Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0004610 (bacteremia)
 13,199 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In general, defects in phagocytosis and in humoral or cellular immunity do not appear to predispose to the acquisition of UTI but do influence the clinical manifestations and the severity, microbiology, and complications of infection once it is established. The incidence of UTI in immunosuppressed patients other than diabetics or renal transplant recipients is not higher than the incidence in nonimmunosuppressed individuals. The higher frequencies of infection seen in diabetics and in renal transplant recipients correlate best with the duration of bladder instrumentation rather than with glycosuria or immunosuppressive regimen. Neutropenia blunts the clinical manifestations of UTI and predisposes to bacteremia. Use of broad spectrum antibiotics results in alterations in indigenous flora, promotes urinary infections with resistant nosocomial pathogens, and predisposes to fungemia with hematogenous seeding of the urinary tract. Routine screening for detection of asymptomatic bacteriuria and prompt institution of antimicrobial therapy is indicated only in renal transplant recipients within 3 months of their surgery and not in any of the other diseases discussed.
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PMID:Urinary tract infection in the impaired host. 199 41

During the clinical trials 8,861 patients have been treated with ciprofloxacin worldwide. 3,822 of the therapeutic courses were valid for analysis of efficacy according to FDA standards. The following dosages were usually administered: UTI: 100 to 500 mg twice daily orally or 100 mg twice daily intravenously; RTI: 250 to 1000 mg twice daily orally or 200 mg twice daily intravenously; septicemia: 200 mg intravenously twice daily; gonorrhea: 250 to 500 mg single tablet orally; all other infections: 500 to 1000 mg twice daily orally or 200 mg twice daily intravenously. Ciprofloxacin was administered to 762 courses of lower RTI, 88 courses of upper RTI, 108 courses of bacteremia, 766 courses of skin structure infection, 142 courses of bone and joint infections, 149 courses of intra-abdominal infections, 33 courses of gastrointestinal infections, 1,633 courses of UTI, 49 courses of pelvic infections, 279 courses of STD, mainly gonorrhea, and three courses of meningitis. The clinical response was resolution in 76%, improvement in 18% and failure in only 6%. Bacteriologic response by all sites evaluable: pathogens were eradicated from 74%, markedly reduced in 2%, persisted in 10%. Relapse occurred in 4% and reinfection was observed in another 6%. The overall response was favourable for 90% of the patients. Drug safety was established on a data base of 8,861 courses worldwide. The following side-effects according to COSTART terminology were observed: digestive 5%, metabolic nutritional 4.6%, central nervous 1.6%, skin 1.4%, hemic and lymphatic 1%, cardiovascular 0.4%, body as a whole 0.4%, urogenital 0.3%, special senses 0.3%, musculo-skeletal 0.1%, respiratory 0.08%. Several courses had more than one reaction. Thus the total incidence of side-effects for the treated patient population was 10.2%. Ciprofloxacin is a highly effective drug and a breakthrough in several areas of medical interest. It is relatively safe and side-effects are usually mild or moderate in intensity and transient.
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PMID:Worldwide clinical data on efficacy and safety of ciprofloxacin. 328 11

The elderly segment of the population is growing at a rapid rate; this "longevity revolution" is associated with an increasing prevalence of bacteriuria and UTI. Asymptomatic bacteriuria generally requires no treatment. In the absence of obstructive uropathy or infected calculi, asymptomatic bacteriuria in the elderly pursues a benign course. Prevention of UTIs is needed to avoid the risks of symptomatic infection, bacteremia, and urosepsis. Indwelling catheters should be left in situ for short periods of time, and alternative methods of bladder drainage should be used whenever possible. Coexistent chronic disease should be optimally managed and every effort made to avoid invasive procedures and limit GU instrumentation.
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PMID:Urinary tract infection in the elderly. 329 82

Pharmacokinetic and clinical studies of imipenem/cilastatin sodium (MK-0787/MK-0791), a newly developed combined antibiotic in a 1:1 ratio, were performed in the field of pediatrics. The MK-0787/MK-0791 was administered to 15 children. Ten and 20 mg/kg doses of MK-0787 were administered by a intravenous drip infusion for 30 minutes to 3 children each. In the remaining 9 cases, MK-0787 doses of 10, 20 and 30 mg/kg were administered to 3 children each by a 1 hour intravenous drip infusion. Levels of MK-0787 and MK-0791 in plasma, urine and urinary recovery rate of the drugs were also determined. In addition, MK-0787/MK-0791 was administered to a total of 29 children; 2 children with bronchitis, 16 with pneumonia, 4 with UTI, 2 with purulent lymphadenitis and 1 child each with tonsillitis, septicemia suspected disease, peritonitis, staphylococcal scalded skin syndrome and osteomyelitis/bacteremia. The average single dose was 15.3 mg/kg of MK-0787 and administrations were performed by 20-60 minutes intravenous drip infusion 3-4 times daily for an average period of 6 days. The clinical and bacteriological effects of this drug were evaluated in these cases and adverse reactions and unusual laboratory findings were also studied in a total of 33 cases including 4 other drop-out cases. Results of these studies were summarized as follows. In 6 children, 3 each who were given doses of 10 or 20 mg/kg, the mean peak plasma concentrations of the drugs were found at the end of the 30 minutes-infusion with values of 35.20 and 74.90 micrograms/ml for MK-0787 and 44.85 and 93.32 micrograms/ml for MK-0791 after the dose of 10 and 20 mg/kg, respectively. The peak plasma levels of MK-0791 were approximately 1.3 times higher than those of MK-0787 and higher peak levels were observed in the groups with larger doses of either drugs. In the 10 mg/kg group, the mean half-lives of MK-0787 and MK-0791 were 0.97 and 0.71 hour, respectively and those values were 0.89 and 0.63 hour, respectively in the 20 mg/kg group. In both group, MK-0787 tended to have longer half-lives than MK-0791. In 9 children, 3 each who were administered doses of 10, 20 and 30 mg/kg by a 1 hour intravenous drip infusion had the highest plasma levels for both MK-0787 and MK-0791 at the end of the infusion.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[Pharmacokinetic and clinical studies of imipenem/cilastatin sodium in the pediatric field]. 346 84

Aztreonam (AZT) was evaluated for its safety, clinical efficacy and pharmacokinetics in children. AZT was effective in all the 16 children with Gram-negative bacterial infections. The diagnoses included acute bronchitis and pneumonia (11), UTI (2), UTI with bacteremia (1), purulent meningitis (1) and acute mucositis (1). The etiologic agents were H. influenzae (10), B. catarrhalis (1), N. meningitidis group C (1), E. coli (3) and P. aeruginosa (2). The serum half-life was approximately 1.2 hours after intravenous bolus injection. Penetration into the inflamed cerebrospinal fluid was good not only in acute purulent meningitis but also in viral meningitis. From the present study, AZT is a safe and effective antibiotic when used in children with Gram-negative bacterial infections.
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PMID:[Clinical and pharmacokinetic evaluations of aztreonam in children]. 409 55

Sulbactam/cefoperazone (SBT/CPZ), a fifty-fifty combination of a beta-lactamase inhibitor, SBT, and an already marketed broad spectrum cephalosporin, CPZ, was evaluated for its efficacy and safety in 25 children. The diagnoses included purulent lymphadenitis, pneumonia, acute UTI, bacteremia and purulent meningitis. SBT/CPZ was effective in all the 20 cases with bacterial infections, but strains highly resistant to CPZ were not isolated in this study. The serum and cerebrospinal-fluid levels of SBT were grossly parallel with those of CPZ, and the half-life of the serum SBT was 0.754 hour. Although severe adverse reactions were not encountered with SBT/CPZ therapy, loose stools in 20% and diarrhea in 16% of the cases were observed.
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PMID:[Clinical evaluation of sulbactam/cefoperazone in the pediatric infections]. 609 62

Ninety-five infants, less than 2 months of age, diagnosed as urinary tract infections, from July 1984 to June 1991, were reviewed. Their urinary cultures, obtained either by suprapubic puncture or via catheterization, all had bacterial colony counts of over 10(5)/ml. In this survey, males predominated (91.6%). Fever and gastrointestinal problems were the two most prevalent signs. E. coli was the most common causative organism, and gentamicin was the most effective antibiotic. Vesicoureteral reflux (VUR), the most common anomaly, was found in one-third (25/76) of patients on voiding cystourethrography, with 20% being high grade (Gr. IV or Gr. V). Eleven cases (11%) had bacteremia, and one case had bacterial meningitis. Sixty-seven cases were followed up in our hospital and seven of them had second infections within a year of their first UTI. The mean period between episodes was less than two months. All these patients had urinary tract anomalies and received oral chemoprophylactic drugs for variable lengths of time. Five of the seven recurrences were caused by resistant bacilli. Continuous oral antibiotic prophylaxis and regular follow-up examinations were the rules of prevention for further infection and future renal impairment. These preventive methods are especially important in young infants with UTI.
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PMID:Urinary tract infection in infants less than 2 months of age. 808 50

This randomized prospective study evaluated the safety and efficacy of a single oral dose of OFL compared to a single parenteral dose of CTRX prior to TURP. 191 patients (mean age: 68.7 +/- 6.2 years) with bacterial free urine before surgery were enrolled and received either OFL: 400 mg per os (n = 95) or CTRX: 1 g intrasmuscularly (n = 96) at the pre-anaesthetic medication time (two hours prior TURP). Two urine cultures were obtained: on the day of the patient's discharge and within one month after surgery. Blood cultures were performed in case of temperature > 38 degrees 5C. Treatment failure was defined as bacteriuria > 10(5) CFU/ml and/or in case of positive blood culture after surgery. 182 patients were evaluable for efficacy. They were similar with respect to age, prostatic resection, histology, duration of post operative catheterization in the two treatment groups. On discharge from the department, 93.2% of the patients in the OFL group had sterile urines versus 94.6% in the CTRX group. In failure, causative pathogens were in the OFL group: 3 enterococcus, 1 acinetobacter, 1 staphylococcus, 1 citrobacter; in the CTRX group: 1 acinetobacter, 2 citrobacters, 1 enterococcus, 1 streptococcus. No bacteremia occurred. After one month of follow-up, 171 patients were evaluable (success on discharge from the department): the rates of success were: 93.5% in the OFL group and 90.3% in the CTRX group. Tolerance was good in both groups. These two drugs are as effective and as well tolerated for prevention of post operative UTI in TURP. But Ofloxacin is cost effective and simplest for use.
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PMID:[Oral ofloxacin versus intramuscular ceftriaxone in antibiotic prophylaxis in transurethral prostate resection]. 840 17

Infectious diseases are a common cause of increased morbidity and mortality in elderly patients and present a frequent problem in the geriatrician's daily practice. Infections in the elderly are quite different from infections in a younger population. These differences are due to Age-related alterations in immunology Different epidemiology and bacteriology Increased morbidity and mortality Altered clinical presentation Concommittant disability and comorbidity in many older patients Different approaches to therapy. This article is an attempt to discuss these various aspects of infectious disease in the elderly. The most important infections in the elderly are caused by bacteria. Incidence and bacterial spectrum depends on the site of infection and whether the patient is hospitalized, living in a nursing home or in the community. Pneumonia, UTI and pressure ulcer infections are more frequent in patients living in nursing homes than in community dwelling older people. Infections are a frequent cause of hospitalization in elderly people and hospitalization on the other hand is a risk factor for life-threatening nosocomial infections, caused by invasive diagnostic procedures and frequent use of urinary and venous catheters. Infections in the elderly are often accompanied by serious complications as bacteriemia (pneumonia), frequent recurrence (UTI), perforation and abscess (abdominal infections) and severe disability (pressure ulcer infections). Because of these serious and frequent complications mortality of infections is higher in older patients than in younger people. Elderly patients with infectious disease often present in the same way as younger patients do. Many elderly however present with non-specific clinical symptoms and non-specific functional decline which makes an accurate diagnosis difficult and may lead to a life-threatening delay of diagnosis and therapy. In older patients with unexplained functional decline, physicians must be aware of the possibility of a serious infection. Moreover, the physician can not rely on typical signs of infections as fever. In the elderly the fever response is often blunted even in the presence of bacteremia. Leokocytosis may be absent and elevation of acute phase protein is a more reliable marker of infection than elevation of erythrocyte sedimentation rate. Clinical suspicion of bacterial infection in elderly patient should prompt Careful anamnesis and clinical investigation Hospitalization if necessary Diagnostic procedures without delay including blood cultures Immediate empiric antibiotic therapy taking into account the site of infection, if the infection is community acquired or nosocomial and the most likely bacterial spectrum and local resistance factors. The use of broad spectrum antibiotic substances with a low side effect profile and pharmacokinetic properties which are suitable for elderly patients.
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PMID:[Infection in the elderly--what is different?]. 1113 Jan 88

Urinary tract (UTI) is a major disease burden for many patients with diabetes. Asymptomatic bacteriuria is several-fold more common among women and acute plyelonephritis is five to ten times more common in both sexes. The complications of pyelonephritis are also more common in patients with diabetes. These complications include acute papillary necrosis, emphysematous pyelonephritis, and bacteremia with metastatic localization to other sites. The management of urinary infection in patients with diabetes is essentially the same as patients without diabetes. Most infections should be managed as uncomplicated except when they occur in a milieu with obstruction or other factors that merit a diagnosis of complicated UTI. Strategies to prevent these infections and reduce morbidity should be a priority for research.
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PMID:Urinary tract infections in adults with diabetes. 1129 10


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