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)

Eleven children with bacterial meningitis were treated intravenously with amoxicillin sodium to evaluate the efficacy of the parenteral form of amoxicillin for this serious infection and to measure the penetration of the drug into cerebrospinal fluid (CSF). The infecting organisms were Haemophilus influenzae in nine cases and Streptococcus pneumoniae in two. Nine patients had optimal responses to amoxicillin sodium, 200 mg/kg per day for 14 days. Bacteria were also eradicated from CSF of the other two, but one experienced fever and culture-negative CSF pleocytosis after cessation of amoxicillin, and the other developed H. influenzae empyema 2 weeks after termination of therapy. By comparison, 7 of 10 children with meningitis responded optimally to ampicillin (nonrandomized design) during the period of study. The mean peak CSF concentration of amoxicillin was 3.14 mug/ml (ca. 7% of the concomitant mean peak serum level) early during therapy. However, meningeal penetration of the drug declined to a mean peak of 0.63 mug/ml on the final day of therapy. Mild transient neutropenia, noted in five patients, was the most common side effect of amoxicillin sodium therapy; five patients treated with ampicillin also experienced reversible neutropenia. Thus, intravenous amoxicillin sodium provided therapy for bacterial meningitis comparable to that of ampicillin in this limited case-control study.
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PMID:Treatment of bacterial meningitis with intravenous amoxicillin. 48 28

Mezlocillin, a new semisynthetic penicillin chemically related to ampicillin which is more active than carbenicillin against Ps. aeruginosa, B. fragilis and Strep. faecalis and which inhibits many Klebsiella, was evaluated in the therapy of 34 episodes of infection in 26 patients. Infection sites included pulmonary, urinary tract and tissue infections, including peritonitis. Seven patients had bacteremia. Clinical cures were achieved in 83 per cent and bacteria cures in 76 per cent of infections. Cure was achieved with mezlocillin in patients with infections caused by carbenicillin-resistant species. Adverse effects of therapy were minimal, one rash and one episode of reversible neutropenia. Serum and body flevels of susceptible organisms.uid levels were easily maintained above the inhibitory levels of susceptible organisms. Mezlocillin was a safe, well tolerated and effective antibiotic in the treatment of infections due to susceptible organisms.
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PMID:Mezlocillin in the therapy of serious infections. 50 86

Ampicillin sodium has been the drug of choice in the treatment of Haemophilus influenzae meningitis. The development of ampicillin-resistant strains forces the clinician to focus on alternative therapies. We describe two patients in whom neutropenia was noted secondary to chloramphenicol administration, and streptomycin sulfate and sulfonamides were employed. An historical perspective summarizing the evolution of available therapeutic regimens is presented.
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PMID:Haemophilus influenzae meningitis: an evolving therapeutic regimen. 108 10

We reviewed 91 cases of pediatric Escherichia coli bacteremia during a 10-year period. Thirty one patients were afebrile; a significantly greater proportion of these patients were aged less than 1 month, had ampicillin-resistant E coli isolates, or had persistent bacteremia 24 hours after initiating antibiotic therapy. Infection was community acquired in 65 cases; associated urinary tract infection was six times more common in this setting than in nosocomially acquired infections. In 85 cases at least 1 underlying medical condition/focus of infection was identified at the time the positive blood culture was obtained, the most common were immune deficiency states (38 cases), urinary tract infection (29 cases), and lesions of the gastrointestinal tract (27 cases). Polymicrobial bacteremia occurred in five cases. Twelve patients died; significantly associated with death were hypotension requiring pressor therapy, presence of a central venous catheter, and neutropenia.
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PMID:Escherichia coli bacteremia in children. A review of 91 cases in 10 years. 203 96

The authors studied the effect of antibiotics, hydrocortisone and anti-cancer drugs on gastrointestinal infections and dissemination by C. albicans in mice inoculated orally with C. albicans. The mice were given orally, vancomycin, amikacin and polymyxin B, and they also were injected with ampicillin and gentamicin. Hydrocortisone, cyclophosphamide (CPA) which causes leukopenia and neutropenia, and methotrexate (MTX) which injures the mucous membrane of the gastrointestinal tract were injected to the mice. In the mice treated with antibiotics and anti-cancer drugs, and inoculated orally with C. albicans, the colony forming units of the feces conspicuously increased. Gastrointestinal candidiasis was frequently observed, particularly at the cardia and the cardio-antrum line of the stomach of these mice. In addition to these sites, gastrointestinal candidiasis was observed at the antrum and the small intestine of the mice injected with MTX. C. albicans was frequently recovered from the livers and lungs of the mice treated with antibiotics and MTX + CPA which cause leukopenia, neutropenia and the damage of mucous membrane of the gastrointestinal tract. It is suggested that the threshold gut population of C. albicans is a determinant for gastrointestinal candidiasis, and that leukopenia, neutropenia and the damage of mucous membrane of the gastrointestinal tract are important factors for dissemination by C. albicans from the primary gastrointestinal lesions.
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PMID:[Effect of antibiotics and anti-cancer drugs on gastrointestinal infections and dissemination by C. albicans in mice inoculated orally with C. albicans]. 250 22

We reviewed the clinical and laboratory presentation of Haemophilus species bacteremia at our institution, with special attention to predisposing and prognostic factors. Of 36 cases, 18 presented with pneumonia, 1 with cellulitis, and another with sinusitis. No cases of meningitis or endocarditis were detected. Most episodes were caused by Haemophilus influenzae, and the overall response rate to treatment was 72%. Factors including chronic obstructive pulmonary disease, alcoholism, prior splenectomy, and neutropenia did not play an important role in these patients' infections. Most of the isolates serotyped were found to be nontypable. The occurrence of ampicillin resistance was 6% throughout the study. Ampicillin, chloramphenicol, and second-generation cephalosporins were all effective therapeutic regimens. Bacteremia due to Haemophilus species remains an uncommon infection in patients with cancer, despite the predominance of traditional predisposing factors.
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PMID:Haemophilus species bacteremia in patients with cancer. A 13-year experience. 273 Feb 52

Twenty-three children two months to 11 years old were treated with sulbactam/ampicillin or sulbactam/penicillin. Eleven had urinary tract infections (UTI), eight had pus-forming cervical adenitis, and four had lobar pneumonia. Pathogens were isolated from 18 patients: Escherichia coli from 10, Staphylococcus aureus from seven, and Klebsiella pneumoniae from one. All isolates were resistant to ampicillin or penicillin alone. Sulbactam (50 mg/kg per day) plus ampicillin (1:2 or 1:3 ratio) or penicillin (1:1.2 or 1:1.8 ratio) was given by intravenous bolus injection at 6-hr intervals for four to 11 days (mean duration, nine days). All pathogens were eradicated during treatment. Two patients with UTI relapsed after completion of treatment; the isolates were resistant to the combination. Clinical response was rapid and consistent with bacteriologic findings. Twenty-two of 23 children had a favorable clinical response. No systemic or local adverse effects were recorded. One child had eosinophilia and another had neutropenia at the end of treatment. Four children had slight and transient increases in hepatic transaminases. These results indicate that sulbactam/ampicillin may prove safe and effective for the treatment of non-life-threatening pediatric infections.
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PMID:Clinical efficacy of sulbactam/ampicillin in pediatric infections caused by ampicillin-resistant or penicillin-resistant organisms. 302 16

Aztreonam was administered to 30 patients, ages 0.03 to 15.4 years, with severe and in 21 cases complicated urinary tract infections caused by members of the family Enterobacteriaceae and Pseudomonas aeruginosa which were resistant to ampicillin and susceptible to the study drug in vitro. A mean dose of 47.7 mg/kg was given intramuscularly every 12 h to 26 patients. In four patients with renal insufficiency, the dose was reduced according to pharmacokinetic data. Permanent urine sterilization and clinical cure were achieved in 22 patients, 13 of whom had urological malformations. In two patients with P. aeruginosa and Proteus mirabilis infections, the treatment failed. Another patient had an Escherichia coli reinfection 21 days after the end of therapy. Four patients with various urological abnormalities had gram-positive superinfections, and two patients had gram-negative superinfections during and at the end of therapy: all six had indwelling ureteric splints or pyelostomy as predisposing conditions. No adverse clinical effects were observed. Some transient and slight or moderate alterations were observed at the end of treatment: eosinophilia (nine cases), elevation of hepatic enzymes (eight cases), prolongation of prothrombin time (three cases), and neutropenia (one case). A pharmacokinetic study was performed in six patients with normal renal function and in seven patients with various degrees of renal insufficiency. The elimination half-life of the drug was inversely correlated with the glomerular filtration rate. At the dosage used, aztreonam proved effective for severe urinary tract infections caused by members of the family Enterobacteriaceae in pediatric patients.
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PMID:Aztreonam in the treatment of severe urinary tract infections in pediatric patients. 309 42

The therapeutic effects of imipenem-cilastatin (MK-0787-MK-791) on experimental intrauterine infections in progesterone-treated virgin rats and postpartum rats were studied. The relative efficacy of imipenem-cilastatin for the treatment of such intrauterine infections was compared with that of cefazolin and ampicillin for the treatment of infections caused by Escherichia coli and Streptococcus faecalis, respectively. Treatment with imipenem-cilastatin significantly inhibited the proliferation of E. coli and S. faecalis in uteri, as compared with the proliferation in untreated controls. Cefazolin failed to affect the E. coli infection. With the S. faecalis infection, ampicillin effectively reduced bacterial growth, as compared with that in untreated controls. However, ampicillin was inferior to and comparable to imipenem-cilastatin in progesterone-treated virgin rats and postpartum rats, respectively. A further experiment with S. faecalis infections in rats made neutropenic by intraperitoneal injection of cyclophosphamide showed that the therapeutic effectiveness of imipenem-cilastatin was superior to that of ampicillin and was not influenced by neutropenia. Our results suggest that imipenem-cilastatin may be a useful agent for the treatment of obstetric and gynecologic infections.
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PMID:Therapeutic effects of imipenem-cilastatin on experimental intrauterine infections in rats. 311 55

We developed an experimental model of candidiasis in rabbits with prolonged neutropenia. Rabbits were made neutropenic with cytosine arabinoside (Ara-C) administered through an indwelling silastic catheter that had been surgically implanted in the external jugular vein. Neutropenia was sustained with intravenous Ara-C, and bacterial complications were prevented with parenteral ceftazidime plus ampicillin. Candidiasis was established by intravenously administering Candida albicans or Candida tropicalis (1-2 x 10(5) colony-forming units) and resulted in hepatic and splenic lesions that mimicked those associated with hepatosplenic candidiasis in humans. The kidney proved to be the site most refractory to eradication of Candida spp. and offered a target organ for assessing antifungal therapy. We evaluated amphotericin B, 5-flucytosine, ketoconazole, and rifampin, alone and in combination. Although each agent reduced the colony counts of Candida in the liver, spleen, and lung, the combination of amphotericin B and 5-flucytosine was the only regimen effective in eradicating renal candidiasis.
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PMID:Evaluation of single-drug and combination antifungal therapy in an experimental model of candidiasis in rabbits with prolonged neutropenia. 339 23


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