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

Five patients with bacterial endocarditis who were allergic to penicillin were treated successfully with vancomycin. The causative microorganisms were Streptococcus bovis, S faecalis, S agalactiae, S intermedius, and Staphylococcus aureus. Except for the strain of S faecalis, vancomycin was bactericidal against these organisms at easily achievable serum concentrations. To insure a bactericidal serum titer of 1:8 or greater, streptomycin was added in the therapy of the case caused by S faecalis. There was no toxicity from vancomycin therapy in our patients except for mild phlebitis at the infusion site. Vancomycin appears to be an effective alternative to penicillin in individuals with endocarditis due to susceptible organisms. Vancomycin in combination with an aminoglycoside may be appropriate therapy for enterococcal endocarditis.
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PMID:Treatment of bacterial endocarditis with vancomycin. 10 23

Fifteen patients with bacterial endocarditis were treated with vancomycin between 1967 and 1976. The indications for vancomycin therapy were penicillin-cephalosporin allergy in six patients, antibiotic resistant bacteria in six, initial therapy in one and culture-negative endocarditis in two. The causative microorganisms were Staph. epidermidis (four patients), Staph. aureus (two patients), diphtheroids (four patients), viridans streptococci (two patients) and enterococci (one patient). Minimum inhibitory concentrations of vancomycin for these organisms ranged from 0.8 to 3.1 micrograms/ml. The patients received vancomycin for two to 10 weeks (mean five weeks). Cure was achieved in 13 patients, including six with prosthetic valve endocarditis (PVE). Two patients had a relapse of PVE and cultures of blood or heart valve were positive within two months of vancomycin therapy. Vancomycin serum levels did not exceed 50 micrograms/ml, and no serious drug toxicity was encountered in any patient. Three patients had minimal audiogram changes beyond the social hearing range. One patient had mild phlebitis and a rash, and one patient had a transient leukopenia. Vancomycin is an effective nontoxic antibiotic in patients with endocarditis when penicillin or cephalosporin therapy is not appropriate.
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PMID:Vancomycin therapy of bacterial endocarditis. 15 80

Ten patients with a mean age of 34.1 years with infective endocarditis (55% of cases due to Staphylococcus aureus) were treated with cephradine. The peak serum levels of cephradine (8-42 microgram/ml) were 3- to 17-fold higher than the minimum inhibitory concentrations of cephradine against pathogenic strains of S aureus (1.2-4 microgram/ml). Patients treated with cephradine became afebrile in 2 to 13 days of therapy, and their white blood cell count returned to a normal level in 3 to 30 days. Cephradine therapy was well tolerated without any incidence of phlebitis. The drug could be administered by three different routes. Cephradine is a useful cephalosporin for treatment of nonenterococcal gram-positive endocarditis in young heroin addicts.
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PMID:Cephradine in the treatment of infective endocarditis. 45 35

During a 12-month period, 23 patients aged 12 to 78 years were treated for 8 to 40 days (mean, 23 days) at home with intravenous (i.v.) antibiotics. Diseases treated included bone and joint infection (14 patients), blastomycosis (two), actinomycosis (two), staphylococcal bacteremia (two), endocarditis (two), and candidal pyelonephritis (one). After initial in-hospital training, patients self-administered their drugs through a heparin-lock i.v. cannula, which was changed regularly by a visiting home care nurse. Antibiotics administered included cloxacillin, penicillin G, cephalosporins, gentamicin, carbenicillin, and amphotericin B. Patient and family acceptance of the program was good, the program was therapeutically effective, and, apart from a decreased prevalence of phlebitis with the heparin lock at home, side effects were no different from those of in-hospital-treated patients. The cost of home therapy was $ 40 per patient-day compared with an estimated $ 137 had the patients remained in hospital. Most patients were able to resume normal activities while receiving home i.v. therapy.
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PMID:Intravenous antibiotic therapy at home. 71 41

Septic phlebitis is characterized clinically by a local syndrome in an arm, the chest or a leg, by an irregular temperature (toothsaw curve), by blood cultures that are simultaneously or successively positive for one or several pathogenic microorganisms, by repeated, multiple infected embolism and by the possibility of endocarditis as a complication. Septic phlebitis occurs either spontaneously (staphylococcosis, syndrome of angina pectoris and infarction), or through secondary infection by secondary microbial colonization of a thrombosis of gynecological or obstetrical origin or, thirdly, as the consequence of venous catheterization (perfusion, pacemaker, explorations). Prevention is based on the selection of the material (silastic piercing catheters), the choice of the site of injection, the observation of strict surgical asepsis and of choice of the fluid injected (no corticoids, nor heparin which inactivates the oligosaccharides). As regards the curative treatment, no use should be made either of heparin or of anti-inflammatory agents (especially no corticoids); first of all, the material that has caused the thrombophlebitis should be withdrawn immediately; secondly, 24 to 36 hours later, a specific antibiotic treatment should be instituted and after two weeks, if still necessary, surgical ligation may be carried out of the inferior vena cava, the subclavian vein or the brachiocephalic venous trunk, depending on the localization of the phlebitis.
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PMID:[Septic phlebitis. Its consequences and its treatment]. 86 44

Sixteen cattle affected by thrombosis of the posterior vena cava were examined post mortem and the various lesions are described. The thrombus was in the hepatic portion in 12 animals and in the intrathoracic part in four. Thrombi had formed as a result of phlebitis in 13 cases in which hepatic or post-diaphragamatic abscesses were present but the aetiology of the other three was not discovered. Embolism from the vena cava thrombus resulted in pulmonary lesions in every case: these included pulmonary arterial thrombo-embolism, pulmonary arteritis, pulmonary endarteritis, chronic suppurative pneumonia and the formation of multiple pulmonary abscesses. The pulmonary arterial lesions had given rise to mycotic aneurysms of that vessel and rupture of these was followed by massive haemoptysis or intrapulmonaary haemorrhage. Pulmonary arterial aneurysms are not common in man and are very rare in animals, except in association with vena cava thrombosis of cattle. However, the "Hughes-Stovin" syndrome of man has some features in common with the condition described in cattle and these are discussed. The different sequelae of posterior vena cava thrombosis and infective endocarditis of the right heart in cattle are also considered.
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PMID:Pulmonary arterial thrombo-embolism and pulmonary arterial mycotic aneurysms in cattle with vena caval thrombosis: a condition resembling the Hughes-Stovin syndrome. 98 55

Sixty patients were treated with ciprofloxacin: 19 received only intravenous ciprofloxacin, 41 received intravenous followed by oral ciprofloxacin. The mean duration of therapy was 28 days in the intravenous only group and 10 days intravenously and 80 days orally in the intravenous/oral group. Ten (17 percent) patients received 200 mg intravenously every 12 hours and 49 (82 percent) 300 mg every 12 hours. The overall clinical response was 85 percent, with a bacteriologic response of 70 percent. The lowest bacteriologic response (38 percent) occurred in the 13 patients treated for Pseudomonas respiratory infection. Clinical response occurred in 24 of 26 patients with soft-tissue infection, and 10 of 13 patients with respiratory infection. Of three patients with endocarditis, therapy failed in two with resistance developing in Pseudomonas aeruginosa and Staphylococcus aureus. Overall, 19 percent of 26 P. aeruginosa isolates developed resistance to ciprofloxacin. Toxicity was minor, with phlebitis and nausea most commonly reported. Intravenously administered ciprofloxacin or intravenous followed by oral ciprofloxacin is a safe, effective therapy for serious infections due to multiply resistant gram-negative bacteria, including P. aeruginosa and S. aureus.
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PMID:Intravenous/oral ciprofloxacin therapy of infections caused by multiresistant bacteria. 251 58

Three hundred patients submitted to bedside heart catheterization (BHC) from 1973 to 1985 were studied, in order to assess advantages and risks of the procedure. Two-hundred and sixty seven patients (89%) suffered a myocardial infarction (MI) and 146 of them were in functional class (Killip) II, 36 in FC III and 71 in FC IV. Thirty cases were submitted to BHC due to congestive heart failure. BHC was successful in 288 patients (96%) and the wedge pressure (WP) could be measured in 236 cases (78.7%). The WP was less than 18 mmHg in 47.2% of the patients in FC II, in 44.9% of the patients in FC III and in 35.3% of those in FC IV. Minor complications occurred in 33 cases (11.0%); balloon rupture in 12 (4.0%), transient arrhythmias in 11 (3.7%) and lumen obstruction in another 10 cases (3.3%). Forty five patients (15.0%) presented major complications related to the procedure: pulmonary infarction (PI) in 18 cases (6%), phlebitis in 15 cases (5%), sustained arrhythmias in 10 cases (3.3%), pulmonary artery rupture and endocarditis each in 1 case. The mean age between the group of patients with and without complications was similar the maintenance time as greater in the group of patients with complications: 3.4 +/- 0.2 vs 2.7 +/- 0.1 days (p less than 0.05). We concluded that many patients with clinical evidence of heart failure had WP smaller than 18 mmHg, emphasizing the value of the procedure in patients with complicated MI. The maintenance time was associated with the occurrence of complications, mainly PI and phlebitis.
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PMID:[Bedside cardiac catheterization. Advantages and disadvantages]. 260 78

During a 38-month period the bacteremias developing in patients on hemodialysis from three centers of the Barcelona area were evaluated to assess their incidence, characteristics, and response to therapy. In the overall 13376 months of hemodialysis of the study, 75 episodes of bacteremia were detected in 64 patients; this amounts to an incidence of 5.6 episodes per 1000 hemodialysis months. The most common sources of becteremia were intravenous catheters (44%), which were mainly used as temporary vascular access, followed by the definitive vascular access (26%), the genitourinary system (10%), and the lung (6%). Twenty-seven episodes of bacteremia developed in 24 patients in whom dialysis had been started in the two previous months (11% of the overall number of new patients), and, in them, 77% originated in an intravenous catheter, while this was the origin of bacteremia in only 23% of the remaining patients. 72% of bacteremias were caused by gram positive organisms, particularly Staphylococcus aureus and Staphylococcus epidermidis (60%), followed, in frequency order, by aerobic gram negative bacilli (25%), particularly Escherichia coli and Pseudomonas. Stpahylococci were significantly associated with the vascular access, either if this was a catheter or not (81% of instances), while gram negative bacilli were associated with sources different from the vascular access (48% of instances). Severe complications included 2 cases of aortic valve endocarditis, one hemorrhagic shock caused by rupture of an infected vascular access, and one suppurative phlebitis associated with a hemodialysis catheter. Staphylococcal sepsis was randomly treated with vancomycin or vancomycin plus gentamicin, without differences in the results.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Prospective study of 75 episodes of sepsis in hemodialysed patients]. 270 87

Fourteen patients with serious infections caused by Staphylococcus aureus and other gram-positive bacteria were prospectively treated with chromatographically purified vancomycin in an open-label, nonrandomized study, between December 1986 and June 1987. Five patients were excluded from the evaluation of efficacy. Among the nine evaluable patients, cure was achieved in six patients--a success rate of 67%. One patient had a relapse of osteomyelitis, and cultures of draining pus were positive for oxacillin-resistant S aureus within three weeks after the discontinuation of vancomycin therapy. One patient failed to respond to vancomycin therapy for S aureus-induced endocarditis, meningitis, and osteomyelitis; in another patient, the treatment failed to reverse the course of S aureus septicemia. No serious drug toxicity, for example, nephrotoxicity, was encountered in any patient. One patient (7%) experienced mild ototoxicity. Four patients (29%) had mild phlebitis, two patients (14%) had a transiently positive Coombs' test, and one patient (7%) had a "red neck syndrome" and "pain and spasm syndrome." Chromatographically purified vancomycin is an effective antibiotic in the treatment of serious infections caused by susceptible gram-positive bacteria. Some minor side effects of vancomycin may not be due to impurities in the preparation but rather to the vancomycin itself.
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PMID:Chromatographically purified vancomycin: therapy of serious infections caused by Staphylococcus aureus and other gram-positive bacteria. 285


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