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)

Eighteen immuno-compromised children (malignancies, hematological diseases, collagen diseases) with neutropenia and infections were treated with imipenem/cilastatin sodium (IPM/CS), and the efficacy and the safety of the drug were evaluated. 1. Responses to IPM/CS were excellent in 13 patients, good in 1, and fair in 4. None of the patients displayed a poor response to the treatment thus the efficacy rate was 77.8%. 2. Of 5 patients with sepsis, 4 had excellent or good responses. IPM/CS was effective against sepsis caused by Enterococcus faecalis and Pseudomonas aeruginosa. 3. In patients with severe neutropenia (WBC less than 100/mm3), the efficacy rate was 70%. 4. As for side effects, elevations of GOT and GPT were observed in 1 patient with liver cirrhosis. These results indicate that IPM/CS is safe and effective in immuno-compromised children with neutropenia and infections.
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PMID:[Clinical evaluation of imipenem/cilastatin sodium against infections in compromised children (malignancy, hematological disease, collagen disease)]. 143 90

During the 12 year period from 1978 to 1990, 112 mature newborn and premature infants were diagnosed as sepsis in our nursery. The first case of MRSA sepsis was found in 1985. Since then, cases abruptly increased in number and 31 cases were found in total. Seven cases died and 24 were cured. Antibiotics such as AMK, MINO, IPM were effective. As the sensitivity of these drugs has been gradually dropping, we believe that VCM will be selected as the first choice. Early diagnosis and therapy are most important. Daily measurement of low level CRP (0.1 to 1.0 mg/dl) is useful and careful management is necessary in the course of significant PDA.
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PMID:[MRSA sepsis of premature infants]. 150 36

1. To evaluate the efficacy and tolerance of imipenem/cilastatin sodium (IPM/CS) in severe infections associated with hematopoietic disorders, IPM/CS was administered to a total of 105 patients. 2. Out of 96 patients evaluable for efficacy, clinical responses were excellent in 23 patients, good in 30, fair in 15, poor in 19 and unknown in 9, and the overall response rate was 60.9%. 3. The most common underlying hematopoietic disease was acute non-lymphocytic leukemia and the most common infections were sepsis and suspected sepsis. 4. Daily dose, severity of infection and neutrophil count had effects on the clinical response. 5. The overall eradication rate of bacteria was 83.7%. 6. Side effects were observed in 10 patients (9.5%) and abnormal laboratory test results in 12 (11.4%). From the above findings, we have concluded that IPM/CS is very useful for the treatment of severe infections in compromised patients with hematopoietic diseases.
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PMID:[Therapeutic evaluation of imipenem/cilastatin sodium for bacterial infections in patients with hematological diseases]. 161 65

Antibiotic usage for initial empirical treatment of infections in hospitalized patients was assessed by means of a questionnaire sent to physicians in charge of surgical and medical intensive care units, departments of neurosurgery, neurology, general surgery, thoracic surgery, internal medicine and pediatrics. Analysis of a total of 82 questionnaires filled in by the various departments revealed that the most frequently used regimens for initial empirical therapy were combinations of a broad spectrum penicillin with an amino-glycoside or of a second generation cephalosporin with an aminoglycoside in intensive care. Third generation cephalosporins ranked third among combination partners with aminoglycosides. Imipenem and fluoroquinolones were used only rarely for first line treatment. Second line treatment was most frequently with third generation cephalosporins or imipenem/cilastatin for internal wards and intensive care with an extension for staphylococcal infections with vancomycin or teicoplanin as the most frequent additional antibiotics. Patterns of antibiotic usage changed with regard to infection sites with a predominance of third generation cephalosporins or broad spectrum penicillins in combination with an aminoglycoside and metronidazole in abdominal sepsis and peritonitis. In case of pneumonia a differentiation between community acquired and hospital acquired pneumonias was made. Treatment was predominantly carried out with penicillin G, ampicillin or a second generation cephalosporin with or without the addition of an aminoglycoside in case of community acquired pneumonia. The addition of clindamycin or metronidazole was considered for suspected staphylococcal infection or aspiration pneumonia. Third generation cephalosporins were preferred for pneumonia treatment in surgical patients.
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PMID:Antibiotic usage for initial empirical treatment of infections in hospitalized patients in West Germany. 188 63

Fifty-two patients with moderate or severe infections associated with internal medicine were treated with imipenem/cilastatin sodium (IPM/CS) and the efficacy and the safety of this drug were evaluated. There were 20 patients with pneumonia, 10 with acute exacerbation of chronic respiratory tract infections, 9 with sepsis, 2 with pyothorax, 3 with intraabdominal infection, 2 with urinary tract infection, 1 with pulmonary abscess, 1 with infective endocarditis, 4 with fever of unknown origin. Forty-four patients were evaluable for the efficacy. Clinical efficacies were excellent in 12 patients, good in 26, fair in 3 and poor in 3. The overall clinical efficacy was 86.4%. The efficacy rate was 63.6% in patients previously treated and 93.9% in patients previously untreated with other antibiotics. Bacteriologically, Staphylococcus aureus (8 strains), Streptococcus pneumoniae (5), Streptococcus pyogenes (1), other Gram-positive coccus (1), Klebsiella pneumoniae (8), Haemophilus influenzae (4), Pseudomonas aeruginosa (3), Serratia marcescens (3), Escherichia coli (3), Branhamella catarrhalis (1), Citrobacter freundii (1), Klebsiella oxytoca (1), Enterobacter sp. (1), and Peptostreptococcus sp. (1) were eradicated. P. aeruginosa (3) and Acinetobacter sp. (1) decreased. S. aureus (1), S. epidermidis (1), P. aeruginosa (5), and S. marcescens (1) persisted or appeared. The eradication rate was 83.7%. Six patients showed adverse reactions including general fatigue 1, epigastralgia 1, eruption 1, eosinophilia 1 and elevation of S-GOT 2. But all of the adverse reactions were mild or slight, and transient. These findings indicate that IPM/CS is a useful and safe drug against bacterial infections in internal medicine.
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PMID:[Clinical evaluation of imipenem/cilastatin sodium in the internal medicine]. 192 Aug 13

After acute pharyngitis a 21 year old patient developed signs of severe bacteremia with a well demarcated infiltrate in the left lung. The typical course and a prompt response to antibiotic therapy with Imipenem (Tienam) led to the diagnosis of Lemierre's syndrome (post-anginal sepsis)--in spite of negative blood cultures. The patient recovered quickly, a chest radiogram after two weeks showing but pleural scarring and restitution ad integrum after four weeks.
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PMID:[Septic syndrome with a pulmonary focus]. 192 27

Imipenem/cilastatin (IPM/CS) was used to treat 39 documented infections in patients who had failed to respond to other antibiotic regimens. The overall response rating was 76.9%. Respiratory infections responded less frequently (efficacy rating, 55.6%) to IPM/CS than abdominal infections, urinary tract infections, or sepsis. Methicillin-resistant Staphylococcus aureus, Xanthomonas maltophilia, and Acinetobacter calcoaceticus were less sensitive to IPM/CS therapy than the other bacterial strains encountered. Respiratory tract infections were though to be less responsive to IPM/CS, probably because imipenem-resistant strains of S aureus were present in most of those cases. It is concluded that IPM/CS is well tolerated and effective in the treatment of various bacterial infections.
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PMID:Imipenem/cilastatin as secondary therapy for bacterial infections. 193 95

Sixty-eight patients with severe infections associated with hematopoietic disorders were treated with imipenem/cilastatin sodium (IPM/CS) and the efficacy and safety of this drug were evaluated. 1. Fifty-nine patients were evaluable for the efficacy. Clinical efficacies were excellent in 10 patients, good in 24, fair in 11 and poor in 14, and the overall efficacy rate was 57.6%. 2. The clinical efficacy rates were 62% against septicemia and suspected septicemia, 40% against pneumonia and 100% against urinary tract infection (1 case). 3. The clinical efficacy rates when these patients were grouped according to numbers of neutrophils after treatment were: less than 100/mm3; 44.4%, 101-500/mm3; 58.3% and over 501/mm3; 60.5%. The efficacy rate was particularly excellent, 60.0%, for patients with neutrophil counts were less than 100/mm3 both before and after treatment. 4. Sixty-eight patients were evaluable for the safety. Side effects were observed in 5 patients and abnormal laboratory test values were observed in 5 patients.
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PMID:[Clinical evaluation of imipenem/cilastatin sodium against severe infections in patients with hematopoietic disorders]. 208 23

Infections of the foot in the person with diabetes are the result of a complex myriad of pathophysiologic alterations. Neuropathy, vascular disease, and host immune alterations all interact to present a fertile ground for significant microbiologic invasion. When infection occurs, it is commonly due to a mixed flora of aerobic and anaerobic organisms, although "pure" aerobic or anaerobic infections are sometimes seen. Treatment of these infections requires a broad approach, including surgery, local care, and antibiotics. Most often, treatment against aerobic and anaerobic pathogens will be necessary. These infections can be divided into two categories based on clinical appearance. Severe life- or limb-threatening infections can present with massive cellulitis of the foot and leg, high fever, significantly elevated white blood count, septicemia, and tissue gas. Appropriate antibiotics in this setting include either combination or single-agent therapy. Imipenem/cilastatin offers coverage of all usual pathogens along with potentially lower toxicity and lower cost than combinations. Combinations containing clindamycin and aztreonam or ciprofloxacin may be useful for patients allergic to beta-lactam antibiotics. Less severe infections can usually be treated with a single-agent antibiotic such as ticarcillin/clavulanic acid or ampicillin/sulbactam. Cephalosporins with anaerobic activity, including cefoxitin, cefotaxime, and ceftizoxime, can be used in areas where enterococci are not a major problem.
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PMID:Microbiology and antimicrobial therapy of diabetic foot infections. 220 47

The authors compared broad-spectrum monotherapy with imipenem to an aminoglycoside-based antibiotic regimen for the management of intra-abdominal infections. One hundred and four patients who had intra-abdominal infection were randomly allocated to receive imipenem (52) or tobramycin plus clindamycin or metronidazole (52). Patients treated with imipenem had fewer febrile episodes and occurrences of breakthrough bacteremia, less antibiotic resistance and need for drug change; their hospital stay was shorter. The death rate from sepsis was 4% in patients who received imipenem and 13% in those who received the combined regimen (p = 0.08). Treatment was successful in 79% of patients on imipenem versus 67% of those receiving an aminoglycoside. Patient stratification by the APACHE II system and probability of death calculation using delayed-type hypersensitivity scores predicted a similar death rate for the two treatment groups. Imipenem appears to be a safe and efficacious alternative broad-spectrum antibiotic for treating patients who are seriously ill with intra-abdominal infection.
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PMID:Imipenem versus tobramycin--antianaerobe antibiotic therapy in intra-abdominal infections. 222 63


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