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)

Twenty-four episodes of bacterial infections were identified over a 18 month period in 11 patients (8 with acquired immunodeficiency syndrome and 3 with AIDS related complex). Eight of the 11 infected patients were drug abusers and 3 homosexual people. Nosocomial bacterial infections were common in patients with AIDS and had high fatality rates. Gram-negative bacteria resulted the most common micro-organisms (E.coli, Proteus, Enterobacter, Serratia, Klebsiella). The Aztreonam treatment was very useful in providing bacteria eradication. Gram-positive bacteria as Staphylococcus from a sepsis and Enterococcus from a cystopyelitis were eradicated by B-lactam antibiotics. Common micro-organism are frequent in patients affected by LAS/ARC or AIDS and they negatively interfere with the disease outcome.
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PMID:[Significant bacteriological findings in HIV-positive patients]. 249 36

A 69-year-old woman with Pseudomonas aeruginosa sepsis developed wheezing during the course of an oral penicillin desensitization. Despite treatment of the bronchospasm and readministration of the same dose of phenoxymethyl penicillin, wheezing recurred requiring stopping the desensitization procedure. Aztreonam, a monobactam antibiotic with activity against aerobic gram-negative bacilli, was administered along with an aminoglycoside. The patient tolerated a full course of aztreonam with no adverse reactions. This case report supports previous in vitro and in vivo studies, suggesting that aztreonam does not cross-react with penicillin-specific antibodies and that it may be well tolerated in beta-lactam-allergic individuals.
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PMID:Successful use of aztreonam in a patient who failed oral penicillin desensitization. 249 56

A multicenter comparative trial was conducted in 4 university hospitals to evaluate the efficacy of aztreonam, a new monobactam antibiotic. All patients enrolled in the study were admitted to the intensive-care unit with severe underlying conditions. A total of 167 infections were documented in 157 patients (78 pneumonia, 26 urinary tract infection, 23 peritonitis, and 40 septicemia). The study was performed in 2 phases. In phase 1, 49 patients receiving aztreonam were compared with 26 receiving amikacin. These two drugs were administered as the sole coverage against gram-negative bacilli. In phase 2, 48 patients treated with aztreonam were compared with 34 who received a synergistic combination of amikacin and a broad-spectrum beta-lactam. The results suggest that aztreonam can be used as monotherapy in the treatment of systemic gram-negative infections with an efficacy comparable with that of standard antimicrobial therapy. Aztreonam is probably more effective than amikacin in treating respiratory tract infections and it is at least as effective as a beta-lactam-aminoglycoside combination. An adequate standard dosage of aztreonam could be established as 3-4 g/day in compromised patients, and it should be combined with gram-positive coverage when used empirically.
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PMID:A multicenter comparative trial of aztreonam in the treatment of gram-negative infections in compromised intensive-care patients. 265 88

Aztreonam was administered to 25 neonates (16 term, 9 premature) with clinically and bacteriologically proved gram-negative infections. Ten patients had meningitis, 9 had septicemia and 6 had urinary tract infections. Patients were between 1 and 28 days of age. Aztreonam was administered intravenously in doses ranging from 40 to 120 mg/kg/day for 10-30 days, depending on the causative organism. All CSF, blood and urine cultures were sterile 48 h after drug treatment had begun. There was no incidence of bacteriologic relapse. Body temperature returned to normal in 96% of patients within 3-4 days of therapy. Aztreonam was well tolerated. One infant experience nausea and vomiting, but no patient was withdrawn from therapy due to adverse reactions.
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PMID:Successful response of severe neonatal gram-negative infection to treatment with aztreonam. 273 46

Twenty nine patients of an intensive care unit (9 women and 20 men), aged 63.9 +/- 15.8 years, with a mean body weight of 62.5 +/- 11.8 kg were treated during 9.4 +/- 2.1 days by aztreonam (2 x 1 g/24 h) administered by short infusion (30 min) for a severe infection due to a Gram-negative bacilli. The primary (n = 25) or nosocomial (n = 4) infection sites were a peritonitis (14), a septicaemia (6), a cholecystitis (6), a pyelonephritis (5), a cholangitis (2), a subphrenic abscess (1) or a pneumonia (2). The isolated Gram-negative bacilli were all susceptible to aztreonam, their MIC being less than or equal to 0.5 micrograms/ml, except for a Pseudomonas aeruginosa (MIC = 4 micrograms/ml). Aztreonam was administered as a single therapy to 7 patients and in association with metronidazole (18) and/or penicillin G (14) to 22 patients; in fact, anaerobes were isolated in ten patients. The mean serum concentrations of aztreonam, as measured by HPLC, before and after the 7th administration respectively were 83.2 +/- 17.5 and 6.1 +/- 5.5 micrograms/ml for peak and through levels. The treatment of the 29 infections was a success in all the cases. No complication occurred due to the presence of Gram positive cocci (n = 4) in the first bacteriological sample, or due to the emergence (n = 12) of Gram positive cocci, except for one case of sepsis of the abdominal wall by Staphylococcus aureus. Aztreonam (2 x 1 g/24 h) may be a suitable alternative for the treatment of severe infections of intensive care units, mostly due to Gram-negative bacilli.
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PMID:[Aztreonam treatment of severe infections caused by gram-negative aerobic bacilli]. 304 52

The efficacy and safety of aztreonam in the treatment of serious gam-negative infections were investigated in 20 patients, 19 of whom were more than 60 years old. There were 13 cases of upper urinary tract infection, 6 of septicemia and one of peritonitis. Half the patients were in a critical clinical condition with significant severe underlying disease. Aztreonam was given i.v. or i.m. in doses ranging from 1.5 to 4 g/day according to the severity of the infection. The duration of treatment ranged from 7 to 20 days. In 5 patients with mixed infections due to gram-positive and anaerobic organisms in addition to gram-negative pathogens, aztreonam was given in combination with clindamycin and metronidazole as appropriate. Clinical and bacteriological cures were observed in all 20 patients. There were two cases of reinfection and 3 of superinfection--all occurred in patients with severe underlying disease. Untoward effects were few and of minor severity. Creatinine clearance remained stable or improved during aztreonam treatment, even in patients with significant renal impairment. In conclusion, aztreonam was shown to be both effective and safe in the treatment of serious gram-negative infections in elderly patients--even those with impaired renal function. In such indications aztreonam appears to be a good alternative to potentially toxic drugs such as the aminoglycosides.
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PMID:Aztreonam in the treatment of serious gram-negative infections in the elderly. 340 89

Seventy-five aztreonam treatment courses in 74 patients with gram-negative septicemia resulted in 56 clinical cures (75%), 12 partial clinical cures (16%), and 7 clinical failures (9%). Eradication of the original pathogen from the blood was obtained in all patients but two, who had relapses 1 and 4 days, respectively, after treatment. In nine patients (12%) a superinfection was reported. Significant adverse reactions were limited to one transient urticarial rash. Aztreonam may prove to be an effective alternative for the treatment of gram-negative septicemia, but superinfections should be carefully monitored.
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PMID:Aztreonam treatment of gram-negative septicemia. 371 38

Aztreonam was used in the initial treatment of infection of the urinary tract (23 cases), respiratory tract (17 cases), skin and soft tissue (12 cases), abdominal cavity (three cases), endocarditis (two cases), septicemia (eight cases), and osteomyelitis (two cases). In 26 of 60 evaluable infectious episodes, aztreonam was used alone. Clinical cure was observed in 35 of 60, improvement in 24 of 60, and failure in one of 60 cases. Ten patients developed subsequent superinfection. Aztreonam was well tolerated, although one case of exfoliative dermatitis and one of pseudomembranous colitis occurred. However, these cases were complicated by proximal administration of other antibiotics.
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PMID:Efficacy and safety of aztreonam in the treatment of serious gram-negative bacterial infections. 381 51

Aztreonam (AZT) is the first monobactam antibiotic that has significant activity in vitro against aerobic Gram-negative bacteria but not against Gram-positive or anaerobic bacteria. The agent was used 120-200 mg/kg in daily dose to treat 10 hospitalized cases of refractory infections in pediatric field. There were 3 cases of 1 pneumonia, 4 cases of urinary tract infections, 2 cases of pyogenic meningitis and 1 case of septicemia. Seven aerobic Gram-negative bacteria were isolated from patients and 4 bacteria were eradicated by treatment. Clinical cure was achieved in 8 out of 10 cases without adverse reaction or drug toxicity.
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PMID:[Clinical efficacy of aztreonam in refractory infections in children]. 409 68

Possible clinical use of a recombinant human granulocyte colony stimulating factor (rG-CSF) and a newly developed monobactam antibiotics (Aztreonam) for the treatment of gram-negative sepsis was investigated. Gram-negative sepsis was induced in male WKA rats by cecal ligation and puncture (CLP). Untreated CLP rats all died by septicemia with severe peripheral blood leukocytopenia within 5 days after the operation. When we administered 2.0 micrograms/kg of rG-CSF and/or 20 mg/kg of Aztreonam intravenously just after the operation, the rats survived longer than the untreated CLP rats. These drugs were found to be more effective when used in combination. Since these rats showed an increase in leukocyte counts, we next examined the changes in the functions of polymorphonuclear leukocytes (PMNs, mainly neutrophils) after the treatment. PMNs from untreated CLP rats at 24 hr after the operation exhibited enhanced plastic-dish adherence, suppressed chemotaxis, and depressed O2 production when compared with PMNs from control animals. A single injection of rG-CSF restored both the depressed chemotaxis and the O2 production to levels greater than those of controls. Although a single injection of Aztreonam could not improve the suppressed O2 production, it could restore the depressed chemotaxis. Interestingly, simultaneous injection of Aztreonam with rG-CSF significantly enhanced the effect of rG-CSF on the PMN functions. These data suggest that the Aztreonam and rG-CSF may be useful for the treatment of gram-negative sepsis, especially when used in combination.
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PMID:Effects of granulocyte colony stimulating factor and monobactam antibiotics (Aztreonam) on neutrophil functions in sepsis. 769 16


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