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)

A previously healthy breast-fed baby was admitted at 10 days of age to a hospital in the north of Pakistan with diarrhoea and fever. He was treated for suspected sepsis with intravenous cefotaxime and tobramycin. Cultures of blood and faeces at that time proved negative. At 12 days of age, seizures began and examination of CSF revealed evidence of pyogenic meningitis but bacteria were neither seen microscopically nor isolated in culture. Ceftazidime was substituted for cefotaxime and carbenicillin was given also. Since the baby's condition continued to deteriorate with persistent fever, vomiting and recurrent seizures, he was transferred to the Aga Khan University Hospital, Karachi. Examination of CSF there confirmed the diagnosis of pyogenic meningitis and revealed Gram-negative bacteria. Cultures of CSF and faeces yielded Salmonella paratyphi A but the blood culture was negative. The isolate was found to be multiple antimicrobially resistant but sensitive to ciprofloxacin. Treatment with this drug was therefore started 3 days after the baby's admission to the Aga Khan Hospital. Within 36 h, improvement was observed. From then onwards, the baby made a progressive recovery and was healthy when seen at 7 months of age.
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PMID:Eradication of a multiple drug resistant Salmonella paratyphi A causing meningitis with ciprofloxacin. 143 Nov 77

A prospective randomized trial was conducted at Srinagarind and Khon Kaen hospitals. Ceftazidime (100 mg/kg of body weight per day) and co-trimoxazole (trimethoprim, 8 mg/kg/day; sulfamethoxazole, 40 mg/kg/day) therapy was compared with conventional therapy (chloramphenicol, 100 mg/kg/day; doxycycline, 4 mg/kg/day; trimethoprim, 8 mg/kg/day; sulfamethoxazole, 40 mg/kg/day) in the treatment of 64 patients with bacteriologically confirmed cases of severe melioidosis who were admitted during September 1986 to January 1989. Of 61 evaluable patients (3 were excluded because of severe drug allergies), 42 were septicemic, and 31 of these patients had the most severe form, disseminated septicemic melioidosis. Their cumulative mortalities on day 7 were compared. There were significantly lower overall mortalities from melioidosis, septicemic melioidosis, and disseminated septicemic melioidosis in the group receiving the new treatment compared with those in the group receiving the conventional treatment (47 versus 18.5% [P = 0.039], 57.7 versus 25% [P = 0.039], and 82.3 versus 30.7% [P = 0.006], respectively); but the differences could have been influenced by the greater severity of illness, e.g., shock at initial presentation, in the patients who received the conventional treatment. Among patients with disseminated septicemia and initial shock, there was no significant difference in mortality between the regimens. Both regimens effectively eradicated bacteria from the circulation within 24 h (97 versus 96%, respectively). We recommend ceftazidime and co-trimoxazole as the drugs of choice for treatment of severe melioidosis, especially in those patients with disseminated septicemia.
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PMID:Multicenter prospective randomized trial comparing ceftazidime plus co-trimoxazole with chloramphenicol plus doxycycline and co-trimoxazole for treatment of severe melioidosis. 159 Jun 82

In Japan, we experienced the first case of Hafnia alvei septicemia with shock and disseminated intravascular coagulation (DIC) in an adult with postoperative lung cancer. A 63 year-old male, who had been followed up in our department since 1987, was admitted to our hospital with the complaints of fever, hemoptysis and dyspnea on June 25, 1989. After admission, he was treated with sulbactam/cefoperazone 4 g/day intravenously for suspicion of respiratory-tract infection. After antibiotic administration, the fever subsided and the general condition became almost good. The patient experienced fever again after the antibiotic was stopped. For this reason subsequent Clavulanic acid/Amoxicillin, Flomoxef, and Ceftazidime was administered, but was not effective. Therefore septicemia was suspected and blood culture was done. The bacteria isolated from blood culture was identified as Hafnia alvei. Hafnia alvei is a gram-negative organism belonging to the Enterobacteriaceae family and quite rare pathogen in human.
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PMID:[Hafnia alvei septicemia with shock and DIC in an adult with postoperative lung cancer]. 176 1

A review of two third-generation cephalosporins, ceftazidime and cefotaxime, is presented. Ceftazidime, often used as a single agent, has shown greater activity than cefotaxime against Pseudomonas aeruginosa and other Pseudomonas species, Enterobacteriaceae, Acinetobacter sp, and Enterobacter sp. It has been effective as monotherapy in the treatment of peritonitis, gynecologic infections, chronic bronchitis, and infections in patients with leukemia and granulocytopenia, as has cefotaxime when in combination with an aminoglycoside. Cefotaxime has shown good activity against most aerobic gram-negative bacilli and against Staphylococcus. It has been used in respiratory infections, urinary tract infections, and septicemia. In contrast to first-generation and most second-generation cephalosporins, third-generation cephalosporins have proven useful in some types of meningitis. Ceftazidime and cefotaxime successfully penetrate into the cerebrospinal fluid and cures of bacterial meningitis have been reported with both drugs. Both ceftazidime and cefotaxime have been successfully used in children, infants, and neonates, as well as adults. Safety profiles of ceftazidime compare favorably with those of other third-generation cephalosporins.
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PMID:Ceftazidime and cefotaxime--the clinician's choice. 266 Sep 95

The efficacy of ceftazidime in the treatment of neonatal sepsis was studied in 42 low birthweight premature babies. Forty-nine courses of ceftazidime (25 mg/kg bd, iv or im were administered. In 19 babies, treatment was stopped after 48 h, the remainder were treated for 5 days or more. Six neonates had bacteriological evidence of infection, one other was pyrexial and 29 had radiological evidence compatible with respiratory tract infection. Eight of the study population died. Only one death was attributed to infection which arose 3 days after completion of a 5-day course of ceftazidime. Two babies developed clinical signs of necrotizing enterocolitis (NEC). Clostridium difficile (7) and Cl. perfringens (2) were isolated from 34 post-treatment faecal samples but not from the two babies with NEC. No faecal sample contained Cl. difficile toxin. Post-treatment cultures from 12 neonates yielded ceftazidime-resistant micro-organisms. Ceftazidime therapy was not associated with significant alteration in serum alanine aminotransferase, urea, creatinine, protein or albumin. Four babies had an eosinophilia, three transient and one following two intrauterine transfusions. Coombs' tests were performed on 17 babies. There were no false positives. The abnormal clotting studies observed in one baby were not due to ceftazidime. In a concurrent pharmacokinetic study, the half-life of ceftazidime was 7.4 (SD +/- 4.1) h following iv administration. Other pharmacokinetic values were C max 74 (SD +/- 20) mg l-1 trough concentration 20 (SD +/- 10) mg l-1. Total body clearance ranged from 0.13 to 2.10 ml min-1 per kg and increased with increasing postnatal age.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Ceftazidime in the treatment of neonatal infection. 286 90

Ceftazidime, a new cephalosporin antibiotic, was used as monotherapy to treat 75 term neonates with suspected perinatal bacterial infection. Septicemia was documented in ten patients (13%). Ceftazidime was administered as 25 mg/kg doses intravenously every 12 h. Peak serum concentrations at 0.5 h after dose ranged from 57 to 115 micrograms/ml and trough serum concentrations prior to next dose from 2 to 15 micrograms/ml. The overall clinical, bacteriological and laboratory response to ceftazidime was satisfactory and the drug was well tolerated. However, reservations with regard to study design, limited gram-positive drug activity and potential emergence of drug resistance require further well-controlled clinical evaluations of ceftazidime in neonatal intensive care units, before definite recommendations for the use of this antibiotic in perinatal infection can be formulated.
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PMID:Preliminary experience with ceftazidime monotherapy in perinatal infection. 312 59

The majority of gastrointestinal infections due to "thermophilic" Campylobacter is self limiting and does not need antibiotic treatment. Anyhow there are some serious cases (sepsis, persistent and relapsing gastroenteritis, severe immunodeficient patients) which require appropriate therapy. The susceptibility of 15 strains of Campylobacter jejuni and of 1 strain of C. coli, isolated from patients with acute gastroenteritis, has been studied against 12 antibiotics with the broth microdilution method at two different inocula (10(3)-10(4) CFU/ml and 10(7)-10(8) CFU/ml), and with the standard agar disk diffusion test, modified to allow sensitivity testing of Campylobacter. For each antibiotic, the geometric mean of MIC and of MBC and the concentrations of the various drugs needed for inhibition and killing of 50 and 90% of the strains (MIC-MBC50 and MIC-MBC90 respectively) have been calculated. Finally the percentage of resistant strains and the percentage of tolerant strains (ratio MBC/MIC: greater than or equal to 32) at low and high inoculum was determined. Erythromycin and aminoglycosides resulted the most active antibiotics against Campylobacter, being bactericidal as well as bacteriostatic at both low and high inoculum. Among the beta-lactams, cefotaxime was the most active, followed by piperacillin and ampicillin. Ceftazidime, aztreonam and rifampin were inactive. Ciprofloxacin, cotrimoxazole and tetracyclines showed some activity against Campylobacter at low inoculum. The agar disk diffusion method cannot be used for the "routinary" assay of susceptibility of Campylobacter, because it is a "naggy" microaerophilic organism.
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PMID:[Bacteriostatic and bactericidal activity, resistance and tolerance of 16 strains of thermophilic Campylobacter to 12 antibiotic drugs]. 345 49

The pharmacokinetics and clinical efficacy of ceftazidime, a new cephalosporin with activity against Pseudomonas aeruginosa, were studied in children and neonates. Our studies suggest that ceftazidime should be considered for the treatment of sever infections in pediatric patients (neonatal septicemia and meningitis, urinary tract infections due to multiresistant bacteria) and for the empirical therapy of febrile episodes in immunocompromised children. Ceftazidime appears to be effective and safe, alone or associated with an aminoglycoside, in the treatment of acute exacerbation in cystic fibrosis. The dosage recommended on the basis of our pharmacokinetic studies is 30 to 50 mg/kg intravenously every eight hours for infants and children and 30 mg/kg every 12 hours for neonates. Larger doses should be used in cystic fibrosis patients, immunosuppressed children, meningitis, and bacterial infections due to organisms with high MICs.
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PMID:[Multicenter clinical study and pharmacokinetics of ceftazidime in children and newborn infants]. 353 37

Ceftazidime (CAZ) was evaluated for its pharmacokinetics and clinical usefulness in neonates and premature infants. The results obtained were summarized below. Following intravenous injection of CAZ 10 or 20 mg/kg to neonates and premature infants, dose response was observed in serum concentrations ranging from 5.1 to 21.9 micrograms/ml at 6 hours after the injection. The serum half-life tended to be longer in premature infants than in neonates; the half-life being longer for an infant with lower day-age. Urinary recovery rates during the first 6 hours after single administrations of 10 mg/kg of CAZ tended to be higher in neonates than in premature infants, and higher rates were observed in older infants. However, no noticeable difference was observed after the administration of CAZ 20 mg/kg. Clinical efficacy was evaluated in 99 neonates and 55 premature infants (156 infections), daily doses ranging from 21.1 to 246.4 mg/kg. Out of 105 cases of common infections, mainly 44 cases with causative organisms identified (including 17 of sepsis, 7 of pneumonia, 4 of purulent meningitis, 11 of urinary tract infections) were examined for the clinical efficacy. The efficacy of CAZ was excellent in 21, good in 18, fair in 1 and poor in 4, with the efficacy rate of 88.6%. In the remaining 61 cases, i.e., 37 with causative organisms unknown and 24 with signs of intrauterine infections, the efficacy rate was 95.1%. Other than these cases, additional 51 cases were given CAZ solely for prophylaxis of infections, and the results were found satisfactory. On the whole, clinical efficacy rate of CAZ was 94.9% in 156 cases. Out of the 44 cases examined for bacteriological responses, 38 were evaluated as 'eradicated', 3 'persisted' and 3 'unknown' with eradication rate of 92.7%. Replacement of organisms (superinfection) was observed in 3 cases. Out of 179 cases in which adverse effects were assessable, adverse effects were observed in a total of 4 cases (2.2%), i.e., 3 cases of diarrhea (1.7%) and 1 case of rash (0.6%), and abnormal laboratory findings were observed in a total of 14 cases (7.8%), i.e., increase in eosinophiles count in 8 (4.5%), elevation of GOT in 3 (1.7%), increase in platelet, elevation of GOT . GPT, and elevation of GOT . GPT . BUN in 1 case each (0.6%). None of them were severe and they were transient. Elevations of bilirubin and cases of positive PIVKA II associated with CAZ were not observed.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[A pharmacokinetic and clinical evaluation of ceftazidime in neonates and premature infants. A study of ceftazidime in the perinatal co-research group]. 354 Mar 39

Ceftazidime (CAZ) was evaluated for its safety and efficacy in 27 newborns. Four confirmed cases of bacterial infections were cured by the CAZ therapy (efficacy rate 100%). The CAZ was assessed as effective in sepsis (2) and urinary tract infections (2). Main pathogens which responded to CAZ were Escherichia coli, Enterobacter cloacae and Acinetobacter anitratum. As adverse effects, elevations of GOT and GPT (1 case) were found to be associated with the CAZ therapy. Half-lives of the serum levels in mature infants were 1.93-3.52 hours, and those in low birth weight infants were 2.92-4.17 hours. Penetration into the cerebrospinal fluid in 1 case of viral meningitis was satisfactory. The data suggest that CAZ is a safe and effective injectable antibiotic when used in newborn with infection caused by CAZ-susceptible bacteria.
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PMID:[Clinical evaluation of ceftazidime in the treatment of neonatal infections]. 354 Mar 41


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