Publications of Frédéric FRIPPIAT
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See detailMeropenem: continuous or extended infusion?
FRIPPIAT, Frédéric ULiege; Vercheval, Christelle ULiege; Layios, Nathalie ULiege

in Critical care (London, England) (2020), 24(1), 192

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See detailEndocardite infectieuse a Streptococcus agalactiae.
Tajildin, Riad ULiege; MARCHETTA, Stella ULiege; FRIPPIAT, Frédéric ULiege et al

in Revue medicale de Liege (2020), 75(2), 94-99

Infectious endocarditis is a rare pathology whose mortality is high and whose diagnosis is still difficult by the usual clinical, biological and ultrasound tools. We report the case of a patient, drug ... [more ▼]

Infectious endocarditis is a rare pathology whose mortality is high and whose diagnosis is still difficult by the usual clinical, biological and ultrasound tools. We report the case of a patient, drug addict, suffering from an infectious endocarditis of the aortic valve at Streptococcus agalactiae. This germ is rarely at the origin of cardiac infection but it is responsible for quickly destructive lesion by its pathophysiological mechanisms. In this case, the infection unfortunately caused the death of the patient. [less ▲]

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See detailContinuous infusion of cefepime and neurotoxicity: a retrospective cohort study.
Vercheval, Christelle ULiege; Sadzot, Bernard ULiege; MAES, Nathalie ULiege et al

in Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases (2020)

OBJECTIVES: Neurotoxicity related to cefepime is increasingly reported in the literature but specific data concerning continuous infusion (CI) of the drug are still lacking. Our primary objective was to ... [more ▼]

OBJECTIVES: Neurotoxicity related to cefepime is increasingly reported in the literature but specific data concerning continuous infusion (CI) of the drug are still lacking. Our primary objective was to evaluate the incidence of neurotoxicity related to CI of cefepime and the associated risk factors. Our secondary objectives were to analyse the plasma cefepime concentrations and to define the threshold above which neurotoxicity occurs. METHODS: In this single-centre retrospective cohort study, all adult patients who underwent at least one cefepime therapeutic drug monitoring (TDM) and were treated with CI of 4 g/day between January 2017 and June 2019 were included. Neurotoxicity was evaluated according to a strict definition and was correlated with steady-state concentration at the time of toxicity presentation. RESULTS: Ninety-eight patients with 201 cefepime TDM studies were included, with an incidence of neurotoxicity of 14.3% (14/98). Patients with neurotoxicity had more often underlying brain disease (35.7% (5/14) vs 11.9% (10/84), p = 0.030)) and higher steady-state concentrations (mean ± standard deviation 71.8 ± 32.9 mg/L vs 49.6 ± 30.6, p = 0.036) than the others. A receiver operating characteristic curve analysis yielded a cefepime steady-state concentration of 63.2 mg/L as the best cut-off point between patients with or without neurotoxicity. A mean steady-state concentration of 46.4 mg/L was achieved if the dosages of cefepime were adapted to renal function which was under our threshold concentration but above our highest pharmacokinetic/pharmacodynamic target of 32-40 mg/L. CONCLUSIONS: Our results suggest that 4 g/day of cefepime adapted to renal function and infused over 24 h is a trade-off for the risk/benefit ratio, when used empirically. [less ▲]

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See detailEvolution of Drug Interactions With Antiretroviral Medication in People With HIV.
El Moussaoui, Majdouline ULiege; Lambert, Iseult ULiege; MAES, Nathalie ULiege et al

in Open Forum Infectious Diseases (2020), 7(11), 416

BACKGROUND: Polypharmacy and drug interactions are important issues for HIV-infected individuals. The number and nature of those interactions are continuously evolving with the use of new antiretroviral ... [more ▼]

BACKGROUND: Polypharmacy and drug interactions are important issues for HIV-infected individuals. The number and nature of those interactions are continuously evolving with the use of new antiretroviral drugs and the aging of HIV-infected individuals. We aimed to analyze this evolution over time. METHODS: This retrospective cohort study was conducted in the University Hospital of Liège (Belgium). Treatments of HIV-infected outpatients attending Liège University Hospital were collected and analyzed in 2012 and 2016. The University of Liverpool HIV drug interactions database was used to determine drug interactions. RESULTS: We included 1038 patients in 2016, of whom 78% had 1 comedication. Polypharmacy was seen in 20% of the cohort. Four percent of the patients presented red flag interactions, and 38% had orange flag interactions. Nonantiretroviral (non-ARV) therapeutic classes involved in drug interactions were mostly cardiovascular and central nervous system drugs. They were followed by hormone drugs and dietary supplements for orange flag interactions. Two factors significantly contributed to both red and orange flag interactions: the number of non-ARV comedications and protease inhibitor-based ARV regimens. The proportion of patients with red or orange flag interactions remained stable from 2012 to 2016. CONCLUSIONS: This study highlights the persistence of an alarming number of contraindicated drug interactions and a high prevalence of potential drug interactions over time. Identification, prevention, and management of drug interactions remain a key priority in HIV care. [less ▲]

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See detailUtilisation de la nystatine dans la candidose oropharyngée au CHU de Liège
Vercheval, Christelle ULiege; GILLET, Manon ULiege; Koch, Nathan ULiege et al

in Journal de Pharmacie de Belgique (2019)

Le Groupe de Gestion de l’Antibiothérapie du Centre Hospitalier Universitaire de Liègea souligné une utilisation importante et nonjustifiée de nystatine sous forme de bain debouche. Devant ce constat ... [more ▼]

Le Groupe de Gestion de l’Antibiothérapie du Centre Hospitalier Universitaire de Liègea souligné une utilisation importante et nonjustifiée de nystatine sous forme de bain debouche. Devant ce constat, nous avons réalisé une revue de la littérature sur l’efficacité et l’innocuité de la nystatine dans la candidose oropharyngée (COP) et nous partageons dans cet article quelques recommandations pratiques institutionnelles. La COP est une infection fongique fréquente avec un bon pronostic si elle est diagnostiquée et traitée de manière appropriée. La nystatine sous forme de pastille ou de suspension buvable est recommandée comme traitement alternatif en cas de COP bénigne par la Société Américaine des Maladies Infectieuses. Néanmoins, la littérature évaluant l’efficacité et la sécurité de la nystatine dans la COP est pauvre. En Belgique, la nystatine est commercialisée sous forme de suspension buvable et sous forme de matière première. Aucun consensus national n’est disponible sur la formulation, le dosage ou encore la durée de traitement de la nystatine en cas de COP. Au CHU de Liège, il a été décidé d’arrêter la préparation de bain de bouche à base de nystatine et de privilégier l’utilisation d’une suspension de nystatine en cas de COP bénigne. [less ▲]

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See detailEtude des motifs d'admission au service des Urgences d'une cohorte de patients
Pirotte, Benoit; FRIPPIAT, Frédéric ULiege; DARCIS, Gilles ULiege et al

in Revue Médicale de Liège (2019)

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See detailTemocillin susceptibility testing with Vitek2® system and E-test® Are these methods reliable to determine temocillin MIC ?
DESCY, Julie ULiege; VISEE, Clotilde; FRIPPIAT, Frédéric ULiege et al

Poster (2018, April 21)

Background: The use of temocillin (TEM) is increasing in serious infections caused by Enterobacteriaceae, including extended-spectrum β-lactamase (ESBL), as an alternative to carbapenems. Accuracy of in ... [more ▼]

Background: The use of temocillin (TEM) is increasing in serious infections caused by Enterobacteriaceae, including extended-spectrum β-lactamase (ESBL), as an alternative to carbapenems. Accuracy of in vitro minimal inhibitory concentration (MIC) values is of high importance in an era of antibiotic stewardship based on PK/PD. We performed a method comparison between Vitek2®, E-test® and the standard method, broth microdilution (BMD), in order to evaluate which method is reliable to determine TEM MIC. Materials/methods: One hundred Enterobacteriaceae were collected from respiratory samples isolated from ICU patients. MIC of temocillin was determined in parallel by 3 methods: Vitek2® (Biomérieux), E-test® (Biomérieux) and BMD, the latter following CLSI recommendations. Susceptibility to temocillin was determined according to breakpoints provided by BSAC (British Society for Antimicrobial Chemotherapy) - S: MIC ≤ 8 mg/L; R: MIC > 8 mg/L.- in order to evaluate categorical agreement (CA), essential agreement (EA), very major errors (VME) and major errors (ME), as defined in Cumitech 31A. Results: Isolates (N=100) included: Klebsiella pneumoniae (34%), Escherichia coli (23%), Serratia sp. (18%), others (25 %). Thirty-five strains were ESBL-producers; 13% were carbapenemase-producers. 41/100 (41%) isolates were resistant to TEM according to BMD. EA of 96 % was calculated for E-test® and 95% for Vitek2® versus BMD, while CA was of 82% (E-test®) and 84% (Vitek2®). Both VME (12.2% for E-test®; 24.4% for Vitek2®) and ME (22.0% for E-test®; 10.2% for Vitek2®) exceeded the 3% threshold. As a part of errors can be explained by BSAC breakpoints (no “intermediate” category), VME and ME with MIC > ± 1 twofold dilution were calculated, for E-test® (VME:0%; ME: 6.8%) and for Vitek2® (VME: 7.3%; ME: 3.4%). Overestimation of TEM resistance (E-test®) or TEM susceptibility (Vitek2®) was observed. Conclusions: Compared to BMD, E-test® seems to be more reliable than Vitek2® to predict MIC of TEM. Contrary to E-test®, even when taking the adapted definition of VME and ME with MIC > ± 1 twofold dilution, VME rate for Vitek2® is still unacceptable. When the use of TEM is considered by the clinician, we would recommend to control systematically TEM MIC by E-test®, or, even better, by BMD. [less ▲]

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See detailPrise en charge multidisciplinaire d'une volumineuse hydatidose hepatique.
HALLEUX, Danaé ULiege; Juriens, I.; Delwaide, Jean ULiege et al

in Revue Médicale de Liège (2018), 73(2), 65-71

Cystic echinococcosis or hydatidosis, is a zoonosis caused by larval stages of Echinococcus granulosus that can be encountered in Belgium in patients originating from endemic countries. The liver is the ... [more ▼]

Cystic echinococcosis or hydatidosis, is a zoonosis caused by larval stages of Echinococcus granulosus that can be encountered in Belgium in patients originating from endemic countries. The liver is the most commonly affected organ. In this paper, the authors describe the multidisciplinary management of this pathology based on the clinical case of a patient suffering from a 28 cm cystic echinococcosis treated by combination of albendazole and liver resection. Several treatment options are described in the literature although there is currently no clear consensus on the management of this condition. [less ▲]

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See detailUne urgence bien souvent meconnue.
MARCHETTA, Stella ULiege; DULGHERU, Raluca Elena ULiege; Oury, Cécile ULiege et al

in Revue Médicale de Liège (2018), 73(5-6), 283-289

Infective endocarditis is a rare disease that can lead to some diagnostic wandering because of its often nonspecific and polymorphic clinical manifestations. This latency is at the origin of severe ... [more ▼]

Infective endocarditis is a rare disease that can lead to some diagnostic wandering because of its often nonspecific and polymorphic clinical manifestations. This latency is at the origin of severe cardiac and extra-cardiac complications, yet highly fatal. The clinician should always bear in mind the differential diagnosis of a patient with fever of undetermined origin, with risk factors for valve infection such as foreign material, and history recent invasive procedures (including dental procedures) or recent hospitalization. The current medical tools make it possible to highlight the infection and its complications in a fast and complete manner, so as not to delay the patient's management, particularly with the introduction of urgent empirical antibiotherapy. [less ▲]

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See detailEpithelial lining fluid penetration of temocillin administered by continuous infusion in critically ill patients with nosocomial pneumonia
VISEE, Clotilde ULiege; LAYIOS, Nathalie ULiege; MISTRETTA, Virginie ULiege et al

Conference (2017, April 23)

The administration of 6g per day of temocillin by continuous infusion in critically patients with severe nosocomial pneumonia allows a penetration ratio, measured by the ELF/plasma ratio of AUCs, of 0.14 ... [more ▼]

The administration of 6g per day of temocillin by continuous infusion in critically patients with severe nosocomial pneumonia allows a penetration ratio, measured by the ELF/plasma ratio of AUCs, of 0.14 and 0.57 and a mean (± SE) ELF concentration , in mg/L, of 9.8 ± 1.3 and 9.8 ± 1.6 for total and free drug, respectively. Standard error of AUCs should be calculated by the Bootstrap method and Monte Carlo simulations should be performed for subsequent PK/PD analysis. [less ▲]

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See detailAre Vitek2 system and E-test relevant and reliable for determining susceptibility to temocillin?
VISEE, Clotilde ULiege; FRIPPIAT, Frédéric ULiege; DESCY, Julie ULiege et al

Poster (2017, April 22)

Compared to BMD, Vitek2® seems to overestimate sensitivity and underestimate resistance, while E-test® seems to overestimate resistance, pleading for the use of BMD when evaluating susceptibility to ... [more ▼]

Compared to BMD, Vitek2® seems to overestimate sensitivity and underestimate resistance, while E-test® seems to overestimate resistance, pleading for the use of BMD when evaluating susceptibility to temocillin. However, this study, which is currently enrolling more patients, will include more isolates in order to meet FDA criteria set out in Cumitech 31A for validation of method comparison [less ▲]

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See detailEndocardite à aggregatibacter aphrophilus sur prothèses valvulaires
Deleixhe, Benjamin ULiege; FRIPPIAT, Frédéric ULiege; Léonard, Philippe ULiege et al

in Revue Médicale de Liège (2017), 72(12), 522-528

We present the case of an acute endocarditis of mitral and aortic prosthetic heart valves caused by Aggregatibacter aphrophilus (Haemophilus aphrophilus-paraphrophilus). This third report in the ... [more ▼]

We present the case of an acute endocarditis of mitral and aortic prosthetic heart valves caused by Aggregatibacter aphrophilus (Haemophilus aphrophilus-paraphrophilus). This third report in the literature emphasizes the diagnostic work-up and the role of positron emission tomography combined with computed tomography in this setting. The specificities of endocarditis due to the HACEK group (Haemophilus spp., Aggregatibacter, Cardiobacterium hominis, Eikenella corrodens and Kingella spp.) and the specific microbiological data and therapeutic options pertinent to this germ are discussed. [less ▲]

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See detailDecreased antibiotic consumption in the Belgian community: Is it credible?
FRIPPIAT, Frédéric ULiege; VERCHEVAL, Christelle ULiege; LAYIOS, Nathalie ULiege

in Clinical Infectious Diseases (2016), 62(3), 403-404

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See detailQuality of documentation on antibiotic therapy in medical records: evaluation of combined interventions in a teaching hospital by repeated point prevalence survey.
VERCHEVAL, Christelle ULiege; GILLET, Manon ULiege; MAES, Nathalie ULiege et al

in European Journal of Clinical Microbiology and Infectious Diseases (2016), 35(9), 14951500

This study aimed to improve the quality of documentation on antibiotic therapy in the computerized medical records of inpatients. A prospective, uncontrolled, interrupted time series (ITS) study was ... [more ▼]

This study aimed to improve the quality of documentation on antibiotic therapy in the computerized medical records of inpatients. A prospective, uncontrolled, interrupted time series (ITS) study was conducted by repeated point prevalence survey (PPS) to audit the quality of documentation on antibiotic therapy in the medical records before and after a combined intervention strategy (implementation of guidelines, distribution of educational materials, educational outreach visits, group educational interactive sessions) from the antimicrobial stewardship team (AST) in the academic teaching hospital (CHU) of Liege, Belgium. The primary outcome measure was the documentation rate on three quality indicators in the computerized medical records: (1) indication for treatment, (2) antibiotics prescribed, and (3) duration or review date. Segmented regression analysis was used to analyze the ITS. The medical records of 2306 patients receiving antibiotics for an infection (1177 in the pre-intervention period and 1129 in the post-intervention period) were analyzed. A significant increase in mean percentages in the post-intervention period was observed as compared with the pre-intervention period for the three quality indicators (indication documented 83.4 +/- 10.4 % vs. 90.3 +/- 6.6 %, p = 0.0013; antibiotics documented 87.9 +/- 9.0 % vs. 95.6 +/- 5.1 %, p < 0.0001; and duration or review date documented 31.9 +/- 15.4 % vs. 67.7 +/- 15.2 %, p < 0.0001). The study demonstrated the successful implementation of a combined intervention strategy from the AST. This strategy was associated with significant changes in the documentation rate in the computerized medical records for the three quality indicators. [less ▲]

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