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 54,520 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Infections caused by Gram-positive bacteria are an important and common cause of morbidity and mortality. Staphylococci and streptococci are the most frequent infecting organisms in skin and soft tissue infections, pneumonia, bone and joint infections, and endocarditis. Anaerobic Gram-positive bacteria such as Clostridia spp. cause infections that can rapidly produce tissue necrosis and death. The cephalosporins are indicated for the treatment of infections caused by Gram-positive bacteria in certain circumstances. These include selected patients with endocarditis, osteomyelitis, septic arthritis and cellulitis. They are also used as alternatives to the penicillins in penicillin-allergic patients and for 'mixed' infections caused by Gram-positive and Gram-negative organisms. This article discusses the indications for the cephalosporin group of antibiotics in patients suffering from infections caused by Gram-positive bacteria.
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PMID:Cephalosporins in gram-positive infections. 331 96

Group B streptococci (GBS) have gained much attention in recent years as a cause of serious infection in the newborn. Traditionally two clinical syndromes have been defined as "early onset", with fulminant septicemia, pneumonia and meningitis, and "late onset", with a mild meningitis. More recently some previously unrecognized clinical presentations of GBS disease have been documented. These include asymptomatic bacteremia, septic arthritis, osteomyelitis, ethmoiditis with orbital cellulitis, pneumoniae with empyema, conjunctivitis. The literature to date reports 30 instances of osteomyelitis due to GBS. This report describes a forty days infant with a group B streptococcal osteomyelitis of the proximal humerus. Has been also emphasized the increased frequency and the benign clinical course of streptococcal osteomyelitis in the neonate.
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PMID:[Osteomyelitis and arthritis caused by Streptococcus group B in a 40-day-old boy]. 332 62

Ceftriaxone treatment (50 to 80 mg/kg once daily) was given to 201 children between 1 month and 18 years of age. There were 201 serious bacterial infections, including epiglottitis, pneumonia, cellulitis, osteomyelitis, septic arthritis, pyelonephritis, sepsis, and meningitis. The common pathogens responsible for pediatric infections isolated from these patients included Haemophilus influenzae, Staphylococcus aureus, Streptococcus pyogenes, Streptococcus pneumoniae, and Escherichia coli. The overall clinic cure rate was 94%. Ten patients were clinically improved but not cured. There were two clinical failures. Bacteriologic failure occurred in six patients. The overall bacteriologic cure rate was 97%. Twenty patients (10%) experienced adverse effects; none required discontinuation of therapy. The efficacy, safety, spectrum, and convenience of ceftriaxone monotherapy make this antimicrobial agent a candidate for the treatment of choice of selected serious pediatric infections.
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PMID:Once-daily administration of ceftriaxone for the treatment of selected serious bacterial infections in children. 340 85

Pyarthrosis of the knee was treated in 30 patients by arthroscopic decompression and lavage, coupled with parenteral and oral antibiotics. There were 21 men and nine women patients whose ages ranged from 6 months to 65 years of age. Twenty-two patients were considered to have a hematogenous origin as a cause of their pyarthrosis, and eight were caused by penetrating trauma. Twenty-eight of these patients had the onset of symptoms within 72 h prior to arthroscopy. Two adults had the onset of their symptoms 1 week prior to treatment. Follow-up has ranged from 6 months to 5 years. Staphylococcus aureus was cultured in 20 knees, Streptococcus pneumonia in three knees, Haemophilus influenzae in four knees, and Neisseria gonorrhoeae in one knee. The average hospital stay among 22 children aged 12 years or younger was 3.50 days. The other eight patients had an average hospital stay of 9.50 days. Three adults with diabetes and other medical problems, such as renal failure, had an average hospital stay of 17.33 days. Excellent results were obtained in 28 (93.3%) of 30 patients and good results were obtained in two (6.7%) of 30 patients. There were no poor results or recurrences, and no cases of osteomyelitis occurred. This method of treatment markedly reduces the morbidity and hospital stay of patients with a septic knee.
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PMID:Arthroscopic treatment of the septic knee. 348 36

The clinical and diagnostic features of 29 adult patients with H. influenzae septic arthritis are reviewed. Twelve men and 17 women ranging in age from 22 to 82 years developed the infection. H. influenzae septic arthritis is an acute, febrile disease with a mean duration of symptoms before diagnosis of 4 days. Fifteen patients had monoarticular arthritis, 6 with an infected knee. Polyarticular involvement, with a range of 2 to 9 joints, was diagnosed in 14 patients. Nineteen patients had concurrent extraarticular sites of infection, including meningitis, pneumonia, pharyngitis, sinusitis, conjunctivitis, and cellulitis. Twenty-two of 29 patients had predisposing factors for infection, including ethanolism, trauma, rheumatoid arthritis, systemic lupus erythematosus, diabetes mellitus, splenectomy, multiple myeloma, lymphoma, gout, and acquired common variable hypogammaglobulinemia. Characteristic synovial fluid findings included purulent, greenish fluid, elevated WBC count, and gram-negative pleomorphic microorganisms. Treatment for these patients included antibiotic therapy, most often ampicillin and chloramphenicol, and joint drainage by repeated arthrocentesis or arthrotomy. A favorable outcome was reported in 25 of 29 patients. Hemophilus influenzae septic arthritis should be suspected in adults who are immunocompromised and have a concurrent extraarticular source of infection.
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PMID:Hemophilus influenzae septic arthritis in adults. A report of four cases and a review of the literature. 348 37

We describe a healthy woman in whom pyomyositis of the left buttock, polyarticular septic arthritis, and meningitis due to Hemophilus influenzae type B developed after pneumonia. Systemic antibiotic therapy and local drainage provided a good result. This is the first case of pyomyositis and the 30th case of septic arthritis from Hemophilus influenzae described in an adult.
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PMID:Pyomyositis and polyarticular septic arthritis from Hemophilus influenzae in a nonimmunocompromised adult. 350 5

Thirty-four patients were treated with intravenous ciprofloxacin. Thirty infections occurring in 28 patients were assessable for the efficacy analysis. The drug dosage was 300 mg every 12 hours in 19 patients and 200 mg intravenously every 12 hours in nine patients. Twelve patients were also given ciprofloxacin orally after initial intravenous therapy. The mean duration of total therapy was 31 days. The overall clinical response rate was 87 percent, and the bacteriologic response rate was 70 percent. Favorable responses were observed in 10 of 12 patients with osteomyelitis/septic arthritis; seven of eight with soft tissue infection; four of four with pneumonitis; one of two with cystic fibrosis; and four of four with urinary tract infections. Resistance to ciprofloxacin developed in three Pseudomonas aeruginosa isolates. Toxicity was minor: phlebitis occurred in six patients, nausea in six, and rash in one. Intravenously administered ciprofloxacin or intravenous ciprofloxacin followed by oral ciprofloxacin is a safe and effective therapy for serious infections.
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PMID:Treatment of serious infections with intravenous ciprofloxacin. 355 62

The antibacterial efficacy of some of the newer quinolone antimicrobial agents in general, and ciprofloxacin in particular, in animal models of experimental septic arthritis, burn wound sepsis, empyema, chronic gastroenteritis, granuloma pouch infection, intraabdominal abscess, osteomyelitis, prostatis, sinusitis, urinary tract infection, and severe septicemia caused by Pseudomonas aeruginosa is reviewed. In addition, the efficacy of these newer quinolones has been studied in animal models of pneumonia, endocarditis, meningitis, skin and soft tissue infections, and a variety of other systemic infections. Although certain limitations are associated with animal models of infection, properly performed studies clearly have the potential to provide guidelines for evaluating the efficacy of antimicrobial agents in the treatment of some infections in humans.
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PMID:Efficacy of ciprofloxacin in animal models of infection. 355 64

Three unrelated severe infections with Streptococcus zooepidemicus occurred in England in 1985. The first patient developed septic arthritis, which has not been recorded before with this organism. The second died with septicaemia, pneumonia and post-streptococcal glomerulonephritis, the only record so far of nephritis following sporadic S. zooepidemicus infection and of nephritis and systemic sepsis in the same patient. The third patient experienced septicaemia during pregnancy but recovered without complications. A likely animal source of infection was found in only one case.
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PMID:Human infection with Streptococcus zooepidemicus (Lancefield group C): three case reports. 355 45

Clinical studies were performed on cefuzonam (L-105, CZON), a new cephem antibiotic, as follows. Cerebrospinal fluid (CSF) and serum concentrations. CSF and serum concentrations of CZON were measured in 1 case of septic arthritis without meningitis. One hour after 50 mg/kg intravenous bolus injection, the CSF and serum concentrations were 0.10 and 18.1 micrograms/ml, respectively, and CSF to serum concentration ratio was 0.55%. Clinical efficacy CZON was administered to 15 patients in doses ranging 54.5 approximately 212.4 mg/kg/day (94.1 mg/kg/day on average) t.i.d. or q.i.d. for 4 approximately 12 days (6.5 days on average). Of those patients, 9 were with pneumonia, one each was with bronchitis, with tonsillitis, with septic arthritis, with septicemia, with purulent meningitis and with urinary tract infection. The overall efficacy rate was 100%, i.e., efficacy was excellent in 12, good in 3. Bacteriological efficacy was excellent, i.e., 8 of 8 strains were eradicated. Side effects were observed in 2 cases, i.e., one case with loose stool and another with eruption. Laboratory abnormalities to the drug were not observed during the treatment. The above results suggested that CZON would be a useful antibiotic for treating pediatric bacterial infections.
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PMID:[Clinical experience with cefuzonam in bacterial infection of children]. 359 93


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