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

To assess the sites, incidence, and bacteriology of infections in intensive care burn patients, a prospective survey of all admissions to a tertiary care institution burn unit was carried out over a 12-month period. One hundred and sixteen patients were admitted, 106 with a diagnosis of thermal burns. Forty patients developed 90 infections. Only two deaths occurred, one in a patient with sepsis. In order of frequency, pneumonia, burn infection, UTI and primary bacteraemia were most common. Staphylococcal species accounted for a majority of infections at all body sites except UTI (47 per cent of all infections, including 11 of 14 bacteraemic infections). Staph. aureus sepsis was more common in those carrying the organism on admission. Strain typing of paired admission and subsequent clinical isolates in 19 patients with Staph. aureus sepsis indicated that eight (42 per cent) became infected with a strain they carried on admission. Further reductions in septic complications of burns in our center would be best directed at staphylococcal species, particularly Staph. aureus. Both eradication of carrier state, and prevention of acquisition of Staph. aureus strains could be explored.
 ...
PMID:Predominance of staphylococcal organisms in infections occurring in a burns intensive care unit. 141 12

Pharmacokinetic and clinical evaluations in pediatrics were made on meropenem (SM-7338, MEPM), a new parenteral dehydropeptidase-1 stable carbapenem used without any inhibitors, at 33 medical institutions. The results are summarized as follows. 1. Pharmacokinetic studies. MEPM at a dose of 10, 20, or 40 mg/kg was administered to 53 children by 30-minute drip infusion. Peak plasma concentrations (Cmax's) and plasma half-lives (T1/2's) of these doses were 28.5, 47.2 and 130.0 micrograms/ml, and 0.80, 0.93 and 0.94 hours, respectively. A clear dose response was observed in Cmax's and T1/2 values were quite similar to those observed in adults. In the first 6 hours after administration, 54.4 to 68.1% of the administered drug was recovered in urine. The cerebrospinal fluid (CSF) levels of MEPM in patients with purulent meningitis were 0.13 microgram/ml at a dose of 6 mg/kg, and 0.64 to 4.22 micrograms/ml at a dose of 29 to 44 mg/kg within day 4 of onset. The penetration rate of MEPM showed an intermediate value among those for other cephalosporin antibiotics. 2. Clinical study. Clinical efficacies of MEPM were evaluated in 389 cases. The most common doses used were 10 to 20 mg/kg/once, 2 to 3 times a day. The maximum dose was 173 mg/kg/day q.i.d. MEPM gave "excellent" or "good" responses in 242 (97.6%) out of 248 cases in which causative organisms were documented and in 134 (95.0%) out of 141 cases in which causative organisms were not identified. Clinical efficacy rates were 100% in 11 patients with purulent meningitis, 85.7% in 7 with septicemia, 98.8% in 173 with pneumonia, and 100% in 65 with UTI. Bacteriologically, 260 strains (96.7%) out of 269 strains were eradicated by MEPM treatment. Eradication rates were 89.2% for Staphylococcus aureus (37 strains) and 100% for Streptococcus pneumoniae (35 strains). The overall eradication rate for Gram-positive bacteria was 94.6%. Among Gram-negative bacteria, 98.3% out of 172 strains were eradicated. The eradication rate of Haemophilus influenzae (73 strains) was 98.6% and Pseudomonas aeruginosa (11 strains) was 90.9%, and all of Branhamella catarrhalis (15 strains), Escherichia coli (42 strains), and Klebsiella pneumoniae (6 strains) were eradicated. Out of 84 cases for which previous antibiotic therapies of 3 days or longer were not successful, MEPM gave "excellent" or "good" responses in 77 cases (91.7%) and excellent bacteriological responses (95.7%).(ABSTRACT TRUNCATED AT 400 WORDS)
 ...
PMID:[Pharmacokinetic and clinical studies with meropenem in the pediatric field. Pediatric Study Group of Meropenem]. 150 1

Two hundred and seventy-six hospitalized patients with severe infection (complicated UTI, pneumonia, skin and soft tissue infection or septicaemia) were randomly allocated to receive either 1g or 2g cefpirome bd. Two hundred and seventy-four patients were evaluable for tolerance, 210 for bacteriological efficacy. The two groups were similar in terms of underlying disease, age, sex, and general condition on admission. The overall clinical and bacteriological response rates were 97/103 (94%) and 68/76 (90%) respectively in the 1g group, compared with 102/107 (95%) and 67/71 (94%) in the 2g group. There was no significant difference between the treatment groups. Eighteen adverse events, possibly or probably drug related, were reported (7 in the 1g group, 11 in the 2g group). This resulted in discontinuation of therapy in four cases (two in each group). Fourteen of the adverse events were local (five receiving 1g, nine receiving 2g), mainly phlebitis or pain at the injection site. Thirteen patients died during the study period (up to 14 days after the last dose) but in no case was death attributed to cefpirome. A review of routine laboratory parameters revealed no abnormalities which could definitely be attributed to cefpirome although in four cases a relationship was considered possible; these included two increases in serum creatinine, one increase in SGPT, and one episode of neutropenia. Cefpirome administered as 1 or 2g twice daily was a well tolerated, effective agent for the treatment of severe sepsis in hospitalized patients.
 ...
PMID:Prospective randomized phase II study of intravenous cefpirome 1g or 2g bd in the treatment of hospitalized patients with different infections. Cefpirome Study Group. 160 64

During the clinical trials 8,861 patients have been treated with ciprofloxacin worldwide. 3,822 of the therapeutic courses were valid for analysis of efficacy according to FDA standards. The following dosages were usually administered: UTI: 100 to 500 mg twice daily orally or 100 mg twice daily intravenously; RTI: 250 to 1000 mg twice daily orally or 200 mg twice daily intravenously; septicemia: 200 mg intravenously twice daily; gonorrhea: 250 to 500 mg single tablet orally; all other infections: 500 to 1000 mg twice daily orally or 200 mg twice daily intravenously. Ciprofloxacin was administered to 762 courses of lower RTI, 88 courses of upper RTI, 108 courses of bacteremia, 766 courses of skin structure infection, 142 courses of bone and joint infections, 149 courses of intra-abdominal infections, 33 courses of gastrointestinal infections, 1,633 courses of UTI, 49 courses of pelvic infections, 279 courses of STD, mainly gonorrhea, and three courses of meningitis. The clinical response was resolution in 76%, improvement in 18% and failure in only 6%. Bacteriologic response by all sites evaluable: pathogens were eradicated from 74%, markedly reduced in 2%, persisted in 10%. Relapse occurred in 4% and reinfection was observed in another 6%. The overall response was favourable for 90% of the patients. Drug safety was established on a data base of 8,861 courses worldwide. The following side-effects according to COSTART terminology were observed: digestive 5%, metabolic nutritional 4.6%, central nervous 1.6%, skin 1.4%, hemic and lymphatic 1%, cardiovascular 0.4%, body as a whole 0.4%, urogenital 0.3%, special senses 0.3%, musculo-skeletal 0.1%, respiratory 0.08%. Several courses had more than one reaction. Thus the total incidence of side-effects for the treated patient population was 10.2%. Ciprofloxacin is a highly effective drug and a breakthrough in several areas of medical interest. It is relatively safe and side-effects are usually mild or moderate in intensity and transient.
 ...
PMID:Worldwide clinical data on efficacy and safety of ciprofloxacin. 328 11

Haemolysin production (HLY), mannose resistant haemagglutinating activity (MRA), presence of antigens K1 and K5 and colicinogenicity (Col) were compared with LD50 for mice in 663 Escherichia coli strains, including 281 faecal, 129 urinary and 253 other extraintestinal isolates. Those isolates that LD50 value fell into less than or equal to 10(6) LD50 category were arbitrarily termed highly virulent (HV) and those which belonged to greater than or equal to 10(7) LD50 category were considered avirulent (AV). HV isolates occurred significantly more frequently (58%) among strains from different extraintestinal samples than from faeces (14%) or urine (16%). The incidence of HV strains was significantly higher in patients with sepsis (43%) or meningitis (100%) than in patients with enteritis (20%), urinary tract infections (UTI, 16%) or in healthy subjects (28%). The incidence of HV strains in the most frequent (O1, O2, O4, O6, O7, O18, O75) serogroups was significantly higher (60%) than in others (10%). Strains with different virulence markers (HLY, MRA, K1, K5, Col) belonged significantly more frequently to the HV group than those which failed to have these markers (44 vs 27%, 51 vs 25%, 83 vs 17%, 78 vs 27%, 52 vs 16%, respectively). Important role of antigen K1 playing in pathomechanism of meningitis was confirmed by data of analysis according to which significant difference was revealed in the incidence of HV strains between groups of isolates with MRA+K1+ (71%) and MRA+K1- (44%, p less than 0.02), or between groups of isolates with MRA+K1- and MRA-K1+ (91%, p less than 0.001). Moreover there were significant differences in the incidences of HV strains in K1+Col- (73%) and K1-Col+ (29%, p less than 0.001), and in K1+Col+ (86%) and K1-Col+ (29%, p less than 0.001) groups. Further evidence was given by those data that there were no significant differences between groups of HV strains with MRA+K1+ and MRA-K1+ (p greater than 0.05) or with K1+Col+ and K1+Col- (p greater than 0.1) properties. Isolates that possessed simultaneously two of MRA, HLY, Col markers were more pathogenic in LD50 assay than those that had one or the other of these markers alone. Strains in serogroup O18 killed mice significantly more frequently than those of other serogroups independently of having any virulence factor, suggesting that bacteria in serogroups O18 must have some special virulence other than K1, Col, MRA or K5. MRA+HLY+ HV strains occurred frequently in extraintestinal diseases (42%) supporting the preconception that these properties play an important role also in the pathomechanism of extraintestinal infections other than UTI.(ABSTRACT TRUNCATED AT 400 WORDS)
 ...
PMID:Virulence factors of Escherichia coli. IV. Association in Escherichia coli of LD50 with haemolysin production, haemagglutinating capacity, antigens K1, K5 colicinogenicity and pathogenicity. 330 77

Pharmacokinetic and clinical studies of imipenem/cilastatin sodium (MK-0787/MK-0791), a newly developed combined antibiotic in a 1:1 ratio, were performed in the field of pediatrics. The MK-0787/MK-0791 was administered to 15 children. Ten and 20 mg/kg doses of MK-0787 were administered by a intravenous drip infusion for 30 minutes to 3 children each. In the remaining 9 cases, MK-0787 doses of 10, 20 and 30 mg/kg were administered to 3 children each by a 1 hour intravenous drip infusion. Levels of MK-0787 and MK-0791 in plasma, urine and urinary recovery rate of the drugs were also determined. In addition, MK-0787/MK-0791 was administered to a total of 29 children; 2 children with bronchitis, 16 with pneumonia, 4 with UTI, 2 with purulent lymphadenitis and 1 child each with tonsillitis, septicemia suspected disease, peritonitis, staphylococcal scalded skin syndrome and osteomyelitis/bacteremia. The average single dose was 15.3 mg/kg of MK-0787 and administrations were performed by 20-60 minutes intravenous drip infusion 3-4 times daily for an average period of 6 days. The clinical and bacteriological effects of this drug were evaluated in these cases and adverse reactions and unusual laboratory findings were also studied in a total of 33 cases including 4 other drop-out cases. Results of these studies were summarized as follows. In 6 children, 3 each who were given doses of 10 or 20 mg/kg, the mean peak plasma concentrations of the drugs were found at the end of the 30 minutes-infusion with values of 35.20 and 74.90 micrograms/ml for MK-0787 and 44.85 and 93.32 micrograms/ml for MK-0791 after the dose of 10 and 20 mg/kg, respectively. The peak plasma levels of MK-0791 were approximately 1.3 times higher than those of MK-0787 and higher peak levels were observed in the groups with larger doses of either drugs. In the 10 mg/kg group, the mean half-lives of MK-0787 and MK-0791 were 0.97 and 0.71 hour, respectively and those values were 0.89 and 0.63 hour, respectively in the 20 mg/kg group. In both group, MK-0787 tended to have longer half-lives than MK-0791. In 9 children, 3 each who were administered doses of 10, 20 and 30 mg/kg by a 1 hour intravenous drip infusion had the highest plasma levels for both MK-0787 and MK-0791 at the end of the infusion.(ABSTRACT TRUNCATED AT 400 WORDS)
 ...
PMID:[Pharmacokinetic and clinical studies of imipenem/cilastatin sodium in the pediatric field]. 346 84

Intravenous drip infusion (d.i.) of cefotiam (CTM) in neonates and infants produced the following pharmacokinetic and clinical results: In a 2 and 3 day-old neonates group, blood concentrations at 1 and 5 hours after intravenous drip infusion of 20 mg/kg of CTM were 33.0 micrograms/ml and 12.3 micrograms/ml, respectively. Thus high blood CTM levels were maintained in these cases. In a 4 day-old neonate, blood concentrations after 1 and 6 hours were 20.5 micrograms/ml and 5.8 micrograms/ml. respectively. In a 8-13 day-old neonates group, blood levels after 1 and 6 hours were 12.2-18.5 micrograms/ml and 0.7-2.4 micrograms/ml, respectively. Compared to the corresponding values in the 2 and 3 day-old neonates, the blood CTM levels in this group were low. Half-lives of CTM in the blood were 1.8-2.7 hours, 2.1 hours, 1.1-1.7 hours and 0.7 hour, in 2-3 day-old neonates, 4 day-old neonate, 8-13 day-old neonates and a 45 day-old infant, respectively. Half-lives tended to become shorter with increasing age. The 6-hour urinary recoveries ranged between 20.3 and 62.3%. Transport of the drug into the spinal fluid was also observed. The CTM was very effective in the treatment of 6 patients suffering from suppurative meningitis, septicemia, bronchopneumonia or UTI with ampicillin-resistant E. coli. The daily dose ranged between 41 and 175 mg/kg. The duration of the treatment was 5 to 18 days, with total doses of 0.72 to 16.25 g. In only one case, a transient eosinophilia was noted.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:[Study on intravenous drip infusion therapy of cefotiam in neonates and infants]. 346 83

A multicentre, non-comparative study was performed to evaluate the clinical efficacy and safety of imipenem/cilastatin given iv to 53 seriously ill patients with severe bacterial infections, including 16 episodes of UTI, 12 pleuropulmonary, eight intra-abdominal, seven osteoarticular, and two soft tissue infections, three episodes of catheter related sepsis, two primary bacteraemias, one case of endocarditis, one of endophthalmitis, and one of disseminated gonococcal infection. Twenty-five patients were bacteraemic. The overall rate of clinical response was 94% of treated episodes; three cases failed to respond. Adverse reactions were mild and comparable with those reported with other beta-lactams. No patient had clinical superinfection; colonization occurred in seven patients. Imipenem is effective and safe as a single drug therapy for a wide range of infections in seriously ill patients.
 ...
PMID:Imipenem in the treatment of severe bacterial infections in seriously ill patients. 346 85

Certain infections, such as UTI, may have an increased incidence during pregnancy owing to physiological changes. Between 2 and 10% of pregnant women have covert or asymptomatic bacteriuria which is associated with an increased incidence of acute symptomatic UTI in later pregnancy if left untreated. Thus antenatal screening to detect the presence of bacteriuria is justified. Most women will remain abacteriuric throughout the remainder of pregnancy after a single course of antibiotic therapy but a small percentage will fail to respond or have recurrent UTIs. Maternal infection with certain organisms, namely those which resist phagocytosis, may result in transplacental infection of the fetus in utero. Congenital syphilis is preventable and antenatal serological screening is usually routinely performed. Listeriosis following maternal infection in pregnancy is less predictable and the epidemiology of L. monocytogenes remains unclear. Genital tract carriage of sexually transmitted organisms, such as N. gonorrhoeae or C. trachomatis, may also be detected during pregnancy and antibiotic therapy will be indicated to eradicate such organisms and prevent maternal and neonatal morbidity. Antibiotic therapy during pregnancy will not, however, eradicate carriage of GBS from the genital tract, although carriage status at term can now be reliably predicted by using enriched culture techniques and swabbing multiple sites on more than one occasion. Where carriage is confirmed, the administration of intrapartum antibiotics to the mother appears a useful approach in the prevention of early onset neonatal GBS disease. Broad spectrum intrapartum antibiotics may also be indicated when there are complications, such as prolonged labour or premature rupture of membranes, which are associated with a higher incidence of maternal postpartum endometritis and morbidity than in women following uncomplicated vaginal delivery. Serious postnatal sepsis and shock is fortunately now rare. The pharmacokinetics of antibiotics in late pregnancy and the puerperium are altered and maternal serum levels may be reduced by 10-50%. Most antibiotics cross the placenta and are excreted in breast milk. Some agents, such as the beta-lactams, are considered safe in pregnancy and breast-feeding women while other antibiotics are contraindicated owing to risk of toxicity (often rare) or teratogenicity (often theoretical). Caution is necessary with many agents which may cause side effects or toxicity although this does not necessarily contraindicate their use in pregnancy.(ABSTRACT TRUNCATED AT 400 WORDS)
 ...
PMID:Prescribing in pregnancy. Bacterial infections in pregnancy. 352 53

Fundamental and clinical studies on cefuzonam (L-105, CZON), a newly semisynthesized cephem antibiotic, were carried out in the field of pediatrics and the following results were obtained. Antibacterial activities of CZON against clinically isolated strains of Staphylococcus aureus, S. epidermidis, Streptococcus pneumoniae, S. pyogenes, Escherichia coli, Klebsiella pneumoniae, Haemophilus parainfluenzae and H. influenzae were compared with those of cefmenoxime (CMX), latamoxef (LMOX), cefoperazone (CPZ), cefmetazole (CMZ), cefotiam (CTM) and cefazolin (CEZ). CZON was nearly as active as CEZ against S. aureus and S. epidermidis and superior to other antibiotics against other Gram-positive cocci. Against Gram-negative rods, CZON was as active as CMX and superior to other 5 antibiotics compared. Serum concentrations and urinary excretion rates after intravenous bolus injection of CZON at doses of 10 mg/kg, 20 mg/kg and 40 mg/kg for 5 minutes in 1, 5 and 4 cases, respectively, were determined. Mean serum concentrations of CZON at these dose levels were 11.0, 43.8 and 111.5 micrograms/ml at 15 minutes, 2.4, 10.3 and 30.3 micrograms/ml at 1 hour and 0.17, 0.72 and 1.28 micrograms/ml at 4 hours, with serum half-lives of 1.79, 0.88 and 1.19 hours, respectively. Mean cumulative urinary excretion rates within 6 hours after administration were 47.9, 56.3 and 40.3%, respectively. Thirty-four pediatric patients with various bacterial infections (tonsillitis 2, acute bronchitis 1, pneumonia 14, pyothorax 1, sepsis 1, suppurative lymphadenitis 1, UTI 13 and enteritis 1) were treated with CZON at a daily dose of 40-94 mg/kg t.i.d. or q.i.d.. The overall clinical efficacy rate was 94.1%. No adverse reactions were observed except 2 cases with mild diarrhea. Abnormal laboratory findings were also mild; slight elevation of GOT and GPT in 2, eosinophilia in 1 and thrombocytosis in 1. These results clearly indicate the usefulness of CZON in the treatment of bacterial infections in children.
 ...
PMID:[Fundamental and clinical studies on cefuzonam in the field of pediatrics]. 359 89


1 2 3 4 5 6 Next >>