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

Over a recent 22 month period, 222 patients in two adjacent hospitals became infected with a multiply antibiotic-resistant strain of Serratia marcescens; 13 were bacteremic. Nineteen patients with clinically significant infections received amikacin. Nine of 11 patients with urinary tract infections were cured. In contrast, only one of eight patients with pneumonia or other deep tissue infections was cured and four died. These eight patients were severely ill; many had infections with multiple microorganisms. In four of five patients in whom the infection failed to clear promptly. Serratia strains became increasingly resistant to amikacin during therapy and these strains contributed to the death of two of these patients. Amikacin proved useful in treating patients with infections due to gentamicin-resistant S. marcescens organisms, especially urinary tract infections. However, the capacity of some strains of S. marcescens to develop resistance to amikacin may limit the usefulness of this antibiotic in the treatment of deep tissue infections which involve this microorganism.
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PMID:Amikacin therapy of patients with multiply antibiotic-resistant Serratia marcescens infections: development of increasing resistance during therapy. 32 46

Amikacin was evaluated in patients with malignant diseases during 134 episodes of identified infection, most of which were cases of pneumonia and septicemia. The overall rate of response of the identified infections was 63%. The majority of infections were caused by Escherichia coli, the Klebsiella-Enterobacter-Serratia group, and Pseudomonas aeruginosa. The response rate for infections caused by these organisms was 80%. Five of eight infections caused by organisms resistant to gentamicin responded to therapy with amikacin. Nephrotoxicity was observed in 13% of patients who had normal renal function initially.
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PMID:Amikacin for treatment of infections in patients with malignant diseases. 99 33

Amikacin, a new aminoglycoside antibiotic, was utilized in the treatment of 49 cases of infection which occurred in 39 neutropenic cancer patients. Thirty-four patients (69 per cent) responded to this antibiotic. Pneumonia and septicemia were the most common types of infection treated and the response rates were 65 per cent and 75 per cent, respectively. Gram-negative bacili were responsible for 93 per cent of the identified infections and 74 per cent responded. E. coli, Ps. aeruginosa, and organisms of the Klebsiella-Enterobacter-Serratia group were the most common gram-negative bacilli causing infection. Responses were more frequent among patients who maintained higher serum concentrations of antibiotic, but the differences were not statistically significant. Patients with severe neutropenia (less than 100 neutrophils/mm3) had a response rate of 68 per cent. Toxicity was manifested as azotemia and hearing loss which occurred in 13 per cent and 6 per cent, respectively. However, toxicity was directly related to serum concentration and to the number of treatments with amikacin. This antibiotic is of potential importance because of its efficacy against gram-negative bacilli infections. Best results were obtained when sufficient drug was given as a continuous intravenous infusion to maintain serum concentrations of about 15 mu g/ml.
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PMID:Amikacin therapy of infections in neutropenic patients. 110 49

The clinical presentation, complications and sensitivity pattern was studied in 30 cases of enteric fever. Fever was the main presenting feature in all. Other associated predominant presenting feature were vomiting in 15 (50%), Loose motion 9 (30%), Cough 6 (20%), headache 4 (13.33%) and altered sensorium in 2 (6.66%). The various complications observed during hospital stay were myocarditis 5 (6.16%), Paralytic ileus 2 (6.66%), Pneumonia 1 (3.33%) and Joint effusion in 2 (6.66%) cases respectively. In laboratory parameters-mild elevation of blood urea and SGOT/SGPT were detected in 1st week, which returned to normal in 2-3 weeks time. In vitro sensitivity of organism isolated (24 cases) were as follow--Chloramphenicol 7 (29.16%), Ampicillin 8 (33.33%), Gentamicin 22 (91.66%), Amikacin 24 (100%), Cefotaxime 22 (91.66%), Ciprofloxacin 24 (100%), and Ofloxacin 24 (100%). Clinical response to Ofloxacin and Ciprofloxacin was 100%, and fever subsided in 3-5 days.
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PMID:Changing profile of enteric fever--in summer-91. 130 27

We identified and reviewed retrospectively all the cases of infection by Pseudomonas and related genera in patients with AIDS and AIDS-related complex (ARC) who were hospitalized at our Institution over a 36-month period. We recorded 48 episodes of infection in 34 of 355 patients with AIDS, and in two of 73 patients with ARC: 25 pneumonias (9 community-acquired and 16 of nosocomial origin). 20 urinary tract infections, two soft tissue infections and one sepsis. In 14 of 16 patients with nosocomial pneumonia but in only one of nine patients with community-acquired pneumonia did we find coexisting opportunistic lung diseases. The following micro-organisms were isolated: P. aeruginosa in 41 cases, P. fluorescens in three cases, Xanthomonas maltophilia (P. maltophilia) in two cases, P. putida in one case. Comamonas testosteronis (P. testosteronis) and Comamonas acidovorans (P. acidovorans) in one case. Amikacin and ceftazidime, alone or in combination, appear to be the optimal choice of therapy for severe Pseudomonas infections in HIV-infected patients, although in our study six of 47 isolates were resistant in vitro to amikacin, and nine of 31 isolates were resistant to ceftazidime.
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PMID:Pseudomonas infections in patients with AIDS and AIDS-related complex. 158 72

Serratia marcescens bacteremia has become ubiquitous recently. S. marcescens bacteremia, either hospital- or community-acquired, can no longer be treated as insignificant. We reviewed 23 episodes of S. marcescens bacteremia in 1985. Among them, 17 patients (74%) were hospital-acquired infections, while 6 (26%) were community-acquired. Nine patients died, and the case fatality rate was 39%. Eleven patients (48%) had no clinically apparent source of infection, 5 (22%) had urinary tract infection, 3 (13%) had pneumonia, 2 (9%) had biliary tract infection, 1 (4%) had intra-abdominal infection, and 1 (4%) had skin and soft-tissue infection. Nosocomial isolates are often resistant to many antibiotics. Amikacin and the beta-lactamase-stable (third generation) cephalosporins are superior to gentamicin in the treatment of nosocomial S. marcescens bacteremia. We here emphasize that the awareness and treatment of S. marcescens bacteremia in daily clinical practice is unequivocally critical.
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PMID:Serratia marcescens bacteremia. 167 15

The culture results of sputum (SP), blood (BL) and wound secretions (WS) of 47 cases of burns with lung infection were analyzed. Symptoms of pneumonia within 5 days after burn were observed in 90.3% of inhalation injury patients (IIG, 31 cases) whereas only in 25.0% of noninhalation injury patients (NIIG, 16 cases). The isolation rates of Gr(-) bacteria from the 3 sources of culture were markedly higher than those of Gr(+) cocci. The same bacteria, mainly Ps. aeruginosa and Staph. aureus, were identified simultaneously from the 3 sources of culture in 12 cases (25.5%). Isolates from SP correlated well with those from WS, the coincidence rates of 4 main Gr(-) bacteria were over 58%. Ps. aeruginosa was the commonest pathogen of IIG but Staph. aureus was the commonest in SP and BL of NIIG. The isolation rate of fungi of SP in NIIG was about twice that in IIG. Ps. aeruginosa and E. coli were susceptible to Amikacin and Polymixin B, Ps. aeruginosa was more susceptible to Cefoperazone, while the Gr(+) cocci were susceptible to first generation Cephalosporins.
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PMID:[Bacteriologic study of lung infection in 47 cases of burns]. 211 35

We compared the bactericidal efficacies of various antimicrobial agents and combinations thereof in experimentally induced Nocardia asteroides pneumonia in immunocompromised mice. Cortisone acetate treatment, which produced impaired cell-mediated immune function, was followed by nasal inoculation of 5 x 10(4) CFU of N. asteroides into each mouse. Therapy was begun 24 h after inoculation and continued for the next 96 h. Dosages of antimicrobial agents resulted in concentrations approximating levels in human serum. Animals from each of nine treatment groups were sacrificed every 24 h. The pulmonary tissue obtained was homogenized and quantitatively cultured. Results were calculated to indicate the number of CFU per gram of lung tissue. Amikacin and imipenem were the two most effective single agents studied. Sulfadiazine and ciprofloxacin were ineffective, and ceftriaxone reduced bacterial counts modestly. Combination therapy did not enhance the bactericidal activities of the agents tested. We conclude that amikacin and imipenem, as well as select broad-spectrum cephalosporins, represent therapy superior to the sulfonamides in this experimental model and may represent alternative treatment for patients who cannot tolerate sulfa agents (e.g., human immunodeficiency virus-infected patients) or who fail primary treatment.
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PMID:Therapy of pulmonary nocardiosis in immunocompromised mice. 228 88

Amikacin (AMK) by intravenous drip infusion was given to patients with infections in the field of internal medicine and the results were followings: AMK was administered to 19 patients. Diagnosis included sepsis or suspected sepsis (11 cases), pneumonia (2 cases), chronic respiratory tract infections (3 cases) and urinary tract infections (3 cases). Underlying disease included hematologic disease (13 cases), lung fibrosis (1 case), chronic respiratory insufficiency (1 case), diabetes mellitus (1 case), hepatic coma and bronchial asthma (1 case) and prostatic hypertrophy (1 case). Nineteen episodes responded to single therapy (2 cases) or combined therapy with other antibiotics (17 cases). AMK by intravenous drip infusion (dissolved in not less than 100 ml of saline or glucose) was administered at the dose of 200 mg/day to 600 mg/day divided into 2 or 3 times, over 1 hour to 2 hours. The mean duration of therapy was 10 days and the mean total dose was 4.3 g. Clinical effects: Excellent in 7 cases, good in 7 cases, fair in 3 cases and poor in 2 cases, and efficacy rate was 74%. Bacteriological effects: Disappeared in 3 cases, partly disappeared and unchanged in 3 cases, superinfection in 1 case and newly appeared in 1 case. Four strains out of 7 cases of which were detected the causative bacteria were disappeared. GM resistant bacteria (S. marcescens in 2 strains and C. diversus in 1 strain) were disappeared by the administration of AMK, also some clinical symptoms and signs were improved. No side effects and no abnormalities in laboratory findings were noted in any cases attributed to AMK. In conclusion, high efficacy rate was obtained without any side effects, intravenous drip infusion of AMK seemed to be useful for infections in patients with bleeding tendency (e.g. leukemia) or malignant disease.
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PMID:[Clinical evaluation of amikacin by intravenous drip infusion for infections in the field of internal medicine]. 407 2

Amikacin was studied for clinical effect in 7 patients with acute leukemia, 1 patient with chronic myelogenous leukemia-blastic crisis, 1 patient with malignant lymphoma and 1 patient with aplastic anemia, who were suffered from severe infection such as sepsis, pneumonia or subcutaneous abscess. Most of these patients had bleeding tendency, so amikacin was administered by intravenous drip infusion in a dose of 200 mg--400 mg for 1 hour. Total doses of amikacin were between 3.2 g and 12.6 g. These doses of amikacin gave good response to 3 patients with sepsis, 1 patient with subcutaneous abscess and 1 patient with pneumonia. We didn't observe any side effect most likely associated with amikacin. Therefore, intravenous drip administration of amikacin might be useful drug for management of severe infections in patients of hematological disorder, and seemed to be as safe as intramuscular administration.
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PMID:[Experiences with intravenous drip infusion therapy of amikacin for severe infections in patients of hematological disorder]. 713 57


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