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Associated with
increased length of hospitalization
healthcare costs
$20 million a year
additional costs $35 billion a year
mortality
Threat Report 2013
Bad bugs, need drugs
New antibacterial agents approved by the US Food and Drug Administration
1983 - 2012
RIFAMPIN
Phoenix rising
Citations in the PubMed from 1960 to 2011 using either the term
'colistin' or 'colistin resistance'.
Negative pressure
wound therapy
Since 1990s, advances
in wound management
VAC or negative
pressure wound
therapy combined with
local antiseptic wound
cleansing
KCI V.A.C. Instill Therapy Unit
Instillation Therapy Combined
with Negative Pressure Wound
Therapy
How it works
Synergy testing
expand the antibiotic spectrum
prevent the emergence of resistance
Thank you!
Questions? Comments
References
Back DA, Scheuermann-Poley C, Willy C. Recommendations on negative pressure wound therapy
with instillation and antimicrobial solutions when, where and how to use: what does the evidence
show? Int Wound J 2013; 10 (suppl. 1):3242.
Bassetti M. New treatment options against gram-negative organisms. Crit Care. 2011; 15(2): 215.
Biswas, S et al. Colistin: An Update on the Antibiotic of the 21st Century. Expert Rev Anti Infect
Ther. 2012; 10(8): 917-934.
Boucher, HW et al. Clin Infect Dis. 2013; 152.
Calhoun, JH et al. Multidrug-resistant Organisms in Military Wounds from Iraq and Afghanistan. Clin
Orthop Relat Res (2008) 466:13561362.
Centers for Disease Control and Prevention (CDC). Antibiotic Resistance Threats in the United
States. Atlanta: CDC, 2013.
Centers for Disease Control and Prevention (CDC). Healthcare-associated infections. Atlanta: CDC,
2014.
Conly JM, Johnston BL. Colistin: The Phoenix Arises. Can J Infect Dis Med Microbiol. 2006 Sep-Oct;
17(5): 267269.
Saiman L. Clinical utility of synergy testing for multidrug-resistant Pseudomonas aeruginosa isolated
from patients with cystic fibrosis: the motion for. Paed Resp Rev. 2007; 8: 249255.