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)

Cefpodoxime proxetil (RU 51807) is an enterally absorbed ester prodrug which is rapidly cleaved in vivo after oral administration, with release of the active free acid metabolite cefpodoxime. The in vitro antibacterial activity of the sodium salt of cefpodoxime (RU 51746) against approximately 800 clinical isolates was evaluated comparatively with other orally active beta-lactams. RU 51746 was found to be active against enterobacteria normally susceptible to third generation cephalosporins, with MIC50 values ranging from 0.02 mg/l (Providencia sp) to 5 mg/l (C. freundii). RU 51746 was also active against H. influenzae, including beta-lactamase producing strains (MIC50 0.04 mg/l), oxa-S S. aureus (2,5), beta-hemolytic streptococci (0.05) and S. pneumoniae (0.002). Oxa-R staphylococci and P. aeruginosa were resistant to RU 51746 (MIC50 greater than 40 mg/l for both organisms). The antibacterial activity of RU 51746 was bactericidal in nature and independent from test conditions. The molecule was stable to all the beta-lactamases studied, with the exception of cefuroximase (type Ic). RU 51746 exhibited no strong inhibitory effects on these enzymes, except with Enterobacter P99 (type Ia). A good correlation was found between in vivo activity of RU 51807 and in vitro activity of RU 51746. Cefpodoxime proxetil was found to be more effective than cefaclor in mice with experimental septicemia caused by various streptococci, with a DP50 ratio in the 10-100 range. This advantage was again evidenced for septicemias due to various enterobacteria. In contrast, cefaclor proved more effective in experimental staphylococcus infections. In mice with experimental pneumonia, cefpodoxime proxetil caused sharp falls in K. pneumoniae lung counts. Six days after induction of the infection, 60% of animals under cefpodoxime proxetil had sterile lungs, versus 25% of animals under amoxicillin.
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PMID:[RU 51807 (cefpodoxime proxetil). In vitro and in vivo antibacterial activity of a new orally administered active cephalosporin]. 190 3

Since 1980, numerous reports have been published throughout the world on the pathogenic role of Branhamella catarrhalis. Apparently, Branhamella infections have been increasing in many places. Although they can affect various organs, they are most commonly observed in the airways and eye (both in children and adults). Not infrequently, Branhamella catarrhalis causes sepsis, in particular in immunosuppressed patients. The rapid increase in beta-lactamase-forming Branhamella strains results in frequent ineffectiveness of treatment with penicillin. In patients treated with penicillin for a primary infection by other bacteria, a secondary infection due to penicillin-resistant Branhamella organisms can subsequently occur. For treatment, therefore, beta-lactamase-stable antibiotics should be preferred.
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PMID:[Branhamella catarrhalis as a disease pathogen]. 193 24

Eighty-one episodes of bacteremia and candidemia were recorded in 78 infants in our neonatal intensive care unit during the years 1984 to 1988. The species isolated from monomicrobial episodes were as follows: Enterobacteriaceae 38%, group B streptococci or pneumococci 12%, staphylococci 20%, Candida albicans 9%, and other species 15%. Polymicrobial bacteremia occurred in 6%. Group B streptococci and pneumococci were predominantly isolated from early infections, whereas Enterobacteriaceae, Staphylococcus epidermidis and C. albicans were associated mainly with late septicemia. More than 80% of the episodes occurred in premature infants. During the study period, initial empiric antibiotic therapy consisted of ampicillin plus gentamicin. In spite of the fact that Enterobacteriaceae isolates, often ampicillin resistant, and penicillinase producing staphylococci, were the dominant etiologic agents, choice of this initial therapy did not seem to contribute to mortality. Mortality was most convincingly associated with overwhelming infections caused by group B streptococci and pneumococci.
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PMID:[Neonatal sepsis at Rigshospitalet in 1984-1988]. 199 42

Production of beta-lactamase is the most common mechanism of bacterial resistance to beta-lactam antibiotics. Virtually all bacteria have the capability of synthesizing the enzyme. Microorganisms may already possess the native genetic information necessary for beta-lactamase production (i.e., chromosomal), or may acquire the capacity by transfer of DNA from another organism (i.e., plasmid-mediated). The level of beta-lactamase production may be stable and noninducible (constitutive enzyme production), or may be stimulated on exposure to selected beta-lactam antibiotics (inducible enzyme production). Inhibitors such as clavulanic acid and sulbactam prevent antibiotic degradation by the beta-lactamases of many clinically significant pathogens. Therefore, currently available beta-lactam-beta-lactamase-inhibitor combinations exhibit broad spectra of in vitro activity. Ticarcillin-clavulanate possesses clinically significant activity against many bacteria, including streptococci, Staphylococcus aureus, Bacteroides fragilis, and numerous Enterobacteriaceae. Amoxicillin-clavulanate and ampicillin-sulbactam demonstrate clinically significant activity against streptococci (including enterococci), S. aureus, B. fragilis, and some Enterobacteriaceae. Ticarcillin-clavulanate is indicated for treatment of serious infections, including septicemia. Amoxicillin-clavulanate is useful in the treatment of upper respiratory, urinary tract, and skin and soft tissue infections. Ampicillin-sulbactam may be used for treatment of intraabdominal, gynecologic, urinary tract, and skin and soft tissue infections.
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PMID:Effects of beta-lactamase-mediated antimicrobial resistance: the role of beta-lactamase inhibitors. 204 31

Aztreonam, the first monocyclic beta-lactam antibiotic with pure anti-Gram-negative activity, combined with flucloxacillin, a penicillinase resistant penicillin, was given as empirical treatment of 53 serious infections in very elderly people. Eighteen of the cases had positive blood cultures and 11 had a clinical picture of sepsis without positive blood cultures: Of 49 evaluable infections, 45 (92%) were cured. In 40% of the infections, antibiotic treatment could be narrowed after 72 hours to one antibiotic. Diarrhoea, mostly transitory, was the only side-effect. Aztreonam-flucloxacillin combination is a safe and effective empirical treatment regimen for serious infections in very elderly patients.
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PMID:Aztreonam-flucloxacillin double beta-lactam treatment as empirical therapy of serious infections in very elderly patients. 205 4

The occurrence of Klebsiella oxytoca resistant to ampicillin, piperacillin, aztreonam and cefuroxime in a neonatal intensive care unit, including two cases of septicemia, was shown to consist of a spread on three consecutive occasions caused by three different biochemical Klebsiella oxytoca phenotypes. All isolates, except six surface isolates from one infant belonging to phenotype 1, were sensitive to cefotaxime (MIC 0.5-4 mg/l) and ceftazidime (MIC 0.25-1 mg/l). Isolates of phenotypes 1 and 2 produced a beta-lactamase with an isoelectric point of 5.5 and isolates of phenotype 3, a beta-lactamase with an isoelectric point of 7.9. The beta-lactamases of all three phenotypes hydrolysed benzylpenicillin and more slowly cephalothin. All phenotype 1 isolates carried a 2.9 Md plasmid and most isolates also a 36 Md plasmid. All phenotype 2 isolates carried a 4.8 Md plasmid and one isolate also a 30 Md plasmid. The phenotype 3 isolates carried only one 85 Md plasmid.
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PMID:Characterization of beta-lactam-resistant Klebsiella oxytoca isolated in a neonatal intensive care unit. 205 70

Gynaecological infections range from vaginitis to septic shock. Postoperative infections are common sequelae of hysterectomy. Sexually transmitted infections start as vaginitis or rather as cervicitis. During pregnancy and delivery we find septic abortion, amnionitis, endometritis, wound infections, thrombophlebitis, sepsis, mastitis and urinary tract infections. In most infections cephalosporins are drugs of first choice because of their broad spectrum, their beta-lactamase stability and their lack of toxicity, which is especially important in pregnancy.
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PMID:Infections in gynaecology and obstetrics and cefotaxime. 261 36

The microbial flora of the genital tract of 95 women who developed clinical signs of infection within 48 hr of vaginal delivery, Cesarean section delivery or abortion were compared with 111 women who delivered at the same hospital during the same time period but who showed no signs of sepsis. While there were no significant differences in the prevalence of most organisms in the lower genital tract of women with and without sepsis, there was evidence of a higher prevalence of gonococcal, chlamydial and anaerobic infection in the former. Gonococci were isolated from over 20 percent of untreated women with sepsis, more than three times the prevalence in controls. A third of the isolates were penicillinase-producing and another third showed in vitro resistance to penicillin. Chlamydial antigen was detected in 16-20 percent of women with sepsis following vaginal delivery or abortion, compared with 6 percent of controls. Neither gonococcal nor chlamydial infections were significantly associated with sepsis following Cesarean section delivery. Clue cells, indicative of G. vaginalis infection were noted in 20 percent of patients with sepsis compared with 7 percent of controls while amongst the other anaerobes only pigment producing Bacteroides were associated with sepsis. These findings suggest that antepartum investigations for clue cells, chlamydial antigen, gonococci and pigment producing anaerobes may identify patients most at risk from obstetric sepsis in Harare, and identify those for whom prophylactic administration of antibiotics may be of benefit.
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PMID:Vaginal flora of women admitted to hospital with signs of sepsis following normal delivery, cesarean section or abortion. The Puerperal Sepsis Study Group. 278 4

Infectious episodes in 90 patients with hematological disorders were treated with sulbactam/cefoperazone (SBT/CPZ), a new combination drug of a potent beta-lactamase inhibitor, sodium sulbactam, and a third generation cephalosporin, sodium cefoperazone. Clinical responses to the SBT/CPZ regimen were excellent in 23 cases, good in 30 cases, fair in 11 cases, and poor in 26 cases. The overall efficacy rate (percentage of cases showing excellent or good responses) was 58.9%. Efficacy rates classified according to different infections were: 80% in documented sepsis, 57.6% in suspected sepsis, 61.1% in pneumonia and 50% in other infections. One episode of side effect was encountered with redness and itching of skin. Hepatic disorders were observed in 3 cases. These adverse reactions, however, were not serious. These results indicate that SBT/CPZ has a high therapeutic efficacy to severe infections in patients with hematological disorders.
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PMID:[Treatment with sulbactam/cefoperazone of severe infections in patients with hematological disorders]. 281 Jul 34

Sixty-six cases of Gram positive infections were treated with teicoplanin in an open multicenter study, comprising 7 centers in Eastern France. There were 38 male patients and 28 females. Teicoplanin was given at a dose of 400 mg daily for a mean duration of 18.4 days. The most common infections were due to Staphylococcus aureus, found in 43 out of 56 documented cases. 69 (89.9%) of the 78 Gram + strains isolated had an MIC for teicoplanin of less than or equal to 2 mg/l. There were 44 serious infections (30 septicemia, 10 endocarditis, 1 joint and bone infection, 2 mediastinitis, 1 toxic shock syndrome) and 22 less serious infections (4 urinary infections, 14 skin and soft tissue infections, 3 lower respiratory infections, 1 hepatic abscess). In 42 cases concurrent medication was given: beta-lactamase in 11 cases, rifampicin in 10 cases, aminoglycosides in 22, phosphomycin in 3, pefloxacin in 5. The clinical cure and improvement rate was 90.10%. Adverse events were reported in 11 patients, and in only 3 cases was the therapy stopped. All were reversible on stopping therapy. Teicoplanin was found to be well tolerated and effective in the treatment of Gram positive infections in this study.
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PMID:[Teicoplanin and Gram-positive coccus infections. Results of a multicenter study on 66 cases]. 295 64


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