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 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A single, selective study was performed in order to evaluate the efficacy and safety of cefotetan in the treatment of complicated urinary tract infections (UTI). Of 34 pre-treatment isolated strains, 60% were pluri-resistant to other antibiotics (ampicillin, carbenicillin, piperacillin, cefalotin, aztreonam) but only 21.2% to cefotetan. Pseudomonas aeruginosa and enterococci were resistant to cefotetan. Escherichia coli was the common strain isolated (50%). Nineteen adult patients, with complicated UTI caused by sensitive organisms, were treated with a 1 g intramuscular (i.m.) daily dose. Duration of treatment ranged from 5-15 days, with a mean of 13.75 days. Within 24-48 h and 30 days post-therapy, the infection was cured in 84% and 52% of patients, respectively. Reinfection, relapse or super-infection occurred in 42% of the cases. In only one patient, the infecting organism did not respond to treatment. The clinical response was evaluated in only seven patients with symptomatic UTI. Six of them (85.7%) were cured after therapy and the cure persisted at follow-up. In most cases, the adverse reactions were local, mild and negligible. In only 15.8% and 10.5% of patients, side-effects (diarrhoea, headache, abdominal pain, tachycardia, chill, pain and erythema in the injection site) were severe and moderate. In these cases, the adverse reactions were reversible when the therapy was discontinued. The relationship between treatment and side-effects was doubtful in two cases. It is concluded that cefotetan, administered at 1 g i.m. daily dose, is effective in treating complicated UTI caused by sensitive organisms, pluri-resistant to other antibiotics.
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PMID:Efficacy and safety of cefotetan in the treatment of complicated urinary tract infections: clinical experience in a selective and single study. 259 2

Experience with typhoid fever in 111 children over a 5-year period was reviewed. There were 66 boys and 45 girls, ranging in age from 1 to 11.5 years. The symptoms of typhoid fever were quite non-specific. Fever was the most common presenting symptom (in 98.3%). Other common presenting features were diarrhoea (25.7%), constipation (22%), vomiting (21.1%), cough (25%), abdominal pain (27.5%), headache (9.2%), epistaxis, meningism and convulsions. Rose spots were detected in 20% of cases, occurring mainly during the first 2 weeks of illness. Significant Widal reactions were present in 84.7% of cases. Blood and stool cultures were positive in 57% and 44% of cases, respectively. Peripheral blood white cell counts were not found to be of great diagnostic value. Chloramphenicol remained the drug of choice in the treatment of typhoid fever. It was more effective than ampicillin or co-trimoxazole. Complications were uncommon, occurring in only two patients. There were two deaths; both were admitted late and in moribund state. Early diagnosis and treatment is vital in typhoid fever and, as the presenting features are non-specific, a high index of suspicion is required.
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PMID:Typhoid fever in Hong Kong children. 278 7

Thirteen patients with Aeromonas species septicemia were seen at Westmead Hospital between 1983 and 1987. In 10 patients (77%) septicemia was caused by A. sobria, and in 3 (23%) by A. hydrophila, A. caviae was not isolated. Chronic underlying illness was present in 10 patients (77%), hematological malignancy being the most common (46%). The average age of the patients was 65.8 years. Seven patients (54%) presented with clinical sepsis, diarrhea and abdominal pain. The biliary tract, lung and soft tissue were other primary sites of infection. Nosocomial infection occurred in 5 patients (38%). Cross-infection was not seen. Contact with fresh water or fish was observed in only 2 patients (15%). The majority of cases occurred in the warmer months of the year. The overall mortality was 46%. All isolates of Aeromonas species were resistant to ampicillin 8 mg/L. Ten isolates were resistant to tobramycin 1 mg/L, and 3 to tobramycin 4 mg/L. In contrast, 3 isolates were resistant to gentamicin 1 mg/L, and none to 4 mg/L. The isolates showed a varied pattern of resistance to other antibiotics tested, but all were susceptible to piperacillin 64 mg/L, imipenem 4 mg/L, ciprofloxacin 1 mg/L, and amikacin 16 mg/L.
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PMID:Aeromonas septicemia: relationship of species and clinical features. 281 70

For evaluation of the efficacy of early treatment with ampicillin on the clinical course of Yersinia pseudotuberculosis infection in children, 136 patients were randomly assigned to receive either ampicillin or placebo. Subjects were those who were diagnosed as having Kawasaki syndrome and those who satisfied three of the following four criteria: fever; rash; abdominal symptoms; and a history of ingestion of untreated drinking water. Fifty-six patients had evidence of Y. pseudotuberculosis infection bacteriologically and/or serologically. Twenty-six were assigned to placebo and 28 to ampicillin. Ampicillin therapy did not show a significant benefit in shortening the duration of fever, diarrhea and abdominal pain or in preventing rash, erythema nodosum and acute renal failure. After 5 days of treatment none of the patients in the ampicillin group excreted the organism in the stool whereas 19 (90%) of 21 in the placebo group did (P less than 0.001). Ampicillin did not show a clinical benefit but reduced the fecal excretion of the organism.
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PMID:Ampicillin vs. placebo for Yersinia pseudotuberculosis infection in children. 305 77

We evaluated the efficacy of medical therapy, consisting of liquid bismuth subsalicylate prescribed either in combination with oral ampicillin (n = 15) or alone (n = 1), in the clearing of bacterial colonization on the antrum in 16 children with Campylobacter pylori-associated antral gastritis. We also examined the effects of medical treatment on altering the severity of associated antral inflammation. Eight patients had upper gastrointestinal tract hemorrhage, two had acute gastric outlet obstruction, and 10 had symptoms of episodic epigastric abdominal pain. Duodenal ulcers were demonstrated in 10 of the 16 patients; in the other six, C. pylori-associated antral gastritis was documented without evidence of acute peptic ulceration. Seven days after a 6-week course of medical therapy, repeat upper endoscopy plus mucosal biopsy specimens showed that C. pylori colonization of the antrum had cleared in 12 of the 16 (75%) patients. Inflammation in the antrum improved in all patients in whom colonization by C. pylori was eradicated. In contrast, in the four with persistent colonization of the antrum, the severity of antral gastritis had not improved (p less than 0.01). Clinical symptoms improved in 9 of 12 patients in whom C. pylori colonization was no longer present, whereas subjective symptoms were unaffected in those with continued bacterial colonization of the antrum (p less than 0.05). We conclude that oral bismuth subsalicylate, in conjunction with ampicillin, can eradicate C. pylori colonization of the antrum, and that clearing of C. pylori is correlated with an improvement in the associated antral gastritis and clinical symptoms. These findings provide additional support for the hypothesis that these gastric organisms could play an etiologic role in primary antral gastritis and peptic ulcer disease.
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PMID:Treatment of Campylobacter pylori-associated antral gastritis in children with bismuth subsalicylate and ampicillin. 262 43

This case report presents an unusual case of primary IUD-associated ovarian actinomycosis, which spread to the sigmoid causing intestinal obstruction. A 43-year-old gravida 3, para 2, had her 1st IUD from 1978-80 (Gyne-T) and her 2nd IUD from 1980 to October 1983 (Multiload). Right lower abdominal pain led to hospitalization in May 1983. A tender nodular mass was palpated in the left pelvic area. Laboratory results confirmed the presence of inflammation. Rapid improvement followed a course of laxatives and cephalosporin antibiotics, and the patient was discharged with the diagnosis of acute sigmoid diverticulitis. 2 months later, a double contrast examination of the large intestine was done and showed severe narrowing of the sigmoid colon over a distance of 12 cm and occasional sharp recesses. Colonoscopy showed a spastic stricture of the sigmoid with massive edema of the otherwise intact mucosa at 18 cm. Computer tomography of the abdomen showed a large, focally cystic infiltrative mass in the pelvis with congestion and displacement of both ureters as well as bilateral hydronephrosis, predominantly on the right side. The descending colon was congested. The patient was readmitted to hospital with the tentative diagnosis of ovarian cancer when her general condition deteriorated. She complained again of abdominal pain in the right lower quadrant and alternating diarrhea and constipation. Pyrexia and the hematological findings suggested sepsis. The pelvis contained a predominantly leftsided nodular mass and a brown fetid discharge was coming through the cervix. The IUD was removed and treatment with ampicillin and clindamycin was started with rapid improvement in the patient's condition. Obstruction with extreme distention of the colon required emergency laparotomy. An inflammatory mass was found in the pelvis consisting of a right-sided ovarian tumor, bilateral hydrosalpinges, and a tightly encased sigmoid colon. The dilated caecum had a large necrotic area in its wall which necessitated caecostomy and double-current sigmoidostomy after subtotal hysterectomy and bilateral salpingo-oophorectomy. The patient made a good recovery. As recently as the 1950s, primary pelvic actinomycosis was a rarity. In the last 4 years alone, 20% of all reported cases of actinomycosis involved the female genital tract. The percentage of cases found among IUD users has been continuously increasing and in the last 2 years all published cases were IUD users. The presence of actinomyces in vaginal smears always is indicative of the presence of a foreign body, most commonly and IUD.
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PMID:IUD-associated ovarian actinomycosis causing bowel obstruction. 374 Sep 65

Some aspects of typhoid fever in 77 children are discussed. There were 48 boys and 29 girls and their ages ranged from 1 month to 12 years. The patients were treated with chloramphenicol 100 mg/kg/d during the first 2 weeks and with either amoxycillin (100 mg/kg/d) or ampicillin (200 mg/kg/d) during the third week. The average duration of fever was 5.2 days. There was 1 relapse and 1 child, a baby aged 1 month, died. The correct diagnosis was not suspected by the referring doctor in 38% of the patients. On admission the commonest complaints were fever, abdominal pain, diarrhoea, headache and vomiting. The commonest findings on examination were tenderness or distension of the abdomen, apathy or delirium, rhonchi or crepitations, liver enlargement and meningism. There was anaemia (Hb less than 10 g/dl) in 23% and lymphopenia (less than 1500/microliter) in 43% of the patients. The differential white blood cell count revealed 5% or more unsegmented neutrophils in 32% of the patients, while 25% had 10% or more band cells. Two patients (sisters) failed to respond after 15 and 16 days of therapy with chloramphenicol and ampicillin because of resistant Salmonella typhi and were successfully treated with co-trimoxazole. Practitioners caring for black patients should always be on the alert for typhoid fever; some patients may not respond to chloramphenicol or amoxicillin. During the acute phase milk feeds are best replaced by soya products because of abdominal distension or aggravation of diarrhoea by milk.
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PMID:[Aspects of typhoid fever in children]. 376 9

A comparative well-controlled study was performed to evaluate the efficacy and tolerability of KS-R1 (ampicillin rectal suppository, 125 mg X 4/day) administered to the rectum as compared with those of orally administered ampicillin (ABPC) with same dosage. The results obtained were as follows. The clinical effect of the drug was judged in 100 cases (suppository group in 45 cases, oral group in 55 cases) out of 111 cases. The overall efficacy rates evaluated on standard criteria were 93.3% for the suppository group and 89.1% for the oral group. There was no statistically significant difference between 2 groups. Evaluation by stratification according to the dose, disease type and age also revealed a slightly higher efficacy rate on each parameter in the suppository group, but no significant difference between 2 groups. The bacteriological effects evaluated in 84 cases (suppository group in 38 cases, oral group in 46 cases) were 94.7% and 93.5%, respectively. There was no statistically significant difference between 2 groups. Side effects were evaluated in 101 cases (suppository group in 46 cases, oral group in 55 cases), but the incidence rate showed no significant difference between the 2 groups; 3 cases (each 1 of abdominal pain, periproctal redness and periproctal erosion) were observed in suppository group and 2 cases (each 1 of stomach pain + soft stool and diarrhea) in oral group. The results indicate that KS-R1 is equally effective and tolerable against acute suppurative otitis media compared to oral administration of ABPC, and considered to be useful.
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PMID:[Therapeutic evaluation of an ampicillin suppository (KS-R1) used against acute suppurative otitis media in children: a comparison with an oral preparation]. 636 21

Fifty-eight patients seen in general practice presenting with symptoms of acute urinary tract infection were entered consecutively into an open randomized trial of 200 mg pivmecillinam plus 250 mg pivampicillin twice daily or 250 mg amoxycillin plus 125 mg clavulanate 3-times daily for 5 days. The results were analyzed in 41 patients with significant bacteriuria (23 on pivmecillinam/pivampicillin and 18 on amoxycillin/clavulanate). Both antibiotic combinations produced good overall bacteriological cure, but there were a considerable number of persisting symptoms despite the absence of significant bacteriuria. Eight patients in the pivmecillinam/pivampicillin group and 5 in the amoxycillin/clavulanate group had side-effects, principally thrush, vomiting and abdominal pain, and 1 patient from each group ceased treatment for this reason. Sensitivity profiles of urinary isolates (41 trial, 135 non-trial) to both combinations and to ampicillin and mecillinam showed that the majority were fully sensitive to amoxycillin/clavulanate and to a lesser extent to pivmecillinam/pivampicillin; resistance was highest to ampicillin.
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PMID:A comparative trial of pivmecillinam/pivampicillin and amoxycillin/clavulanate in the therapy of urinary tract infection in a general practice population. 639 34

A Doberman with jaundice, hepatomegaly and cranial abdominal pain had evidence of centrilobular necrosis on liver biopsy. Therapy with fluids, ampicillin and rest resulted in recovery. A Collie hit by a car developed traumatic hepatopathy and myopathy. The animal recovered with rest as the only treatment. A mongrel with hepatic lymphosarcoma benefited from chemotherapy for 5 months before euthanasia was necessary. A cat became lethargic and anorectic 9 days after an oral dose of piperazine. Liver biopsy revealed fatty change, vacuolation and mononuclear infiltration. Supportive care with amoxicillin, fluids and a high caloric intake resulted in recovery. Laparotomy in a jaundiced, anorectic cat revealed an obstructed common bile duct. Cholecystoduodenostomy and supportive care resulted in recovery. A vomiting, lethargic, jaundiced cat had evidence of chronic cholangitis on liver biopsy. The animal recovered after treatment with amoxicillin, fluids, prednisolone and forced feeding.
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PMID:Management of liver disease in dogs and cats. 654 4


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