Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0036690 (sepsis)
 59,461 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The pharmacokinetics, efficacy and safety of sulbactam/ampicillin (SBT/ABPC) were evaluated in 21 children with a variety of infections. The results obtained are summarized as follows. 1. Pharmacokinetics in 4 children, each receiving a single dose of 60 mg/kg, were evaluated. The average half-life of SBT was 1.03 hours and that of ABPC was 0.83 hour. 2. In vitro antimicrobiol activity (MIC) of SBT/ABPC in which SBT and ABPC are combined at a ratio of 1:2 was stronger than ABPC alone and was quite effective against Staphylococcus aureus and Haemophilus influenzae, but activity against Escherichia coli was relatively low. Antimicrobial activity of SBT/ABPC against S. aureus was almost equal to those of piperacillin (PIPC), cefazolin (CEZ) and cefmetazole (CMZ), but against H. influenzae was stronger than those of CEZ and CMZ. Activity against E. coli was lower than those of PIPC, CEZ and CMZ. 3. A total of 21 patients including 3 with pharyngitis, 10 with bronchitis, 5 with pneumonia, 1 each with acute enteritis, pyelonephritis and suspected sepsis were treated with SBT/ABPC. The clinical efficacy rate for these patients was 95.2% (20/21). The bacteriological eradication rate was 80% (8/10). 4. There were 4 instances of side effects, 1 case each of eruption, diarrhea, thrombocytosis and eosinophilia, but all symptoms were transient.
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PMID:[Pharmacokinetic, bacteriological and clinical evaluation of sulbactam/ampicillin in pediatrics]. 274 54

Pharmacokinetic, bacteriological and clinical studies on imipenem/cilastatin sodium (IPM/CS) were performed in neonates. The results obtained are summarized as follows. 1. Plasma levels and urinary excretion of IPM and CS sodium were determined in 7 neonates with ages between 7 and 26 days (gestation periods were 37 to 41 weeks and birth weights were 2,410 to 3,890 g) upon 1 hour drip intravenous infusion of IPM/CS at 10 mg/10 mg/kg, or 20 mg/20 mg/kg. Mean plasma concentrations of IPM reached their peaks at the end of infusion with levels of 12.7 +/- 3.0 micrograms/ml for the group given 10 mg/10 mg/kg, and 19.1 +/- 4.1 micrograms/ml for 20 mg/20 mg/kg. The concentration of IPM in plasma showed a dose-response to the 10 mg/10 mg/kg and 20 mg/20 mg/kg dosages. Concentrations decreased with half-lives of 1.87 +/- 0.71 hours and 1.97 +/- 0.21 hours for the low and the high dosages, and plasma levels at 8 hours after administration were 0.3 +/- 0.1 microgram/ml and 0.8 +/- 0.3 microgram/ml, respectively. Mean urinary recovery rates in 8 hours after administration were 37.6 +/- 11.8% and 26.8 +/- 17.2% for the low and the high dosages. While, mean plasma concentrations and mean urinary recovery rates of CS were higher than those of IPM, mean plasma half-lives of CS were similar to IPM. 2. IPM/CS was administered to 11 neonatal patients (with ages between 1 and 26 days) of various bacterial infections, and clinical effectiveness, bacteriological efficacy and adverse reactions were evaluated. Clinical efficacies in cases including 7 with acute pneumonia and 1 each with suspected septicemia, intrauterine infection, acute urinary tract infection and periproctal abscess were judged excellent in 10 and good in 1 case, and the efficacy rate was 100%. Causative organisms isolated from these patients included 3 strains of Escherichia coli and 1 strain each of Streptococcus pyogenes, Streptococcus agalactiae Enterococcus faecalis and Haemophilus influenzae. All the organisms were eradicated by IPM/CS, thus the bacteriological eradication rate was 100%. No adverse reactions were observed, but decreased platelet in 1 patient and increased GOT in 2 patients were found as abnormal laboratory test values. These changes, however were transient, and returned to normal after discontinuation of IPM/CS. It was concluded that the clinical results of IPM/CS are indicative of excellent efficacy, safety and usefulness of the drug in the treatment of infections in neonates.
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PMID:[Pharmacokinetic, bacteriological and clinical studies on imipenem/cilastatin sodium in neonates]. 274 58

Immune thrombocytopenia is a well-recognized part of the clinical spectrum of infection with the human immunodeficiency virus. From November 1985 to February 1988, 15 patients who were human immunodeficiency virus-positive underwent splenectomy for refractory immune thrombocytopenia. Eight patients had thrombocytopenia only, and 7 others were pancytopenic prior to splenectomy. Three of the 15 patients fulfilled criteria for acquired immunodeficiency syndrome before splenectomy, and acquired immunodeficiency syndrome developed in 5 patients during the follow-up period. The median duration of thrombocytopenia prior to surgical therapy was 6 months. A bone marrow biopsy specimen showed hypercellularity with increased megakaryocytes. All patients had a therapeutic response to splenectomy. Long-term remission from thrombocytopenia/pancytopenia was achieved in 14 of the 15 patients during a follow-up period of 2 to 21 months. Splenectomy can be accomplished with an acceptable morbidity. Pneumonia developed postoperatively in 2 patients, but they did not manifest the characteristic picture of overwhelming postsplenectomy sepsis. They had received vaccinations against encapsulated organisms preoperatively. We conclude that splenectomy provides a durable and lasting response for HIV-related thrombocytopenia. Vaccination for Streptococcus pneumonia and Haemophilus influenzae should be given prior to splenectomy although its efficacy is not clear in this group.
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PMID:Splenectomy. The treatment of choice for human immunodeficiency virus-related immune thrombocytopenia? 278 77

The spectrum of severe Haemophilus influenzae type b disease exclusive of meningitis includes: epiglottitis, pneumonia, arthritis, septicemia, cellulitis and pericarditis. The results of a 7 year-epidemiologic study (Jan 1980 to Dec 1986) performed in 2 French departments are reported. Sixty-nine cases were detected, representing a yearly rate of 9/100,000 children aged 0 to 4 years. The real incidence is probably higher and was estimated as 11/100,000. In all of France, it corresponds to 382 annual cases and, more specifically to 60 to 70 annual cases of epiglottitis. No deaths were recorded and only 2 cases with minor sequelae were documented in this series. These results, as compared with those of previous studies, show that the incidence is lower than that in other countries, especially with regard to epiglottitis which is more frequent in North America and in Scandinavian countries.
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PMID:[Epidemiology of Haemophilus influenzae type b infections (excluding meningitis) in 2 French departments]. 278 12

Cefodizime (THR-221, CDZM), a new cephalosporin antibiotic, was evaluated for its safety and efficacy in 27 children with various bacterial infections. The episodes of infections included pneumonia (6 cases), bronchopneumonia (11 cases), lung abscess (1 case), acute pharyngitis (2 cases), cervical lymphadenitis (1 case), infected cephalohematoma (1 case), urinary tract infection (1 case), sepsis (2 cases) and purulent meningitis (2 cases). CDZM was effective in all but one, and its efficacy rate was 96.3%. The main etiologic pathogens were Staphylococcus aureus, Haemophilus influenzae, Haemophilus parainfluenzae, Streptococcus pneumoniae, Streptococcus agalactiae, Escherichia coli, Citrobacter freundii and Branhamella catarrhalis. The elimination rate was 92.3%. As adverse reactions or abnormalities, diarrhea was encountered in 4 cases. A slight elevation of serum transaminases or eosinophils was observed in 4 cases. The serum half-life was approximately 1.8-1.9 hours in children after intravenous bolus injections. Concentrations of CDZM in cerebrospinal fluids were well above MIC values of CDZM against those organisms responsible for the infections. The data suggest that CDZM is a safe and effective antibiotic when used in children with bacterial infections including purulent meningitis.
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PMID:[Clinical and pharmacokinetic study on cefodizime, a new cephalosporin antibiotic, in the pediatric infections]. 279 54

Secondary infection of post-traumatic cavitary lung lesions is unusual. This report describes the clinical course of four patients who sustained severe blunt chest trauma and developed pulmonary pseudocysts that became foci for systemic sepsis. All four patients were adolescents or young adults. Hemophilus species and aerobic Gram-negative rods were the predominant pathogens recovered. Computed tomography of the chest was instrumental in establishing the diagnosis in each case. Despite appropriate antibiotic therapy, all four patients remained septic for weeks. One of the patients died as a result of this infectious process. One patient underwent successful operative debridement and drainage of the involved lung and pleural space. Because infected traumatic pseudocysts may not respond like typical lung abscesses to appropriate antibiotic management, early exploratory thoracotomy should be considered in those patients with prolonged fever and pulmonary deterioration.
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PMID:Secondary infection of post-traumatic pulmonary cavitary lesions in adolescents and young adults: role of computed tomography and operative debridement and drainage. 231 65

This retrospective hospital study concerns 159 infectious episodes observed in 60 patients with chronic lymphoid leukaemia (CLL) staged A, B or C on first admission. The most frequent site of infection was pulmonary (33%), followed by ENT and stomatological infections (15%), septicaemia (9%), urinary and genital tracts infections (9%), herpes virus infections (9%), skin and soft tissue purulent sepsis (8%), digestive tract (3%) and meningeal (1%) infections and isolated fever (8%). Seventy nine bacteria were isolated, including 35 Gram-positive cocci (Staphylococcus spp. 12, Streptococcus spp. 13, D. pneumoniae 5, Enterococcus spp. 5), 43 Gram-negative bacilli (Enterobacteriaceae 36, Pseudomonas spp. 5, Haemophilus influenzae 2) and 1 M. tuberculosis. The other documented infections were: candidiasis 11, viral infections 19 (including 17 of the herpes group) and 2 parasitoses (1 pneumocystosis, 1 toxoplasmosis). Sixteen patients died of toxic -infectious shock (9 cases, including 1 meningitis) or pneumonia (7 cases, including one chicken-pox). Stage C leukaemia and granulopenia (less than 1 X 10(9) PN/l) were associated with significantly more frequent and severe infections.
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PMID:[Severe infections associated with chronic lymphoid leukemia. 159 infectious episodes in 60 patients]. 294 30

There is poor correlation between the MICs and zone sizes obtained for erythromycin against Haemophilus influenzae. The effect of two media, Mueller-Hinton medium supplemented with 3% lysed horse blood and 10 micrograms of NAD per ml (MHA + LYHB) and Mueller-Hinton agar supplemented with 1% bovine hemoglobin and 1% IsoVitaleX (MHA + HGB), on the MICs and zone sizes of erythromycin against H. influenzae was determined. The effect of three different methods for inoculum preparation on the susceptibility of H. influenzae was also determined. The MICs were independent of the method of inoculum preparation, but the zone sizes were smaller if the inoculum was carefully adjusted to contain approximately 10(8) CFU/ml. MICs were higher and zone sizes were smaller when MHA + HGB was used instead of MHA + LYHB. Good correlation was found when MHA + LYHB was used for determining the MIC and MHA + HGB was used for determining susceptibility by the disk method. When the inoculum was adjusted to match a McFarland 0.5 standard, the viable counts had to be approximately 10(8) CFU/ml for good correlation between MICs and zone sizes. A-56268, a new macrolide antibiotic, was tested against H. influenzae, and its MICs and tentative breakpoints against this organism were determined. The MICs obtained by various methods were correlated with in vivo efficacy by using a mouse septicemia model. MICs obtained on MHA + HGB or MHA + LYHB incubated without a 5% CO2 atmosphere showed the best correlation with in vivo efficacy.
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PMID:Susceptibility testing of macrolide antibiotics against Haemophilus influenzae and correlation of in vitro results with in vivo efficacy in a mouse septicemia model. 295 54

The potential endotoxin modifying effects of subinhibitory doses of polymyxin B were evaluated in an animal model of overwhelming septicemia. Five to six day old Sprague-Dawley rats were infected intraperitoneally with 10(6)-10(7) cfu of Haemophilus influenzae type b. At 12 h after infection, at which time mortality was 18%, subinhibitory doses of polymyxin b (0.0125 mg/kg X 3 q 3 h) either alone or in combination with 500 mg/kg ampicillin significantly increased survival at 17 and 20 h (p = 0.009, 0.01 and p = 0.003, 0.01) compared to animals treated with 0.5 mg/kg of ampicillin alone. Prolonged survival at 36 h (p = 0.009) was seen in animals receiving both ampicillin and low dose polymyxin compared to either ampicillin dose alone. Ampicillin significantly reduced the number of bacteria in blood of survivors (p less than 0.023 at 30 min) compared to untreated animals but increased the activity of free endotoxin at 30 min compared to controls (p = 0.006). In vitro endotoxin release from H. influenzae type b increased 5-fold after addition of 100 micrograms/ml of ampicillin, whereas a six-fold reduction in endotoxin activity was measured after the addition of 7 micrograms/ml of polymyxin B. Subinhibitory doses of polymyxin B modulate the ethal effects of overwhelming H. influenzae type b infection in infant rats and might be beneficial as adjunct treatment in gram-negative septicemia.
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PMID:Protective effect of subinhibitory polymyxin B alone and in combination with ampicillin for overwhelming Haemophilus influenzae type B infection in the infant rat: evidence for in vivo and in vitro release of free endotoxin after ampicillin treatment. 301 Feb 23

A double blind placebo-controlled efficacy trial of two acellular pertussis vaccines was conducted in 3801 6- to 11-month-old children. Four vaccinated children died during 7 to 9 months follow-up as a result of Haemophilus influenzae type b meningitis, heroin intoxication with concomitant pneumonia, suspected septicemia, and Neisseria meningitidis Group B septicemia. From the actual death rate in children belonging to the same birth cohort in Sweden that could have been eligible for the trial, one death was expected among vaccinated children. Several investigations were carried out to examine the possibility that the deaths could be causally related to the vaccination. The relative risk for hospitalization due to systemic or respiratory infections was 1.07 (95% confidence interval, 0.95 to 1.20) and 0.83 (95% confidence interval, 0.64 to 1.08) in the vaccine groups as compared with the placebo group. Subsets of the population were studied for signs of immunosuppression. There was no indication of immunoglobulin deficiency or any sign of clinically significant leukopenia or lymphocytosis in vaccine recipients. The results of this analysis provide no evidence for a causal relation between vaccination with the studied acellular pertussis vaccines and altered resistance to invasive disease caused by encapsulated bacteria. The hypothesis that the two variables are related, however, cannot be refuted from these data.
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PMID:Mortality and morbidity from invasive bacterial infections during a clinical trial of acellular pertussis vaccines in Sweden. 305 Aug 58


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