title: Activity of antimicrobial drugs against bacterial pathogens under mild hypothermic conditions.
abstract: BACKGROUND
  Infections are a common problem in cardiac arrest survivors. Antimicrobial drugs are often administered in routine care during treatment of patients with mild therapeutic hypothermia (MTH). Because there is to date no evidence for the pharmacodynamics of antimicrobial drugs under MTH conditions, we investigated the in vitro activity of common antimicrobials against clinically relevant bacterial pathogens.
  
  
  METHODS
  Activities of antimicrobial drugs against clinically relevant bacterial pathogens were assessed in vitro by disk diffusion and broth microdilution assays at normothermic (37°C) and hypothermic (32°C) conditions.
  
  
  RESULTS
  Seventy-three bacterial isolates were tested in disk diffusion and 15 in broth microdilution assays. Mean differences in zone diameters and minimal inhibitory concentration ratios were 0.6 mm (95% confidence interval, 0.3-0.9 mm) and 0.98 (95% confidence interval, 0.95-1.02), respectively, meeting predefined criteria for equivalence of in vitro antimicrobial activity.
  
  
  CONCLUSIONS
  The presented data provide reassuring evidence that the intrinsic activity of antimicrobials seems to be unaltered in MTH. However, further studies evaluating the pharmacokinetics including target site concentrations of the respective drugs and in vivo pharmacodynamics are necessary to complement our understanding of the appropriate use of antimicrobials in MTH.
authors.affiliation: Department of Emergency Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria; Division of Clinical Microbiology, Department of Laboratory Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria. Electronic address: christian.wallmueller@meduniwien.ac.at.
authors.forename: Christian
authors.initials: C
authors.lastname: Wallmüller
authors.affiliation: Division of Clinical Microbiology, Department of Laboratory Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria; Department of Medicine I, Division of Infectious Diseases and Tropical Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria. Electronic address: b-herold@t-online.de.
authors.forename: Birger
authors.initials: B
authors.lastname: Herold
authors.affiliation: Department of Emergency Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria. Electronic address: fritz.sterz@meduniwien.ac.at.
authors.forename: Fritz
authors.initials: F
authors.lastname: Sterz
authors.affiliation: Division of Clinical Microbiology, Department of Laboratory Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria. Electronic address: athanasios.makristathis@meduniwien.ac.at.
authors.forename: Athanasios
authors.initials: A
authors.lastname: Makristathis
authors.affiliation: Department of Medicine I, Division of Infectious Diseases and Tropical Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria; Institute für Tropenmedizin, Universität of Tübingen, Wilhelmstraße 27, 72074 Tübingen, Germany. Electronic address: michael.ramharter@meduniwien.ac.at.
authors.forename: Michael
authors.initials: M
authors.lastname: Ramharter
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001419:Bacteria / Q000187:drug effects* / Q000254:growth & development; D052978:Disk Diffusion Antimicrobial Tests; D006801:Humans; D007036:Hypothermia, Induced; D008826:Microbial Sensitivity Tests; D010865:Pilot Projects
chemical_list: D000900:Anti-Bacterial Agents