The Experts below are selected from a list of 624 Experts worldwide ranked by ideXlab platform
J A Tooth - One of the best experts on this subject based on the ideXlab platform.
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a randomized trial of high dose ciprofloxacin versus Azlocillin and netilmicin in the empirical therapy of febrile neutropenic patients
Journal of Antimicrobial Chemotherapy, 1992Co-Authors: P R E Johnson, J Lin A Yin, J A ToothAbstract:A prospective, randomized trial comparing monotherapy with high-dose ciprofloxacin versus a standard combination regimen of Azlocillin and netilmicin in the empirical treatment of febrile episodes in neutropenic patients was performed. One hundred and forty-six patient episodes were randomized, but ten (seven ciprofloxacin and three Azlocillin/netilmicin) were considered unevaluable for efficacy, and three episodes were withdrawn due to incorrect randomization or non-neutropenia. Of the remaining 133 episodes, infections resolved without modification of therapy in 25/66 (38%) versus 28/67 (42%) of ciprofloxacin and Azlocillin/netilmicin treated groups respectively (P = 0.72). Considering all randomized episodes, therapy was modified in 46/73 (63%) episodes with ciprofloxacin and 39/70 (56%) with Azlocillin/netilmicin (P = 0.40). Of 73 patient episodes randomized to ciprofloxacin, 25 (34%) received oral follow-on therapy after a median of three days of intravenous therapy. Infections were microbiologically documented in 31/73 (42%) ciprofloxacin and 32/70 (46%) Azlocillin/netilmicin, of which 8/27 (30%) and 14/31 (45%) of evaluable episodes resolved without modification of therapy respectively (P = 0.28). Gram-positive organisms accounted for 78% of all organisms cultured with 36% coagulase-negative staphylococci. Bacteriological eradication was recorded in 18/24 (75%) and 26/29 (90%) evaluable patient episodes treated with ciprofloxacin and Azlocillin/netilmicin respectively (P = 0.27). Superinfections were seen in 14% of episodes in both groups, and subsequent infections in 12% ciprofloxacin and 14% Azlocillin/netilmicin treated patients. Two patients (one ciprofloxacin and one Azlocillin/netilmicin) died within 48 h of randomization, and a further 13 patients (four ciprofloxacin and nine Azlocillin/netilmicin) died before resolution of neutropenia. Adverse events were recorded in 9% and 15% of ciprofloxacin and Azlocillin/netilmicin treated patients respectively, with skin rash (five ciprofloxacin and four Azlocillin/netilmicin), nephrotoxicity (two Azlocillin/netilmicin), abnormal liver function tests (two Azlocillin/netilmicin), ototoxicity (one Azlocillin/netilmicin) and nausea (one ciprofloxacin) being the major events recorded. It was concluded that monotherapy with ciprofloxacin at this dosage is a safe alternative to combination therapy with Azlocillin/netilmicin, and has the advantages of twice daily administration, iv and oral presentations, no cross allergy in beta-lactam-hypersensitive patients, and no nephro- or oto-toxicity.
D M Livermore - One of the best experts on this subject based on the ideXlab platform.
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mezlocillin and piperacillin
2016Co-Authors: J. Y. Jacobs, D M Livermore, K. W. M. DavycAbstract:Pseadomonas aeruginosa fi-\actamase as a defence against Azlocillin
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mechanisms of resistance to beta lactam antibiotics amongst pseudomonas aeruginosa isolates collected in the uk in 1993
Journal of Medical Microbiology, 1995Co-Authors: H Y Chen, Mei Yuan, D M LivermoreAbstract:Antimicrobial resistance among 1991 Pseudomonas aeruginosa isolates collected at 24 UK hospitals during late 1993 was surveyed. Three-hundred and seventy-two of the isolates were resistant, or had reduced susceptibility, to some or all of Azlocillin, carbenicillin, ceftazidime, imipenem and meropenem, and the mechanisms underlying their behaviour were examined. Only 13 isolates produced secondary beta-lactamases: six possessed PSE-1 or PSE-4 enzymes and seven had novel OXA enzyme types. Those with PSE types were highly resistant to Azlocillin and carbenicillin whereas those with OXA enzymes were less resistant to these penicillins. Chromosomal beta-lactamase derepression was demonstrated in 54 isolates, most of which were resistant to ceftazidime and Azlocillin although susceptible to carbenicillin and carbapenems. beta-Lactamase-independent "intrinsic" resistance occurred in 277 isolates and is believed to reflect some combination of impermeability and efflux. Two forms were seen: the classical type, present in 195 isolates, gave carbenicillin resistance (MIC > 128 mg/L) and reduced susceptibility to ciprofloxacin and to all beta-lactam agents except imipenem; a novel variant, seen in 82 isolates, affected only Azlocillin, ceftazidime and, to a small extent, meropenem. Resistance to imipenem was largely dissociated from that to other beta-lactam agents, and probably reflected loss of D2 porin, whereas resistance to meropenem was mostly associated with intrinsic resistance to penicillins and cephalosporins. Comparison of the present results with those of a similar study in 1982 revealed significant increases in the proportions of isolates with intrinsic resistance or stable derepression (p < 0.01, chi 2 test).(ABSTRACT TRUNCATED AT 250 WORDS)
María Julia Couto Ramos - One of the best experts on this subject based on the ideXlab platform.
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Tratamiento con Azlocillin y amikacina en sepsis neonatal por staphylococcus haemolyticus multirresistente
Editorial Ciencias Médicas, 2000Co-Authors: María Espino Hernández, Niurka Fiol Ferrer, Mario Lee López, María Julia Couto RamosAbstract:El estafilococo coagulasa negativa es actualmente un importante patógeno nosocomial y agente causal de infección en el neonato. Cepas multirresistentes comúnmente aisladas de recién nacidos sometidos a cuidados intensivos dificultan la terapéutica, por lo que se hace necesario el empleo de combinaciones antibióticas que garanticen un efecto antibacteriano más eficiente. Se presentan los resultados obtenidos en un paciente con bronconeumonía adquirida por Staphylococcus haemolyticus multirresistente y que fue sometido a tratamiento combinado de Azlocillin y amikacina. Se estudió el patrón de resistencia de la cepa para 30 antibióticos por métodos de difusión y dilución, así como la efectividad in vitro de la combinación antibiótica aplicada por el método del «tablero de ajedrez». Se observó en los resultados in vitro una marcada potencialización de la actividad aminoglucosídica por la presencia del antibiótico beta-lactámico, resultado que se correspondió con una excelente respuesta in vivo.Negative-coagulase Staphyloccocus, is at present time an important nosocomial pathogen and a causal agent of neonatal infection. Multirresistant strains commonly isolated from newborn under intensive care, make difficult treatment, so it is necessary use of antibiotic combination to assure a more efficient antibacterial effect. We present results obtained in a patient presenting with acquired bronchopneumonia from multirresistant Staphylococcus haemolyticus who received a combination of Azlocillin and Amikacin. Resistance pattern to this strain was studied by diffusion and dilution methods, as well as in vitro effectiveness of antibiotic combination, applied by "Chequerboard" method. In in vitro results, we found a significant potentiation of aminoglucoside activity by presence of Beta-lactamic antibiotic, result corresponding to an in vivo excellent response
Couto Ramos,maría Julia - One of the best experts on this subject based on the ideXlab platform.
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Tratamiento con Azlocillin y amikacina en sepsis neonatal por staphylococcus haemolyticus multirresistente
Editorial Ciencias Médicas, 2000Co-Authors: Espino Hernández,maría, Fiol Ferrer,niurka, Lee López,mario, Couto Ramos,maría JuliaAbstract:El estafilococo coagulasa negativa es actualmente un importante patógeno nosocomial y agente causal de infección en el neonato. Cepas multirresistentes comúnmente aisladas de recién nacidos sometidos a cuidados intensivos dificultan la terapéutica, por lo que se hace necesario el empleo de combinaciones antibióticas que garanticen un efecto antibacteriano más eficiente. Se presentan los resultados obtenidos en un paciente con bronconeumonía adquirida por Staphylococcus haemolyticus multirresistente y que fue sometido a tratamiento combinado de Azlocillin y amikacina. Se estudió el patrón de resistencia de la cepa para 30 antibióticos por métodos de difusión y dilución, así como la efectividad in vitro de la combinación antibiótica aplicada por el método del «tablero de ajedrez». Se observó en los resultados in vitro una marcada potencialización de la actividad aminoglucosídica por la presencia del antibiótico beta-lactámico, resultado que se correspondió con una excelente respuesta in vivo
P R E Johnson - One of the best experts on this subject based on the ideXlab platform.
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a randomized trial of high dose ciprofloxacin versus Azlocillin and netilmicin in the empirical therapy of febrile neutropenic patients
Journal of Antimicrobial Chemotherapy, 1992Co-Authors: P R E Johnson, J Lin A Yin, J A ToothAbstract:A prospective, randomized trial comparing monotherapy with high-dose ciprofloxacin versus a standard combination regimen of Azlocillin and netilmicin in the empirical treatment of febrile episodes in neutropenic patients was performed. One hundred and forty-six patient episodes were randomized, but ten (seven ciprofloxacin and three Azlocillin/netilmicin) were considered unevaluable for efficacy, and three episodes were withdrawn due to incorrect randomization or non-neutropenia. Of the remaining 133 episodes, infections resolved without modification of therapy in 25/66 (38%) versus 28/67 (42%) of ciprofloxacin and Azlocillin/netilmicin treated groups respectively (P = 0.72). Considering all randomized episodes, therapy was modified in 46/73 (63%) episodes with ciprofloxacin and 39/70 (56%) with Azlocillin/netilmicin (P = 0.40). Of 73 patient episodes randomized to ciprofloxacin, 25 (34%) received oral follow-on therapy after a median of three days of intravenous therapy. Infections were microbiologically documented in 31/73 (42%) ciprofloxacin and 32/70 (46%) Azlocillin/netilmicin, of which 8/27 (30%) and 14/31 (45%) of evaluable episodes resolved without modification of therapy respectively (P = 0.28). Gram-positive organisms accounted for 78% of all organisms cultured with 36% coagulase-negative staphylococci. Bacteriological eradication was recorded in 18/24 (75%) and 26/29 (90%) evaluable patient episodes treated with ciprofloxacin and Azlocillin/netilmicin respectively (P = 0.27). Superinfections were seen in 14% of episodes in both groups, and subsequent infections in 12% ciprofloxacin and 14% Azlocillin/netilmicin treated patients. Two patients (one ciprofloxacin and one Azlocillin/netilmicin) died within 48 h of randomization, and a further 13 patients (four ciprofloxacin and nine Azlocillin/netilmicin) died before resolution of neutropenia. Adverse events were recorded in 9% and 15% of ciprofloxacin and Azlocillin/netilmicin treated patients respectively, with skin rash (five ciprofloxacin and four Azlocillin/netilmicin), nephrotoxicity (two Azlocillin/netilmicin), abnormal liver function tests (two Azlocillin/netilmicin), ototoxicity (one Azlocillin/netilmicin) and nausea (one ciprofloxacin) being the major events recorded. It was concluded that monotherapy with ciprofloxacin at this dosage is a safe alternative to combination therapy with Azlocillin/netilmicin, and has the advantages of twice daily administration, iv and oral presentations, no cross allergy in beta-lactam-hypersensitive patients, and no nephro- or oto-toxicity.
