment of infections (bacterial) upper respiratory tract, urogenital, digestive system. It is worth noting that the improved molecular structure of these synthetic antibiotics allows to achieve a minimum amount of side effects on the body. In addition, cephalosporins of the 3rd generation produce a less depressing effect on immunity, the reaction of the defense system does not practically decrease, interferon is released in a normal amount. Also, drugs do not affect the production of lacto- and bifidobacteria in the lumen of the intestine, so dysbiosis, accompanied by defecation disorders, is excluded.
Thus, some types of proposedMedicinal agents can be used in the therapy of children and people with pathologies of the immune system. The safety of these antibiotics provides an opportunity to treat patients with endocrine disorders, thyroid, pancreatic and thymus gland diseases.
Tableted oral cephalosporins of 3 generations are represented by the following names:
The described drugs are used for infectionsSecondary genus for out-of-hospital and in-patient treatment. They can also be used as maintenance therapy along with parenteral agents.
Cephalosporins 3 generations for solution preparation
A significant part of this group of medicines is available in the form of powders for the manufacture of a suspension.
Among them, the most effective antibiotics are 3 generation cephalosporins:
- Ixim Lupine;
Powder must be diluted with a special solvent, supplied in the package, in the proportions specified in the instructions. The prepared suspension is used at one time, stored
the medicine can not be obtained.
Cephalosporin preparations of the third generation in ampoules for injections
Usually, the described group of antibiotics is not produced as a ready-made solution. This allows you to store medicines for a long time and always use fresh medication.
The kit consists of the active substance in the formpowder and solvent. The latter contains lidocaine hydrochloride, water for injection and sodium hydroxide. The liquid is introduced into the container with the antibiotic by means of a syringe, after which it is vigorously shaken for 1 minute.
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Third-generation cephalosporins as antibiotic prophylaxis in neurosurgery: what’s the evidence?
Clin Neurol Neurosurg 2014 Jan 1;116:13-9. Epub 2013 Nov 1.
Department of Medical Microbiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands.
To analyze the role of third-generation cephalosporins as prophylactic antibiotics in neurosurgery. We reviewed the literature for data from randomized controlled trials (RCTs) on third-generation cephalosporins compared to other antibiotic regimen in neurosurgery. End point of the RCTs was the occurrence of surgical site infections (SSIs)–data were pooled in a fixed-effects meta-analysis. Five randomized controlled trials enrolling a total of 2209 patients were identified. The pooled odds ratio for SSIs (overall) with third-generation cephalosporins prophylaxis in the five RCTs was 0.94 (95% CI, 0.59-1.52; P=0.81). No significant difference between third-generation cephalosporins and alternative regimen was identified. When analyzing organ SSIs (osteomyelitis, meningitis, and others intracranial infections) in data derived from four RCTs (1596 patients), third-generation cephalosporins failed to show superiority (pooled odds ratio 0.88; 95% CI 0.45-1.74; P=0.72). Third-generation cephalosporin antibiotic prophylaxis fails to show superiority over conventional regimens regarding both incisional and organ related SSIs in neurosurgery.
Network meta-analysis of antibiotic prophylaxis for prevention of surgical-site infection after groin hernia surgery.
- T Boonchan,
- C Wilasrusmee,
- M McEvoy,
- J Attia,
- A Thakkinstian
Br J Surg 2017 Jan;104(2):e106-e117
Section for Clinical Epidemiology and Biostatistics and, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
: First-generation cephalosporins (such as cefazolin) are recommended as antibiotic prophylaxis in groin hernia repair, but other broad-spectrum antibiotics have also been prescribed in clinical practice. This was a systematic review and network meta-analysis to compare the efficacy of different antibiotic classes for prevention of surgical-site infection (SSI) after hernia repair.
Methods: RCTs were identified that compared efficacy of antibiotic prophylaxis on SSI after inguinal or femoral hernia repair from PubMed and Scopus databases up to March 2016. Read More
Antibiotic prophylaxis for cardiothoracic operations. Meta-analysis of thirty years of clinical trials.
- B Kreter,
- M Woods
J Thorac Cardiovasc Surg 1992 Sep;104(3):590-9
Department of Anti-Infectives, Bristol-Myers Squibb U.S. Pharmaceutical Division, Princeton, N.J. 08543-4500.
Antistaphylococcal penicillins and first-generation cephalosporins have traditionally been the prophylactic antibiotics of choice for patients undergoing cardiothoracic operations. Recently published studies have claimed improved outcomes with respect to postoperative wound infection when second-generation cephalosporins were used for prophylaxis. The purpose of this study was to critically review the infectious outcomes of prospective, randomized, and controlled studies of cardiothoracic surgery prophylaxis by means of meta-analytic techniques.
Antibiotic prophylaxis in cardiac surgery: systematic review and meta-analysis.
- Adi Lador,
- Hanaa Nasir,
- Nariman Mansur,
- Erez Sharoni,
- Philippe Biderman,
- Leonard Leibovici,
- Mical Paul
J Antimicrob Chemother 2012 Mar 13;67(3):541-50. Epub 2011 Nov 13.
Medicine E, Rabin Medical Center, Beilinson Hospital, Petah-Tikva, Israel.
: Antibiotic prophylaxis is recommended in cardiac surgery. Current debate concerns the type of antibiotic(s), dosing and the duration of prophylaxis.
Methods: Systematic review of randomized controlled trials comparing one antibiotic regimen versus another in cardiac surgery. Read More
A systematic review and economic model of switching from non-glycopeptide to glycopeptide antibiotic prophylaxis for surgery.
- G Cranny,
- R Elliott,
- H Weatherly,
- D Chambers,
- N Hawkins,
- L Myers,
- M Sculpher,
- A Eastwood
Health Technol Assess 2008 Jan;12(1):iii-iv, xi-xii, 1-147
Centre for Reviews and Dissemination, University of York, UK.
: To determine whether there is a level of methicillin-resistant Staphylococcus aureus (MRSA) prevalence at which a switch from non-glycopeptide to glycopeptide antibiotics for routine prophylaxis is indicated in surgical environments with a high risk of MRSA infection.
Data Sources: Major electronic databases were searched up to September 2005.
Review Methods: The effectiveness review included controlled clinical trials comparing a glycopeptide with an alternative antibiotic regimen that reported effectiveness and/or adverse events. Read More