Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0085437 (bacterial meningitis)
 4,038 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The parenteral kinetics of sulbactam, a potent synergist with ampicillin against a broad range of clinically important organisms in humans, are similar to those of ampicillin. The kinetics of ampicillin were not affected by co-administration of sulbactam, and high levels of both agents were attained: 15-min infusions of 2 g of ampicillin plus 1 g of sulbactam produced peak serum concentrations of approximately 120 micrograms of ampicillin/ml plus 60 micrograms of sulbactam/ml; intramuscular injections of 1 g of ampicillin plus 0.5 g of sulbactam produced peak concentrations of 18 micrograms of ampicillin/ml plus 13 micrograms of sulbactam/ml. The drugs had similar half-lives (approximately 1 hr), and both drugs were excreted primarily in the urine (greater than 75%). Although the kinetics of sulbactam in postpartem women and in surgical patients were similar to the kinetics in young men, the half-life of sulbactam (like that of ampicillin) was altered in the elderly, during labor, in neonates, and in patients with renal impairment. After distribution of the agents in the body, the concentrations of both drugs in blister and parenteral fluid were similar to those in serum. Furthermore, useful antibacterial concentrations of both drugs were found in pus, sputum, and middle-ear fluid. The normally low penetration of sulbactam and ampicillin into cerebrospinal fluid was increased in patients with bacterial meningitis.
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PMID:Pharmacokinetics of sulbactam/ampicillin in humans: a review. 302 97

Ninety-five infants, less than 2 months of age, diagnosed as urinary tract infections, from July 1984 to June 1991, were reviewed. Their urinary cultures, obtained either by suprapubic puncture or via catheterization, all had bacterial colony counts of over 10(5)/ml. In this survey, males predominated (91.6%). Fever and gastrointestinal problems were the two most prevalent signs. E. coli was the most common causative organism, and gentamicin was the most effective antibiotic. Vesicoureteral reflux (VUR), the most common anomaly, was found in one-third (25/76) of patients on voiding cystourethrography, with 20% being high grade (Gr. IV or Gr. V). Eleven cases (11%) had bacteremia, and one case had bacterial meningitis. Sixty-seven cases were followed up in our hospital and seven of them had second infections within a year of their first UTI. The mean period between episodes was less than two months. All these patients had urinary tract anomalies and received oral chemoprophylactic drugs for variable lengths of time. Five of the seven recurrences were caused by resistant bacilli. Continuous oral antibiotic prophylaxis and regular follow-up examinations were the rules of prevention for further infection and future renal impairment. These preventive methods are especially important in young infants with UTI.
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PMID:Urinary tract infection in infants less than 2 months of age. 808 50

Data from 3125 patients (3220 patient exposures) treated with meropenem were compared with those from 2886 patients (2960 patient exposures) treated with a variety of comparator agents including cephalosporins (alone or in combination with aminoglycosides or an anti-anaerobe agent) and imipenem/cilastatin. Patients treated included those with bacterial infections of the lower respiratory tract, urinary tract and skin and soft tissues, abdominal, obstetric and gynaecological infections, meningitis, febrile episodes in neutropenic patients and paediatric patients with infections. In three studies, meropenem was administered intramuscularly; in the remainder, meropenem was given by 15-30 min iv infusion or by bolus injection over approximately 5 min. The usual dosages were 500 mg or 1 g 8 hourly in adults and 10 or 20 mg/kg 8 hourly in children. In bacterial meningitis, the meropenem dosage in adults was 2 g 8 hourly and 40 mg/kg 8 hourly in children. The overall pattern and frequency of adverse events with meropenem were similar to those of the other beta-lactam antibiotics with which it was compared. The most frequently reported adverse events were diarrhoea, rash, nausea and vomiting, thrombocytosis, eosinophilia and changes in hepatic biochemistry. Abnormal laboratory tests occurred with similar frequencies between meropenem and the comparator agents. The safety profile of meropenem was similar in adults and children, and the presence of renal impairment did not alter the safety profile of meropenem. Experience in clinical studies in 3220 patient exposures has revealed no unusual or unexpected toxicity. The possibility of administration by either iv infusion or bolus injection with a low incidence of nausea and vomiting also provides flexibility in the clinical management of patients. Moreover, the low incidence of reported seizures and good tolerability at high doses, make meropenem particularly useful for the treatment of meningitis and other indications which carry a risk of seizures, or in the treatment of serious infections where high doses of antibiotics are frequently indicated.
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PMID:Safety profile of meropenem: international clinical experience based on the first 3125 patients treated with meropenem. 854 96

Pharmacokinetic and pharmacodynamic profiles of antibiotics are important in determining effective dosing regimens. Although minimum inhibitory concentration (MIC) data reflect microbial susceptibility to an antibiotic, they do not provide dosing information. The integration of pharmacokinetic and microbiological data, however, can be used to design rational dosing strategies. Meropenem is a broad-spectrum beta-lactam antibiotic that penetrates most body fluids and tissues rapidly after intravenous administration. Meropenem undergoes primarily renal elimination; therefore, dosage adjustment is required for patients with renal impairment. Meropenem is indicated for the treatment of complicated skin and skin-structure infections, complicated intra-abdominal infections, and bacterial meningitis. Meropenem has time-dependent bactericidal activity; thus, the percentage of time that free-drug concentrations are higher than the MIC (%T>MIC) best characterizes the drug's pharmacodynamic profile (bactericidal target of approximately 40%T>MIC). Pharmacodynamic modeling can identify regimens with the greatest probability of attaining this target, and probabilities can be compared with clinical and microbiological responses in patients.
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PMID:Pharmacokinetic and pharmacodynamic properties of meropenem. 1871 48