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

The pharmacokinetics and safety of ceftriaxone were examined in 39 neonates who required antibiotics for clinically suspected sepsis. The drug was administered as a once daily dose of 50 mg/kg by the intravenous (IV) or intramuscular (IM) route. Ceftriaxone was assayed in 49 series of blood samples, 3 samples of cerebrospinal fluid (CSF) and 15 samples of urine by a microbiological technique. Blood was collected before, during and after treatment for biochemical analysis. Routine haematological investigations were also monitored. There was no significant difference between the maximum plasma concentrations following IV (153 +/- 39 mg/l) or IM (141 +/- 19 mg/l) administration (first dose). The mean elimination half-life, total body clearance, and volume of distribution following the first dose were 15.4 +/- 5.4 h, 0.28 +/- 0.12 ml/min per kg and 325 +/- 59 ml/kg respectively. Clearance increased with increasing postnatal age and body temperature (P less than 0.0002) and decreasing plasma creatinine concentration (P less than 0.005). Increasing plasma protein concentration was associated with a decrease in volume of distribution (P less than 0.001). There were no drug-associated changes in any of the biochemical or haematological parameters examined. Ceftriaxone is a safe and well tolerated antibiotic for use in the treatment of newborn sepsis and possibly meningitis. A once daily administration of 50 mg/kg by the IV and IM routes provides satisfactory plasma concentrations throughout the dosage interval whilst avoiding accumulation.
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PMID:Pharmacokinetics and safety of ceftriaxone in the neonate. 407 54

The clinical and bacteriologic efficacy of ceftriaxone given once or twice daily was evaluated in 153 studies. A total of 2,635 patients received ceftriaxone given intramuscularly or intravenously, 930 received comparative antibiotics, and 81 received placebo. For the 10 major categories of infections treated (central nervous system, upper and lower respiratory tract, intraabdominal, skin and skin structure, bone and joint, urinary tract, gynecologic, and bacterial sepsis), the clinical response rates were 89 percent or greater. Bacteriologic cure rates were 84 percent or greater overall and 90 percent or greater for seven of 10 categories. Ceftriaxone achieved a satisfactory clinical response (cure or improvement) for 89 (intraabdominal) to 99 percent (urinary tract) of the infections treated. Additionally, pediatric central nervous system infections responded to twice-daily ceftriaxone injection; ceftriaxone, in a single dose as low as 250 mg, cured gonorrhea, and a single dose of ceftriaxone was as effective as multiple doses of cefazolin in surgical prophylaxis.
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PMID:Clinical and bacteriologic efficacy of ceftriaxone in the United States. 609 28

Ceftriaxone (Ro 13-9904, CTRX), a new parenteral cephalosporin, was used for pediatric infections and the following results were obtained. CTRX was administered twice daily by intravenous injection with about 20 mg/kg in 6 cases consisting of 2 cases with purulent lymphadenitis of the neck, 2 with urinary tract infection, 1 with sepsis and pyelonephritis and 1 with sepsis and purulent lymphadenitis of the neck. The result was excellent in 4 and good in 2. One case with H. influenzae meningitis, receiving 50 mg/kg CTRX by intravenous injection twice daily, showed an excellent response without having any sequela. Among those mentioned above, diarrhea in 2 cases and elevated GOT and GPT in 2 were observed, all of which were transitory and not serious. The blood level of CTRX at 1/2, 1, 2, 4, 6 and 8 hours after intravenous injection with 20 mg/kg to a girl of 8 years and 8 months of age with urinary tract infection was 114, 86, 70, 42, 29 and 21.8 micrograms/ml, respectively. The half-life time was 3.5 hours while the urinary recovery rate up to 6 hours was 58.0%. The concentration in the cerebrospinal fluid of 1 case with H. influenzae meningitis ranged from 2.1 to 8.2 micrograms/ml at 3 hours after administration and from 1.15 to 2.65 micrograms/ml after about 12 hours (prior to the next administration). The above-mentioned results suggest that CTRX is a new antibiotic useful for pediatric infections caused with susceptible bacteria and is effective by intravenous injection with 10 mg/kg twice daily for moderate infections and with 20 mg/kg twice daily for severe ones, except for meningitis. As for purulent meningitis, the administration dosage and frequency will have to be further examined based on the intravenous injection with 50 mg/kg twice daily.
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PMID:[Clinical evaluation on ceftriaxone in the field of pediatrics]. 609 7

Ceftriaxone is an investigational cephalosporin with a half-life of five to eight hours. In an uncontrolled study, we evaluated its efficacy and safety in 30 pediatric and 12 young adult patients with serious bacterial infections. This agent was administered to children at a dosage of 50 to 75 mg/kg/day intravenously in two divided doses. Those with CNS infections received 100 mg/kg/day. In adults, the dosage was 1 g either once or twice daily. The diseases we treated included pneumonia (17), sepsis (eight), ventriculoperitoneal shunt infections (three), osteomyelitis (three), brain abscess (two), peritonitis (two), and miscellaneous (seven). Clinical cures were achieved in all cases, although one child with cystic fibrosis and Pseudomonas pneumonia had persistent colonization in his sputum. No serious side effects were observed. Although not the agent of choice for many of these pathogens, ceftriaxone appears to represent an important alternative to therapy.
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PMID:Ceftriaxone for the treatment of serious infections. 631 5

208 H. influenzae (HI) strains originating from the whole of Switzerland have been analysed for capsular serotype, biotype, and susceptibility to the following antibiotics: ampicillin, chloramphenicol, tetracycline, co-trimoxazole, and ceftriaxone. Serotype b is the commonest of the encapsulated strains. Biotypes II and III (respiratory tract) and I (invasive diseases) are the biotypes most encountered. Ceftriaxone is the most active among the antibiotics tested: 0.03 microgram inhibits 100% of strains, whether penicillinase producers (PP) or not. To evaluate the rate of resistant HI in Switzerland, 1883 isolates, 206 of which originated from invasive diseases (meningitis, epiglottitis, septicemia) have been considered. The PP rate is about 4%, irrespective of the group considered. Among the isolates from the invasive diseases, 3 were resistant to chloramphenicol, and 1 to ampicillin and chloramphenicol. The value of 4% for the PP strains is not very high; however, because of its powerful antibacterial activity and its high penetration into the cerebrospinal fluid, it seems reasonable to consider the use of a third generation cephalosporin, such as ceftriaxone, for the early treatment of meningitis in infants. If such a drug is indicated as a first-choice antibiotic for this meningitis it should be confined to this use only, to avoid the emergence of resistant strains.
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PMID:[Haemophilus influenzae isolated in Switzerland: antibiotic sensitivity and biotyping]. 633 96

Between the years 1981 and 1983 we treated with Ceftriaxone (Cx) 34 children--aged 15 days to 13 years--affected with serious infections: 18 infections of lower respiratory tract, 1 sepsis caused by E. Coli, 1 meningitis with cloudy cerebrospinal fluid, 1 submandibular adenitis with otitis, 1 otitis, 12 infections of the urinary tract caused by Proteus mirabilis, E. Coli, Klebsiella oxitocica and Klebsiella pneumoniae. Whenever bacteria were isolated by cultures, sensibility in vitro to Cx was tested. Cx was given i.m. or i.v. at a dose ranging from 50 to 135 mg/Kg/die according to the age and the seriousness of the infections; in 17 children Cx was administered once daily, in the other patients in two divided doses. The following laboratory measurements were obtained before, during and after treatment: complete blood cell count, platelet count, total bilirubin, creatinine, SGOT, SGPT, alkaline phosphatase and urinalysis. Patients were also monitored daily for clinical signs and symptoms such as fever, general conditions, heart rate, respiratory rate, blood pressure. Twenty children showed a good clinical response (1 sepsis, 1 otitis, 1 adenitis, 1 meningitis, 12 infections of the urinary tract, 4 infections of the lower respiratory tract); urine sterilization was achieved after three days of therapy in all patients with infections of the urinary tract. Remarkable clinical and radiological improvement in 9 patients with infections of lower respiratory tract was observed while in only 4 children with bronchopneumonia therapy was ineffective although the dosage of Cx was adeguate; in these patients a further antibiotic treatment was necessary for a complete recovery.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Evaluation of the efficacy and tolerance of ceftriaxone in childhood]. 654 91

The safety of ceftriaxone has been evaluated in 80 neonates who were treated empirically for suspected infection with either ceftriaxone and ampicillin (group A, age 0-72 h) or ceftriaxone and vancomycin (group B, age greater than 72 h). Within 48 h after birth 2 group A patients died from sepsis (Haemophilus influenzae, Streptococcus pneumoniae, 1 case each); 1 group B patient died from sepsis (Pseudomonas aeruginosa). All bacterial isolates from group A patients were susceptible to ceftriaxone, but in 4 of the 8 group B patients with positive cultures a change in antibiotic therapy was required. Eosinophilia, thrombocytosis and an increase in serum alkaline phosphatases were observed in a limited number of patients during and after discontinuation of treatment. Direct hyperbilirubinemia ( > 2 mg/dl) occurred in 2 cases during treatment. Gallbladder sludge was sonographically diagnosed in 6 patients, but disappeared within 2 weeks after detection. One neonate had exanthema. Nurses rated ease of administration as very good. Ceftriaxone appears to be an interesting alternative in the empiric antibiotic treatment in the early neonatal period.
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PMID:Clinical experience with ceftriaxone treatment in the neonate. 755 13

Prompt initiation of empiric antibiotic therapy is the cornerstone in the therapy of chemotherapy-induced neutropenic sepsis in cancer patients. Ceftriaxone plus gentamicin (ceftriaxone/gentamicin) is the most widely used combination of empiric antibiotics in the Department of Medical Oncology, Singapore General Hospital. However, imipenem/cilastatin has been shown to be a practical alternative. To compare the efficacy and cost effectiveness of monotherapy with our usual combination antibiotic therapy, 50 evaluable neutropenic cancer patients admitted for fever were randomised to empiric imipenem/cilastatin or ceftriaxone/gentamicin. Ceftriaxone/gentamicin was started in 24 patients. The initial clinical response rate to ceftriaxone/gentamicin was 62.5% and 84.6% to imipenem/cilastatin (P = 0.075). The average cost of antibiotics per patient started on ceftriaxone/gentamicin including cost of change of antibiotics was S$63 per day of antibiotic use and for imipenem/cilastatin it was S$252 (P < 0.02). In conclusion, although more patients receiving imipenem/cilastatin had an initial clinical response than those receiving ceftriaxone/gentamicin, this difference was not statistically significant. It would appear that imipenem/cilastatin is equivalent to ceftriaxone/gentamicin for the treatment of neutropenic sepsis. However, ceftriaxone/gentamicin was more cost effective.
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PMID:Randomised study comparing imipenem/cilastatin to ceftriaxone plus gentamicin in cancer chemotherapy-induced neutropenic fever. 774 92

We reviewed in a retrospective study all our 616 electively operated colons over 15 years from 1976 to 1990 for morbidity and mortality depending the antibiotic prophylaxis. Interventions were performed on 578 patients with a mean age of 65.5 + 13.7 years; in 38 cases there was an earlier elective colic operation. The sex ratio was 1.26 men to 1 woman. 71.8% of the indications were adenocarcinomas of the colon. All other diagnostics, as well as different types of interventions were included in the study. All interventions was preceded by large bowel preparation. The colic anastomosis were almost always handswen in two layers. Until 1982 systematically, we gave prophylaxis by combination of aminoglycoside with metronidazole or clindamycin, n = 329 (53.4% of 616). We then changed to ceftriaxone, n = 287 (46.6% of 616). Ceftriaxone was applied in single dose (n = 142), in multi doses (n = 71) and combined in almost all cases with metronidazole (n = 74). We found significantly better morbidity and mortality results with ceftriaxone than in the aminoglycoside combined group: The ceftriaxone group had a septicemia or colocutaneous fistulas requiring reoperation incidence of 1.4% (4/287) versus 4.6% (15/329) (p = 0.023). Mortality decreased from 4.9% (16/329) under aminoglycoside combined prophylaxis to 1.74% (5/287) in the ceftriaxone group (p = 0.033). The infection rate of the surgical accesses diminished from 13.1% (43/329) to 8% (23/287) under ceftriaxone (p = 0.043).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Personal experience with preventive use of antibiotics in elective colon surgery. A retrospective study]. 822 87

In cranioplasty complexity is proportional to the size of the detect, particularly if greater than 50 cm2. If the patient's own bone flap is not available, allogenic frozen bone graft can be used instead. Between June 1990 and June 1995 twenty cranioplasties with allogenic frozen bone grafts were performed. Age of patients ranged between 23 and 63 years (average 38.4 years). Male/female ratio was 2:1.7. Size of craniectomy ranged between 65 and 150 cm2 (average 83.3 cm2). Follow-up ranged between 10 and 58 months (average 41 months). Donors were tested to rule out transmissible diseases, infections, sepsis and/or cancer. Bone grafts were removed under aseptic conditions, microbiological cultures were taken, wrapped in a gauze soaked with Gentamicin sulphate and Bacitracin, sealed in three sterilised vinyl plastic bags, and stored in a deep freezer for a minimum of 30 days (range 36-93 days, average 67 days), at a temperature of -80 degrees C. Grafts were placed in the defect after a step was carved on its borders to facilitate the contact between host and graft. Vancomycin 1 g. IV/12 hours and Ceftriaxone 1 g. IV/12 hours were administered for five days. Grafts were covered by means of scalp flaps. Only one required a musculocutaneous free flap. None was exposed, extruded or had to be removed. Plain skull X-ray studies showed progressive remodelling of the grafts. Partial resorption was observed in two (2/20, 10%) and loss of thickness in another 3/20 (15%), but with no changes in the contour. Biopsies were taken in 3/20 (15%) cases at a second surgical procedure. Areas of osteoclastic resorptive activity mixed with others of osteoblastic bone apposition, showed replacement with new bone. We conclude that cranial vault frozen allografts are a good alternative to autologous bone when the latter is absent or not present in sufficient amount.
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PMID:Use of frozen cranial vault bone allografts in the repair of extensive cranial bone defects. 926 59


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