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Query: UMLS:C0027497 (nausea)
 23,468 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Twenty-seven patients with chronic osteomyelitis were treated with oral ciprofloxacin, 500 mg (13 patients) or 750 mg (13) twice daily and one patient was treated with 300 mg twice daily intravenously. Treatment was given for 17-189 days (mean 69). Twenty-three patients had prosthetic implants, 16 patients had infections caused by one bacterium and 11 had polymicrobial infections. The predominant organisms were strains of Enterobacteriaceae, Pseudomonas aeruginosa and Staphylococcus aureus. Cure was obtained in 20 patients and improvement in four. Three patients failed to respond to therapy. Concentrations of ciprofloxacin, measured in pus 1 h after 500 mg orally ranged from 0.6-1.3 mg/l, whilst 2 h after 750 mg orally concentrations of 2.4-6.8 mg/l were found. Sterilization of pus and closure of infected wounds or draining sinuses were observed within four weeks of treatment in the majority of patients. Ciprofloxacin was well tolerated in 26 patients, whilst one had severe nausea after oral administration.
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PMID:Treatment of chronic osteomyelitis with ciprofloxacin. 273 24

Bone and joint infections have traditionally required long-term parenteral antimicrobial therapy, which is often expensive and inconvenient. Because of their excellent absorption and tissue penetration, oral quinolones may provide an alternative to parenteral therapy. This multicenter study was designed to evaluate the efficacy and safety of oral fleroxacin in osteomyelitis and septic arthritis. A total of 96 patients with either septic arthritis or acute or chronic osteomyelitis from 17 U.S. centers were enrolled in a noncomparative study using oral fleroxacin 400 mg per day. Patients with implantable devices were excluded. Proof of infection for evaluability required clinical findings in addition to bacteriologic recovery of a susceptible organism from synovial fluid or bone. Treatment lasted 2-12 weeks. Clinical and bacteriologic outcomes were judged at the conclusion of therapy and in the 6-week follow-up period. A total of 30 patients qualified for efficacy analysis (26 osteomyelitis, 4 septic arthritis). Bacteriologic cure was achieved in 77% of the osteomyelitis group and 50% of the septic arthritis group. Clinical cures were reported in 54% of the osteomyelitis group and 50% of the septic arthritis group. Staphylococcus aureus was the most frequently recovered pathogen (62% evaluable cases). Safety was evaluated in 96 patients. The most common side effects were nausea, vomiting, and skin reactions. Oral fleroxacin may be a safe, effective, and certainly less expensive alternative to standard intravenous antimicrobial therapy in patients with bone and joint infections.
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PMID:Efficacy of oral fleroxacin in bone and joint infections. 845 76

Patients with serious staphylococcal infections, e.g. endocarditis and osteomyelitis, need prompt and prolonged parenteral antibiotic treatment to ensure eradication of the causative pathogen. The major cost in the treatment of these infections is the long period of hospitalisation required for the administration of intravenous antibiotics. To shorten the hospitalisation period, outpatient treatment can be given to some patients. In this study, patients with acute exacerbations of chronic osteomyelitis (n = 44) or endocarditis (n = 10) were treated with intravenous teicoplanin. The pathogens were Staphylococcus aureus (n = 41, 13 of which were methicillin resistant) and coagulase-negative staphylococci (n = 13, one of which was methicillin resistant). After a mean loading dose of 15 mg/kg for 3 to 10 days, patients received teicoplanin 3 times a week at a dose (mean 15 mg/kg) individualised to achieve serum trough concentrations of approximately 10 mg/L for osteomyelitis and 20 mg/L for endocarditis. Treatment duration ranged from 28 to 150 (mean 62) days for patients with osteomyelitis and from 28 to 88 (mean 49) days for patients with endocarditis. 37 (84%) patients with osteomyelitis and 8 (80%) patients with endocarditis were treated successfully. Adverse events were observed in 9 patients and included rash (n = 3), thrombocytopenia (n = 3), and drug fever, pseudomembranous colitis, nausea, leucopenia and transient hearing impairment (one patient each). In conclusion, this study demonstrates that teicoplanin can be administered successfully in an outpatient setting according to a 3-times weekly schedule for the treatment of patients with staphylococcal osteomyelitis and endocarditis.
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PMID:Management of serious staphylococcal infections in the outpatient setting. 947 78

Osteomyelitis due to Cryptococcus neoformans are described in mostly 10% of patients with disseminated cryptococcosis, being direct inoculation even more uncommon. We report the case of an HIV-infected patient with history of recurring itching on his scalp and repetitive local trauma. For eighteen months, he noticed a painful and slow growing lump on his scalp. He was submitted to an excisional biopsy of the lesion but no etiological diagnosis was identified. After this procedure, the post-surgical wound never completely healed. At admission, the patient presented nausea and headache for three days and an open orifice into his skull. Investigations confirmed meningitis and skull osteomyelitis caused by Cryptococcus neoformans. He was treated with bone debridement and combined systemic antifungals, showing good clinical and laboratorial outcome. Cryptococcal disease should be included in the differential diagnoses of chronic osteomyelitis in HIV-infected patients and trauma is a possible source of infection.
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PMID:Chronic skull osteomyelitis due to Cryptococcus neoformans: first case report in an HIV-infected patient. 3052 89

BACKGROUND Medications are one of the most common causes of acute kidney injury (AKI). Elderly patients with diabetes mellitus and chronic kidney disease seem to be at particularly high risk for development of medication-induced AKI. Among antibiotics, the most commonly implicated agents are aminoglycosides, cephalosporins, trimethoprim-sulfamethoxazole, acyclovir, and amphotericin. Despite its widespread use, clindamycin has been rarely associated with AKI. CASE REPORT A 52-year-old male patient with type II insulin dependent diabetes mellitus without diabetic nephropathy was treated with clindamycin for chronic osteomyelitis. Five days following initiation of therapy, he developed nausea, poor appetite, decrease in urine output, and profound generalized weakness. His symptoms were initially attributed to gastrointestinal side effects of clindamycin and he was advised to take it with food and to hydrate himself vigorously. Despite this change, his symptoms progressed and he developed hematuria and AKI which prompted hospital admission. Extensive workup for AKI that included evaluation for pre-renal, intrinsic renal, and post-renal etiologies failed to point to other etiologies apart from clindamycin-induced AKI. Following cessation of medication and temporary renal replacement therapy (RRT), his renal function returned to baseline. CONCLUSIONS We present a case of clindamycin-induced AKI that was diagnosed after a delay due to uremia symptoms being mistakenly attributed to gastrointestinal side effects of clindamycin. Although rare, clindamycin can be a cause of AKI and clinician should be aware of this association in order to recognize and treat it in timely manner.
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PMID:Clindamycin: An Unusual Cause of Acute Kidney Injury. 3079 34