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Query: UMLS:C0014118 (endocarditis)
 15,629 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The prophylactic use of antimicrobial agents is recommended for prevention of numerous infections, including tuberculosis, endocarditis, rheumatic fever, recurrent cellulitis and lymphangitis in patients with lymphedema, meningococcal meningitis, and bite wounds. In addition, the prophylactic use of antimicrobial agents has proved effective in certain surgical procedures such as various abdominal operations, hysterectomy, and major operations that involve the head and neck. Except for oral bowel preparations, antimicrobial prophylaxis should be limited, in general, to the operative period. Prolonged perioperative prophylaxis has not been shown to enhance effectiveness and may result in increased toxicity, resistant superinfections, and inflated costs. The investigation of antimicrobial prophylaxis necessitates adequate evaluation of the potential advantages and disadvantages in a prospective, double-blind fashion.
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PMID:Prophylactic use of antimicrobial agents in adult patients. 140 80

Decisions on treatment times with antibiotics are often arbitrary and based on empirical decisions or clinical trials which are too small to exclude even considerable differences between two study groups. Single-dose treatment of uncomplicated cystitis in women has been advocated by many but a careful analysis of available information clearly shows that a single-dose has so far always been inferior to 3-day or greater than 5-day treatment. With trimethoprim-sulphonamide combinations, no further efficacy is gained by increasing the treatment time in uncomplicated cystitis above three days while frequency of side effects increases drastically with extended treatment. In contrast, treatment with beta-lactams, for less than five days seems to result in unacceptable failure rates. In pyelonephritis there are few studies of the efficacy of antibiotic treatment for less than ten days. A comparison of two and six weeks' treatment showed no advantages with the extended time. There has also been a tendency towards reduced treatment times in upper respiratory tract infections such as streptococcal pharyngotonsillitis. However, two studies comparing 10-day treatment to 7-day and 5-day treatments, respectively, have clearly shown that the shorter treatment times give much higher rates of both clinical and bacteriological relapse. In more severe infections such as meningitis, no studies comparing treatment times have been carried out. It seems possible to use treatment for five days or less in meningococcal meningitis while other pathogens should be treated for ten days or longer. In endocarditis, the treatment time must vary with causative pathogens and can only rarely be shorter than four weeks.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Efficacy and safety of antibiotic treatment in relation to treatment time. 209 14

Prophylactic antimicrobial agents are recommended for prevention of a variety of conditions, including tuberculosis, endocarditis, rheumatic fever, recurrent cellulitis and lymphangitis in patients with lymphedema, meningococcal meningitis, bite wounds, and herpes virus infections. In addition, prophylactic antimicrobial agents have proved effective in certain surgical procedures such as a variety of abdominal operations, hysterectomy, and head and neck operations for cancer. Except for oral bowel preparations, administration of antimicrobial agents for prophylaxis should be limited, in general, to the perioperative time period. Doses given more than an hour before or 3 hours after a surgical procedure have not been shown to increase effectiveness, and such an approach increases the cost and the probability of toxicity and superinfection. Investigation of antimicrobial prophylaxis necessitates adequate evaluation of potential advantages and disadvantages in prospective double-blind fashion.
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PMID:Prophylactic use of antimicrobial agents in adult patients. 368 58

Penicillin made possible the cure of many common, and also the most serious, infections, such as meningococcal meningitis and bacterial endocarditis, often with few or no sequelae. Endocarditis had been invariably fatal. Semisynthetic penicillins added new dimensions of convenience of administration and a broader spectrum in the presence of many beta-lactamases. A quantum step forward was permitted by the derivatives of cephalosporin C. Specific clinical advances were (1) the opportunity to use these in some penicillin-allergic patients, (2) activity against wider range of Gram-negative bacilli, (3) activity against Bacteroides fragilis (cefoxitin), (4) more complete renal excretion after oral cephalosporins than with oral penicillins, and (5) delayed renal excretion. Major remaining problems limiting beta-lactam use are (1) allergy, (2) resistant organisms, (3) relatively poor entry into the cerebrospinal fluid (especially of cephalosporins, (4) some nephrotoxicity, (5) local irritation of veins and tissues during administration, and (6) poor results in patients with agranulocytosis.
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PMID:Achievements and problems from the view of a physician. 610 21

A case of Staphylococcus aureus meningitis (SAM) secondary to endocarditis is presented. The presence of a petechial rash affecting the lower limbs led to an initial presumptive diagnosis of meningococcal meningitis. There were no stigmata of endocarditis at presentation, though these subsequently developed. Underlying endocarditis should be diligently sought in any patient presenting with spontaneous SAM, even if typical stigmata are initially absent. In view of the association with skin lesions and neurological complications, S. aureus endocarditis may mimic the classical presentation of meningococcal sepsis.
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PMID:Staphylococcus aureus endocarditis presenting as meningitis and mimicking meningococcal sepsis. 1056 77

In recent supplement of neuroendocrinology letters, first time the authors from West and East, North and South of EU and the "Third World" present data on neuroinfections in high technology society - on nosocomial meningitis and vice versa in low technology and income countries of sub-Saharan Africa. 14 years survey of 171 cases of nosocomial paediatric meningitis is presented by Rudinsky et al. [1] and subpopulations of Acinetobacter baumannii and Pseudomonas aeruginosa [1,2] within last 20 years are briefly analyzed by Huttova et al. [2] and Ondrusova et al. [3]. All cases were complicating high technology procedures, such as neurosurgery, very low birth weight neonates after shunt implants etc. Current problems of management of nosocomial meningitis are reviewed by Bauer et al. [4] and consequence of inappropriate therapy by Huttova et al. [5]. Another high technology associated infection is septic embolisation followed by brain abscess and meningitis in patients with endocarditis after cardiac surgery (Kovac et al.) [6]. Experience from more than 600 cases is discussed in the article by Karvaj et al. [7] who outlines extremely high mortality in patients with endocarditis embolizing to central nervous system - up to 60%. The rest of papers are in contrary to problems of neuroinfections in EU and US focused on meningitis and cerebral malaria as commonest neuroinfections in the third world: 261 cases of cerebral malaria are discussed in a brief research note by Sudanese team of tropical programme in area of famine and civil war in southern Sudan (Bartkovjak and Ianetti et al.) [8]. Fungal neuroinfections complicating AIDS are of decreasing trend as reported by Njambi et al. from Kenya [9] and data from 497 cases from Uganda, Ethiopia and Burundi are presented by Benca et al. [10]. Finally an outbreak of meningococcal meningitis is reported by Benca et al. [11] from meningitis belt in Darfur and southern Sudan. We hope that the supplement may show difference in etiology, risk factors, therapy and outcome of neuroinfections (which is a burning public health and social problem in tropics) in other third world countries versus developed high-tech medical settings of US, EU and other high income countries, as presented by Benca et al. [12].
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PMID:Neuroinfections in developed versus developing countries. 1755 64