Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0519030 (Klebsiella)
 21,988 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The distribution of respiratory tract infections (RTI) among the general population is not uniform. The incidence in neonates and the elderly (older than 65) is 2 to 3 times higher than that in adults. Examinations to determine the responsible pathogen are conducted in less than 1% of cases of RTI. The overall incidence of Haemophilus influenzae and Streptococcus pneumoniae in hospitalized patients amounts to 13 to 27%. The incidences of Staphylococcus aureus, Klebsiella and Pseudomonas aeruginosa in intensive care units are approximately 20% each. The management of the disease should be based on an aetiological diagnosis, and must take the individual patient's condition into account. Examination of the sputum or bronchial rinsing fluid is still the most reliable form of diagnosis, however, a sufficient number of quantitative methods must be applied. In hospitalized--and especially intensive care--patients these methods are often successful in isolating H. influenzae and pneumococci which we cannot afford to ignore as pathogens.
Infection 1987
PMID:[Incidence of deep respiratory tract infections]. 330 84

Infection is the most important cause of mortality in leucopenic patients. A broad spectrum antibiotic therapy is imperative in febrile and neutropenic patients. In a multicentric study we have used ceftazidime (100 mg/kg/d) and netilmicin (6 mg/kg/d) in 88 children (fever greater than or equal to 38.5 degrees C, neutropenia less than 500/mm3) treated for acute leukemias (59), non Hodgkin lymphomas (13) or solid tumors (16). Median age was 7 years (2 months-16 years). In patients who continued to remain febrile, vancomycin (40 mg/kg/d) was added after 48 hours. The effective treatment was continued until a neutrophil count greater than 1,000/mm3. The first combination (ceftazidime + netilmicin) was effective in 64 children (73%) and the second combination (ceftazidime + netilmicin + vancomycin) in 11 patients. Bacteria were isolated in 39 children: Escherichia coli: 9, Staphylococcus epidermidis: 9, Staphylococcus aureus: 8, Streptococcus: 6, Pseudomonas aeruginosa: 3, Streptococcus pneumoniae: 1, Haemophilus: 1, Klebsiella pneumoniae: 1, Proteus: 1, Serratia: 1, Flavobacterium: 1. In these 39 patients, 30 became apyretic with ceftazidime and netilmicin and 6 after vancomycin. All blood culture were negative after the first combination. The median duration of antibiotic therapy was 14 days (5-9 days: 28, 10-20 days: 43, greater than 20 days: 17). There were no death, no superinfection. Tolerance was good without kidney or liver or biological perturbation. We conclude that the combination ceftazidime and netilmicin is effective in neutropenic children.
 ...
PMID:[Treatment of febrile episodes in neutropenic children by ceftazidime combined with netilmicin. Results of a multicenter study apropos of 88 cases]. 330 78

In a randomized study, 42 patients undergoing extensive maxillo-facial surgery (correction of the position of the mandible or maxilla by using autologous bone transplants) received prophylactically ten-day courses of either flucloxacillin or amoxicillin with clavulanic acid. Patients were comparable with regard to age and type of surgery. During the prophylactic treatment the effect of antibiotics used on the microbial flora of the alimentary tract was studied. Patients receiving flucloxacillin showed increased numbers of Klebsiella spp. isolated from the faeces (59% of the patients versus 19% of the patients receiving amoxicillin with clavulanic acid). Patients receiving amoxicillin with clavulanic acid showed higher colonization rates of oropharynx with Enterobacteriaceae than patients receiving flucloxacillin (ten patients versus five patients). 60% of those strains isolated from patients receiving amoxicillin with clavulanic acid were resistant to this combination, as compared to 20% of gram-negative bacilli isolated from patients receiving flucloxacillin. In 50% of patients receiving amoxicillin with clavulanic acid, colonization of the gut with yeast occurred, as compared to 18% of patients receiving flucloxacillin. Only one infection leading to a partial loss of the graft was seen in the group of patients receiving flucloxacillin.
Infection
PMID:The influence of flucloxacillin and amoxicillin with clavulanic acid on the aerobic flora of the alimentary tract. 331 20

The antimicrobial activity of ceftazidime was tested against 1482 gram-negative and 1216 gram-positive strains isolated from fresh clinical specimens and compared with generally used antibiotics including other third generation cephalosporins and broad spectrum penicillins. Minimal inhibitory concentrations were determined in a broth dilution test on microtiter plates. In the group of the gram-negative bacteria ceftazidime was the most active of the antimicrobial agents tested with an MIC of 0.5 mg/l (MIC90) for most of the isolates. Ceftazidime exhibited a broad spectrum of activity against gram-negative pathogenic bacteria including Enterobacteriaceae (Escherichia coli, Klebsiella spp., Proteus spp. Enterobacter spp., Citrobacter spp., Serratia spp.) including frequently resistant strains of Pseudomonas aeruginosa, Acinetobacter spp. and Alcaligenes faecalis. The activity against P. aeruginosa is the most remarkable property of the agent. Ceftazidime is less effective against gram-positive compared to gram-negative bacteria. No inhibitory action can be observed against Streptococcus faecalis.
Infection 1987
PMID:[Comparative in vitro study of the antimicrobial activity of ceftazidime against clinical isolates]. 331 26

In a randomized controlled, clinical study the efficacy of ceftazidime at a dosage of 2 g b. i. d. was compared to that of cefotaxime at a dosage of 2 g t. i. d. or more in the treatment of pneumonia or peritonitis in intensive care patients. 61 of 67 assessable cases were evaluable. In the ceftazidime group ten out of 11 patients with pneumonia and 17 out of 20 with peritonitis showed a clinical success. In the cefotaxime group 15 out of 19 patients with pneumonia and eight out of 11 with peritonitis were clinically cured or improved. With ceftazidime an overall success was achieved in 87% of the patients (27 out of 31) and with cefotaxime in 77% of the patients (23 out of 30). Two patients in the cefotaxime group developed a reinfection. Five of the patients treated with cefotaxime and four of those treated with ceftazidime were therapeutical failures. Escherichia coli, Pseudomonas, Klebsiella, Enterobacter and Proteus species as well as Staphylococcus aureus and enterococci were the most frequent organisms isolated prior to therapy. Following ceftazidime therapy 30 of the 32 gram-negative species were eliminated, whereas in the cefotaxime group the number of gram-negative species isolated was reduced from 28 to ten. Gram-positive species isolated in ten cases prior to therapy, were still present in seven cases after ceftazidime therapy and the number of gram-positive organisms was reduced from 19 to ten following treatment with cefotaxime. In one patient therapy with ceftazidime was stopped due to urticaria. Reversible leukopenia was observed in a patient treated with ceftazidime and a cholestatic reaction in a patient treated with cefotaxime. In both groups a slight elevation of transaminases was seen.
Infection 1987
PMID:[Ceftazidime versus cefotaxime in the therapy of severe infections in intensive care patients]. 331 30

Trimethoprim-sulfamethoxazole in vitro activity was compared with ampicillin, tetracycline, sulfonamide and trimethoprim against isolates of 24 gram-negative and 11 gram-positive species. The incidence of more than 10% of strains with minimal inhibitory concentrations above 32 mg/l was restricted to Escherichia coli, Shigella spp., Klebsiella pneumoniae, Providencia rettgeri, Morganella morganii, methicillin-resistant Staphylococcus aureus and Staphylococcus epidermidis. Occasionally, Streptococcus pneumoniae and Haemophilus influenzae strains with MICs above 32 mg/l were identified. Co-trimoxazole in vitro activity was superior to the comparative drugs for the majority of species. Co-trimoxazole remains an active combination against major pathogens of infections of the upper and lower respiratory, urinary tract and enteric infections with a still low incidence of resistant organisms.
Infection 1987
PMID:Microbiological perspectives of co-trimoxazole. 332 34

Sixty-one hospitalized infants aged one day to six months were enrolled in an open, multicenter noncomparative clinical study of the efficacy and safety of imipenem/cilastatin. Patients weighing less than 1500 g (four males/ten females, Group 1) and those greater than or equal to 1500 g (31 males/16 females, Group 2) were analyzed separately. Total daily dose (divided into b.i.d. (27) or t.i.d. (34) regimens) ranged from 50 to 101.4 mg/kg given for 10.8 days (means, range 2 to 35 days) for Group 1 and 39.7 to 103 mg/kg given for 11.2 days (means, range 1 to 41 days) for Group 2. The investigators graded the intensity of signs and symptoms of infections as moderate or severe in 86 and 91% of patients in groups 1 and 2, respectively, and bacterial pathogens were isolated pretreatment in 43 and 32% of patients. Eighty-eight percent of all bacterial pathogens were susceptible to imipenem in vitro. The most commonly isolated pathogens were Pseudomonas aeruginosa and Klebsiella pneumoniae. Patients who had confirmed bacterial infections and who did not receive concomitant antibiotics were considered evaluable for efficacy, including 6 (43%) in Group 1 and 15 (32%) in Group 2. Infection sites were (Group 1) respiratory (100%), and (Group 2) skin and skin structures (33%), urinary (11%), gastrointestinal (11%), septicemia alone (11%) and meningitis or respiratory (28% and 6% with sepsis, respectively). Safety analysis included all patients. Imipenem/cilastatin was well tolerated in 93% of Group 1 and 85% of Group 2 patients. Three patients' treatments were discontinued due to rash, oliguria or poor local tolerability. Three patients in Group 1 and four in Group 2 died; deaths were considered unrelated to imipenem/cilastatin. Results are as follows: (table; see text) In summary, 81% (17 of 21) of evaluable patients were clinically cured or improved, among whom 3 of 21 patients (14%) had serious clinical or laboratory adverse experiences which were considered possibly related to imipenem/cilastatin. These results are comparable to results reported with other single or multiple antibiotic regimens.
 ...
PMID:Imipenem/cilastatin therapy for serious infections in neonates and infants. 333 Oct 42

Urinary tract infections caused by urea-splitting bacteria are severe clinical conditions and very difficult to treat due to their association with calculi, and because such bacteria form ammonium hydroxide raising the urinary pH and thereby creating an unfavourable condition for the action of most antimicrobials. We tested ofloxacin, norfloxacin, nalidixic acid, amoxicillin, amoxicillin-clavulanic acid, gentamicin, co-trimoxazole and nitrofurantoin against 143 gram-negative and 99 gram-positive bacteria, all urea-splitting, isolated from patients with urinary tract infections. All drugs were tested using media at two different pHs (pH 7.4 and PH 8.5) and two inoculum sizes (10(4) and 10(6) cfu). Although ofloxacin and norfloxacin had a similar spectrum of activity, ofloxacin had somewhat greater intrinsic activity against gram-positive organisms. MICs of ofloxacin for 90% of Proteus mirabilis, indole-positive Proteus spp., Klebsiella pneumoniae, Staphylococcus aureus, coagulase-negative staphylococci and the Corynebacterium group D2 were greater than or equal to 4 mg/l. The activity of the other drugs varied, but there were many strains resistant to these antimicrobials. The pH and inoculum size did not significantly affect the activity of ofloxacin so that this drug should be useful for the treatment of urinary tract infections caused by the commonest urea-splitting bacteria involved in such infections.
Infection 1986
PMID:Comparative activity of ofloxacin and seven other antimicrobials against urea-splitting microorganisms. 346 52

A-56619 and A-56620 are two new aryl-fluoroquinolones which are as potent as or more potent than norfloxacin when administered orally and subcutaneously in mouse protection tests against Staphylococcus aureus, Streptococcus pyogenes, and Streptococcus pneumoniae. A-56619 and A-56620 were more potent than norfloxacin when administered orally against Escherichia coli, Proteus mirabilis, Serratia marcescens, and Pseudomonas aeruginosa. A-56620 was as potent or two- to threefold more potent than norfloxacin when administered subcutaneously against members of the family Enterobacteriaceae and Pseudomonas aeruginosa. Infection with Salmonella typhimurium was more effectively treated with A-56619 (50% effective dose [ED50], 1.4 mg/kg per day) than with norfloxacin (ED50, 62.8 mg/kg per day). E. coli or Pseudomonas pyelonephritis in mice was more effectively treated with A-56619 or A-56620 than with norfloxacin. After oral treatment, the ED50s of A-56619 and A-56620 were less than 12.5 mg/kg per day against E. coli and 62.9 and 38 mg/kg per day against P. aeruginosa pyelonephritis, respectively. Norfloxacin was ineffective at 200 mg/kg per day against E. coli or P. aeruginosa pyelonephritis. A-56619 and A-56620 were also more potent than norfloxacin in treatment of mixed bacterial pyelonephritis caused by E. coli and Streptococcus faecalis. A-56619 was at least 30 times more potent than norfloxacin and A-56620 was 4 to 11 times more potent than norfloxacin when administered against Klebsiella pneumonia in mice. A-56619 and A-56620 were at least 2 to 10 times more potent than norfloxacin against Staphylococcus aureus infections in immunosuppressed mice. A-56619 was equally potent in all in vivo tests when administered orally or subcutaneously, whereas A-56620 was similar to norfloxacin in being more potent when administered subcutaneously. The peak serum levels after subcutaneous and oral administration of A-56619 and A-56620 were higher than that of norfloxacin. The serum hal-lives of A-56619 and A-56620 after subcutaneous and oral administration were longer than the serum half-life of norfloxacin.
 ...
PMID:In vivo evaluation of A-56619 (difloxacin) and A-56620: new aryl-fluoroquinolones. 352 73

The effectiveness and safety of orally administered ciprofloxacin and intravenously administered cefotaxime were compared in a double-blind study of 60 men with infections of skin and soft tissue, including cellulitis, ulcers, abscesses, cellulitis with ulcers or abscesses, wound infections, and post-traumatic infections. Patients in the ciprofloxacin group received 750 mg orally every 12 hours for a mean duration of 9.6 days (six to 18 days), and those in the cefotaxime group received 2.0 g intravenously every eight hours for a mean duration of 9.3 days (five to 14 days). Infection was documented bacteriologically in 78 percent of the patients in the ciprofloxacin group and in 83 percent of the patients in the cefotaxime group. Pathogens included Staphylococcus aureus, enterococci, group B streptococci, Escherichia coli, Proteus mirabilis, and Klebsiella and Pseudomonas species. Half of the infections were mixed infections. Ninety percent (19 of 21) of the infections were bacteriologically eradicated with ciprofloxacin, and 82 percent (18 of 22) were eradicated with cefotaxime. Treatment was completely successful in 79 percent (22 of 28) of the patients in the ciprofloxacin group and in 68 percent (19 of 28) in the cefotaxime group (p greater than 0.1). The side effects in both treatment groups were comparable. This study demonstrates that orally administered ciprofloxacin is comparable in effectiveness and safety to cefotaxime administered intravenously in the treatment of infections of skin and soft tissue, and that it can offer an alternative in the treatment of such infections.
 ...
PMID:Comparative, double-blind study of oral ciprofloxacin and intravenous cefotaxime in skin and skin structure infections. 355 40


<< Previous 1 2 3 4 5 6 7 8 9 10