Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0243026 (sepsis)
 52,417 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We have conducted a multicentre randomized study to compare piperacillin with the combination of netilmicin and metronidazole in patients undergoing elective colorectal surgery. There was no significant difference in the incidence of operation-related infection, chest or urinary tract infection. Major life-threatening sepsis occurred in 6% and the overall incidence of operation-related infection was 24%. Organisms which normally inhabit the bowel lumen were cultured from most of the postoperative infections; however, Staphylococcus aureus was isolated as a causative organism in nine patients in the piperacillin group compared with none in the netilmicin and metronidazole group. We are concerned at the high incidence of infection in both groups, and we believe that other factors in addition to prophylactic antibiotics need to be evaluated if the incidence of infection is to be reduced further.
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PMID:A multicentre study to compare piperacillin with the combination of netilmicin and metronidazole for prophylaxis in elective colorectal surgery undertaken in district general hospitals. 289 86

Thirteen neonates and young infants, including 5 infants with very low birth weight, were treated with ceftizoxime (CZX) and its clinical efficacy and side effects were evaluated. The ages of the patients ranged from 0 to 96 days, and their body weights ranged from 580 to 5,050 g. Doses given were 20-54 mg/kg every 6 to 12 hours for 2.5 to 7.5 days. Two infants with sepsis, one with urinary tract infection, one with sepsis and urinary tract infection, and 1 with fetal infection were considered to have responded satisfactorily to the CZX treatment. The drug was well tolerated and side effects was not apparent. Pharmacokinetic studies were done on CZX in 8 patients including 4 infants with very low birth weight. Their ages ranged from 2 to 91 days, and body weights from 545 to 5,050 g. Serum concentrations at 2 hours after single 20 mg/kg intravenous bolus injections were 19.2 to 44.2 micrograms/ml and the levels were 2.11 to 26.3 micrograms/ml at 8 hours. Elimination half-lives of CZX ranged 1.90 to 9.57 hours in these patients. In 2 infants with very low birth weights with ages 7 and 91 days, half-lives were as long as 9.57 and 8.24 hours, respectively. Urinary recovery in 6 hours was 31.9-66.9% in 5 patients. Urine concentrations of the drug in 24 samples collected at various time from the 7 patients ranged from 130 to 3,219 micrograms/ml. Influence of CZX on the fecal flora was studied in 1 patient given 20 mg/kg X 4/day of the drug.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Clinical efficacy and pharmacokinetic evaluation of ceftizoxime in neonates and young infants]. 305 Jan 89

The body temperature is measured routinely and carefully charted in our own and presumably all units. Pyrexia is normal after bypass and is discounted on the basis of clinical experience in the first few days. If this pyrexia persists, a search for infection may be instigated and discharge from the hospital may be delayed. A clinical trial of antibiotic prophylaxis provided the opportunity to collect and collate 6-hourly temperature observations for 314 patients for 1 week after operation. The length of bypass and the presence of lower respiratory tract infection were positively correlated with the duration of postoperative fever. However, neither surgical sepsis nor urinary tract infection had any consistent effect on the duration or magnitude of postoperative fever in the first week.
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PMID:Should the temperature chart influence management in cardiac operations? Result of a prospective study in 314 patients. 305 Feb 85

Convenience to the hospital staff is certainly not an acceptable reason for the use of a potentially dangerous drainage tube. An indwelling urinary drainage catheter should be used only in patients who need multiple straight urinary catheterizations, develop urinary obstruction or incontinence, or are comatose and require frequent urinary output measurements. An indwelling catheter may also be needed for drainage or stenting during or following genitourinary surgery. Once it has been determined that urinary catheterization is necessary, a closed urinary drainage system catheter must be carefully and aseptically inserted by experienced hospital personnel after careful preparation. The closed drainage system must be meticulously maintained throughout the patient's hospitalization and catheterization. After the catheter is removed, a urinary culture should be performed to identify any postcatheter infection. If there is infection, the patient must be treated with antibiotics. If symptoms of a urinary tract infection, bacteremia, or sepsis ensue, treatment must be rapidly begun with antibiotics as appropriate on the basis of drug sensitivity testing. These techniques will not eliminate bacteriuria associated with urinary drainage catheters. However, they will reduce the incidence, morbidity, and mortality associated with urinary catheterization.
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PMID:Nosocomial urinary tract infections. 305 56

In a prospective study 43 patients (19 men, 24 women) suffering from severe bacterial infections such as peritonitis (n = 16), soft tissue infection (n = 12), pneumonia (n = 7), septicemia (n = 6), catheter sepsis (n = 2), cholangitis (n = 4), osteomyelitis (n = 3), complicated urinary tract infection (n = 2) or endocarditis (n = 1) were treated t. i. d. with short-time i. v. infusions of 0.5 g imipenem/cilastatin for five to 37 days (means = 9). All the patients were cured or significantly improved following therapy with imipenem/cilastatin alone or in combination with surgical intervention. The most frequent isolates were Escherichia coli, Pseudomonas aeruginosa, Proteus mirabilis, Staphylococcus aureus, Staphylococcus epidermidis and Streptococcus faecalis. 58 (83%) of the 70 pathogens isolated initially were eliminated. The 12 microorganisms (gram-negative aerobic bacteria) which persisted were non-contributory to the course of the infection and had MICs between 0.32 and 4 mg/l. The MICs for 60 isolates were less than or equal to 1 mg/l; the MICs for nine isolates were in the range of 2 to 8 mg/l. One S. epidermidis isolate presented primary resistance to imipenem (MIC 16 mg/l). The tolerability was good. Phlebitis was observed in one case only. Based on our experience we conclude that monotherapy with imipenem/cilastatin at a dosage of 0.5 g t. i. d. is appropriate for the treatment of severe bacterial infections.
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PMID:[Clinical experience with imipenem/cilastatin in the treatment of severe infections in general surgery]. 307 49

We have evaluated a standardized prospective system for managing episodes of fever in pediatric patients with indwelling central vein catheters being used primarily for delivery of parenteral nutrients. Over an 18-month period 72 such patients, accounting for 4347 "catheter days," were followed. Thirty-two patients experienced a total of 88 episodes of fever. An infection unrelated to the presence of the catheter (e.g. otitis media, pneumonia, urinary tract infection) was found to be the cause of fever in 27 episodes (31.7%); in all the infection responded to appropriate antibiotic therapy. Ten of the episodes of fever (11.4%) lasted for less than 2 hours and were not evaluated further. Two episodes occurred in patients who no longer required the catheter; these resolved with elective catheter removal. The cause of the remaining 49 episodes of fever was assumed to be catheter-related sepsis; these were treated empirically with an intravenous antibiotic regimen of vancomycin (40 mg/kg/day) and gentamicin (7.5 mg/kg/day). In 16 of these cases blood cultures were negative and the antibiotic regimen was either stopped or continued for other indications. The remaining 33 episodes of fever were associated with positive blood cultures, i.e. documented episodes of catheter-related sepsis. In 10 of these the catheters were removed. The remaining 23 episodes of catheter-related sepsis were treated for 14 days with antibiotics given through the central vein catheter. In 5 of these episodes blood cultures remained positive after 48 hours of specific antibiotic therapy at which time the catheter was removed.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Management of fever in patients with central vein catheters. 308 Jul 37

The effect of preoperative total parenteral nutrition (TPN) on morbidity and mortality was studied in medical records of discharged surgical patients. Patients were classified into two groups on the basis of their ability to meet established criteria for malnutrition and the use of preoperative or postoperative TPN. The control group consisted of 44 patients who received TPN only after surgery or for less than 5 days preoperatively. The experimental group consisted of 26 patients who received treatment for at least 5 days before surgery and/or after surgery. Nutrition parameters measured included serum albumin, total lymphocyte count, hemoglobin, weight, and percent weight loss. Major septic complications (MSC) considered were intra-abdominal sepsis, wound dehiscence, septicemia, and pneumonia. Other complications included respiratory failure, congestive heart failure, fistulas, urinary tract infection, shock, and death. The experimental group showed improvements after surgery in the nutritional parameters listed and had a lower incidence of morbidity and mortality. Deficits in serum albumin, total lymphocyte count, and weight losses greater than or equal to 10% have been significantly (p less than .01) linked to the incidence of MSC. MSC also has been more frequently noted among patients who did not have TPN prior to surgery and who died following surgery. Therefore, preoperative TPN does appear to make a difference in the outcome of surgery.
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PMID:The effect of preoperative total parenteral nutrition on surgery outcomes. 311 53

Pharmacokinetic and clinical studies of ceftizoxime (CZX) were performed in infants given intravenously. The obtained results are summarized as follows. 1. Serum concentrations of CZX in 2 and 3 day-old mature infants given 20 mg/kg by one shot intravenous injection peaked at 49.0 and 57.9 micrograms/ml in 1 hour and decreased to 14.4 and 24.9 micrograms/ml in 8 hours after dosing, respectively. Half-lives were 3.9 and 5.6 hours, respectively. In 5 day-old or older mature infants, peak serum levels ranged from 20.9 to 38.0 micrograms/ml at 1 hour after the injection. Levels of CZX at 8 hours after injection were 1.31 to 7.32 micrograms/ml. Half-lives were 1.6-3.0 hours in all the infants except one. 2. In a 3 day-old premature infant given the same dose by a bolus intravenous injection, the serum level peaked at 45.7 micrograms/ml in 1 hour after the injection. The level at 8 hours after injection was 15.7 micrograms/ml. The half-life was 4.2 hours. In 5-15 day-old premature infants, half-lives were 2.3-3.1 hours in all the infants except one. 3. Serum concentrations of CZX in 1 and 2 day-old infants given 20 mg/kg by intravenous drip infusion peaked at 49.4 to 115.0 micrograms/ml in 1 hour after dosing. Half-lives were rather long, 4.0 and 5.1 hours, in the 2 infants. 4. Peak serum levels and half-lives tended to be lower and shorter in 5 day-old or older ones than in the 3 day-old or younger infants. 5. No changes in the serum concentration were observed even after dosing with 20 mg/kg of continuous one shot intravenous injection. 6. Urinary recovery rates during the first 8 hours (one is 6 hours, two is 9 hours) after 20 mg/kg intravenous bolus injection of CZX tended to be lower in 3 day-old or younger infants than in 5 day-old or older infants. 7. Eleven infants with various bacterial infections were given CZX by intravenous bolus injection or drip infusion. Dosage of CZX used in the present study were 36-148 mg/kg/day in 2-3 divided doses. Duration of treatment ranged from 3 to 12 days. Clinical efficacy of CZX was excellent or good in all the infants with acute bronchitis, acute pneumonia, suspected sepsis infected in uterine, acute otitis media, cellulitis, meningitis caused by Klebsiella pneumoniae and Escherichia coli, acute urinary tract infection and periproctic abscess except 1 case of acute bronchitis.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Pharmacokinetic and clinical studies of ceftizoxime in newborn infants]. 317 66

Carumonam is a new N-sulfo-beta-lactam antibiotic active against aerobic Gram-negative bacteria. An open study was carried out to evaluate the efficacy, safety and tolerance of carumonam with either 1 g t.i.d. (group A) or 2 g t.i.d. (group B) in bacterial septicaemia or severe sepsis. A total of 24 patients (14 men and 10 women) were included in the study, their ages ranged from 48-87 years (mean age 59). Eighteen patients were treated for bacteraemia, three for bronchopneumonia, two for urinary tract infection and one for a subphrenic abscess; seven were in group A and fourteen in group B; three were treated with a variable regimen. The pathogens isolated included E. coli [10], Klebsiella aerogenes [9], Enterobacter cloacae [3], Citrobacter freundii [2], Pseudomonas spp. [4], Providence stuartii [2], Serratia marcescens [1] and Haemophilus influenzae [1]. Clinical improvement occurred in all patients in both groups. One patient in group A and four patients in group B required further antibiotic therapy. The overall clinical cure rate was 84% and the bacteriological cure rate was 72%. Supra-infection occurred in three patients and adverse reactions attributable to carumonam were seen in two patients: diarrhoea (in one), and aggravation of renal failure in the other. Carumonam is well tolerated at both the dosage regimens; it is effective in the treatment of aerobic Gram-negative sepsis.
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PMID:Clinical efficacy of carumonam. 324 11

Any child with urinary tract infection needs a radiologic work-up to determine his or her potential risk for sustaining renal damage. VCUG, either fluoroscopic or isotopic, should always be performed. If the infection responds to treatment and the VCUG is normal, ultrasonography should be performed. However, when the VCUG demonstrates reflux, radionuclide scan or, less preferably, excretory urography is indicated to assess renal parenchymal damage and function. When a urinary tract infection does not respond to treatment, ultrasonography or CT scan should be obtained to check for renal or perirenal abscess. If the findings are normal, medical treatment to control the infection is indicated. Further evaluation of the urinary tract may be temporarily delayed. In an infant with urinary tract infection and sepsis, renal ultrasonography is indicated. If the sonogram is normal, VCUG can be delayed until the infant responds to medical treatment. If ultrasonography is abnormal, VCUG and radionuclide scan such as 99mtechnetium DTPA with furosemide to evaluate gross morphology and function should be obtained. Complicated medical problems, such as urinary tract infection in combination with a history of intravenous drug abuse or with findings of fever and a mass, deserve immediate evaluation with ultrasonography or CT scan. A patient with fever of unknown origin and normal urine culture should have a radionuclide scan using gallium67 citrate or indium111-tagged leukocytes, both of which can demonstrate an extrarenal or unsuspected intrarenal site of infection. A variety of imaging modalities are available today for investigating urinary tract infections in the pediatric patient. Used intelligently, singly or in combination, these examinations provide information for the clinical evaluation as well as short-and long-term management of infections, their causes and complication, and their effect on renal function.
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PMID:Radiographic evaluation of children with urinary tract infections. 327 31


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