Tigecycline, the first in a new class of antimicrobials, the glycylcyclines, is a 9-t-butylglycylamido derivate of minocycline. In this study, the in vitro activity of tigecycline in combination with gentamicin, find more streptomycin, rifampin, co-trimoxazole,

levofloxacin, and minocycline was investigated using the checkerboard method to evaluate 16 Brucella melitensis isolates. The time-kill method was used to determine the bactericidal activities of combinations of tigecycline with rifampin, gentamicin, and levofloxacin, which were found (via the checkerboard method) to have a synergistic effect in combinations with tigecycline. Using the checkerboard method, combinations of rifampin, gentamicin, and levofloxacin with tigecycline showed synergistic effects against 5 (31.2%), 3 (18.9%), and AL3818 in vitro 8 (50%) of the isolates. No synergy was observed with tigecycline in combination with minocycline, streptomycin, or co-trimoxazole. Tigecycline with gentamicin achieved the earliest complete killing at 4x MIC (in 6 h), while complete killing with the other combinations was delayed up to 24 h. The time-kill method showed that the combination of tigecycline and

levofloxacin had an antagonistic effect, while the checkerboard method detected synergy and no interaction effects. These data suggest that a combination regimen of tigecycline with gentamicin and rifampin may be a good choice for treating brucellosis.”
“Urine output (UO) is usually measured hourly in acutely ill patients. Devices capable of more continuous (minute by minute urine output, UOm) measurements have become available recently. This paper aims to (1) analyze the minute by minute variations of UO, (2) analyze the impact of sepsis on those variations and (3) test if UO measured over periods shorter

than 60 min provides information not available in hourly measurements.

Fifteen male GW786034 mouse pigs were anesthetized, tracheostomized and mechanically ventilated. Sepsis was induced by the administration of live Escherichia coli. Three groups were studied: nonseptic (n = 7) and septic (n = 4), both receiving sodium chloride (NaCl) 0.9 % at 4 ml kg(-1) h(-1); and septic (n = 4) receiving NaCl 0.9 % at 17 ml kg(-1) h(-1). UOm was measured during 6 h.

There was a significant variation of UOm over time, as assessed by the coefficient of variation of the root-mean-squared error (CV(RMSE)), which was significantly more pronounced under conditions of sepsis than under control conditions. A UO production pattern in sepsis was identified, characterized by low UO production compared to baseline levels for approximately 30 min, followed by high UO production for approximately 30 min after initiation of the septic challenge. This pattern was noticeable if UO was measured every 10 min but not over longer periods of time.