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)

Ten adult patients with severe Bacteroides infections were treated with 0.9 approximately 1.8 g/day of parenteral or oral clindamycin, and a child was treated with 0.3 g/day orally. Remarkable responses and cures were obtained in all the patients, who had no underlying diseases and pure anaerobic infections; a case of sepsis, two cases of liver abscess, a case of subcutaneous abscess and a case of spinal epidural abscess. The other six patients who had ultimately fatal underlying diseases or mixed infections did not respond well to the combination of clindamycin and the other antibiotics therapy, althought bacteriological cures were obtained in all but two cases. Clindamycin was well tolerated and generally nontoxic, nevertheless it was administrated for long term (34 approximately 49 days). But transient development of transaminase was seen in a patient. The data suggested that clindamycin should be considered a first choice antibiotic for the treatment of an aerobic, especially, Bacteroides infections.
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PMID:[Therapy for severe anaerobic infections with clindamycin (author's transl)]. 83 38

Clindamycin and gentamicin were used in combination to treat 107 patients empirically for suspected aerobic-anaerobic sepsis. All patients were seriously ill and required initiation of treatment before results of cultures could be obtained. Infections included intraabdominal sepsis, hospital-acquired aspiration pneumonia, and soft tissue infections. Exudate cultured from 65 patients showed that the prediction of a mixed aerobic-anaerobic flora was correct in 46 patients (71%). Isolates from exudate included Escherichia coli, Bacteroides fragilis, clostridia, peptostreptococci, Proteus species, Klebsiella species, and Staphylococcus aureus. In 29 patients with bacteremia, the most frequent blood culture isolate was B. fragilis. Analysis of response to treatment showed that 92 patients were cured, five could not be evaluated adequately, and 10 failed to respond to therapy. Therapeutic failure primarily resulted from overwhelming sepsis, despite susceptibility of the pathogens to prescribed antibiotics.
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PMID:Empiric treatment with clindamycin and gentamicin of suspected sepsis due to anaerobic and aerobic bacteria. 85 96

The Authors studied the effects of a short-term prophylaxis (Aztreonam + Clindamycin) administered to 259 patients operated on for colo-rectal diseases. Thirteen wound sepsis (5.15%) and 49 different infections (19.44%) occurred in this group of patients. The study confirms the link between P.N.I. greater than 50 and the incidence of wound infections. The incidence of urogenital sepsis was correlated with the catheterization period (greater than 6 days), operative time (greater than 200 min.), hospitalization (greater than 12 days) and age (greater than 70 years). General tolerance to the antibiotics was good.
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PMID:[Aztreonam and clindamycin in short-term antibiotic prophylaxis in colorectal surgery: results of a multicenter studies]. 209 26

Clindamycin pharmacokinetics was compared in critically ill patients with sepsis and healthy volunteers, and the relationship between pharmacokinetic values and physiological measurements obtained from the critically ill patients was characterized. Pharmacokinetic evaluations were performed on 10 patients with sepsis who were receiving clindamycin phosphate 900 mg i.v. every eight hours and on 6 previously studied healthy men receiving the same dosage regimen. Physiological variables measured included age, weight, cardiac index, systemic vascular resistance, central venous pressure, liver-function tests, alpha 1-acid glycoprotein concentration, and APACHE II score. Clindamycin was administered to the critically ill patients via a central venous catheter over 30 minutes; the healthy volunteers received their infusions via a peripheral venous catheter over 30 minutes. Blood samples were obtained at five minutes before and at various intervals after drug administration. Serum clindamycin concentrations were determined by a gas-liquid chromatographic method. Serum concentration data were analyzed using noncompartmental methods based on statistical moment theory, and the a priori level of significance was 0.05. The critically ill patients had significantly increased values for area under the curve (AUC), area under the moment curve (AUMC), mean residence time (MRT), and average concentration at steady state (Css), while total body clearance (TBC) was less than half that in the healthy volunteers. TBC in three of the critically ill patients was not different from that in the healthy volunteers. The apparent volume of distribution at steady state (Vss) was not significantly different between the two groups.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Decreased hepatic clearance of clindamycin in critically ill patients with sepsis. 366 68

The penicillinase-resistant penicillins (methicillin, oxacillin, nafcillin) have been the mainstay of antibiotic therapy for S. aureus septicaemia and endocarditis. In experimental rabbit S. aureus endocarditis, these three antibiotics were equally effective. There has been no prospective comparative clinical studies to determine the relative effectiveness of these antibiotics. In experimental rabbit S. aureus endocarditis, cephalothin and cefazolin are less effective than methicillin and nafcillin. The results of therapy with cephalosporins in patients with S. aureus endocarditis are variable. Clindamycin therapy of S. aureus endocarditis has been associated with clinical relapse. Vancomycin has been used to treat S. aureus septicaemia and endocarditis with good results. Fusidic acid has been used in combination with another effective drug in treating S. aureus septicaemia and endocarditis. Although the combination of a cell-wall acting antibiotic with an aminoglycoside has been shown to have an enhanced anti-staphylococcal activity in vitro and in animal studies, there is no evidence that such a combination reduces morbidity or mortality clinically. Rifampin in combination with a cell-wall acting antibiotic is antagonistic against S. aureus in vitro and in experimental endocarditis in rabbits. The use of such a combination has not shown consistent benefits clinically. The clinical importance of tolerance (MBC/MIC greater than or equal to 32) of cell-wall acting antibiotics to S. aureus is not clear. It appears not to be important in animal studies. Cephalosporins appear not to be effective in the treatment of methicillin-resistant S. aureus infections. The treatment of choice of sepsis and endocarditis due to such strains is vancomycin which is effective against all strains of methicillin-resistant S. aureus.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:A general survey of antibiotic treatment of staphylococcal septicaemia and endocarditis. 658 52

A Bacteroides fragilis wound sepsis model was developed in rats. Topical and parenteral administration of clindamycin, chloramphenicol, and carbenicillin were used prophylactically to eradicate bacteria from contaminated wounds. Topical clindamycin prevented bacterial growth in 15 of 34 wounds, while topical chloramphenicol and carbenicillin were not effective. Clindamycin injected into the wound margins or at a distal site prevented bacterial growth in 16 of 18 wounds and in a lower dose prevented growth of 50 per cent of 12 wounds. These results support the clinical use of clindamycin for the prevention of Bacteroides wound infection.
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PMID:Use of antibiotics for prevention of Bacteroides fragilis wound sepsis in rats. 737 63

The results of a prospective, randomized comparative study of the efficacy and toxicity of clindamycin, chloramphenicol, and ticarcillin in the treatment, concomitantly with gentamicin to ensure complete aerobic coverage, of 175 patients with serious mixed aerobic/anaerobic intraabdominal or female genital tract sepsis are reported. In the group with intraabdominal sepsis, 33 (79%) of 42 treated with clindamycin, 43 (81%) of 53 treated with chloramphenicol, and 35 (90%) of 39 treated with ticarcillin were cured. In the group with genital tract sepsis, 16 (94%) of 17 treated with clindamycin, 11 (100%) of 11 treated with chloramphenicol, and 12 (92%) of 13 treated with ticarcillin were cured. Diarrhea occurred most frequently in patients treated with clindamycin (P < 0.001), hematologic suppression occurred most frequently in patients treated with chloramphenicol (P < 0.01), and hypokalemia occurred most frequently in patients treated with ticarcillin (P < 0.01). Clindamycin, chloramphenicol, and ticarcillin, each in combination with gentamicin, are equally effective in therapy for intraabdominal or female genital tract sepsis.
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PMID:Prospective, randomized comparative study of clindamycin, chloramphenicol, and ticarcillin, each in combination with gentamicin, in therapy for intraabdominal and female genital tract sepsis. 744 Oct 9

Forty-three patients reviewed from the literature and five cases of agranulocytosis during antibiotic therapy studied by the author are presented. Time required to develop agranulocytosis with antibiotics was < 19 days in comparison to > 40 days required with nonantibiotic drugs. In all, agranulocytosis occurred concomitantly with drug treatment and became normal as treatment was discontinued. Retrospective rechallenge studies suggest that agranulocytosis may be dose related. In all cases PMNs were almost completely deleted and marrows were devoid of granulocyte precursors. In contrast, leukopenia secondary to overwhelming sepsis displayed persisting granulocytes in peripheral blood and marrow. While leukagglutinins were not found in nine cited cases, four serums were toxic to test PMNs as measured by suppression of postphagocytosis respiratory burst. Clindamycin directly suppressed development of CFU-G in one sensitive patient but not in 16 normal controls. The hazard of antibiotics in suppressing granulocytopoiesis is emphasized by these observations.
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PMID:Agranulocytosis during antibiotic therapy: drug sensitivity or sepsis? 841 89

The abnormal colonization of gastrointestinal tract (GIT), the loss of the intestinal barrier function, the bacterial translocation (BT) are signs of intestinal insufficiency which are supposed to be involved in the pathogenesis of MODS. This worsens the condition or leads to lethal outcome in patients after major abdominal surgery in ICU. The goal of this investigation was to consider the scientific and clinical evidence for the BT role in the pathogenesis of MODS and to present evidence about the advantages and the efficiency of antibiotic combination Amikacin plus Clindamycin as a new therapeutic strategy for the improvement of the outcome in patients with MODS and sepsis. To that purpose patients with diffuse peritonitis of different origin were analyzed. After surgery some patients were left with laparostomy. This gave the possibility for revisions and lavages of the abdominal cavity and for taking material for microbiological analyses. The patients were grouped into two subgroups according to antibiotic treatment: 1st group--combination of usually used antibiotics; 2nd group--Amikacin plus Clindamycin. The second group patients showed good tolerance to this antibiotic combination and good therapeutic effect.
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PMID:[Bacterial translocation from the gastrointestinal tract: catalyst of multiple organ dysfunction syndrome]. 1148 81

Antibiotics are frequently administered to ICU patients in case of bacterial infections. Little is known, however, about the interference of antibiotics with neutrophil host defence mechanisms in patients with sepsis and multiple organ dysfunction syndrome (MODS). With our study, evidence for differential clindamycin effects on neutrophils in healthy donors and septic patients without or with MODS was sought. Functional parameters (oxidative response and phagocytosis) and fMLP receptor expression were analysed. The study was approved by the local ethical board. Venous blood was drawn from healthy donors and septic patients. Neutrophils in PBS were incubated with 0, 5, 25 or 125 microg/ml clindamycin and analysed flow cytometrically. Neutrophils of patients with sepsis and MODS showed a significantly higher basal activation compared to healthy donors. Clindamycin application led to a dose-dependent significant suppression of the fMLP-induced oxidative response in patients with sepsis and MODS, but not in healthy donors or septic patients in the absence of MODS. In patients with sepsis and MODS, phagocytosis of Escherichia coli and Staphylococcus aureus was significantly suppressed by clindamycin 125 microg/ml. In both other treatment groups, clindamycin did not affect phagocytosis. fMLP receptor expression was not altered by clindamycin. High-dose clindamycin selectively suppresses functional responses of neutrophils in septic patients with MODS. Simultaneously applied drugs, such as general anaesthetics, may potentiate this modulation of antibacterial defence and inflammation.
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PMID:Differential effects of clindamycin on neutrophils of healthy donors and septic patients. 1518 32


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