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

The therapeutic perspectives of flomoxef, SCE 2787, cefpirome, cefepime, latamoxef, cefotaxime and of piperacillin plus tazobactam were comparatively evaluated by their in vitro activity against 1119 clinical isolates of 83 bacterial species. Escherichia coli, Klebsiella spp. Enterobacter sakazakii, Proteus spp. and Shigella spp. were about equally susceptible to the cephalosporins (MIC90: 0.06 to 0.5 mg/l), while the MIC90 for piperacillin plus tazobactam was between 2 and 16 mg/l. Enterobacter cloacae, Enterobacter aerogenes and Serratia spp. were most susceptible to SCE 2787, cefpirome and cefepime (MIC90: 0.06 to 2 mg/l) followed by latamoxef, cefotaxime, flomoxef and piperacillin plus tazobactam. For Citrobacter spp., Providencia spp. and Yersinia enterocolitica MIC90 were between 0.06 and 0.5 mg/l. Flomoxef was between 2 to 4 log2 less active against these species but more active than piperacillin plus tazobactam (MIC90: 2 and 8 mg/l). Morganella morganii and Hafnia alvei were most susceptible to cefepime, cefpirome and latamoxef (MIC90: 0.13 to 0.5 mg/l) while cefotaxime (MIC90: 8 mg/l) and piperacillin plus tazobactam (MIC90: 8 and greater than 64 mg/l) were the least active compounds. SCE 2787, cefepime and cefpirome were the most potent beta-lactams against the majority of the 13 species of non-fermentative bacilli (NFB) investigated (MIC90: 0.5 to 16 mg/l). The oxacephems were the least active compounds against NFB. Cefepime was the most active of the compounds included against Pseudomonas aeruginosa (MIC90: 16 mg/l). Haemophilus spp., Neisseria gonorrhoeae and Bordetella pertussis were most susceptible to cefotaxime (MIC90: 0.03 to 0.06 mg/l). Latamoxef had the lowest activity of all compounds against gram-positive cocci. Flomoxef was the most active compound against penicillinase producing Staphylococcus aureus and about equally active as the other betalactams against methicillin susceptible staphylococci of other staphylococcal species.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:In vitro activity and stability against novel beta-lactamases of investigational beta-lactams (cefepime, cefpirome, flomoxef, SCE2787 and piperacillin plus tazobactam) in comparison with established compounds (cefotaxime, latamoxef and piperacillin). 166 18

Cases with infections of urinary tracts were divided into 3 groups of the simple infections, and complicated infections without indwelling of catheter, and complicated infections with indwelling of catheter. Susceptibilities to antimicrobial agents of Escherichia coli, Klebsiella spp., Proteus spp., Citrobacter spp., Enterobacter spp., Pseudomonas aeruginosa and Serratia marcescens which were isolated from patients with these infections were determined. There was no tendency of decline in the susceptibilities of E. coli isolated from the patients with simple urinary tract infections (UTI). Susceptibilities of E. coli isolated from the patients with complicated UTI without and with indwelling of catheter to cephem antibiotics of the third generation were examined. The susceptibility of E. coli strains isolated from patients with complicated UTI without and with indwelling of catheter remained the same. More specifically, cefmenoxime (CMX) at a concentration of less than 0.10 microgram/ml inhibited the growth of E. coli isolated from cases without: with catheter at 74.1%: 78.3% in 1982, 75.4%: 73.3% in 1983, and 81.3%: 84.8% in 1984. Also, ceftizoxime (CZX) at a concentration of less than 0.10 microgram/ml inhibited the growth at 83.3%: 95.7% in 1982, 89.2%: 86.7% in 1983, and 91.7%: 97.0% in 1984. Latamoxef (LMOX) at less than 0.10 microgram/ml inhibited the growth at 59.3%: 43.5% in 1982, 47.7%: 40.0% in 1983, and 47.9%: 42.4% in 1984. The antibacterial effect of penicillin against Klebsiella spp. was found to be poor, while those of oral cephem antibiotics, cephalexin (CEX), cefaclor (CCL), and cefazolin (CEZ) which is the cephem antibiotics of the so-called first generation and cefotiam (CTM) among other cephem antibiotics of the so-called second generation were relatively good. A study of susceptibilities of Klebsiella spp. isolated from patients with complicated UTI without and with indwelling of catheter revealed inhibition of growth by CTM at a concentration of 0.39 microgram/ml at 84.0%: 75.9% in 1982, 70.6%: 75.0% in 1983, and 95.8%: 77.8% in 1984. Cefmetazole (CMZ) at a concentration of 0.39 microgram/ml showed a relatively lower rate of growth inhibition of Klebsiella spp., while at 0.78 microgram/ml it inhibited the growth at 88.0%: 72.4% in 1982, 52.9%: 50.0% in 1983, and 70.8%: 66.7% in 1984. The antibacterial effects of both CTM and CMZ against Klebsiella spp. isolated from patients with indwelling of catheter were found to be poor, and some of the bacterial strains showed a MIC over than 100 micrograms/ml.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[Comparative studies of antimicrobial agents against causative organisms isolated from urinary tract infections (1984). III. Secular changes in susceptibility]. 310 9

Antimicrobial activities of sulbactam/cefoperazone (SBT/CPZ) against 50 fresh clinical isolates of Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, Citrobacter freundii, Enterobacter spp., Serratia marcescens, Proteus mirabilis, Proteus vulgaris and Pseudomonas aeruginosa were compared to those of CPZ, Cefotiam (CTM), Cefotaxime (CTX) and Latamoxef (LMOX). Minimal inhibitory concentrations (MIC's) of SBT and CPZ mixed in a ratio of 1:1 were determined by the dilution method using Mueller-Hinton agar and expressed by absolute concentrations of CPZ. Antimicrobial activities of SBT/CPZ against principally penicillinase (PCase) producing bacteria, i.e., S. aureus, E. coli, K. pneumoniae, P. mirabilis, were superior to those of CPZ alone. The presence of SBT in concentrations around 0.39 approximately 1.56 micrograms/ml clearly enhanced CPZ's antimicrobial activities against these PCase producing strains. The synergistic antimicrobial effects of SBT in combination with CPZ were less pronounced against principally cephalosporinase (CEPase) producing bacteria, i.e., C. freundii, Enterobacter spp., S. marcescens, P. vulgaris, and P. aeruginosa, and exerted with SBT at concentrations around 3.13 approximately 12.5 micrograms/ml. Comparative antimicrobial activities indicated by MIC80's of tested agents showed that SBT/CPZ had more stable activities against bacteria ranging from Gram-positive to Gram-negative bacteria than CTM, CTX and LMOX. MIC's of SBT/CPZ were higher than 25 micrograms/ml against 8% of S. aureus, 18% of C. freundii, 10% of Enterobacter spp., 26% of S. marcescens, 2% of P. vulgaris, and 18% of P. aeruginosa. These resistant strains against which the addition of SBT showed no synergism, may possess other mechanism of resistance than beta-lactamase production. It is concluded that the presence of CPZ resistant strains is an actual current problem and not an imaginary future problem, and that the number of resistant strains against other new cephems which have different chemical structure from CPZ is increasing. When these present bacteriological environments are considered, the appearance of SBT/CPZ in the clinical practice is timely and meaningful.
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PMID:[Antimicrobial activity of sulbactam/cefoperazone. Comparison with other new cephems]. 344 15

The recent literature was reviewed with regard to the risks of superinfection following beta-lactam chemotherapy. The summary publications for the pseudomonas-active penicillins (azlocillin, carbenicillin, mezlocillin, piperacillin and ticarcillin), cefoperazone, cefotaxime, ceftazidime, imipenem and moxalactam show marked variations. Moxalactam was most likely to produce both gram-negative (5-38%) and enterococcal (2.2-12%) superinfections. Ceftazidime or moxalactam therapy was more often associated with anaerobic superinfections, usually by Clostridium spp., than the other beta-lactams. Comparable and lower incidences of superinfections were cited for cefoperazone, ceftazidime, mezlocillin and imipenem. The most common pathogens for the above drugs were the fungi (Candida spp.), Pseudomonas spp. and some beta-lactamase-producing Enterobacteriaceae. Staphylococcal, Escherichia coli and Klebsiella spp. secondary infections were more common in patients receiving the newer penicillins. Cefotaxime had a very low incidence of superinfections (1.1%), especially caused by gram-positive organisms such as enterococci. The reasons for this favorable feature seem to be: excellent inhibitory activity and beta-lactamase stability against a wide variety of bacterial pathogens, synergistic interactions of cefotaxime and its desacetyl metabolite, enhanced anti-enterococcal activity of cefotaxime in the presence of a human serum factor and interactions of cefotaxime and desacetyl cefotaxime to suppress the development of antimicrobial resistance. The most common superinfections following cefotaxime treatment were with Pseudomonas spp., Enterobacter spp. and fungi. Cefotaxime appears to possess physical-chemical characteristics that react favorably with bacteria and the host to minimize gram-positive superinfections, especially with most enteric Streptococcus spp. (Streptococcus faecalis and Streptococcus faecium).
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PMID:Gram-positive superinfections following beta-lactam chemotherapy: the significance of the enterococcus. 390 52

We evaluated the microbiologic characteristics including MIC determinations, synergy plate assays and serum bactericidal activity for two regimens being examined as empiric antibiotic therapy for febrile granulocytopenic cancer patients. The regimens consisted of moxalactam (4 g.i.v. q12h) plus piperacillin (75 mg/kg i.v. q6h) or moxalactam (as above) plus amikacin (levels adjusted to one hour post-infusion levels of 25 mg/l and troughs of 6-8 mg/l). Detailed pharmacokinetics were ascertained for the beta lactams. All drugs were active against a panel of 11 strains each of Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Staphylococcus aureus. The pharmacokinetic profile showed serum levels sufficient to provide good antimicrobial activity throughout the dosing interval. Both regimens displayed synergistic or partially synergistic activity in the main for the test organisms; moxalactam plus piperacillin produced good results against S. aureus and P. aeruginosa. In the serum bactericidal assays, the moxalactam-piperacillin combination produced significantly higher mean titers at both peak and trough when compared to the moxalactam-amikacin regimen. This may be because moxalactam acts as a beta lactamase inhibitor for both staphylococcal beta lactamase, as well as the Sabath-Abraham Id type beta lactamase carried by P. aeruginosa (among others). Moxalactam-piperacillin deserves extensive evaluation as empiric therapy for the febrile neutropenic cancer patients.
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PMID:Moxalactam and piperacillin: a study of in vitro characteristics and pharmacokinetics in cancer patients. 398 51

We determined the serum bactericidal activity 1 h after the end of 2 g, 30 min infusions of latamoxef, cefoperazone and cefotaxime in six volunteers against six strains each of Escherichia coli, Klebsiella pneumoniae, Staphylococcus aureus and Pseudomonas aeruginosa. All produced excellent serum bactericidal activity against E. coli. Latamoxef and cefotaxime were superior for K. pneumoniae. Cefoperazone produced the highest titres against Staph. aureus. None of these agents produced sufficient bactericidal activity against Ps. aeruginosa to be useful in initial single agent therapy for the septic, granulocytopenic cancer patient.
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PMID:The serum bactericidal activity of latamoxef (moxalactam), cefoperazone and cefotaxime. 609 48

Five newer beta-lactam antibiotics and two aminoglycosides were tested on 400 freshly isolated clinically significant organisms from specimens at a district general hospital. All the antibiotics had very broad-spectrum activities but none could cover against all probable pathogens. Latamoxef was the best of all against Bacteroides spp. Aminoglycosides, followed by cefotaxime and ceftizoxime, were best against staphylococci. Tobramycin, followed by ceftazidine and netilmicin, had the best activity against Pseudomonas aeruginosa. Of all 7 antibiotics tested only piperacillin demonstrated activity against Streptococcus faecalis. Cefotaxime and ceftizoxime were the best against Escherichia coli, Klebsiella spp. and most of streptococci. The study demonstrated that safer alternatives to aminoglycosides are now available.
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PMID:Activities of two aminoglycosides and five newer beta-lactam antibiotics: safer alternatives to aminoglycosides? 610 Apr 87

Moxalactam is a new cephalosporin with a broad spectrum of activity which includes Pseudomonas aeruginosa in addition to Klebsiella species Escherichia coli, and Staphylococcus aureus. Moxalactam was combined with amikacin (M + A) compared to ticarcillin plus amikacin (T + A) in a prospective, randomized double-blind trial of empiric therapy for febrile episodes among granulocytopenic cancer patients. One hundred and ninety-one epidoses were evaluated; T + A, 93 episodes and M + A, 98 episodes. Median granulocyte count of initiation of therapy was less than 100/microliters. Overall response rates were good. In the T + A group, 21 of 29 (72 percent) microbiologically documented infections, including seven of 14 (50 percent) bacteremias, and 24 of 27 (89 percent) clinically documented infections improved. In the M + A group, 20 of 28 (71 percent) microbiologically documented infections, including 11 of 18 (61 percent) bacteremias, and 25 of 25 (96 percent) clinically documented infections resolved. Adverse effects were minimal and equivalent in both groups. Hypokalemia (decrease in serum potassium of greater than 11 mEq/liter from baseline) occurred in 14 of the 93 episodes in the T + A group and in 10 of the 98 episodes in the M + A group with decline in mean serum potassium level of 0.5 and 0.4 mEq/liter respectively. Nephrotoxicity (increase in serum creatinine greater than 0.04 mg/dl) occurred in only one patient in the T + A group and in two patients in the M + A group. Moxalactam plus amikacin has a broader in vitro spectrum, is as effective, and is no more toxic than ticarcillin plus amikacin as empiric therapy for febrile granulocytopenic cancer patients.
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PMID:Empiric antibiotic therapy for suspected infection in granulocytopenic cancer patients: a comparison between the combination of moxalactam plus amikacin and ticarcillin plus amikacin. 621 81

Amikacin was evaluated in vitro by agar dilution testing against 148 different clinical isolates of cephalothin-resistant Enterobacteriaceae and Pseudomonas aeruginosa in parallel with cephalothin, cefoxitin, moxalactam, N-formimidoyl thienamycin, ceftriaxone, and cefmenoxime. Cefsulodin was also evaluated against 39 isolates of P. aeruginosa. More than 80% of all isolates tested were also gentamicin resistant, as determined by disk testing. Moxalactam and amikacin had comparable high activities against Proteus species, Escherichia coli, Serratia species, and Providencia species, and both amikacin and N-formimidoyl thienamycin had comparably high activities against the Klebsiella-Enterobacter group. N-Formimidoyl thienamycin was the most active agent against P. aeruginosa, followed by cefsulodin and amikacin.
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PMID:In vitro susceptibility of cephalothin-resistant Enterobacteriaceae and Pseudomonas aeruginosa to Amikacin and selected new beta-lactam agents. 621 96

Sixty-five episodes of nosocomial infections of the blood, lungs, urinary tract, soft tissues, bones, or central nervous system were treated with intravenous moxalactam (3-12 g per day). Bacteremia was documented in 21 patients. Despite the severely compromised condition of many patients, 80% of the infections responded satisfactorily, as defined by clinical and microbiologic cure or improvement. Of the 21 cases of nosocomial bacteremia, 14 (67%) responded satisfactorily. Of the six cases of bacteremia caused by gram-negative bacilli resistant to aminoglycosides, three responded satisfactorily. Moxalactam therapy also resulted in cure or improvement in nine (69%) of 13 pulmonary infections, and it was used alone to cure one case of meningitis-ventriculitis due to Klebsiella pneumoniae. Seven of 13 therapeutic failures involved Pseudomonas aeruginosa, and moxalactam-resistant P. aeruginosa emerged during therapy for 12 patients. Adverse effects, usually mild diarrhea, occurred in 9.2% of the patients. Except for some severe infections due to P. aeruginosa, moxalactam is effective and safe therapy for nosocomial infections caused by susceptible organisms.
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PMID:Moxalactam for treatment of nosocomial infections. 621 78


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