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Query: UMLS:C0036690 (sepsis)
 59,461 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A fusobacterium necrophorum septicemia due to a neglected peritonsillar abscess is reported in a 7 year-old boy with no significant past medical history. Osteo-articulary, hepatic and pleuro-pulmonary septic localizations, with an otherwise favourable outcome left severe orthopedic sequelae in the right hip. This resembles the post-peritonsillar abscess septicemia described by Lemierre in 1936 which was due to an anaerobic bacillus (fusobacterium). The reappearance of this pathology should lead to systematic anaerobic blood and abscess studies. Penicillin G and Metronidazole are still efficient in controlling this organism.
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PMID:[Post-angina septicemia caused by Fusobacterium necrophorum in a 7-year-old child]. 346 89

Post-appendicectomy sepsis still causes considerable morbidity and prolongs hospital stay. A large amount of recent work has gone into attempts to reduce such problems using various topical and systemic agents in differing regimes, with wide variation in their results. The aim of our study was to examine further the effectiveness of those different lines of prophylaxis against placebo in reducing post-appendicectomy sepsis. It is a comparative study of 400 cases of uncomplicated appendicitis operated upon by three senior Surgeons. The cases were allocated randomly in equal number to four groups according to the prophylactic antibiotic regime used: (a) Placebo; (b) Metronidazole alone; (c) Metronidazole and cefazolin; (d) Metronidazole and tobramycin. Antibiotics were given preoperatively with premedication and continued postoperatively for three days. The patients were checked for signs of sepsis during hospital stay and weekly up to a minimum of four weeks after discharge. They were also compared as far as their hospital stay is concerned. The conclusion of this study is that a combination of an antibiotic aimed at aerobes (cefazolin or tobramycin) with another aiming at anaerobes (metronidazole) is the best prophylactic regime against post-appendicectomy sepsis.
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PMID:The place of antibiotics in the prevention of post-appendicectomy sepsis: a prospective study of 400 cases. 352 66

The incidence of pelvic inflammatory disease (PID) attributable to IUD use has been increasing, especially after the removal of the Dalkon shield from the market, but this relationship has not been settled conclusively. In recent decades PID included a variety of infections, but lately the definition of PID has meant acute ascending infections of the female genital tract. Its most common risk factors include promiscuity of IUD use, although this can be reduced to one fourth by regular checkups and proper hygiene. The frequency of PID is estimated at 2-5% of IUD users. Microorganisms contributing to PID include Neisseria gonorrhoeae, Chlamydia trachomatis, Mycoplasma hominis, Escherichia coli, Proteus, Staphylococcus epidermis, Haemophilus influenzae, Bacteroides, Peptococcus, Peptostreptococcus, Clostridium, and Actinomyces israelii, The differentiation of actinomycosis (AC) and pseudoactinomycosis (PAC) is well advised. The potential of IUD use in increasing the risk of AIDS should not be discounted. The clinical picture of PID is varied, it can be mild requiring conservative drug therapy; with medium severity requiring removal of the IUD and drug therapy; severe necessitating removal, antibiotics and sulfonamide treatment and laparotomy; and very severe with potentially fatal generalized sepsis. In addition to antibiotics, e.g., penicillin, treatment can include the so called catastrophy combination of Mandokef- Metronidazol-Gentamycin. An analysis of the data of 8536 IUD fittings in Debrecen, Hungary showed 1.4% removals due to PID after 4 years, 694 patients (8.1%) had lower abdominal pain 73 of which (0.9%) had palpable resistance, and suppuration occurred in only 30 cases (0.4%). Treatment included Semicillin or Tetran, or removal of the IUD, and even surgery if no improvement resulted. Prevention of PID include elimination of risk factors, the careful selection of IUD users, regular checkups, the use of copper (Cu) T device, and strict adherence to professional standards.
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PMID:[The role of intrauterine contraceptive devices in the development of inflammatory processes in the small pelvis]. 376 5

A prospective, randomized clinical trial was undertaken to compare the value of a combination of two antibiotics for the prevention of postoperative septic complications after large bowel surgery. In group I the patients received three doses daily for 2 days of 80 mg gentamicin and 600 mg clindamycin, intravenously. Patients in group II received three doses daily for 2 days of 80 mg gentamicin and 500 mg metronidazole. Antibiotic administration was started in the operating room before the surgical procedure. The two antibiotics were administered by separate venous routes. One hundred and seven patients were allocated to either one of the two groups. Both groups were equally matched for gender, age, and surgical procedure. Bacteriologic specimens were taken in the wound as soon as the peritoneum was closed. They were immediately incubated for identification by aerobic and anaerobic cultures and sensitivity determinations. Cultures of one or more organisms were positive in 63 of 107 specimens. There was no difference between the two groups. No death occurred as a result of intra-abdominal complication, no reoperation was required, and in no case did peritonitis occur. Six wound abscesses and three delayed stitch infections were observed: five in group I and two in group II. Five clinical anastomotic leakages were observed (5.1%): two in group I and three in group II. They did not require treatment and healed spontaneously. Furthermore, five radiologic anastomotic leakages were present in 45 patients who received a control barium enema. No side effects were noted with metronidazole of with clindamycin. No clinical evidence of ototoxicity or nephrotoxicity was observed in patients receiving gentamicin. There is no statistically significant clinical difference between the combination of gentamicin and metronidazole or gentamicin and clindamycin. Both combinations are effective in preventing wound sepsis in large bowel surgery. Metronidazole and clindamycin were equally effective in preventing postoperative anaerobic infections. No resistance of anaerobic organisms to metronidazole was observed.
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PMID:Antibiotic prophylaxis in large bowel surgery: results of a controlled clinical trial. 633 62

Prophylactic chemotherapy was given to 100 patients who underwent cesarean section. Ampicillin was given to 50 patients and I.V. metronidazole to the other 50 (in a single dose of 500 mg to 20 and in 3 doses to 30 patients). The overall febrile morbidity was 20%. Metronidazole was superior in reducing febrile morbidity and wound sepsis, compared to ampicillin (P less than 0.05). This study supports the concept of prophylactic chemotherapy being beneficial to the obstetric patient. A single dose of 500 mg I.V. is satisfactory for prophylactic use in cesarean section.
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PMID:Prophylactic intravenous metronidazole in cesarean section. 653 54

Metronidazole, a nitroimidazole derivative, is a unique antimicrobial agent that is active against both bacterial and parasitic organisms, although only the anaerobic members of these groups are susceptible. It has been used for the treatment of trichomoniasis for about 20 years and is also effective against amebiasis and giardiasis. More recently, metronidazole has emerged as a principal agent for the treatment of anaerobic bacterial infections. It is highly effective against all species of anaerobes except certain non-spore-forming gram-positive bacilli and cocci and is the only agent rapidly bactericidal against the Bacteroides fragilis group. Clinical studies have proved its efficacy in prophylaxis for elective colorectal surgical procedures and in the treatment of deep abdominal sepsis (usually in combination with another agent, such as an aminoglycoside). Metronidazole is the treatment of choice for nonspecific vaginitis that seems to be a mixed infection due to anaerobes and Gardnerella vaginalis. Adequate concentrations in the blood are produced after both oral and intravenous administration, and the side effects are infrequent and minimal.
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PMID:Metronidazole. 660 Aug 4

Abscesses of the liver represent the most common complications of amebiasis. In general they are treated non-surgically by the aid of Metronidazol. Complications, however, such as perforations, development of fistulas or septicemia may occur and necessitate surgical intervention. The role of CT in diagnostic problems and therapeutic management is discussed in three different cases with respect to other diagnostic techniques.
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PMID:[Diagnostic and therapeutic problems in amebic liver abscess]. 667 24

Metronidazole, in particular, and the other nitroimidazoles (tinidazole, ornidazole) available in Australia are well established drugs for the treatment of protozoal (trichomonal or amoebic) infections; recent data testify to their efficacy in the prevention and therapy of anaerobic infections. Administration by oral and rectal routes is indicated rather than by the intravenous route on the basis of efficacy, safety and cost; this recommendation is applicable to both loading and maintenance dosing. Intravenous administration should be restricted to emergency preoperative loading (single 500-mg dose); to patients with proven anaerobic infections; patients with serious sepsis associated with an unidentified organism; patients who are unable to take medication by mouth and those without a functional rectum or with diarrhoea; and patients with leukaemia who are vomiting. These drugs are remarkably safe under conditions of acute use if the intravenous route is avoided. However, extreme caution in their long-term use and use in obstetric and paediatric patients should be exercised until toxicological issues are resolved. It is concluded that the nitroimidazoles are effective, cheap and safe drugs for the short-term treatment of protozoal and bacterial (anaerobic) infections.
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PMID:Current clinical applications and dose regimens of metronidazole and related nitroimidazoles. 674 31

For the past 6 years at St. Thomas' Hospital, metronidazole has been used to treat proven anaerobic infection at a wide variety of sites and of varying clinical severity. Throughout this period, intravenous, oral, and rectal preparations of the drug have been available. Initial experience was predominantly in abdominal sepsis where excellent therapeutic results were obtained and treated patients included many with mixed aerobic/anaerobic infection in whom metronidazole was used alone. Metronidazole also has been used either alone or in combination, most frequently with amoxicillin, to treat many other anaerobic infections: head and neck, pleuropulmonary, genital tract, bone and joint, skin and soft tissue, and cases of fusobacterial septicemia (necrobacillosis). Although, as in pyogenic infection of any etiology, surgical intervention often is required in anaerobic sepsis, there is little doubt of the useful therapeutic role of metronidazole in these patients. Increasing awareness of the wide clinical spectrum of human anaerobic infections has led to increasing therapeutic dependence on metronidazole with as yet little evidence of bacterial resistance.
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PMID:The therapeutic use of metronidazole in anaerobic infection: six years' experience in a London hospital. 684 7

Metronidazole is a 5-nitroimidazole that has selective activity against anaerobic microorganisms, including bacteria and protozoa. Intravenous metronidazole has recently been approved by the U.S. Food and Drug Administration for the treatment of serious anaerobic bacterial infections. It is usually bactericidal at low concentrations, and its spectrum of activity encompasses almost all anaerobic bacteria and some capnophilic organisms. Anaerobic bacteria known to be resistant to metronidazole include occasional anaerobic cocci, some nonsporulating gram-positive bacilli and propionibacterium. Metronidazole is the most active antimicrobial agent against Bacteroides fragilis, the most resistant of anaerobic bacteria. Kill-curve studies demonstrate that there is a 2 to 5 log decrease in the number of colony forming units of B. fragilis and Clostridium perfringens within one hour. The only well documented metronidazole-resistant strain is a B. fragilis isolated from the normal flora of a patient on long-term metronidazole therapy for Crohn's Disease. Metronidazole resistance in Trichomonas vaginalis has recently been described in a few strains that are able to survive at increased oxygen tensions. Metronidazole has been shown to be efficacious in certain protozoal infections including trichomonal vaginitis, extraintestinal amebiasis, and giardiasis. Clinical studies have shown metronidazole to be efficacious in the therapy of a variety of anaerobic infections, including non-traumatic brain abscesses, intraabdominal sepsis, pelvic suppuration and necrotizing soft tissue infections. There have been disappointing results in the therapy of anaerobic pleuropulmonary infections with a number of superinfections caused by aerobic bacteria. Since metronidazole lacks any activity against aerobic bacteria, it must be combined with other agents, usually aminoglycosides, in the treatment of mixed infections involving anaerobic and aerobic bacteria.
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PMID:Metronidazole: in vitro activity, pharmacology and efficacy in anaerobic bacterial infections. 692 1


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