ZINFORO® Introducing the patient

Prescribing information is available at the bottom of this page.

ZINFORO® Introducing the patient

Discover more about risk factors associated with disease severity, comorbidities and resistance in CAP and cSSTI

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Risk of mortality in patients with infections increases with older age, the presence of comorbidities, disease severity and delayed initiation of appropriate antimicrobial therapy/treatment failure5,7,12,17,19,23,28–31

 

Initial treatment choice is key to success in patients with CAP or cSSTI

In CAP patients initial antimicrobial treatment modification occurs in >25% of patients and is frequently the result of insufficient response or treatment failure*32

Comorbidities are associated with higher rates of initial treatment modification32

Initial treatment failure increases patients' risk of mortality in CAP33

In cSSTI patients up to 54% of patients experience initial treatment modification/failure†17,30,31,34
Initial treatment failure increases patients risk of mortality in cSSTI31
Comorbidities are associated with higher rates of initial treatment modification17

 

Initial treatment is more common in patients with comorbities17

Footnotes: *There is no experience with ZINFORO® in the treatment of CAP in the following patient groups: the immunocompromised, patients with severe sepsis/septic shock, severe underlying lung disease, patients with PORT Risk Class V, and/or CAP requiring ventilation, CAP due to MRSA, patients requiring intensive care; the available clinical data cannot substantiate efficacy against PNSP.1

There is no experience with ZINFORO® in the treatment of cSSTI in the following patient groups: the immunocompromised; patients with severe sepsis/septic shock, necrotisingfasciitis, perirectal abscess and patients with third-degree and extensive burns. There is limited experience in treating patients with diabetic foot infections. Caution is advised when treating such patients.1

Abbreviations: CAP, community-acquired pneumonia; COPD, chronic obstructive pulmonary disease; cSSTI, complicated skin and soft tissue infections; CURB-65, Confusion, blood Urea, Respiratory rate, Blood pressure, age >65; ICU, intensive care unit; MRSA, methicillin-resistant Staphylococcus aureus; PNSP, penicillin non-susceptible Streptococcus pneumoniae; PORT, Pneumonia Patient Outcomes Research Team; PVD, peripheral vascular disease.

References: 1. ZINFORO®. Summary of Product Characteristics; 2. Horita N, et al. Sci Rep 2015;5:14061; 3. Prina E, Ranzani OT, Torres A. Lancet 2015;386:1097–108; 4. Ramani A, Udeani G, Evans J, et al. J Chemother 2014;26:229–34; 5. Welte T, Torres A, Nathwani D. Thorax 2012;67:71–9; 6. File TM, Low DE, Eckburg PB, et al. Clin Infect Dis 2010;51:1395–405; 7. British Thoracic Society Community Acquired Pneumonia in Adults Guideline Group. Thorax 2009;64(SupplIII):iii1–iii55; 8. Eckmann C, Dryden M. Eur J Med Res 2010;15:554–63; 9. Marwick C, et al. J Antimicrob Chemother 2011;66:387–97; 10. Cooke FJ, Brown NM. Br Med Bull 2010;94:215–27; 11. Mannino DM, Davis KJ, Kiri VA. Respir Med 2009;103:224–9; 12. Udeani G, et al. Hosp Prac 2014;42:109–15; 13. Luna CM, et al. Ann Am Thorac Soc 2016;13:1519–26; 14. Rajan S. Cleve ClinJ Med 2012;79:57–66; 15. Corey GR, et al. J Antimicrob Chemother 2010;65(Suppl4):iv41–iv51; 16. Amara S, et al. CurrMed Res Opin 2013;29:869–77; 17. Garau J, et al. Clin Microbiol Infect 2013;19:E377–E385; 18. Evans JD, et al. Postgrad Med 2014;126:128–34; 19. Dryden M, et al. Clin Microbiol Infect 2015;21:S27–S32; 20. Dryden M, et al. J Antimicrob Chemother 2016;71:3575–84; 21. Garcia-Vidal C, et al. Clin Microbiol Infect 2009;15:1033–8; 22. Alberti S, et al. Clin Infect Dis 2012;54:470–8; 23. Caballero J, Rello J. Ann Intensive Care 2011;1:48; 24. Dryden M, et al. J Antimicrob Chemother 2010;65(Suppl3):iii35–iii44; 25. Poulakou G, et al. Curr Opin Infect Dis 2017;30:158–71; 26. Mpenge MA, MacGowan AP. Ther Clin Risk Manag 2015;11:565–79; 27. Augustine S, Bonomo R. Eur J Microbiol Immunol 2011;3:190–7; 28. Stupka J E, et al. Aging Health 2009;5:763–74; 29. Kothe H, et al. Eur Respir J 2008;32:139–46; 30. Garau J, et al. BMC Infect Dis 2015;15:78; 31. Edelsberg J, et al. Infect Control Hosp Epidemiol 2008;29:160–9; 32. Blasi F, et al. Resp Res 2013;14:44; 33. Menéndez R, et al. Thorax 2004;59:960–5; 34. Cogo A, et al. Infect Dis Ther 2015;4:273–82.

ZINFORO® CAP Patient profiles

George a 70-year-old nursing home resident presented with fever, cough and sputum production

Severity

  • PORT score IV (severe)
    • 70-year-old male
    • RR >30/min
    • Temperature >40°C
    • Nursing home resident

History/comorbidities

  • History of smoking

Risk factors for difficult-to-treat infection

  • Age >65 years
  • Recurrent infection (hospitalised for pneumonia 3 months ago)
  • Previous antibiotic use

 

Marco presented with fever, cough and pleuritic chest pain and there has been no improvement with ceftriaxone

Severity

  • PORT score IV (severe)
    • 78-year-old male
    • Chronic renal disease
    • Pulse >125 bpm
    • RR >30/min
    • No clinical improvement within 72 hours of ceftriaxone initiation

History/comorbidities

  • Renal insufficiency 
  • Recent alcoholism

Risk factors for difficult-to-treat infection

  • Age >65 years
  • Medical comorbidities
  • Alcoholism

 

Marie presented with fever, dyspnoea and cough

Severity

  • PORT score III (moderate)
    • 56-year-old female
    • PO2<90% (upon admission)
    • Glucose >250
    • Increasing oxygen requirements to maintain oxygen saturation
  • May require move to ICU in next 24 hours

History/comorbidities

  • Asthma
  • Diabetes

Risk factors for difficult-to-treat infection

  • Recent antibiotic exposure for URTI within previous 3 months

 

Please note: The examples described here are not actual patients, but fictitious representations of scenarios for which ZINFORO® could be considered.

Abbreviations: CAP, community-acquired pneumonia; ICU, intensive care unit; PORT, Pneumonia Patient Outcomes Research Team; RR, respiratory rate; URTI, upper respiratory tract infection.
Reference: 1. ZINFORO®. Summary of Product Characteristics.

ZINFORO® cSSTI Patient profiles

Laura, 71-year-old diabetic with cellulitis, presented with tender erythematous, non-raised lesions 

Severity

  • Deep and extensive cellulitis on the right leg that extends mid-calf to the ankle (~275 cm2)
  • Signs of systemic inflammatory response
    • Temp >38°C
  • Rapid spread of erythema over past 24 hours

History/comorbidities

  • History of smoking
  • Type 2 insulin-dependent diabetes HbA1c= 7.4%

Risk factors for difficult-to-treat infection

  • Nursing home resident
  • Poorly managed diabetes

 

Martin, 44-year-old readmitted to hospital following inguinal hernia repair with purulent drainage from incision and localised pain

Severity

  • Signs of systemic inflammatory response
    • Temp >38°C
    • Heart rate >90 bpm

History/comorbidities

  • History of depression (currently controlled by medication)
  • Obese
    • Weight = 132 kg
    •  BMI = 37

Risk factors for difficult-to-treat infection

  • MRSA colonisation identified during admission screening for surgery

 

Mark, 67-year-old admitted to Accident and Emergency with a painful and fluctuant gluteal abscess

Severity

  • Abscess area 12 cmwith 95 cmsurrounding cellulitis
  • Rapidly spreading infection
  • Signs of systemic inflammatory response
    • Temp >38°C
    •  Heart rate >90 bpm
    •  RR >20/min
  • May require move to ICU in the next 24 hours

History/comorbidities

  • Chronic renal impairment
    • CrCI at hospital admission = 17 mL/min

Risk factors for difficult-to-treat infection

  • Chronic renal disease
  • Treatment with fluoroquinolone within 6 months for UTI

 

Please note: The examples described here are not actual patients, but fictitious representations of scenarios for which ZINFORO® could be considered.
Abbreviations:  BMI, body mass index; CrCl, creatinine clearance; cSSTI, complicated skin and soft tissue infections; DM, diabetes mellitus; HbA1c, hemoglobin A1c; ICU, intensive care unit; MRSA, methicillin-resistant Staphylococcus aureus; RR, respiratory rate; UTI, urinary tract infection.
Reference: 1. ZINFORO®. Summary of Product Characteristics.

ZINFORO® 600 mg powder for concentrate for solution for infusion – SPC
Legal category: POM.   Basic NHS cost: 10 vial pack £375.00.

Vancomycin – SPC
Legal Category: POM       Basic NHS Cost: 500 mg 10 vial pack £8.50, 1000 mg 10 vial pack £17.25

PP-ZFO-GBR-0027

Date of Preparation: June 2018