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)

A previously healthy breast-fed baby was admitted at 10 days of age to a hospital in the north of Pakistan with diarrhoea and fever. He was treated for suspected sepsis with intravenous cefotaxime and tobramycin. Cultures of blood and faeces at that time proved negative. At 12 days of age, seizures began and examination of CSF revealed evidence of pyogenic meningitis but bacteria were neither seen microscopically nor isolated in culture. Ceftazidime was substituted for cefotaxime and carbenicillin was given also. Since the baby's condition continued to deteriorate with persistent fever, vomiting and recurrent seizures, he was transferred to the Aga Khan University Hospital, Karachi. Examination of CSF there confirmed the diagnosis of pyogenic meningitis and revealed Gram-negative bacteria. Cultures of CSF and faeces yielded Salmonella paratyphi A but the blood culture was negative. The isolate was found to be multiple antimicrobially resistant but sensitive to ciprofloxacin. Treatment with this drug was therefore started 3 days after the baby's admission to the Aga Khan Hospital. Within 36 h, improvement was observed. From then onwards, the baby made a progressive recovery and was healthy when seen at 7 months of age.
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PMID:Eradication of a multiple drug resistant Salmonella paratyphi A causing meningitis with ciprofloxacin. 143 Nov 77

The efficacy of ceftazidime in the treatment of neonatal sepsis was studied in 42 low birthweight premature babies. Forty-nine courses of ceftazidime (25 mg/kg bd, iv or im were administered. In 19 babies, treatment was stopped after 48 h, the remainder were treated for 5 days or more. Six neonates had bacteriological evidence of infection, one other was pyrexial and 29 had radiological evidence compatible with respiratory tract infection. Eight of the study population died. Only one death was attributed to infection which arose 3 days after completion of a 5-day course of ceftazidime. Two babies developed clinical signs of necrotizing enterocolitis (NEC). Clostridium difficile (7) and Cl. perfringens (2) were isolated from 34 post-treatment faecal samples but not from the two babies with NEC. No faecal sample contained Cl. difficile toxin. Post-treatment cultures from 12 neonates yielded ceftazidime-resistant micro-organisms. Ceftazidime therapy was not associated with significant alteration in serum alanine aminotransferase, urea, creatinine, protein or albumin. Four babies had an eosinophilia, three transient and one following two intrauterine transfusions. Coombs' tests were performed on 17 babies. There were no false positives. The abnormal clotting studies observed in one baby were not due to ceftazidime. In a concurrent pharmacokinetic study, the half-life of ceftazidime was 7.4 (SD +/- 4.1) h following iv administration. Other pharmacokinetic values were C max 74 (SD +/- 20) mg l-1 trough concentration 20 (SD +/- 10) mg l-1. Total body clearance ranged from 0.13 to 2.10 ml min-1 per kg and increased with increasing postnatal age.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Ceftazidime in the treatment of neonatal infection. 286 90

The majority of gastrointestinal infections due to "thermophilic" Campylobacter is self limiting and does not need antibiotic treatment. Anyhow there are some serious cases (sepsis, persistent and relapsing gastroenteritis, severe immunodeficient patients) which require appropriate therapy. The susceptibility of 15 strains of Campylobacter jejuni and of 1 strain of C. coli, isolated from patients with acute gastroenteritis, has been studied against 12 antibiotics with the broth microdilution method at two different inocula (10(3)-10(4) CFU/ml and 10(7)-10(8) CFU/ml), and with the standard agar disk diffusion test, modified to allow sensitivity testing of Campylobacter. For each antibiotic, the geometric mean of MIC and of MBC and the concentrations of the various drugs needed for inhibition and killing of 50 and 90% of the strains (MIC-MBC50 and MIC-MBC90 respectively) have been calculated. Finally the percentage of resistant strains and the percentage of tolerant strains (ratio MBC/MIC: greater than or equal to 32) at low and high inoculum was determined. Erythromycin and aminoglycosides resulted the most active antibiotics against Campylobacter, being bactericidal as well as bacteriostatic at both low and high inoculum. Among the beta-lactams, cefotaxime was the most active, followed by piperacillin and ampicillin. Ceftazidime, aztreonam and rifampin were inactive. Ciprofloxacin, cotrimoxazole and tetracyclines showed some activity against Campylobacter at low inoculum. The agar disk diffusion method cannot be used for the "routinary" assay of susceptibility of Campylobacter, because it is a "naggy" microaerophilic organism.
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PMID:[Bacteriostatic and bactericidal activity, resistance and tolerance of 16 strains of thermophilic Campylobacter to 12 antibiotic drugs]. 345 49

Ceftazidime (CAZ) was evaluated for its pharmacokinetics and clinical usefulness in neonates and premature infants. The results obtained were summarized below. Following intravenous injection of CAZ 10 or 20 mg/kg to neonates and premature infants, dose response was observed in serum concentrations ranging from 5.1 to 21.9 micrograms/ml at 6 hours after the injection. The serum half-life tended to be longer in premature infants than in neonates; the half-life being longer for an infant with lower day-age. Urinary recovery rates during the first 6 hours after single administrations of 10 mg/kg of CAZ tended to be higher in neonates than in premature infants, and higher rates were observed in older infants. However, no noticeable difference was observed after the administration of CAZ 20 mg/kg. Clinical efficacy was evaluated in 99 neonates and 55 premature infants (156 infections), daily doses ranging from 21.1 to 246.4 mg/kg. Out of 105 cases of common infections, mainly 44 cases with causative organisms identified (including 17 of sepsis, 7 of pneumonia, 4 of purulent meningitis, 11 of urinary tract infections) were examined for the clinical efficacy. The efficacy of CAZ was excellent in 21, good in 18, fair in 1 and poor in 4, with the efficacy rate of 88.6%. In the remaining 61 cases, i.e., 37 with causative organisms unknown and 24 with signs of intrauterine infections, the efficacy rate was 95.1%. Other than these cases, additional 51 cases were given CAZ solely for prophylaxis of infections, and the results were found satisfactory. On the whole, clinical efficacy rate of CAZ was 94.9% in 156 cases. Out of the 44 cases examined for bacteriological responses, 38 were evaluated as 'eradicated', 3 'persisted' and 3 'unknown' with eradication rate of 92.7%. Replacement of organisms (superinfection) was observed in 3 cases. Out of 179 cases in which adverse effects were assessable, adverse effects were observed in a total of 4 cases (2.2%), i.e., 3 cases of diarrhea (1.7%) and 1 case of rash (0.6%), and abnormal laboratory findings were observed in a total of 14 cases (7.8%), i.e., increase in eosinophiles count in 8 (4.5%), elevation of GOT in 3 (1.7%), increase in platelet, elevation of GOT . GPT, and elevation of GOT . GPT . BUN in 1 case each (0.6%). None of them were severe and they were transient. Elevations of bilirubin and cases of positive PIVKA II associated with CAZ were not observed.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[A pharmacokinetic and clinical evaluation of ceftazidime in neonates and premature infants. A study of ceftazidime in the perinatal co-research group]. 354 Mar 39

Ceftazidime (CAZ) was evaluated for its safety and efficacy in 27 newborns. Four confirmed cases of bacterial infections were cured by the CAZ therapy (efficacy rate 100%). The CAZ was assessed as effective in sepsis (2) and urinary tract infections (2). Main pathogens which responded to CAZ were Escherichia coli, Enterobacter cloacae and Acinetobacter anitratum. As adverse effects, elevations of GOT and GPT (1 case) were found to be associated with the CAZ therapy. Half-lives of the serum levels in mature infants were 1.93-3.52 hours, and those in low birth weight infants were 2.92-4.17 hours. Penetration into the cerebrospinal fluid in 1 case of viral meningitis was satisfactory. The data suggest that CAZ is a safe and effective injectable antibiotic when used in newborn with infection caused by CAZ-susceptible bacteria.
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PMID:[Clinical evaluation of ceftazidime in the treatment of neonatal infections]. 354 Mar 41

Ceftazidime (CAZ) intravenous injection was evaluated from fundamental and clinical aspects in neonates, and the results obtained are summarized below. Following a 60-minute intravenous drip infusion of CAZ at 10 mg/kg, the peak serum level was 19.8 micrograms/ml at 30 minutes after the completion of the infusion(half-life: 2.75 hours). Following 30 to 60-minute intravenous drip infusions of CAZ at 20 mg/kg, the mean peak serum levels of CAZ were 33.1-33.0 micrograms/ml. Mean levels at 6 hours were 5.2-6.7 micrograms/ml (half-life: 1.6-4.1 hours). Following 30 to 60-minute intravenous drip infusions of CAZ at 25-30 mg/kg, peak serum levels were 51.7-64.6 micrograms/ml (half-life: 1.6-2.05 hours). Dose response relationship was clearly observed in peak serum levels after intravenous drip infusion, and half-lives of serum CAZ levels in neonates aged 0-10 days tended to be longer than those in infants. Following intravenous administration of CAZ at 20-30 mg/kg, urinary excretion rates during the first 6 hours were 18.7-66.5%, and the rates were low in neonates compared to those in infants and children. Following a 60-minute intravenous drip infusion of CAZ at 28.7 mg/kg, the cerebrospinal fluid level was 5.0 micrograms/ml at 3 hours, the ratio of cerebrospinal fluid level to serum level was 22.5%. Eleven neonates were subjected to the present study. Clinical efficacy of CAZ was excellent in sepsis caused by A. anitratus, which showed higher sensitivity to CAZ compared with other cephem antibiotics of the third generation. In all of the other cases, including those of pertussis and acute urinary tract infections and in the prophylaxis of amniotic infection, clinical efficacy of CAZ was excellent or good. S. epidermidis, E. coli and A. anitratus, identified from cultures of pharynx, urine or blood, were rapidly eliminated during the CAZ treatment. Doses of CAZ used in the present study were 29-133 mg/kg/day, mostly in the range of 40-60 mg/kg/day. Durations of treatment ranged from 3 to 10 days. Neither systemic nor local adverse effect was observed, nor was any abnormality observed in laboratory findings.
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PMID:[Fundamental and clinical evaluations of ceftazidime in neonates]. 354 Mar 44

Ceftazidime (CAZ) was evaluated in the treatment of infections in neonates and premature infants. In 1 mature neonate (age: 14 days) administered with 30.3 mg/kg of CAZ by a single bolus intravenous injection, the serum concentration of CAZ was 50 micrograms/ml at 30 minutes after the dosing, and the elimination half-life was 1.38 hours. The urinary recovery rate of administered CAZ during the first 6 hours was 52.9%. In 6 neonates (mean gestational period: 37.8 weeks, mean birth weight: 2,508 g, mean age: 3.7 days) administered with ca. 20 mg/kg of CAZ by single bolus intravenous injections, the mean serum concentration of CAZ was 63.6 micrograms/ml at 30 minutes after the dosing, and the half-life was 3.78 hours. In 3 out of the above 6 neonates, the mean urinary recovery rate of CAZ during the first 6 hours was 59.8%. Five neonates and 2 infants with infections were given 18.4-65.9 mg/kg of CAZ b.i.d.-q.i.d. by intravenous injections. One of these cases was excluded from an evaluation for clinical efficacy, because CAZ was given only for 2 days. In the remaining 6 cases, clinical efficacy was excellent in 1 case of urinary tract infection (E. coli + E. faecalis), good in 3 cases of pneumonia (P. aeruginosa + K. pneumoniae: 1, P. aeruginosa: 1, and causative organism unknown: 1), and poor in 1 case of sepsis (S. aureus). In 1 case of asphyxia neonatorum contaminated with meconium, CAZ was used prophylactically, resulting with no infection. No clinically adverse effect was observed. Also no abnormality was observed in laboratory analyses in the 6 cases.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Clinical evaluation of ceftazidime in infections in neonates and premature infants]. 354 Mar 48

A clinical trial was conducted to assess the value of ceftazidime as a first-line antibiotic in a neonatal intensive care unit. Fifty-five infants less than 48 h old with suspected sepsis were randomly treated with ceftazidime or penicillin and gentamicin. A full septic screen was performed in all infants before treatment. Treatment was stopped after 48 h if cultures were sterile. A further 22 infants more than 48 h old, with clinical evidence of sepsis, were treated with ceftazidime in an open trial. Ceftazidime proved effective against all but two of the septicaemias. A group D beta-haemolytic streptococcus and a coagulase-negative staphylococcus proved resistant, but were also resistant to penicillin and gentamicin. No adverse response to ceftazidime was noted, and the incidence of later candidiasis was similar to that after other broad-spectrum antibiotic combinations. The avoidance of gentamicin assay in the ceftazidime group was an advantage in this age group.
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PMID:Ceftazidime or gentamicin plus benzylpenicillin in neonates less than forty-eight hours old. 635 43

An open study of the use of ceftazidime in patients with Gram-negative infections was undertaken in a district general hospital. Ceftazidime was used in three groups of patients: 17 adults with infections due to Pseudomonas sp. or multi-resistant enterobacteria, three children with cystic fibrosis who had chest infections, and two premature neonates with severe pseudomonal pneumonia. The infections in the adult group included respiratory tract (6), urinary tract (4), wound infection (3), abdominal sepsis (2), osteomyelitis and panophthalmitis. In this group, ceftazidime was given as 1-2 g tid intravenously. In three patients, gentamicin was used concurrently and in four metronidazole was added. 76% of the adult group achieved complete clinical cure, all three cystic fibrosis cases improved markedly, and the two neonates showed complete resolution of the pneumonia. No adverse biochemical or haematological side effects occurred, although one patient developed an urticarial skin rash on the last day of a ten-day treatment course which resolved after discontinuing the ceftazidime.
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PMID:An open study of the use of ceftazidime in Gram-negative infections. 635 50

Melioidosis was diagnosed in a diabetic sailor who presented with a history and chest radiograph that suggested tuberculosis. Melioidosis is a tropical disease with protean manifestations: from asymptomatic infection to chronic cavitary lung disease to overwhelming sepsis. The diagnosis is easily made, even in nonendemic areas when duly considered by the clinicians and microbiology laboratory. Ceftazidime has dramatically improved outcomes in hospitalized patients with severe melioidosis.
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PMID:Melioidosis in a diabetic sailor. 752 16


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