Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0027947 (neutropenia)
 17,527 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Twenty-six children received a single daily intravenous dose of ceftriaxone, 50 mg/kg, for a variety of bacterial infections including abscess (5), cellulitis (5), periorbital cellulitis (5), bacteremia without focus (4), osteomyelitis (2), pneumonia (2), pyelonephritis (2) and otitis media (1). Organisms isolated from infectious foci were Staphylococcus aureus (9), Streptococcus pneumoniae (6), Streptococcus pyogenes (3), Escherichia coli (2); and Haemophilus influenzae type b, nontypable H. influenzae, Group B streptococcus, Pasteurella multocida, Haemophilus parainfluenzae and satelliting streptococcus (1 each). Microbiologic cure was achieved in 20 of 22 (91%) infections and clinical cure in 25 of 26 (96%). Fifteen possible adverse reactions occurred in 34 patients evaluable for drug safety; most were mild and self-limited. Neutropenia developed in two patients necessitating discontinuation of ceftriaxone in one, followed by prompt resolution. Seventeen children received ceftriaxone, 75 mg/kg/day, in two divided doses for a similar variety of infections. Bacteriologic and clinical cure rates of 100 and 94%, respectively, were demonstrated. Leukopenia developed in one patient and resolved when ceftriaxone was discontinued. Once a day dosing of ceftriaxone in pediatric patients provides greater ease of administration combined with efficacy equal to that achieved with a divided dosage schedule.
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PMID:Ceftriaxone administered once or twice a day for treatment of bacterial infections of childhood. 396 62

Spontaneous clostridial myonecrosis occurred in 30- and 69-year-old patients with pancytopenia (after treatment of acute myelogenous leukemia) and diabetes with neutropenia respectively. They presented with fever and sudden onset of pain plus tenderness in involved muscles. They rapidly deteriorated and died within hours after admission. A review of the literature for previous reports of this condition disclosed 31 additional cases. Mean age of patients was 50 years, male to female ratio was 2.2:1, and an underlying condition was present in all of them. Presenting manifestations were spontaneously occurring excruciating pain in the involved muscle (67%), generalized sepsis and shock (24%), nonpainful swelling in the involved muscles (6%) and pain, swelling and shock (3%). Mortality rate was 91% (30/33). The clostridial strains associated with this condition were identified in 31 cases, with Clostridium perfringens and C. septicum causing 28 of them. Bacteremia was described in 10 cases. Awareness of this rare catastrophe may aid in early recognition and surgical intervention which are essential for patient survival.
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PMID:Characteristic manifestations of clostridium induced spontaneous gangrenous myositis. 405 70

Mammary glands of 6 lactating Holstein cows were inoculated with Haemophilus somnus strain 43826. Three cows developed chronic mastitis and shed bacteria for up to 1 year. Three cows developed acute gangrenous mastitis, with evidence of bacteremia and endotoxemia. Cows with gangrenous mastitis had lower somatic cell counts early after inoculation in affected quarter secretions compared with those in cows that developed chronic mastitis. Cows with gangrenous mastitis developed hypocalcemia, hypoalbuminemia, azotemia, hyperbilirubinemia, mildly increased serum aspartate aminotransferase and creatine kinase activity, and a marked neutropenia with a degenerative left shift. Histopathologic examination of gangrenous quarters revealed edema, necrosis, and vascular thrombosis with few inflammatory cells. A limited survey failed to recover H somnus from dairy cows with clinical mastitis or from mammary secretions from 41 beef cattle at an abattoir.
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PMID:Haemophilus somnus: investigations of its potential role in bovine mastitis. 407 31

Squirrel monkeys were significantly depleted of complement by a nontoxic protein constituent of cobra venom, and the influence of cobra factor (CoF) treatment on the course of Escherichia coli bacteremia was studied. Striking neutropenia occurred rapidly in control animals while the rate of occurrence of neutropenia was 20 to 30 times slower in the CoF-treated animals, suggesting that the E. coli-induced neutropenia was at least partially a complement-mediated response. In the CoF-treated monkeys, the initial rate of clearance of the E. coli from the circulation tended to be slower and the resultant levels of bacteremia were higher than in control animals. These observations are consistent with a hypothesis that complement-mediated neutrophilic leucocyte function is an important host defense mechanism in gram-ngeative bacillary bacteremia.
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PMID:Escherichia coli bacteremia in the squirrel monkey. I. Effect of cobra venom factor treatment. 463 Jun 2

At the present time, gram-negative bacillary bacteremia in patients with neutropenia will respond favorably in 60% to 70% of the patients when carbenicillin-ticarcillin or cephalothin-cefazolin combined with aminoglycosides (gentamicin, tobramycin, sisomicin, netilmicin, or amikacin) are given. Piperacillin alone will cure 20/34 (59%) of bacteremic episodes in patients without granulocytopenia who have a severe underlying disease. In patients with neutropenia, the combination of piperacillin with amikacin was found to be associated with a favorable response in 76/121 patients (63%). These results are thus as good as those obtained with other broad-spectrum, beta-lactam antibiotics whether used alone in patients without granulocytopenia or in combination with aminoglycosides in patients with neutropenia. It seems likely that in patients with severe underlying disease and/or granulocytopenia, antibiotic combinations have reached an optimal efficacy. More attention should be paid to the correction of the basic predisposing factors to infection (granulocytopenia and immunodepression) and to infections caused by nonbacterial pathogens.
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PMID:Treatment of severe infections in patients with cancer. The role of new acyl-penicillins. 621 7

Cefoperazone was used for the treatment of 105 febrile episodes in 103 patients with cancer. A dose of 12 g/day was administered according to two different schedules, one for neutropenic patients (neutrophil count, less than 1,000/mm3), the other for nonneutropenic patients. The rate of response for 85 episodes of documented infection was 68%. The rates of response for patients with bacteremia and pneumonia were 72% and 41%, respectively; all patients with soft-tissue and urinary-tract infections responded. Fifty-five percent of patients infected with Pseudomonas aeruginosa, the most common gram-negative organism causing infection, responded to therapy. Among patients infected with Staphylococcus aureus, the most common gram-positive organism causing infection, 82% responded. As expected, the rate of response was higher for patients with adequate neutrophil counts. In neutropenic patients the overall response was good, particularly when the neutropenia resolved. However, the occasional occurrence of resistant strains of bacteria precludes the use of cefoperazone alone as initial therapy for neutropenic patients. Toxic adverse reactions, including drug-induced fever, diarrhea, and rash, occurred rarely and were transient. This study indicates that cefoperazone has low toxicity and is effective for the treatment of infections in patients with cancer.
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PMID:Cefoperazone for the treatment of infections in patients with cancer. 622 89

Clinical studies on ceftizoxime, a new cephalosporin, were carried out in our department. The following results were obtained. 1. Antibacterial activity. Antibacterial activity of ceftizoxime against 7 strains of E. coli, 6 strains of Klebsiella, 6 strains of H. influenzae, 7 strains of E. cloacae and 10 strains of S. aureus, recently isolated from patients, was compared with that of cefotiam, cefmetazole and cefazolin. Ceftizoxime was more active than the other antibiotics against E. coli, Klebsiella, H. influenzae and E. cloacae, but less active against S. aureus. 2. Urinary excretion. Urinary excretion was measured in 2 cases with normal renal function after dosing with 750 mg (35 mg/kg) and 350 mg (17 mg/kg) of ceftizoxime by intravenous injections. Urinary recovery rates within 6 hours were 97% and 82% respectively. 3. Clinical study. Eighteen children with the following bacterial infections were treated with ceftizoxime; respiratory tract infection (13), acute otitis media (1), acute intervertebral chondritis and tonsillitis (1), chronic cystitis (1), subcutaneous abscess (1) and chronic bacteremia (1). The dosage was 69--147 mg/kg q.i.d. by intravenous injection. The duration of administration was from 3 to 32 days. The clinical results were excellent in 4 cases, good in 13 cases and fair in 1 case of chronic bacteremia. The overall effectiveness rate was 94%. Slight elevation of GPT in 1 case and leukopenia (neutropenia) in 1 case were observed, but returned to the normal range immediately after discontinuation of dosing. It is considered that ceftizoxime is one of the useful first choice antibiotics used for children with bacterial infections.
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PMID:[Clinical studies on ceftizoxime in pediatric field (author's transl)]. 627 3

The clinical records of 66 consecutive episodes of Gram-negative bacteremia occurring in 60 patients with hematologic malignancies during a 66-month period were reviewed to assess the major prognostic factors. The bacteremia-related mortality was 53%. Overall, Pseudomonas aeruginosa (54%) and Escherichia coli (24%) were the predominant isolates (fatality rate 78 and 31% respectively). The majority of patients (58/66) were granulocytopenic (PMN less than 1000/microliters). Among the 18 patients whose circulating granulocytes increased by one log10 or to above 1000/mmc during therapy, the fatality rate was 39%, as opposed to 70% in the 40 patients without such an increase. Pneumonia-associated bacteremia (56%) had a high fatality rate (73%) compared to isolated bacteremias (27%). Septic shock and inappropriate antibiotic therapy accounted for the highest mortality. Our data suggest that Pseudomonas etiology, persistent neutropenia, associated pneumonia, septic shock and inappropriate antibiotic therapy account for a bad prognosis in Gram-negative bacteremia in hematologic malignancies.
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PMID:Gram-negative septicemia in patients with hematologic malignancies. 636 45

Of 545 patients expected to develop prolonged neutropenia and randomized to received trimethoprim-sulfamethoxazole (TMP-SMZ) or placebo, 342 were evaluable for occurrence of infection or bacteremia. Some centers used oral nonabsorbable antibiotics in addition. Infection occurred in 64 (39%) of 165 placebo recipients and 46 (26%) of 177 TMP-SMZ recipients (P = .016), whereas bacteremia occurred in 32 (19%) and 22 (12%), respectively (P = .106, difference not significant [NS]). In the 139 patients with acute nonlymphocytic leukemia (ANLL), infection occurred in 35 (55%) of 64 placebo-treated patients and 31 (41%) of 75 TMP-SMZ-treated patients (P = .162, NS), whereas bacteremia occurred in 15 (23%) and 18 (24%; NS), respectively. Excluding patients with ANLL, infection occurred in 29 (29%) of 101 placebo-treated patients and 15 (15%) of 102 TMP-SMZ recipients (P = .038), whereas bacteremia occurred in 17 (17%) and four (4%; P = .005), respectively. Gram-positive cocci were isolated less frequently from TMP-SMZ-treated, bacteremic patients, but more of their isolates were resistant to TMP-SMZ than were those from placebo recipients.
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PMID:Trimethoprim-sulfamethoxazole in the prevention of infection in neutropenic patients. EORTC International Antimicrobial Therapy Project Group. 638 77

We investigated the clinical efficiency and safety of lamoxactam for treatment of 28 episodes of infection in 26 adult patients (15 males and 11 females) whose ages ranged from 17 to 83 years (mean 48.7). 4 patients had 'ultimately fatal diseases' and the remaining 22 had 'nonfatal diseases'. The clinical condition at the beginning of treatment was 'critical' or 'poor' in 15 cases. Episodes of infection treated were: 14 intraabdominal, 9 bacteremia, 5 nephro-urinary, 3 osteomyelitis, and a miscellaneous group including pneumonia, soft tissue, parameningeal focus and infected V-P shunt. A total of 34 microorganisms were responsible for 25 episodes of infection. 15 and 10 episodes were mono- and polymicrobial, respectively. Isolated microorganisms included 13 aerobic facultative gram-negative bacillus, 5 facultative gram-positive cocci, and 16 anaerobes. Total dosage of lamoxactam administered by patient ranged from 24 to 234 g (mean 57.6 g), and mean duration of therapy was 15.2 days (range 8-42 days). The overall rate of clinical response to lamoxactam was excellent, amounting to 84% of episodes and 91% of patients. Local and general tolerance was good, and lamoxactam had to be discontinued only once during therapy due to an episode of neutropenia. Enterococcal colonization (5 of 26 patients, 19%) and superinfections (3 of 26 cases, 11.5%) were undesirably frequent in our patients. Lamoxactam seems to be an effective and safe single-agent therapy for many bacterial infections. The possibility of enterococcal colonization and superinfections should be monitored, specially in patients with urinary or intraabdominal infections.
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PMID:Evaluation of lamoxactam in the treatment of severe bacterial infections. 661 97


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