Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0017160 (gastroenteritis)
 11,398 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Campylobacter jejuni is the most common bacterial cause of gastroenteritis and is often missed by routine stool cultures. Patients may present with a clinical syndrome and endoscopic findings that are similar to acute ulcerative colitis. Ciprofloxacin is currently the recommended antibiotic therapy.
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PMID:Campylobacter jejuni enteritis mistaken for ulcerative colitis. 154 61

Ciprofloxacin, a quinolone antibiotic which exhibits minimal side effects and has broad antimicrobial spectrum, is being used frequently to treat various infections. A patient is reported who had previously maintained a stable prothrombin time on Coumadin for 5 years, and who exhibited a marked prolongation of prothrombin time when placed on ciprofloxacin for gastroenteritis.
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PMID:Ciprofloxacin interaction with sodium warfarin: a potentially dangerous side effect. 193 Mar 95

The number of reports of outbreaks of salmonella gastroenteritis in hospitals has decreased since 1984 but the number of outbreaks in institutions such as old peoples' homes have increased during 1988. Foods, particularly chickens, remain a source of salmonellae and particular attention has to be paid to training and practices in food preparation areas. Staff who are convalescent are very unlikely to be sources of salmonella and do not need to be excluded unless they handle food that receives no further cooking. Outbreaks that do occur can usually be controlled by patient isolation and good control-of-infection measures and an effective Major Outbreak Control Plan is necessary. In some large old hospitals cross infection outbreaks may continue despite good control-of-infection measures. Antibiotics have been contraindicated in the treatment of salmonella gastroenteritis, but the new 4-quinolone antibiotics have demonstrated potential. Ciprofloxacin was used successfully in two outbreaks of salmonella gastroenteritis at a dose of 500 mg bd orally for seven days. Relapses did not occur and resistance did not develop. Ciprofloxacin should be considered as a therapeutic adjunct to control of infection measures in cross infection outbreaks in these situations.
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PMID:Management of institutional outbreaks of Salmonella gastroenteritis. 229 44

Ciprofloxacin and other related fluorinated 4-quinolones have microbiological and pharmacokinetic properties that suggest they could be useful agents in the management of typhoid fever and bacterial gastroenteritis. Initial studies confirm that this is the case. Against fully sensitive Salmonella typhi ciprofloxacin is clinically as effective as chloramphenicol or co-trimoxazole. It is also effective treatment for antibiotic-resistant strains which cause epidemic and endemic infection throughout the world. Furthermore, ciprofloxacin appears to eliminate chronic carriage of Salm. typhi more efficiently than other antibiotics. Ciprofloxacin has excellent in-vitro activity against all the bacterial pathogens that commonly cause infective diarrhoea. There are limited data concerning its use in the treatment of shigella dysentery but, in appropriate situations, ciprofloxacin is effective treatment for salmonella enteritis and is also effective in infections complicated by septicaemia and bone and liver abscesses. Ciprofloxacin appears to be of benefit in Campylobacter jejuni enteritis and is effective in the treatment of travellers' diarrhoea were enterotoxigenic Escherichia coli and shigellae are most important.
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PMID:Treatment of typhoid fever and infectious diarrhoea with ciprofloxacin. 229 45

Malignant external otitis (MEO) is still a potentially lethal disease. Early treatment based on a correct diagnosis is the most important single factor in achieving a cure for the disease. The preferred treatment is long-term systemic antibiotics followed by surgical intervention. Hyperbaric oxygen therapy may be supplemented in refractory cases. A new fluoroquinolone, Ciprofloxacin, has been successfully used in four cases of MEO which did not respond to the accepted treatment. Ciprofloxacin is active against a broad spectrum of bacteria, including Pseudomonas aeruginosa, and several clinical studies have demonstrated its efficacy in the treatment of urinary tract and soft tissue infections, osteomyelitis, pneumonia, and gastroenteritis. This report is the first of which we are aware to document the use of Ciprofloxacin in the treatment of MEO.
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PMID:Malignant external otitis: treatment with fluoroquinolones. 317 62

The majority of gastrointestinal infections due to "thermophilic" Campylobacter is self limiting and does not need antibiotic treatment. Anyhow there are some serious cases (sepsis, persistent and relapsing gastroenteritis, severe immunodeficient patients) which require appropriate therapy. The susceptibility of 15 strains of Campylobacter jejuni and of 1 strain of C. coli, isolated from patients with acute gastroenteritis, has been studied against 12 antibiotics with the broth microdilution method at two different inocula (10(3)-10(4) CFU/ml and 10(7)-10(8) CFU/ml), and with the standard agar disk diffusion test, modified to allow sensitivity testing of Campylobacter. For each antibiotic, the geometric mean of MIC and of MBC and the concentrations of the various drugs needed for inhibition and killing of 50 and 90% of the strains (MIC-MBC50 and MIC-MBC90 respectively) have been calculated. Finally the percentage of resistant strains and the percentage of tolerant strains (ratio MBC/MIC: greater than or equal to 32) at low and high inoculum was determined. Erythromycin and aminoglycosides resulted the most active antibiotics against Campylobacter, being bactericidal as well as bacteriostatic at both low and high inoculum. Among the beta-lactams, cefotaxime was the most active, followed by piperacillin and ampicillin. Ceftazidime, aztreonam and rifampin were inactive. Ciprofloxacin, cotrimoxazole and tetracyclines showed some activity against Campylobacter at low inoculum. The agar disk diffusion method cannot be used for the "routinary" assay of susceptibility of Campylobacter, because it is a "naggy" microaerophilic organism.
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PMID:[Bacteriostatic and bactericidal activity, resistance and tolerance of 16 strains of thermophilic Campylobacter to 12 antibiotic drugs]. 345 49

Since the introduction of the floroquinolones for clinical use in the late 1980s, they have been used successfully for a large number of clinical situations. As experience accumulates, the indications and optimal use of these agents gradually become more clear. Unfortunately, two of the pathogens for which these agents were most promising--methicillin-resistant S. aureus and P. aeruginosa--have developed resistance. Currently, the quinolones are excellent agents for the treatment of complicated urinary tract infections, including those caused by P. aeruginosa. In addition, they should be considered as initial therapy for the treatment of severe bacterial gastroenteritis. The quinolones should also be considered when attempting to eradicate the chronic stool carriage of S. typhi. These agents also offer significant advantages in the treatment of osteomyelitis and prostatitis caused by gram-negative bacilli that frequently require prolonged antimicrobial therapy. Treatment of STDs, especially gonorrhea, is another clear indication for their use. Ciprofloxacin should be considered as initial therapy in patients with malignant otitis externa and in cystic fibrosis patients with exacerbations secondary to P. aeruginosa in the sputum. The role of the quinolones for soft tissue and respiratory tract infections is less clear and their use probably should be limited to certain situations in which there is a clear advantage over beta-lactams, macrolides, and trimethoprim-sulfamethoxazole. The new quinolones, fleroxacin, perfloxacin, sparfloxacin, and tosufloxacin, which are being developed and tested for clinical use, will offer advantages in once-a-day dosing and better gram-positive antimicrobial activity. Because the inappropriate or heavy use of the fluoroquinoles has resulted in considerable development of resistance, it is imperative that they be used only when there is a distinct advantage over conventional therapy in terms of efficacy, safety, or cost. Otherwise, the rapid development of resistance will jeopardize the potentially bright future for this entire class of compounds.
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PMID:Fluoroquinolones. 749 Apr 40

An audit of ciprofloxacin use at Southmead Hospital, Bristol was carried out for forty patients treated in early 1992 employing a modified Delphi technique with six assessors. Most patients assessed (20/40, 50%) had urinary tract infections (UTIs), 5/40 (12.5%) had chest infections, 4/40 (10%) had bacterial gastroenteritis and 3/40 (7.5%) had either bacteraemia or infection following an orthopaedic procedure. A likely bacterial pathogen was isolated from 32/40 (80%) of patients; 14/32 (44%) had Pseudomonas aeruginosa infections and from the remainder Enterobacteriaceae including Salmonella spp. (non-typhoid) were cultured. Oral therapy with ciprofloxacin was used in 37 (93%) of the 40 patients, and the three others received iv treatment. In 21/35 (60%) of patients where an assessment was made by majority scoring, a quinolone was felt to be clinically justified. A quinolone was least likely to be thought justified if the patient had a chest infection. The assessors had few concerns about the effectiveness or toxicity of ciprofloxacin but for 41% (14/34) of patients, where there was a majority opinion, a cheaper alternative was felt to be available; most of these patients had hospital-acquired UTIs caused by Enterobacteriaceae. The duration of therapy was felt to be too long in 35% (10/29) of patients, mainly because of prolonged treatment of UTIs. In some cases of P. aeruginosa infection the assessors would have used higher doses than those prescribed. Ciprofloxacin was the quinolone of choice in 24/32 (75%) of assessable cases. Norfloxacin was chosen to treat UTI due to multi-resistant Enterobacteriaceae in 6.2% (2/32) cases.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:An audit of ciprofloxacin use in a district general hospital. 853 66

Vibrio parahaemolyticus causes seafood-borne gastroenteritis in humans. It is particularly important in Japan, where raw seafood is frequently consumed. Fluoroquinolone is one of the current drugs of choice for treating patients infected by V. parahaemolyticus because resistant strains are rarely found. To study a possible fluoroquinolone resistance mechanism in this organism, nucleotide sequences that are homologous to known gyrA and parC genes have been cloned from V. parahaemolyticus AQ3815 and sequenced by amplification with degenerate primers of the quinolone resistance-determining region (QRDR), followed by cassette ligation-mediated PCR. Open reading frames encoding polypeptides of 878 and 761 amino acid residues were detected in the gyrA and parC homologues, respectively. The V. parahaemolyticus GyrA and ParC sequences were most closely related to Erwinia carotovora GyrA (76% identity) and Escherichia coli ParC (69% identity) sequences, respectively. Ciprofloxacin-resistant mutants of AQ3815 were obtained on an agar medium by multistep selection with increasing levels of the quinolone. One point mutation only in the gyrA QRDR was detected among mutants with low- to intermediate-level resistance, while point mutations in both the gyrA and parC QRDRs were detected only in strains with high-level resistance. These results strongly suggest that, as in other gram-negative bacteria, GyrA and ParC are the primary and secondary targets, respectively, of ciprofloxacin in V. parahaemolyticus.
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PMID:Sequence analysis of the gyrA and parC homologues of a wild-type strain of Vibrio parahaemolyticus and its fluoroquinolone-resistant mutants. 1022 29

Non-typhi Salmonella spp. are a common cause of gastroenteritis. In patients with a greater risk of bacteremia (those with immunosuppression, cardiovascular abnormalities, prostheses, those older than 50, especially those with atherosclerosis, and neonates) the need for antibiotic treatment may be affected by the presence of resistance. We retrospectively studied the evolution of antibiotic resistance of 917 strains isolated from feces, during the period between January 1992 and May 1998. Resistances of 32.1% to ampicillin, 14.6% to amoxicillin- clavulanic acid, 14.8% to chloramphenicol, 3.5% to trimethoprim-sulfamethoxazole and 1.8% to gentamicin were found. All the strains were susceptible to cefotaxime and ciprofloxacin. There was a distinct increase in the ampicillin resistance (12.9% in 1992 to 52.5% in 1998), amoxicillin-clavulanic acid (8.3% in 1992 to 23% in 1998), chloramphenicol (8.3% in 1994 to 23% in 1998) and trimethoprim-sulfamethoxazole (0% in 1992 to 6.6% in 1998). The typhimurium serotype showed higher resistance levels than the enteritidis serotype. Ciprofloxacin and trimethoprim-sulfamethoxazole (in children), used as first-choice antibiotics in patients with intestinal infections caused by non-typhi Salmonella spp., show excellent activity in our area.
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PMID:[Susceptibility of non-typhi Salmonella spp. at the Galdakao Hospital (1992-1998)]. 1137 50


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