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Query: UMLS:C0032285 (pneumonia)
 54,520 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Cephacetrile, a new derivative of 7-aminocephalosporanic acid, was evaluated in 27 patients. Soft tissue infections due primarily to gram-positive cocci were treated in 16 patients; 12 had bacteriological and clinical cure, and 4 improved but the lesions resolved incompletely or cultures remained positive. Seven of eight patients with respiratory tract infections were cured, including three with pneumococcal pneumonia; the eighth proved to have a noninfectious process and failed to respond. Two patients with acute urinary tract infections due to Escherichia coli had prompt clinical and bacteriological improvement, but follow-up was incomplete. One patient with sepsis due to Staphylococcus aureus expired. Laboratory abnormalities observed during cephacetrile therapy included mild eosinophilia in four patients, thrombocytosis in nine, direct Coombs' test positivity in four, and an elevated serum glutamic pyruvic transaminase in eight patients. No evidence of nephrotoxicity was detected. Severe superinfection due to Enterobacter species was observed in one patient. Mean peak serum concentrations of cephacetrile were 22, 69, and 104 mug/ml after 1 g intramuscularly, 1 g intravenously, and 1.5 g intravenously, respectively. Thus, in early studies cephacetrile was efficacious for selected bacterial infections, but determination of its comparative value within the cephalosporin group of antibiotics requires further clinical investigation.
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PMID:Cephacetrile: clinical evaluation in 27 patients. 479 May 88

The clinical efficacy and safety of the new oxacephalosporin moxalactam disodium were evaluated in 54 children with a variety of pediatric infections. Except for a terminally ill neutropenic leukemic patient with pneumonia and sepsis due to Pseudomonas aeruginosa who died shortly after initiation of therapy, moxalactam treatment was effective in all patients. No recurrent infections were observed. The rate of clinical response to moxalactam appeared to be at least comparable to that of patients treated with traditional antibiotics. In vitro sensitivity testing demonstrated that all bacteria isolated except P aeruginosa were sensitive to moxalactam while Haemophilus influenzae was exquisitely sensitive. Side effects included thrombocytosis (five patients), transient SGPT elevations and eosinophilia (three each), fever with rash (one), and neutropenia (one). In one patient, superinfection with Streptococcus faecalis developed. We conclude that moxalactam may be a useful antibiotic in pediatrics, particularly for the treatment of infections due to H. influenzae and Enterobacteriaceae. Its role in infections caused by group B streptococcus and Pseudomonas awaits further studies.
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PMID:Moxalactam in the treatment of pediatric infections. 621 82

Twenty-patients (14 with mechanical ventilation) received moxalactam in an intensive care unit for pneumonia (3 cases), empyema (5 cases), bronchopneumonia (8 cases), bronchopneumonia with bacteremia (4 cases), 23 organism were isolated and 16 were hospital-acquired: Staphylococcus (3), Escherichia coli (1), Klebsiella-Enterobacter-Serratia (5), Proteus (3), Aeruginosa (2), Acinetobacter (2), These patients received moxalactam at the dosage of 500 mg/8H, 5 at 1 g/12H and 13 at 1 g/8H. Daily dosage ranged between 25 and 50 mg/kg; mode of administration was IM (16) or IV infusion pump (5) and mean duration of treatment was 12 days (range 6-21). Serum and bronchial secretion samples were assayed by the agar diffusion technique utilizing a susceptible strain of enterobacter cloacae (0.06 microgram/ml) as assay organism. At 1 h, mean serum concentrations were 31.5 micrograms/ml after 1 g IM every 12H, 54.9 micrograms/ml after 1 g IM every 8H and at 30 mn after the end of the infusion, serum concentrations were 54.2 micrograms/ml. At the same time, bronchial secretion concentrations were respectively 2.1 micrograms/ml, 5 micrograms/ml and 3.7 micrograms/ml. Clinical cures were obtained in 16 (80%) and bacteriological cures occurred in 14 (70%); of the 12 hospital - acquired infections patients, 8 experienced clinical cures (66%) and the emergence of the following organisms was observed during moxalactam treatment: Staphylococcus (1), Enterococcus (1), Pseudomonas aeruginosa (1), Acinetobacter (3), For the 20 patients, we noted 4 adverse effects: pruritic morbilliform eruption (1), thrombocytosis (1), eosinophilia (2), To avoid failures, the usefulness of routine combinations with amyglycosides is discussed for the cases of hospital - acquired infections.
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PMID:[Use of moxalactam in intensive care units: clinical and bacteriological results related to serum and bronchial concentrations ]. 621 58

Ceftriaxone (Ro 13-9904), a newly developed cephalosporin with a long half-life, was evaluated for efficacy and safety in 19 patients with serious infections. Underlying illnesses were present in 16 patients. Ceftriaxone was given intravenously every 12 h. Infections treated included gram-negative bacillary pneumonias (two cases), staphylococcal and streptococcal soft tissue-skeletal infections (six cases), spontaneous peritonitis (two cases), and complicated urinary tract infections (nine cases). Bacteremia was present in three patients. Microbiological and clinical cures were achieved in all but one case, although three patients with urinary infection had recurrences 6 weeks posttherapy. The only failure occurred in a patient with pneumonia who had a Pseudomonas aeruginosa isolated from sputum with an initial minimal inhibitory concentration of 4 micrograms/ml, but after 9 days of therapy, a repeat isolate had a minimal inhibitory concentration of 32 micrograms/ml. The minimal inhibitory concentrations for the other isolates ranged from less than or equal to 0.6 to 8.0 micrograms/ml. The mean peak plasma level of ceftriaxone was 99.9 micrograms/ml. The only side effects noted were drug fever in one patient, phlebitis in two patients, and thrombocytosis in four patients.
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PMID:Ceftriaxone (Ro 13-9904) therapy of serious infection. 628 39

47 episodes of infection due to gram-negative bacilli in 44 patients were treated with moxalactam in an open clinical trial of efficacy and safety. These included 25 urinary tract infections, 8 cases of pneumonia, 2 cases of meningitis, 3 wound and skin infections and 1 case each of peritonitis and osteomyelitis. 17 episodes of gram-negative bacteremia, either associated with local infection or primary septicemia, were treated. Cure, as defined as satisfactory clinical response with eradication of the infecting organism and absence of relapse, occurred in 34/47 episodes (72%). Fatality was associated with 5/17 episodes of bacteremia, but rapid clearance of bacteremia occurred in all but one of the 12 survivors. The most significant complication of therapy was colonization and superinfection with moxalactam-resistant organisms. Fatal infection with moxalactam-resistant Serratia marcescens and Pseudomonas aeruginosa occurred in one case of pneumonia caused by S. marcescens initially sensitive to moxalactam. Significant adverse effects were primarily hematologic with prolongation of clotting times in 4 patients (associated with bleeding in 2), eosinophilia in 6 patients, and thrombocytosis in 4.
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PMID:A clinical study of moxalactam in the treatment of infections due to gram-negative bacilli. 669 59

Pharmacokinetic and clinical studies on cefozopran (CZOP, SCE-2787), a new cephalosporin antibiotic, were carried out in the field of pediatrics. The results obtained are summarized below. 1. Serum concentrations and urinary excretion rates were determined after intravenous bolus injection of CZOP at a dose of 20 mg/kg for 5 minutes in 3 cases. The mean serum concentration of CZOP was 45.9 micrograms/ml at 30 minutes with the serum half-life of 1.77 hours. The mean cumulative urinary excretion rate in the first 8 hours after administration was 71.4%. 2. Fourteen patients with bacterial infections (pneumonia 9 cases, urinary tract infection 4 cases and lymphadenitis 1 case) were treated with CZOP at a daily dose of 55.8-65.7 mg/kg. The overall clinical efficacy and bacteriological eradication rates were both 100%. 3. No adverse reactions were observed. Abnormal laboratory test results were mild, slight elevation of GOT and GOT, GPT & LDH in 1 each and eosinophilia and thrombocytosis in 2 cases each.
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PMID:[Pharmacokinetic and clinical studies of cefozopran in the field of pediatrics]. 785 81

Cefozopran (CZOP, SCE-2787), a new parenteral cephem, was evaluated for its antibacterial activity and clinical efficacy. CZOP, 24.0-78.0 mg/kg/day, was given to 11 pediatric patients in 3 dose a day via 30-minute drip infusion. Clinically evaluated were nine patients including 4 with acute pneumonia, 2 with urinary tract infections, 2 with lymphadenitis and 1 with sepsis. Two patients were excluded because of possible non-bacterial infections. Clinical efficacies were excellent in 5, good in 3 and fair in 1. Bacteriological responses were confirmed for 5 strains in 5 patients. Four strains were eradicated, but one strain was not. MICs of CZOP were equal to those of ceftazidime. Side effects or abnormal laboratory test results were observed in 3 patients; diarrhea in 1, elevated GPT in 1 and thrombocytosis in 1, but none of them was significant.
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PMID:[Clinical evaluation of a new parenteral cephem, cefozopran, in children]. 785 85

Necrotizing pneumonia, massive necrosis of lung tissue, is a serious, often fatal, complication of lobar pneumonia. Four children 1.3 to 7.5 yr of age were hospitalized with bacteremic pneumococcal pneumonia. All of them were acutely ill on presentation with arterial desaturation, and they developed anemia and thrombocytosis. Two patients had pleural effusion requiring drainage. A chest CT scan revealed segmental or lobar pulmonary liquification, which led to the diagnosis of necrotizing pneumonia. This finding could be demonstrated early in the course of the disease. Subsequently, all of the patients developed cavitating lesions. With adequate antipneumococcal therapy and/or chest tube drainage, all of the patients recovered completely; however, clinical improvement was prolonged: fever lasted 9 to 20 days, and length of hospitalization was 12 to 26 days. Contrary to that in adults, complete recovery is anticipated in children with bacteremic necrotizing pneumococcal pneumonia, and no invasive investigations are required.
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PMID:Bacteremic necrotizing pneumococcal pneumonia in children. 811 89

The Budd-Chiari syndrome (BCS) with hepatic vein occlusion is a rare disorder that can effectively be treated with orthotopic liver transplantation. In this retrospective analysis we report on 7 patients who received 9 liver grafts for terminal BCS. One patient died after 4 months due to cytomegalovirus-pneumonia. The actuarial survival rate is 85.7% compared to more than 90% in all other 376 patients transplanted between September 1988 and April 1993 at our institution. Anticoagulation management consisted of early postoperative intravenous heparin and continuation with dicoumarin. One patient with thrombocytosis received hydroxyurea. Under this regimen one postoperative hemorrhage requiring laparotomy was observed. Discontinuation of oral anticoagulation due to gastrointestinal bleeding caused hepatic artery and portal vein thrombosis in 1 patient who had to be retransplanted. One recurrence requiring retransplantation as well was due to an insufficient dicoumarin intake. In conclusion, terminal BCS represents a good indication for orthotopic liver transplantation with a closely-monitored anticoagulation to avoid such adverse side effects as thrombosis and hemorrhage.
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PMID:Treatment of the Budd-Chiari syndrome with orthotopic liver transplantation and long-term anticoagulation. 813 72

A 46-year-old man with Werner's syndrome was admitted with epigastralgia and body weight loss. The peripheral blood findings showed anemia, thrombocytosis and eosinophilia. Bone marrow aspiration and biopsy revealed increases in eosinophils and megakaryocytes, myelodysplastic change with 6.6% myeloblast, and myelofibrosis. Chromosomal analysis revealed 46, XY, +der(1;7), -7, del(20). He was diagnosed as having myelodysplastic syndrome with myelofibrosis or essential thrombocythemia. Three months later, pancytopenia appeared with a relative increase of blasts positive for CD41 and negative for myeloperoxidase. He died of respiratory failure due to pneumonia. An autopsy revealed severe myelofibrosis with proliferation of megakaryocytes and blasts. A final diagnosis of acute megakaryoblastic leukemia was made. Werner's syndrome is rare, and it is even more unusual to have the complication of acute leukemia with der (1;7) seen in this case.
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PMID:[Werner's syndrome developing acute megakaryoblastic leukemia with der(1;7)]. 902 58


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